Soil-transmitted helminth infection, anemia, and malnutrition among preschool-age children in Nangapanda subdistrict, Indonesia

PLoS Negl Trop Dis. 2021 Jun 17;15(6):e0009506. doi: 10.1371/journal.pntd.0009506. eCollection 2021 Jun.

Abstract

Background: Soil-transmitted helminth (STH) infections are still prevalent in Indonesia, with roughly one-third of infected population being preschool-age children (PSC), which are generally at higher risk of morbidity such as malnutrition and anemia. This study aimed to investigate the association of STH infections with nutritional status and anemia among PSC in Nangapanda subdistrict, Ende, East Nusa Tenggara.

Methods: A cross-sectional survey involving PSC ranging from 12 to 59 months old from Nangapanda subdistrict, Ende district, East Nusa Tenggara was performed. Socio-demographic, breastfeeding, and complementary feeding information was obtained from structured questionnaires, while nutritional and anemia status was determined from anthropometry and hemoglobin measurements, respectively. Anthropometric z-scores were calculated based on the World Health Organization 2006 standards and stool samples were examined using Kato-Katz method.

Results: A total of 393 PSC randomly selected from 22 villages were examined. The prevalence of underweight, stunting, wasting, and anemia were 33.1%, 40.2%, 17.1%, and 60.3%, respectively. STH infection, predominated by Ascaris lumbricoides, was found in 160 (58.8%) PSC. Single STH infection, but not multiple infection, was independently associated with a lower risk of anemia (odds ratio [OR] 0.320, 95% confidence interval [CI]: 0.126-0.809, p = 0.016). Similar association with anemia was also found on mild STH infection (OR 0.318 [95% CI: 0.114-0.887], p = 0.029). On the other hand, younger children were found to have a higher risk of anemia and stunting. None of the examined variables were independently associated with underweight and wasting.

Conclusion: STH infection as well as anemia and malnutrition were prevalent in this region. However in this study, current STH infections seemed to have minimal negative impact on children's nutritional status.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia / epidemiology*
  • Animals
  • Ascaris lumbricoides
  • Breast Feeding / statistics & numerical data
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Growth Disorders / epidemiology
  • Helminthiasis / epidemiology*
  • Helminthiasis / parasitology
  • Hemoglobins / analysis
  • Humans
  • Indonesia / epidemiology
  • Infant
  • Male
  • Malnutrition / epidemiology*
  • Nutritional Status
  • Prevalence
  • Surveys and Questionnaires
  • Thinness / epidemiology

Substances

  • Hemoglobins

Grants and funding

TS received financial support for the field study from The EWIDAC Project (Educational Warfare Against Infectious Diseases in Asian Countries), Travelling Doctors, Erasmus University of Rotterdam, The Netherlands. Special thank is given to Dr. Hok Bing Thio from Rotterdam University who initiated the collaboration between Department of Parasitology, Faculty of Medicine Universitas Indonesia and The EWIDAC Project. Sample measurements and data analysis were funded by Universitas Indonesia (PINTER-MIDI UI Grant no. 1908/UN2.R3.1/HKP.05.00/2019). YD received funding for the publication from Universitas Indonesia (Hibah DAMAS PPI Q1 no.NKB-562/UN2.RST/HKP.05.00/2021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.