Impact of Five Years of Albendazole Preventive Chemotherapy on Soil-Transmitted Helminth Infections among School-Aged Children in parts of Nsit Ubium, Akwa Ibom State, Nigeria

Abstract

Soil-transmitted helminth (STH) infections remain a significant public health challenge in sub-Saharan Africa, particularly among school-aged children in rural communities with inadequate sanitation infrastructure. This study was designed to assess the current prevalence of STH infections among school-aged children in Nsit Ubium Local Government Area, Akwa Ibom State, Nigeria, and to evaluate the impact of five years of treatment of infection burden. A cross-sectional parasitological survey was conducted among 719 primary school pupils aged 5 to 15 years, selected from six government primary schools across the study area. Stool samples were collected and examined using formol-ether concentration techniques. Of the 719 pupils examined, 244 (33.9%) tested positive for at least one STH species, compared to a baseline prevalence of 62.93% recorded five years prior, representing an absolute reduction of 29.0% and a relative reduction of approximately 46.1%. Three species were identified: Ascaris lumbricoides was the most prevalent (176; 24.5%), followed by hookworm (63; 8.8%) and Trichuris trichiura (21; 2.9%). GPS Ikot Eyo recorded the highest current prevalence (40.0%) while GPS Ndukpeise and GPS Ekwere recorded the lowest (30.8% each). Male pupils had higher infection rate (128; 35.5%) than females (116; 32.4%), though the difference was not statistically significant (p = 0.416). By age group, the 9–10 years cohort recorded the highest prevalence (83; 37.2%), followed by the 5–6 years group (40; 36.0%) and the 7–8 years group (71; 34.1%), with the 11–12 years group recording the lowest (50; 29.2%); no infections were detected in the 13–15 years cohort. Co-infection was observed in 15 pupils (2.1%). The most common pattern was Ascaris–hookworm double infection (12; 1.7%), followed by Ascaris–Trichuris co-infection (2; 0.3%) and one case of triple infection (1; 0.1 %). The distribution of Ascaris–hookworm co-infections across schools was statistically significant (p = 0.020). Among risk factors assessed, only handwashing before meals reached statistical significance (p = 0.021); toilet type, barefoot walking, drinking water source, fruit washing, and STH knowledge showed no significant associations. The highest school-level reductions were at GPS Ukat Mbak Uno (35.8 %) and GPS Ekwere (31.7%), while GPS Ikot Eyo recorded the least reduction (5.4%). Despite the overall programme success, the current prevalence of 33.9% remains above the WHO control threshold of less than 20%. It is recommended that albendazole-based preventive chemotherapy be sustained and integrated with robust water, sanitation, and hygiene interventions and health education to achieve sustainable STH control in Nsit Ubium.