Epidemiology of intestinal polyparasitism among Orang Asli school children in rural Malaysia

PLoS Negl Trop Dis. 2014 Aug 21;8(8):e3074. doi: 10.1371/journal.pntd.0003074. eCollection 2014 Aug.


Background: This cross-sectional study aimed to investigate the current prevalence and risk factors associated with intestinal polyparasitism (the concurrent infection with multiple intestinal parasite species) among Orang Asli school children in the Lipis district of Pahang state, Malaysia.

Methods/principal findings: Fecal samples were collected from 498 school children (50.6% boys and 49.4% girls), and examined by using direct smear, formalin-ether sedimentation, trichrome stain, modified Ziehl Neelsen stain, Kato-Katz, and Harada Mori techniques. Demographic, socioeconomic, environmental, and personal hygiene information were collected by using a pre-tested questionnaire. Overall, 98.4% of the children were found to be infected by at least one parasite species. Of these, 71.4% had polyparasitism. The overall prevalence of Trichuris trichiura, Ascaris lumbricoides, hookworm, Giardia duodenalis, Entamoeba spp., and Cryptosporidium spp. infections were 95.6%, 47.8%, 28.3%, 28.3%, 14.1% and 5.2%, respectively. Univariate and multivariate analyses showed that using an unsafe water supply as a source for drinking water, presence of other family members infected with intestinal parasitic infections (IPI), not washing vegetables before consumption, absence of a toilet in the house, not wearing shoes when outside, not cutting nails periodically, and not washing hands before eating were significant risk factors associated with intestinal polyparasitism among these children.

Conclusions/significance: Intestinal polyparasitism is highly prevalent among children in the peninsular Malaysian Aboriginal communities. Hence, effective and sustainable control measures, including school-based periodic chemotherapy, providing adequate health education focused on good personal hygiene practices and proper sanitation, as well as safe drinking water supply should be implemented to reduce the prevalence and consequences of these infections in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Animals
  • Child
  • Cross-Sectional Studies
  • Feces / parasitology
  • Female
  • Humans
  • Hygiene
  • Intestinal Diseases, Parasitic / epidemiology*
  • Intestinal Diseases, Parasitic / etiology
  • Malaysia / epidemiology
  • Male
  • Prevalence
  • Risk Factors

Grant support

The work presented in this paper was funded by the University of Malaya High Impact Research Grant UM-MOHE UM.C/625/1/HIR/MOHE/MED/18 from the Ministry of Higher Education, Malaysia, the University of Malaya Research Grant (RG439/12HTM) and PJM-KTP Community Project grant (FL001-13SBS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.