Soil-transmitted helminthiasis in children of a rural community part of a school-based deworming program: a cross-sectional study in the Peruvian Amazon

Background: Children in the Peruvian Amazon basin are at risk of soil-transmitted helminthiases (STH). The aim of this study was to determine the prevalence of STH (Ascaris lumbricoides, Trichuris trichiura, hookworm and Strongyloides stercoralis) in children from a rural community in the Peruvian Amazon and associated clinical, maternal, sanitation and hygiene factors associated. The community had an active school-based deworming program with mebendazole. Methods: A cross-sectional study was carried out in children aged 2-14 years in Iquitos, Peru; by parasitological analysis of their stools through five methods: direct smear examination, Kato-Katz, spontaneous sedimentation in tube, Baermann method modified by Lumbreras and agar plate culture. Mothers of the participating children were also invited to participate in the study. A questionnaire was completed by each participant to collect demographic and epidemiological information of interest. Results: Among 124 children, 25.8% (32/124) had one or more STH. Prevalence of A. lumbricoides was 16.1% (20/124); S. stercoralis, 10.5% (13/124); hookworm, 1.6% (2/124) and T. trichiura, 1.6% (2/124). STH in mothers was higher in children with any STH than in children without any STH (36.4% vs 14.1%, p<0.02). Prevalence of the common STH (A. lumbricoides, T. trichiura and hookworm) was higher in children aged 2-5 than in older children (31.6% vs 12.8%; p=0.01). Several hygiene and sanitation deficits were identified; of which walking barefoot was significantly associated with STH infection (OR= 3.28; 95% CI= 1.11-12.07). Conclusions: STH are highly prevalent in children in this community; A. lumbricoides and S. stercoralis infections were the most frequent. Further studies should aim to understand the persistent high prevalence of common STH in endemic areas where massive drug administration is practiced, and to determine the appropriateness of controlling STH in mothers and S. stercoralis infection. Walking barefoot and other hygiene and sanitation conditions need to be addressed in this community.