Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia

Romano Ngui Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Romano Ngui in
Current site
Google Scholar
PubMed Close
,
Shafie Aziz Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Shafie Aziz in
Current site
Google Scholar
PubMed Close
,
Kek Heng Chua Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Kek Heng Chua in
Current site
Google Scholar
PubMed Close
,
Roslan Muhammad Aidil Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Roslan Muhammad Aidil in
Current site
Google Scholar
PubMed Close
,
Soo Ching Lee Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Soo Ching Lee in
Current site
Google Scholar
PubMed Close
,
Tiong Kai Tan Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Tiong Kai Tan in
Current site
Google Scholar
PubMed Close
,
Mistam Mohd Sani Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Mistam Mohd Sani in
Current site
Google Scholar
PubMed Close
,
Ahmad Fadzlun Arine Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Ahmad Fadzlun Arine in
Current site
Google Scholar
PubMed Close
,
Mahmud Rohela Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Mahmud Rohela in
Current site
Google Scholar
PubMed Close
, and
Yvonne A. L. Lim Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia; Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Orang Asli Development, Ministry of Rural and Regional Development, West Block, Wisma Selangor Dredging, 142-C, Jalan Ampang, Kuala Lumpur, Malaysia

Search for other papers by Yvonne A. L. Lim in
Current site
Google Scholar
PubMed Close
DOI:
https://doi.org/10.4269/ajtmh.13-0677
Volume/Issue:
Volume 93: Issue 2
Page(s):
361–370
Restricted access
Get Permissions

A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1–63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4–58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3–30.1%) and hookworm (9.1%; 95% CI = 6.9–11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections.

Author Notes

* Address correspondence to Romano Ngui, Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. E-mail: romano@um.edu.my

Financial support: This study was supported by the UM/MoHE High Impact Research (H-20001-00-E000061), E-Science (16-02-03-6034), and BKP 007-2014 grant. The funders had no role in study design, data collection, analysis and preparation, or decision to publish the manuscript.

Authors' addresses: Romano Ngui, Roslan Muhammad Aidil, Soo Ching Lee, Tiong Kai Tan, Mahmud Rohela, and Yvonne A. L. Lim, Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, E-mails: romano@um.edu.my, aidil_lanang@ymail.com, eustacialee@gmail.com, stanley.monas@gmail.com, arineahmad@um.edu. my.rohela@ummc.edu.my, and limailian@um.edu.my. Shafie Aziz, Department of Geography, Faculty of Arts and Social Sciences, University of Malaya, Kuala Lumpur, Malaysia, E-mail: azizs@um.edu.my. Kek Heng Chua, Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, E-mail: khchua@um.edu.my. Mistam Mohd Sani, Department of Orang Asli Development, Ministry of Rural and Regional Development, Wisma Selangor Dredging, Jalan Ampang, Kuala Lumpur, Malaysia, E-mail: romano_sky05@yahoo.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2015
Received:
21 Nov 2013
|
Accepted:
30 Jan 2015
|
Published Online:
05 Aug 2015
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
  • 1.

    Liese B, Rosenberg M, Schratz A, 2010. Programmes, partnerships and governance for elimination and control of neglected tropical diseases. Lancet 375: 67–76.

    • Search Google Scholar
    • Export Citation
  • 2.

    WHO, 2002. Prevention and Control of Schistosomiasis and Soil-Transmitted Helminthiasis. World Health Organization (WHO) Technical Series Report 912. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 3.

    WHO, 2005. Deworming for health and development. World Health Organization (WHO) Report of the Third Global Meeting of the Partners for Parasite Control. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 4.

    Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ, 2006. Soil-transmitted helminthes infections: ascariasis, trichuriasis and hookworm. Lancet 367: 1521–1532.

    • Search Google Scholar
    • Export Citation
  • 5.

    Al-Mekhlafi HM, Atiya AS, Lim YA, Mohammed Mahdy AK, Wan Ariffin WA, Surin J, 2007. An unceasing problem: soil-transmitted helminthiases in rural Malaysian communities. Southeast Asian J Trop Med Public Health 38: 998–1008.

    • Search Google Scholar
    • Export Citation
  • 6.

    Lim YAL, Romano N, Colin N, Chow SC, Smith HV, 2009. Intestinal parasitic infections among Orang Asli (indigenous) in Malaysia: has socioeconomic development alleviated the problem? Trop Biomed 26: 110–122.

    • Search Google Scholar
    • Export Citation
  • 7.

    Ngui R, Saidon I, Chow SK, Rohela M, Lim YAL, 2011. Prevalence and risk factors of intestinal parasitism in rural and remote west Malaysia. PLoS Negl Trop Dis 5: e974.

    • Search Google Scholar
    • Export Citation
  • 8.

    Ahmed A, Al-Mekhlafi HM, Choy SH, Ithoi I, Al-Adhroey AH, Abdulsalam AM, Surin J, 2011. The burden of moderate-to-heavy soil-transmitted helminth infections among rural Malaysian aborigines: an urgent need for an integrated control programme. Parasit Vectors 4: 242.

    • Search Google Scholar
    • Export Citation
  • 9.

    Nasr NA, Al-Mekhlafi HMS, Ahmed A, Roslan MA, Bulgiba A, 2013. Towards an effective control programme of soil-transmitted helminth infections among Orang Asli in rural Malaysia. Part 1: prevalence and associated key factors. Parasit Vectors 6: 27.

    • Search Google Scholar
    • Export Citation
  • 10.

    Anon, 2006. Data Maklumat Asas Jabatan Hal Ehwal Orang Asli Malaysia. Jabatan Hal Ehwal Orang Asli (JHEOA). Kuala Lumpur, Malaysia.

  • 11.

    Nicholas C, 2000. The Orang Asli and the Contest for Resources: Indigenous Politics, Development and Identity in Peninsular Malaysia. Copenhagen, Denmark: IWGIA Publication.

    • Search Google Scholar
    • Export Citation
  • 12.

    Nevin HM, 1938. Health Survey. Ipoh Branch Laboratory, Malaya States Rept Inst Med Res Fed, 145–148.

  • 13.

    Dunn FL, 1972. Intestinal parasites in Malayan aborigines (Orang Asli). Bull World Health Organ 46: 99–113.

  • 14.

    Cheesbrough M, 1998. Parasitological Tests: District Laboratory Practice in Tropical Countries, Part 1. Cambridge, United Kingdom: Cambridge University Press.

    • Search Google Scholar
    • Export Citation
  • 15.

    Bendel RB, Afifi AA, 1977. Comparison of stopping rules in forward “stepwise” regression. J Am Stat Assoc 72: 46–53.

  • 16.

    Yap P, Du ZW, Chen R, Zhang LP, Wu FW, Wang J, Wang XZ, Zhou H, Zhou XN, Utzinger J, Steinmann P, 2012. Soil-transmitted helminth infections and physical fitness in school-aged Bulang children in southwest China: results from a cross-sectional survey. Parasit Vectors 5: 50.

    • Search Google Scholar
    • Export Citation
  • 17.

    Bennett A, Guyatt H, 2000. Reducing intestinal nematode infection: efficacy of albendazole and mebendazole. Parasitol Today 6: 71–74.

  • 18.

    Albonico M, Bickle Q, Ramsan M, Montresor A, Savioli L, Taylor M, 2003. Efficacy of mebendazole and levamisole alone or in combination against intestinal nematode infections after repeated targeted mebendazole treatment in Zanzibar. Bull World Health Organ 81: 343–352.

    • Search Google Scholar
    • Export Citation
  • 19.

    Chan L, Kan SP, Bundy DA, 1992. The effect of repeated chemotherapy on the prevalence and intensity infection of Ascaris lumbricoides and Trichuris trichiura. Parasitol 104: 371–377.

    • Search Google Scholar
    • Export Citation
  • 20.

    Anderson RM, May RM, 1991. Infectious Diseases of Humans: Dynamics and Control. Oxford, United Kingdom: Oxford University Press.

  • 21.

    Chan L, Bundy DA, Kan SP, 1994. Aggregation and predisposition to Ascaris lumbricoides and Trichuris trichiura at the familial level. Trans R Soc Trop Med Hyg 88: 46–48.

    • Search Google Scholar
    • Export Citation
  • 22.

    Mehraj V, Hatcher J, Akhtar S, Rafique G, Beg MA, 2008. Prevalence and factors associated with intestinal parasitic infection among children in an urban slum of Karachi. PLoS ONE 3: e3680.

    • Search Google Scholar
    • Export Citation
  • 23.

    Conlan JV, Khamlome B, Vongxay K, Elliot A, Pallant L, Sripa B, Blacksell SD, Fenwick A, Thompson RC, 2012. Soil-transmitted helminthiasis in Laos: a community-wide cross-sectional study of humans and dogs in a mass drug administration environment. Am J Trop Med Hyg 86: 624–634.

    • Search Google Scholar
    • Export Citation
  • 24.

    Gilles H, 1996. Soil-transmitted helminths (geohelminths). In: Tropical Diseases. Cook G, ed. London, United Kingdom: Manson's. W.B. Saunders, 1369–1412.

    • Search Google Scholar
    • Export Citation
  • 25.

    Nematian J, Nematian E, Gholamrezanezhad A, Asgari AA, 2004. Prevalence of intestinal parasitic infections and their relation with socio-economic factors and hygienic habits in Tehran primary school students. Acta Trop 92: 179–186.

    • Search Google Scholar
    • Export Citation
  • 26.

    Karan A, Chapman GB, Galvani A, 2012. The influence of poverty and culture on the transmission of parasitic infections in rural Nicaraguan villages. J Parasitol Res 2012: 478292.

    • Search Google Scholar
    • Export Citation
  • 27.

    Harpham T, 2002. Measuring child poverty and health: a new international study. J Trop Pediatr 48: 128–131.

  • 28.

    de Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L, 2003. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol 19: 547–551.

    • Search Google Scholar
    • Export Citation
  • 29.

    Fung IC, Cairncross S, 2009. Ascariasis and hand washing. Trans R Soc Trop Med Hyg 103: 215–222.

  • 30.

    Dzwairo B, Hoko Z, Love D, Guzha E, 2006. Assessment of the impacts of pit latrines on groundwater quality in rural areas: a case study from Marondera district, Zimbabwe. Phys Chem Earth Pt A 31: 779–788.

    • Search Google Scholar
    • Export Citation
  • 31.

    Banks D, Karnachuk OV, Parnachev VP, Holden W, Frengstad B, 2002. Groundwater contamination from rural pit latrines: examples from Siberia and Kosova. Water Environ J 16: 147–152.

    • Search Google Scholar
    • Export Citation
  • 32.

    Lee SC, Ngui R, Tan TK, Roslan MA, Ithoi I, Lim YAL, 2014. Aquatic biomonitoring of Giardia cysts and Cryptosporidium oocysts in peninsular Malaysia. Environ Sci Pollut Res Int 21: 445–453.

    • Search Google Scholar
    • Export Citation
  • 33.

    Ngui R, Lim YA, Traub R, Mahmud R, Mistam MS, 2012. Epidemiological and genetic data supporting the transmission of Ancylostoma ceylanicum among human and domestic animals. PLoS Negl Trop Dis 6: e1522.

    • Search Google Scholar
    • Export Citation
  • 34.

    Traub RJ, Robertson ID, Irwin P, Mencke N, Thompson RC, 2002. The role of dogs in transmission of gastrointestinal parasites in a remote tea-growing community in northeastern India. Am J Trop Med Hyg 67: 539–545.

    • Search Google Scholar
    • Export Citation
  • 35.

    Ngui R, Ching LS, Kai TT, Roslan MA, Lim YA, 2012. Molecular identification of human hookworm infections in economically disadvantaged communities in Peninsular Malaysia. Am J Trop Med Hyg 86: 837–842.

    • Search Google Scholar
    • Export Citation
  • 36.

    Jiraanankul V, Aphijirawat W, Mungthin M, Khositnithikul R, Rangsin R, Traub RJ, Piyaraj P, Naaglor T, Taamari P, Leelayoova S, 2011. Incidence and risk factors of hookworm infection in a rural community of central Thailand. Am J Trop Med Hyg 84: 594–598.

    • Search Google Scholar
    • Export Citation
  • 37.

    Ngui R, Mahdy MA, Chua KH, Traub R, Lim YAL, 2013. Genetic characterization of the partial mitochondrial cytochrome oxidase c subunit I (cox 1) gene of the zoonotic parasitic nematode, Ancylostoma ceylanicum from humans, dogs and cats. Acta Trop 128: 154–157.

    • Search Google Scholar
    • Export Citation
  • 38.

    Shalaby HA, Abdel-Shafy S, Derbala AA, 2010. The role of dogs in transmission of Ascaris lumbricoides for humans. Parasitol Res 106: 1021–1026.

    • Search Google Scholar
    • Export Citation
  • 39.

    Traub RJ, Robertson ID, Irwin PJ, Mencke N, Monis P, Thompson RC, 2003. Humans, dogs and parasitic zoonoses—unraveling the relationships in a remote endemic community in Northeast India using molecular tools. Parasitol Res 90: 156–157.

    • Search Google Scholar
    • Export Citation
  • 40.

    Brooker S, Michael E, 2000. The potential of geographical information systems and remote sensing in the epidemiology and control of human helminth infections. Adv Parasitol 47: 245–288.

    • Search Google Scholar
    • Export Citation
  • 41.

    Ngui R, Aziz S, Chua KH, Mistam MS, Al-Mekhlafi HM, Wan Yusoff WS, Rohela M, Lim YA, 2014. Mapping and modeling the geographical distribution of soil-transmitted helminthiases in Peninsular Malaysia: implications for control approaches. Geospat Health 8: 365–376.

    • Search Google Scholar
    • Export Citation
  • 42.

    Marti HP, Koella JC, 1993. Multiple stool examinations for ova and parasites and rate of false-negative results. J Clin Microbiol 31: 3044–3045.

    • Search Google Scholar
    • Export Citation
  • 43.

    Steinmann P, Zhou XN, Du ZW, Jiang JY, Wang LB, Wang XZ, Li LH, Marti H, Utzinger J, 2007. Occurrence of Strongyloides stercoralis in Yunnan Province, China, and comparison of diagnostic methods. PLoS Negl Trop Dis 1: e75.

    • Search Google Scholar
    • Export Citation
  • 44.

    Glinz D, Silué KD, Knopp S, Lohourignon LK, Yao KP, Steinmann P, Rinaldi L, Cringoli G, N'Goran EK, Utzinger J, 2010. Comparing diagnostic accuracy of Kato-Katz, Koga agar plate, ether-concentration, and FLOTAC for Schistosoma mansoni and soil-transmitted helminths. PLoS Negl Trop Dis 4: e754.

    • Search Google Scholar
    • Export Citation
  • 45.

    Speich B, Utzinger J, Marti H, Ame SM, Ali SM, Albonico M, Keiser J, 2014. Comparison of the Kato-Katz method and ether-concentration technique for the diagnosis of soil-transmitted helminth infections in the framework of a randomized controlled trial. Eur J Clin Microbiol Infect Dis 33: 815–822.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 105 105 14
Full Text Views 616 162 0
PDF Downloads 302 57 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save