03348nas a2200253 4500000000100000008004100001260005300042653003100095653002900126653002500155653002400180653001600204653003100220653001400251653001500265100002500280700001700305700001900322245016000341856008300501300001100584520248500595022001403080 2026 d c09/2026bSpringer Science and Business Media LLC10aSoil-transmitted helminths10aMass drug administration10aLymphatic filariasis10aTrichuris trichiura10aAlbendazole10aAnti-helminthic treatments10aSri Lanka10aPrevalence1 aLiyanapathiranage DA1 aFernando BNT1 aYahathugoda TC00aSoil-transmitted helminth prevalence in a Sri Lankan sentinel community 22 years after the initiation of mass drug administration: a cross-sectional survey uhttps://link.springer.com/content/pdf/10.1186/s12879-026-14364-6_reference.pdf a1 - 133 a

Background

Soil-transmitted helminth (STH) infections remain a public health concern in settings with inadequate sanitation and hygiene. There are 3 types of STH found worldwide, namely Ascaris lumbricoides, Trichuris trichiura, and hookworms. STH infections happen when microscopic worm eggs or larvae from human feces get into the soil in places with poor sanitation. People get infected by swallowing these eggs on dirty food or unwashed hands, or when active larvae go straight through the skin. In Sri Lanka, albendazole (ALB) was co-administered with diethylcarbamazine (DEC) during the national lymphatic filariasis elimination programme (NLFEP) and may have had ancillary effects on STH transmission. The present study aimed to assess the current prevalence of STH infections and determine whether the reduction achieved following MDA has been sustained over the long term while comparing it with surveys conducted during 2001–2006 in the Hamugewaththa area in Matara District.

Methods

A community-based cross-sectional survey was conducted in July 2023 among 273 children aged 2–15 years in the Hamugewatta area, Matara. Fresh stool samples were examined using direct saline and iodine smears and Kato-Katz thick smears. Prevalence and egg density were compared descriptively with historical data (2001–2006). Socio-demographic, sanitation, hygiene, and recent anthelmintic-treatment data were collected using an interviewer-administered questionnaire.

Results

One of 273 children was infected with Trichuris trichiura (0.37%; 1080 eggs per gram), while no Ascaris lumbricoides or hookworm infections were detected. This contrasted with an overall STH prevalence of 54.9% in June 2001. In 2023, 166/273 (60.8%) participants reported recent anthelmintic treatment, and none reported recent LF-MDA or antifilarial treatment. All participants reported handwashing before meals and after toilet use.

Conclusions

STH prevalence was very low in Hamugewatta in 2023, indicating a markedly reduced current burden. However, the contribution of the 2001–2006 LF-MDA programme to this reduction cannot be isolated because of the 17-year surveillance gap, differences in study populations, and subsequent deworming and improvements in sanitation and hygiene. Continued surveillance is warranted to determine the factors sustaining the low STH burden.

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