Knowledge, Health Seeking Behaviour and Deworming Practices towards Pinworm Infestation among Primary Stakeholders of Preschools in Northern Sri Lanka: A Qualitative Approach

Pinworm infestation, caused by Enterobius vermicularis, is a common public health problem among children in developing countries including Sri Lanka. This qualitative study explores the knowledge, health-seeking behavior, and deworming practices regarding pinworm infestation among primary stakeholders of preschools in Jaffna and Kilinochchi districts, in Northern Sri Lanka. Focus group interviews with parents and teachers of preschools along with key informant interviews with healthcare providers were conducted, and data were analyzed thematically. The findings revealed substantial gaps in knowledge about clinical manifestations (57%) and transmission of pinworm infestation (78%). Among the participants, 78% mistakenly attributed pinworm infestation to non-communicable causes or dietary habits rather than understanding its communicable nature. Health-seeking behaviors indicated a preference for purchasing deworming medications from private pharmacies due to convenience (35%), perceived efficacy (17%), and dissatisfaction with public health services (78%), despite financial constraints (35%). Deworming practices varied, with inconsistent treatment intervals (74%) and an absence of thorough treatments for the entire family at the same time (13%). The COVID-19 pandemic and economic challenges disrupted schoolbased deworming campaigns, exposing the vulnerability of public health programs. Participants expressed a need for educational initiatives, including seminars, parent meetings, and engaging awareness tools. This study highlights the urgent need for targeted educational interventions, strengthening public health delivery systems, and designing community-based approaches for sustainable control of pinworm infestation in Northern Sri Lanka.