Int
ern
at
i
onal
Journ
al of
P
u
bli
c Hea
lt
h S
c
ie
nce (IJPH
S)
Vo
l.
7
, No
.
2,
J
un
e
201
8
, pp.
130~
136
IS
S
N: 22
52
-
8806,
DOI: 10
.11
591/ij
phs.
v7
i
2.
1
29
40
130
Journ
al h
om
e
page
:
https:
//
ww
w.i
aesco
re
.c
om
/j
our
nals/
ind
ex.
php/IJP
H
S
Soil
-
Tra
nsmi
tted Helmin
ths Infect
ion am
on
g Pr
im
ary Scho
ol
Stu
dents: Which
Policy S
hould
b
e Emphas
ized?
Bumi
Z
ulheri
Herma
n
1,2
, Ra
nisa Ha
nday
ani
Ramla
n
3
, F
erawa
ti Rahm
at
4
1
Depa
rtment of
Public
He
al
th
an
d
Com
m
unity
M
edi
c
ine
,
Facu
lty
of
Medicine
Hasanuddi
n
Univ
ersity
,
Indone
si
a
2
Coll
ege of
Public
He
al
th
Sci
ences,
Chul
al
ongko
rn
Univer
sit
y
,
T
hai
l
and
3
Depa
rtment of
Cli
nical
Pathol
o
g
y
,
Facu
lty
of
M
edi
c
ine
H
asa
nud
din
Univer
si
t
y
,
I
n
donesia
4
Cli
nical
La
bor
a
tori
um
,
Lo
cal
Of
fic
e
of
Publ
ic
H
e
al
th
Balikpapa
n
,
Indone
sia
Art
ic
le
In
f
o
ABSTR
A
CT
Art
ic
le
history:
Re
cei
ved
A
pr
25
, 201
8
Re
vised
Jun
6
,
201
8
Accepte
d
J
un
6
, 2
01
8
S
oil
Tra
nsm
it
te
d
Helminths
is
a
negl
e
ct
ed
dise
as
e
and
remai
n
un
touc
hed
in
Bal
ikpa
p
an
des
pit
e
of
it
s
de
teriora
t
ing
eff
e
ct
s
on
chi
ld
healt
h.
A
cro
ss
-
sec
ti
on
al
stud
y
t
o
rev
eal
the
a
ctual
infect
ion
among
school
-
age
chi
ldr
en
in
Bal
ikpa
p
an
was
conduc
t
ed
from
Janu
ar
y
-
Marc
h
2016
invol
ved
1
01
student
s
from
10
schools.
All
subje
ct
s
an
d
par
en
ts
were
i
nte
rvi
ewe
d
usin
g
validate
d
questi
onnaire
fo
ll
owed
b
y
stool
exa
m
ina
t
ion.
Al
l
dat
a
under
wen
t
univa
ri
at
e
and
biva
r
ia
t
e
te
s
t
using
fisher
ex
ac
t’s
t
est,
AN
OV
A
and
logi
stic
reg
r
ession
te
st
(95%
CI).
Rat
e
of
posit
ive
infe
c
ti
on
was
62
.
4%.
As
soci
at
ed
risk
factors
were
,
rout
ine
h
and
wash
(p=
0
.
004
OR=0.
050
),
ta
k
ing
ora
l
proph
y
l
axi
s
(p=
0.
001
OR=0
.
182),
use
of
f
ootwea
r
(p=
0
.
0
09
OR=2.
529),
invol
ved
in
“
Young
Doctor
Program
”
or
oth
er
he
a
lt
h
prom
oti
on
progr
am
(p=
0.
014
O
R
0.
324)
and
the
t
y
p
e
of
toi
l
et
at
hom
e
(p=
0.
048
).
Know
le
dge
a
bout
worm
infe
c
ti
on
(p
=0.
6
59),
histor
y
of
pr
evi
ous
worm
infe
ction
(p=
0
.
768)
and
a
ccess
to
clea
n
wa
te
r
at
hom
e
(p=
0
.
361)
were
insi
gnifi
c
ant
l
y
associate
d
wit
h
infe
c
ti
on
rate.
C
om
m
unit
y
servi
c
e
(such
as
“
The
Cle
an
,
Gree
n
And
Hea
lt
h
y
”
progra
m
)
(p=
0.
0
37
OR
0.
395)
a
nd
Com
m
unity
Hea
lt
h
Care
(p
=0.
000
OR
0.
155)
were
associate
d
with
lo
wer
risk
of
infect
ion
.
Regr
ession
te
st
show
s
tha
t
comm
unity
hea
l
th
ca
r
e
and
ora
l
proph
y
la
x
i
s
were
the
m
ost
infl
uencing
fac
tor
and
th
ese
factors
shoul
d
be
consid
ered
as
the
m
ai
n
foc
us
of
int
erv
ent
ion
.
Ke
yw
or
d:
Chil
d healt
h
Healt
h po
li
cy
Healt
h prom
oti
on
Helm
inthiasi
s
Pr
im
ary care
Copyright
©
201
8
Instit
ut
e
o
f Ad
vanc
ed
Engi
n
ee
r
ing
and
S
cienc
e
.
Al
l
rights re
serv
ed
.
Corres
pond
in
g
Aut
h
or
:
Bum
i Zulher
i
Her
m
an,
Coll
ege
of
Pub
li
c H
eal
th Scie
nce,
Chu
la
lo
ngkor
n U
niv
e
rsity
,
In
sti
tute B
uilding 3
(1
0
th
-
11
th
flo
or), C
hula
long
kor
n
s
oi 62
,
Ph
ya
thai R
d.
,
Ba
ngkok 1
0330, T
haila
nd.
Em
a
il
:
bu
m
iz
ulh
erihe
rm
an@
gm
ail.co
m
1.
INTROD
U
CTION
Ba
li
kp
apa
n
is
a
gro
wing
ci
ty
sit
uated
i
n
Ea
st
Kali
m
antan
Pr
ovi
nce.
Its
vi
sion
as
“C
hil
d
F
rien
dly
City”
enco
ura
ge
the
go
vern
m
ent
to
creat
e
poli
ci
es
to
accom
od
at
e
childre
n
t
o
gr
own
up
in
the
best
env
i
ronm
ent,
f
ro
m
best
ed
uc
at
ion
,
t
o
be
st
healt
h
c
ov
e
ra
ge
an
d
ser
vice.
In
sch
ool
-
a
ge
,
the
P
ubli
c
H
eal
th
Office
are
f
oc
us
in
g
on
how
to
i
ncr
ease
the
a
bili
ty
of
s
tud
e
nts
to
ach
ie
ve
highest
l
earn
i
ng
rete
ntion
a
nd
m
ai
ntain their
healt
h
sta
tu
s.
The
healt
h
poli
cy
fo
c
us
in
Ba
li
kp
apa
n
is
how
to
e
rad
ic
at
e
diseases
w
hich
m
ay
aff
ect
the
healt
h
sta
tus
in
sc
hool
-
age.
So
il
T
ra
ns
m
itted
Helm
inth
(
ST
H)
i
nfect
ion
is
a
ne
gl
ect
ed
disease
wh
ic
h
m
ay
aff
ect
the
grow
t
h
an
d
de
velo
pm
ent
of
childre
n
es
pecial
ly
in
their
school
-
a
ge.
In
Indonesia,
th
e
ra
te
of
ST
H
in
fe
ct
ion
reach
ap
pro
xi
m
at
ely
22.12
%
in
2012
an
d
base
d
on
20
14
WHO
data,
only
10.
98%
of
sch
ool
-
a
ge
childre
n
wer
e
treat
ed
with
or
al
pr
ophyla
xis
[
1].
Most
of
cases
cannot
be
di
sti
nguish
e
d
to
oth
er
c
ases
without
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N: 22
52
-
8806
So
il
-
Trans
mitt
ed Hel
mint
hs
I
nfect
ion
a
mon
g
Pri
ma
r
y
Schoo
l
Stude
nts…
(
Bum
i
Zu
l
heri
Herma
n
)
131
la
borator
y
e
xa
m
inati
on
as
STH
ca
n
a
ppear
as
gastr
oin
te
sti
nal
distu
rb
a
nces,
sk
i
n
m
anifestat
ion,
m
il
d
m
al
nu
trit
ion
,
un
e
xpla
ined
a
nem
ia
,
or
s
om
e
m
il
d
sign
s
an
d
sym
pto
m
s
includin
g
le
ss
at
te
ntion
to
stu
dy,
weakness
,
et
cet
era.
The
rate
of
ST
H
in
fec
ti
on
in
Ba
li
kpa
pan
is
no
t
cl
ea
rly
reco
r
de
d,
but
in
a
glance
,
so
m
e
cases
of
ST
H
wer
e
f
ound
i
nclu
ding
intes
ti
nal
and
m
uc
ocu
ta
neus
m
a
nifestat
ion
in
Pr
im
ary
Health
Ca
re
(P
HC
).
Ther
e
wer
e
s
om
e
factor
s
that
ass
ociat
ed
with
ST
H
i
nf
ect
io
n,
the
so
ci
o
-
dem
ogra
ph
y
facto
rs
(kn
ow
le
dg
e
a
nd
healt
h
be
ha
vi
or
)
a
nd
WA
S
H
fact
or
s
(
W
at
er,
Sa
nitat
ion
and
Hygie
ne)
as
m
enti
on
ed
by
the
stud
y
of
F
ree
m
an
[
2]
.
T
her
e
are
s
om
e
program
s
and
po
li
c
ie
s
relat
ed
t
o
WASH
ap
plied
in
the
ci
ty
includi
ng
the
healt
h
pro
m
ot
ion
s
uc
h
a
s
Y
oung
D
octor
Pro
gr
am
,
c
omm
un
it
y
healt
hcar
e,
a
nd
t
he
“C
le
an
Gr
ee
n
a
nd
Healt
hy
pr
ogr
a
m
”.
The
m
ain
obj
ect
ives
of
the
stu
dy
are
to
rev
eal
a
n
act
ual
rate
of
STH
infecti
on
am
ong
pr
im
ary
school
c
hildr
e
n
a
nd
it
s
associat
ed
fa
ct
or
s,
t
o
a
naly
ze
pr
ese
nt
po
li
ci
es
and
pro
gra
m
relat
ed
to
WASH
factors
an
d
ho
w
ef
fecti
ve
th
ese
po
li
ci
es
ca
n
re
du
c
e
the
worm
infecti
on
.
A
f
ur
t
her
re
com
m
end
at
io
n
will
be
m
ade to
c
reate
a sp
eci
fic
an
d effecti
ve
poli
cy
in
era
dicat
i
ng
worm
inf
ect
ion ba
sed
on t
he
r
es
ult o
f
this
stud
y.
2.
RESEA
R
CH MET
HO
D
This
stud
y
wa
s
per
f
orm
ed
in
cro
ss
-
sect
iona
l
m
e
tho
d
f
r
om
Janu
a
ry
to
Ma
rch
20
16
in
volvin
g
10
1
stud
e
nts a
ge 6
-
13 yea
rs old
in
10 s
c
hools
represents
6 dist
ri
ct
s in
Ba
li
kp
a
pa
n.
A
n
in
form
e
d
c
on
s
ent
was giv
e
n
to
pa
re
nts
a
nd
stud
e
nts
in
cl
ud
ing
t
he
pur
pos
es
of
st
ud
y,
m
e
thod
of
sto
ol
e
xam
inati
on
,
re
su
lt
s
an
d
f
ur
t
he
r
plan
includi
ng
or
al
pr
op
hlya
xis
f
or
ne
gative
ca
ses
and
s
pecifi
c
treatm
ent
fo
r
posit
iv
e
cases
us
in
g
al
bend
azole.
A
quest
io
nnai
re
(
13
valid
at
ed
it
em
s)
was
com
po
sed
to
assess
the
fa
ct
or
s
w
hich
unde
r
wen
t
reli
abili
ty
(Cr
onbac
h
Al
pha
Sc
or
e
0.8
01)
a
nd
vali
dity
te
st
(u
sin
g
Product
Mom
ent
Pears
on).
Thi
s
quest
io
nn
ai
re
wer
e
aske
d
to
al
l
s
ubj
ect
s
a
nd
th
ei
r
guar
dia
n
f
ollow
e
d
by
st
oo
l
e
xam
inati
on
.
Va
riables
t
o
be
m
easur
e
d
by
the
qu
e
sti
onnaire
are,
routine
ha
nd
-
wash,
knowle
dge
of
w
orm
infecti
on
,
us
e
of
f
oo
t
we
ar,
at
te
ndin
g
healt
h
prom
otion
/
yo
ung
do
ct
or
pro
gr
am
,
pr
e
vious
histor
y
of
w
orm
infecti
on
,
ac
cess
to
toil
et
,
s
ource
of
cl
ea
n
water,
or
al
pro
phyl
a
xi
s,
com
m
un
it
y
healt
h
care
by
PH
C,
an
d
S
ocial
Wo
r
king/
CGH
(Cle
a
n
Green
an
d
Healt
hy
).
F
or
m
easur
in
g
th
e
knowle
dge
a
bout
w
or
m
infe
ct
ion
,
t
he
st
udents
wer
e
a
sk
e
d
3
qu
e
sti
on
s
(
include
d
i
n
val
idate
d
qu
e
sti
onnaire
)
to
m
easur
e
the
ir
knowle
dge,
the
sign
a
nd
s
ym
pto
m
s
of
w
or
m
infecti
on
(m
ention
4
ans
wer
s
),
how w
or
m
inf
e
ct
the hum
an
(
at
least
3
answ
ers
incl
ud
e:
nai
l, foot,
a
nim
al
flesh, feces
)
a
nd
how
t
o
pre
ve
nt the
STH
(at
le
ast
3
a
ns
we
rs,
ha
nd
was
h,
nail
cl
ipp
in
g,
us
e
f
oo
t
wear,
ta
ke
anti
-
helm
inth
dru
g)
.
Stu
de
nts
we
r
e
cl
assifi
ed
as
ha
ving s
uffici
ent
knowle
dge if
they can
answe
r 5 fr
om
1
0
e
xpect
ed
a
nswer
s
.
A
total
of
10
1
sam
ples
we
re
c
ollec
te
d
a
nd
analy
ze
d
a
t
the
sam
e
day
wh
e
n
t
he
s
ubj
ect
s
were
intervie
wed.
S
a
m
ples
wer
e
a
naly
zed
in
Ma
ngga
r
Ba
ru
PHC
la
bo
rat
or
i
um
(stan
da
r
dized
by
ISO
15
189:
20
03)
us
in
g
Kato
Ka
tz
m
et
ho
d
[
3
-
4]
.
Id
e
ntific
at
io
n
of
helm
inths
m
or
ph
ology
s
uch
a
s
eg
gs,
la
rv
ae
a
nd
ad
ult
wor
m
was
perform
ed
an
d
cr
os
s
-
c
he
cked
by
la
bora
tory
sta
f
f.
Po
si
ti
ve
fin
dings
will
be
no
te
d
as
posit
ive
a
nd
vice
ver
sa
.
A
cl
os
e
d
i
nt
er
view
t
o
10
te
a
cher
s
f
ro
m
10
sch
oo
ls,
27
P
ri
m
ary
Healt
h
C
are
Ce
nte
r
re
presentat
ives
and
15
sub
-
dis
tric
t
of
fice
were
cond
ucted
to
analy
ze
and
c
onfirm
so
m
e
a
ns
we
rs
a
nd
he
al
th
beh
a
viou
r
of
t
he
respo
nd
e
nts
an
d
al
so
to
ob
ta
i
n
so
m
e
inform
at
ion
ab
out
the
ro
le
of
each
i
ns
ti
tuti
on
i
n
S
TH
era
dicat
ion
(su
c
h
as
the
Young
Do
ct
or
P
rogra
m
,
An
nual
Or
a
l
Pr
ophyla
xis,
com
m
un
it
y
healt
h
care
by
PH
C
su
c
h
as
sto
p
O
pen
Def
ecat
io
n
F
re
e
Cam
paign
,
s
anita
ti
on
inter
ve
ntion,
an
d
the
“C
le
an
Gr
ee
n
and
Healt
hy
Program
”
held
by
the
Distric
t o
ff
ic
e t
o prom
ote san
it
at
ion
, gree
n
e
nv
i
ronm
ent, and no sm
ok
in
g
a
rea)
All
pa
ram
et
ers
we
re
a
naly
ze
descr
i
ptively
a
nd
bi
var
ia
te
usi
ng
Chi
S
quare
/Fi
sh
er
Exact
Test
(if
Chi
Square
is
unab
le
),
an
d
Lo
gisti
c
Re
gr
essio
n
Test
to
rev
eal
the
m
os
t
influ
encin
g
facto
r
of
STH
infecti
on
us
in
g
sta
ti
sti
c
so
ftwar
e
SPS
S
16.
0
ve
rsion.
Odd
Ra
ti
o
al
so
analy
z
ed,
with
95%
Confide
nce
I
nt
erv
al
(
p
value
<
0.05
consi
der
e
d
a
s s
ign
ific
a
nt).
3.
RESU
LT
S
A
ND AN
ALYSIS
A
total
10
1
stu
den
ts
we
re
involve
d
in
this
stud
y
an
d
their
a
ge
var
ie
s
f
ro
m
6
-
13
ye
ars
old
(m
ean
age
10
ye
a
rs
3
m
on
ths
old
SD
±
1.287
56).
M
ost
of
st
ud
e
nts
c
om
e
fr
om
Dist
rict
Ce
ntral
(
29.
7%)
f
ollow
e
d
by
Distric
t
W
est
(
21.8%
)
Distric
t
East
(18.8%)
Distric
South
(17.8%
)
an
d
D
ist
rict
No
rt
h
(
11.
9%)
,
as
s
hown
i
n
Table
1.
Nu
m
ber
of
in
fected
stud
e
nt
is
63
(62.4%
)
with
m
os
t
co
m
m
on
infecti
on
is
Ascaris
sp,
fo
ll
owed
by
Trich
ur
is
s
p
and
A
ncylost
oma
Sp.
Mi
xed
in
f
ect
ion
wer
e
al
s
o
fou
nd.
T
he
a
uthors
do
not
i
den
ti
fe
d
t
he
e
ggs
per
gr
am
faeces
as
it
w
il
l
not
sig
nificantl
y
cha
nge
the
do
se
s
of
oral
pr
ophyla
xis.
Ta
ble
2
(a
)
a
nd
(
b)
s
how
s
ab
out
su
bject
’
s
dem
og
ra
phy cha
ract
erist
ic
.
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
7
,
No.
2
,
J
une
20
18
:
13
0
–
136
132
Table
1.
Infecti
on Type
Inf
ectio
n
Frequ
en
cy
Percent/in
f
ected
Asca
ris
sp
34
5
3
.97
Trich
u
ris
sp
17
2
6
.98
Ancylo
sto
ma
sp
9
1
4
.29
Mixed
I
n
fectio
n
3
4
.76
No
I
n
fectio
n
38
-
Table
2
(a
). S
ubj
ect
s
D
em
og
r
aph
y C
har
act
e
r
ist
ic
Ele
m
en
t
Nu
m
b
e
r
Ag
e (
y
ear
)
Mean
1
0
.26
7
3
Mini
m
u
m
6
Maxi
m
u
m
13
Sex
Male
59
Fe
m
ale
52
Table
2
(
b).
Subj
ect
s
D
em
og
r
aph
y C
har
act
e
r
ist
ic
Ele
m
en
t
Nu
m
b
e
r
Inf
ected
No
t I
n
f
ected
Area
W
est
18
4
East
19
0
So
u
th
6
12
No
rth
6
6
Cen
tral
14
16
3.1
.
Kn
owle
d
ge,
A
tt
it
ude
and Pr
act
ic
e
On
ly
78
stud
e
nts
(77.2
3%)
wash
thei
r
ha
nd
routinel
y
with
so
a
p.
I
nteres
ti
ng
ly
,
41
fro
m
78
stud
e
nts
who
pe
rfo
rm
hand
wa
sh
r
outi
nely
sti
ll
ge
t
infected.
Ro
utine
ha
nd
wa
sh
sho
ws
prot
ect
ive
eff
ect
to
w
or
m
infecti
on (p=
0.004 OR=
0.050
95% C
I 0.
006
-
0.3
92).
Abo
ut
20
(
31.
74%)
in
fected
stud
e
nts
di
d
not
wear
foot
c
ov
e
r/flip
floes
wh
il
e
play
in
g
on
t
he
gro
und.
Stud
e
nts
that
wear
i
ng
footw
ear
te
nd
t
o
ha
ve
lo
wer
ris
k
of
in
fecti
on
(
p=
0.009
OR=2.529
95
%
C
I
1.2
56
-
5.095
).
P
rev
i
ous
hist
or
y
of
worm
infecti
on
withi
n
the
la
st
1
ye
a
r
bas
ed
on
cl
inica
l
sig
ns
,
a
nd
sym
pt
om
ps
or
obvious
in
fecti
on
(eg
worm
i
n
sto
ol
et
c)
wa
s
insign
i
ficantl
y
associat
ed
wi
th
infecti
on
(
p=
0.768
).
F
ourty
three
stud
e
nts
with
po
sit
ive
i
nf
ect
i
on
ne
ver
e
xper
ie
nced
worm
i
nf
ect
io
n
befor
e
.
Aro
und
63
from
10
1
st
ud
e
nt
s
ha
d
pyra
ntel
pam
o
at
e
as
or
al
pro
ph
yl
axis
.
Pr
e
vi
ou
s
or
al
pr
ophy
la
xis
sh
ows
protect
ive
ef
fect
(p
=
0.001
OR=0.182
95%
CI
0.0
67
-
0.495
).
A
bout
56
of
t
hem
on
ly
ta
ke
on
ce
i
n
their
li
fetim
e
a
nd
t
he
rest
are
ta
kin
g
t
wice
anu
al
l
y
as r
ec
omm
ended
by the
natio
nal cam
pai
gn
.
Unfortu
natel
y 31 f
ro
m
these
63 stu
de
nts stil
l get in
fected.
Their
knowle
dge
a
bout
wor
m
infecti
on
ar
e
insig
nificantl
y
correla
te
d
w
it
h
infecti
on
(
p=0.65
9)
a
s
there
a
re
26
st
ud
e
nts
with
s
uffici
ent
knowle
dg
e
ab
out
w
orm
infecti
on
st
il
l
get
infected
.
Healt
h
prom
otion
pro
gr
am
about
worm
infecti
on
is
al
so
a
naly
zed.
E
ve
ry
stu
den
t
wer
e
aske
d
ab
out
wet
her
they
eve
r
at
te
ndi
ng
healt
h
prom
otion
pr
ogram
suc
h
as
hand
wa
sh
cam
paign
or
worm
ca
m
paign
or
at
te
nd
t
he
“
Y
oung
Doct
or
Pr
og
ram
”.
The
odd
rati
o
of
att
end
in
g
healt
h
prom
otion
pr
ogram
is
(p
=
0.0
16
OR=
0.324 9
5%
CI 0
.
129
-
0.814
)
.
Abo
ut 52
i
nf
ec
te
d
stu
de
nts n
e
ver join
or att
e
nd h
eal
th
pr
omoti
on pr
ogram
.
At least
10 tea
cher
from
s 1
0 sch
oo
ls
of stu
de
nts in
vo
l
ve
d
in this st
ud
y
we
re also
i
nter
viewed.
On
ly
1
from
10
schoo
ls
at
this
stud
y
held
a
“
Wo
rm
In
fecti
on
Ca
m
paig
n”
withi
n
the
la
st
6
m
on
ths
ag
o.
All
schools
adm
i
tt
ed
that
t
her
e
is
no
re
gula
ti
on
or
s
pec
ific
integrated
pro
gr
am
to
dim
inish
worm
i
nf
ect
io
n
in
stu
den
ts
.
The
“
Y
oung
D
octo
r
Program
”
is
trai
nin
g
he
ld
anu
al
ly
by
PH
C
to
prom
ote
healt
h
beh
a
vi
our
inclu
ding
r
ou
ti
ne
hand
wash
a
nd
wea
rin
g
f
oo
twear
an
d
delegate
certai
n
s
tud
e
nts
as
Y
oung
Do
ct
or
a
nd
bec
om
e
the
healt
h
pioneer
f
or
th
ei
r
fr
ie
nds.
B
ut
the
con
te
nt
of
trai
ni
ng
hel
d
in
sch
ool
is
no
t
sp
eci
fical
y
include
the
wo
r
m
infecti
on c
on
te
nt.
3.2
.
S
an
it
at
i
on As
pects
and
Int
er
venti
on.
Investi
gatio
n
f
or
ap
pro
pr
ia
te
sanita
ti
on
was
al
so
per
f
orm
e
d.
The
re
are
13
stud
e
nts
w
ho
dont
ha
ve
appr
opriat
e
toil
et
at
ho
m
e
(g
oo
se
-
nec
k
ty
pe
connecte
d
t
hro
ugh
se
ptic
ta
nk)
co
ns
ist
of
pit/
ho
le
la
trine
a
nd
7
of
them
do
nt
have.
T
he
ty
pe
of
toil
et
was
sig
ni
ficantl
y
associ
at
ed
with
w
or
m
infecti
on
(
p=
0.048
)
bu
t
O
dd
Ra
ti
o
cannot
be
c
ompu
te
d.
T
he
s
ource
of
cl
ean
w
at
er
at
ho
m
e
su
ch
a
s
well
,
tr
eat
ed
water
,
or
oth
e
r
res
ource
is
no
t
cor
el
at
ed
w
it
h
the incid
ence
of
w
orm
inf
ect
ion
(
p=
0.361).
The
r
ole
of
pr
i
m
ary
healt
h
care
is
al
so
ide
ntifie
d
in
c
omm
un
it
y.
Paren
ts
wer
e
as
ke
d
is
there
any
effor
t
of
the
Pr
im
ary
Health
Ca
re
to
hel
d
a
com
m
un
it
y
healt
h
care,
su
ch
a
s
sanit
ary
insp
ect
io
n,
healt
h
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N: 22
52
-
8806
So
il
-
Trans
mitt
ed Hel
mint
hs
I
nfect
ion
a
mon
g
Pri
ma
r
y
Schoo
l
Stude
nts…
(
Bum
i
Zu
l
heri
Herma
n
)
133
prom
otion
or
healt
h
cam
paign
based
on
“
10
H
eal
th
Be
ha
viour”
or
known
as
“Peril
ak
u
Hidu
p
Be
rsih
da
n
Sehat”
at
t
heir
hom
e.
A
total
of
51
res
pond
ents
sai
d
that
t
he
P
rim
ary
Healt
h
Ca
re
at
t
he
ir
district
al
re
ady
m
ade su
c
h pro
gr
am
an
d t
hey
wer
e
in
vo
l
ved
(p
=
0.0
00 O
R
0.1
55 95%
CI 0.
062
-
0.3
87)
As
t
otal
27
P
rim
ary
Healt
h
Ca
re
was
no
t
co
nductin
g
a
sp
eci
fic
pre
ven
ti
on
pro
gra
m
of
w
or
m
infecti
on
as
ex
pected.
Durin
g
the
la
st
3
ye
a
rs,
there
was
no
integrate
d
pr
ogram
su
ch
as
screening,
a
nd
or
al
pro
ph
yl
axis.
T
he
open
def
ect
ion
f
ree
cam
pa
ign
was
plan
ne
d
but
did
not
cond
ucted
as
exp
ect
e
d.
N
umber
of
no
-
O
DF
s
ub
-
di
stric
t
was
never
declare
d.
T
he
P
HC
wer
e
fo
c
us
on
sa
nitary
ins
pecti
on
and
healt
h
pro
m
ot
io
n
thr
ough
co
uns
el
li
ng
.
All
po
sit
ive
cases
found
in
ou
t
patie
nt
care
we
re
treat
ed
sel
ect
ively
with
pyr
antel
pam
oate
and
a
lben
dazo
le
.
I
nc
idence
rate
of
worm
infecti
on
is
ap
pro
xim
a
te
ly
le
ss
than
1%
per
popula
ti
on
as
confirm
ed
in L
ocal P
HC syst
e
m
. Cu
ta
neo
us
m
anifestat
ion
was
no
t
r
ec
ord
ed
s
pecificl
y.
Inform
at
ion
about
the
ro
le
of
s
ubdistrict
Office
was
ob
ta
ined
from
q
uestio
nn
ai
re
a
nd
inte
rv
ie
w.
On
ly
12
6
f
ro
m
1360
cl
us
te
r
is
ap
plyi
ng
“C
l
ean
G
ree
n
an
d
Healt
hy
(C
G
H)
”
pro
gr
am
and
facil
it
at
ed
by
the
su
bdist
rict
office.
T
hese
pro
gram
s
con
sist
of
Im
plem
entati
on
of
“
Perila
ku
Hidup
Be
rsi
h
dan
Se
hat”
or
10
“Healt
h
Be
ha
vi
our”,
ze
ro
sm
ok
e/
to
bacc
o
a
r
ea
an
d
integ
rat
ed
e
nv
ir
onm
ent
program
.
So
c
ia
l
wo
r
king
t
o
cl
ean
the
en
vir
onm
e
nt
is
one
of
the
el
e
m
ents
in
th
e
“C
le
an
Gr
ee
n
a
nd
Healt
hy”
pro
gr
am
.
The
su
bject
s
w
ho
li
ve
i
n
the
sub
-
district
/c
luster
that
co
nducted
t
he
C
GH
pro
gr
am
t
end
t
o
ha
ve
lo
wer
risk
of
w
orm
infecti
on
(
p=
0.037
OR
0.3
95 9
5%
CI
0.1
67
-
0.9
30)
.
N
onet
heles
s
this
pr
ogram
was
in
de
pende
ntly
held
with
out
co
ordi
nation
from
PH
C.
Lo
gisti
c
Re
gr
e
ssion
Test
wa
s
condu
ct
e
d
to
rev
eal
the
m
os
t
influ
enci
ng
f
act
or
.
Com
m
un
it
y
healt
h
care
s
uch
as
s
anita
ry
ins
pecti
on
,
an
d
healt
h
pr
om
otion
he
ld
by
P
HC
(
β=
-
2.028
p=0,001)
a
nd
ta
ki
ng
oral
pro
ph
yl
axis
(β
=
-
1.2
75
p=0.001)
are
the
m
os
t
influ
e
ncin
g
factor
.
T
he
est
i
m
ation
of
i
nf
ect
io
n
is
Y=
9
.
321
-
1.275
(Oral
Prophyl
axis)
–
2.0
28(Comm
un
it
y
Healt
h
Ca
re
)
with
ye
s
as
hi
gher
dich
oto
m
y.
This
can
predi
ct
fo
r
up to 8
0.2%
po
ssibil
it
y of
in
fe
ct
ion
(adj
us
te
d R
2 0.8
02).
Va
riable a
naly
sis
is
show
n
i
n
Ta
ble 3.
T
able
3
. Varia
ble Analy
sis
Variables
Inf
ected
No
t
OR
9
5
% Exp
P Value
Ro
u
tin
e Hand
wash
Yes
41
37
0
.05
0
0
.00
6
-
0
.392
p
=0
.00
4
No
22
1
Su
f
f
icien
t Kno
wle
d
g
e of
W
o
r
m
Inf
ectio
n
Yes
26
14
1
.20
5
0
.52
6
-
2
.758
p
=0
.65
9
No
37
24
W
ea
ring
f
o
o
twear
wh
ile playing
on
the g
rou
n
d
Yes
43
34
2
.52
9
1
.25
6
-
5
.095
p
=0
.00
9
No
20
40
Atten
d
in
g
Health Pro
m
o
tio
n
/
Yo
u
n
g
Docto
r
Prog
ra
m
Yes
11
15
0
.32
4
0
.12
9
-
0
.814
p
=0
.01
6
No
52
23
Previo
u
s Histo
ry
o
f
wor
m
inf
ectio
n
Yes
20
11
1
.14
2
0
.47
4
-
2
.750
p
=0
.76
8
No
43
27
Takin
g
Or
al P
rop
h
y
lax
is
Yes
31
32
0
.18
2
0
.06
7
-
0
.495
p
=0
.00
1
No
32
6
Has to
ilet with
ap
p
rop
riate
san
itatio
n
Go
o
se Neck
51
37
NA
NA
p
=0
.04
8
No
n
Goo
se Neck
5
1
Do
n
t Have
7
0
So
u
rce
o
f
Clean
Water
Tr
eated
W
at
er
45
31
NA
NA
p
=0
.36
1
W
ell
16
7
Do
n
t hav
e
2
0
Co
m
m
u
n
ity
Healt
h
Care
b
y
PHC
Yes
21
29
0
.15
5
0
.06
2
-
0
.387
p
=0
.00
0
No
42
9
So
cial W
o
rkin
g
/
CGH
Yes
31
27
0
.39
5
0
.16
7
-
0
.930
p
=0
.03
7
No
32
11
4.
DISCUSS
ION
This
st
ud
y
was
fo
c
us
e
d
on
th
r
ee
sect
ors,
Schools
an
d
it
s
stu
den
ts
,
P
rim
ary
Healt
h
Ca
re
an
d
the
S
ub
-
d
ist
rict
Office
.
Fr
om
10
1
st
udents
a
rou
nd
29.
7%
li
ve
in
Distric
t
Ce
ntra
l
wh
ic
h
is
wel
l
known
as
po
pu
l
ous
m
idd
le
-
inc
om
e
district
.
Sout
h
Distric
t
is
t
he
ca
pital
dist
rict
of
Ba
li
kpa
pan.
Ea
st
an
d
West
a
re
c
omm
on
l
y
known
as
s
ub
-
urba
n
district
wh
e
re
m
os
t
of
the
popula
ti
on
are
no
t
the
native
pe
ople
/t
ran
sm
igran
t.
Most
of
them
wo
r
k
as
fishe
rm
an,
a
nd
cl
assifi
e
d
i
n
low
-
inc
om
e
fa
m
ily.
They
li
ve
near
the
ri
ver
ba
nk
i
n
a
sem
i
-
per
m
anen
t
house
with
i
napp
r
opriat
e
sanita
ti
on.
Pe
rh
a
ps,
th
is
m
igh
t
co
ntri
bu
te
t
o
higher
nu
m
ber
of
pos
it
i
ve
infecti
on
at
those
district
s.
F
urt
her
m
or
e,
t
he
resu
lt
s
of
this
stud
y
s
upporte
d
the
ass
um
pti
on
t
hat
own
a
pro
per
toil
et
hav
e
si
gnific
ant
ass
oci
at
ion
with
w
orm
infecti
on
(
p=0.04
8)
Sim
i
la
r
fin
ding
we
re
al
so
re
vealed
by
Ash
e
na
fi
in
2013,
a
toil
et
with
a
n
op
e
n
syst
e
m
is
associat
ed
with
worm
infecti
on
(
OR
3.6
18
p<0.05
1.304
-
10.
04)
[
5]
.
T
he
point
s
howe
d
by
Zie
ge
lbaue
r
in
2012
sai
d
t
hat
a
c
om
bin
at
ion
of
sanita
ti
on
avail
abili
ty
and
us
e,
we
re
sh
owin
g
pr
otect
ive
eff
ect
w
it
h
odd
rati
o
0.5
1
(95%
CI
0.4
4
-
0.6
1)
f
or
the
three
so
il
-
tra
nsm
itted
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
7
,
No.
2
,
J
une
20
18
:
13
0
–
136
134
helm
inths
com
bin
e
d,
0.54
(
95%
CI
0.4
3
–
0.6
9)
for
A
.
lu
mbr
ic
oid
es
,
0.5
8
(
95%
CI
0.45
–
0.7
5)
for
T
.
tri
chiur
a
,
and
0.60
(
95
%
CI
0.
48
–
0.7
5)
f
or
hookw
orm
[6]
.
North
Distric
t
is
the
le
ss
popu
la
te
d
district
as
on
ly
few
hous
i
ng
com
plex
avail
able
and
m
os
t
of
the
la
nd
sca
pe
are
hill
s
and
fore
st.
Most
of
pe
op
le
in
N
or
t
h
Distric
t
work
as
fa
rm
er
and
not
wea
ring
f
oo
t
wear
c
ontrib
ute
to
wor
m
infecti
on
as
rev
el
e
d
in
this
stud
y,
footwea
r
gi
ve
protect
ive
eff
e
ct
to
wo
rm
inf
ect
ion
(p
=
0.0
15
OR
2
.
529
95
%
CI
1.
25
6
-
5.095
).
Stu
dy
co
nducted
by
Stru
nz
in
2014
al
so
ha
ve
the
si
m
il
ar
fin
ding
that
w
earin
g
shoes
was
ass
ociat
ed
with
reduce
d
odds
of
ho
okworm
infecti
on (OR 0.29, 95% CI
0.1
8
-
0.4
7)
an
d
i
nf
ect
io
n
wit
h
a
ny STH
(O
R 0
.
30, 95%
CI 0.11
-
0.8
3)
[
7]
.
Til
ah
un
Alel
ign
in
20
15
al
so
revel
aed
the
sa
m
e
resu
lt
s
that
the
ho
okw
or
m
infecti
on
m
ay
occu
r
2.42
ti
m
es
hig
her
[
8]
.
Anothe
r
dif
fe
r
ent
resu
lt
as
m
entioned
by
Kali
app
a
n
et
al
(2
013)
tha
t
po
or
usa
ge
of
f
ootwea
r
w
as
no
t
associat
ed wit
h i
ncr
ease
d risk
of ST
H
in
fec
ti
on
[
9]
.
Sex
was
not
re
viewe
d
f
or
sig
nificant
facto
rs
as
m
entioned
by
U
ne
ke
in
2006
a
nd
Kali
a
pp
a
n
(20
13)
that
there
is
no
sign
i
ficant
di
ff
ere
nce
of
S
TH
infecti
on
betwee
n
m
a
le
and
fem
al
e
[9
-
10]
.
The
fi
nding
of
Til
ahun
Alel
ig
n
is
al
so
sim
i
l
ar
with
this
st
ud
y
[
8].
Ro
utine
ha
ndwas
h
i
s
def
i
ned
as
a
hand
was
h
pro
cedur
e
perform
ed
us
i
ng
ha
nd
so
a
p
i
n
six
ste
ps
as
reco
m
m
end
by
W
H
O.
I
n
this
stud
y
the
re
w
ere
only
78
st
ud
e
nts
(77.2
3%)
was
h
t
heir
ha
nd
r
ou
ti
nely
with
so
a
p.
In
this
st
ud
y,
r
outi
n
e
ha
nd
w
ash
s
hows
protect
ive
eff
ect
t
o
worm
infecti
on
(
p=0.00
4
O
R
0.
05
0
95%
CI
0.006
-
0.3
92)
.
A
stu
dy
by
Stru
nz
ob
ta
i
n
ed
the
sim
il
a
r
res
ults
especial
ly
,
when
ha
ndwas
h
is
per
f
orm
ed
aft
er
def
ecat
i
ng
a
nd
b
ef
or
e
eat
in
g
[
7].
Rou
ti
ne
hand
wa
sh
trai
ning
is
al
so
in
cl
uded
i
n
“Y
oung
D
oc
tor”
trai
ni
ng
he
ld
by
PH
C
but
the
auth
or
s
ti
ll
find
41
f
rom
78
stud
e
nts
who
perform
hand
wash
r
outi
nely
sti
ll
get
in
fec
te
d
by
w
or
m
.
This
c
ould
po
ssibly
ha
ppen
du
e
to
ina
ppr
opriat
e
routine
ha
nd
w
ash.
Per
ha
ps
stud
e
nts
a
re
perf
or
m
ing
hand
wash
in
inc
orr
ect
ste
ps
,
durat
ion
or
e
ven
dont
us
e
hands
oa
p
r
outi
nely
.
T
his
m
ay
le
ad
to
w
or
m
infecti
on
as
i
nc
orrect
r
outi
ne
ha
nd
was
h
will
no
t
m
ake
ha
nd
a
nd
nails cl
ean.
In
quest
io
nnai
r
e,
stu
de
nts
a
nd
pa
ren
ts
we
re
aske
d
wh
et
her
their
child
ren
ha
ve
s
om
e
ob
vious
si
gn
s
and
sym
pto
m
p
s
of
w
or
m
infecti
on
in
the
pa
st
or
they
ever
exp
e
rience
d
vi
sible
worm
(su
ch
as
intest
ine
worm
com
es
ou
t
fro
m
rectu
m
or
a
ny
m
uco
cuta
ne
us
m
anifestat
ion
/
c
uta
neous
la
rv
a
m
igran
s
)
.
T
hirty
one
stud
e
nts
had
pre
vious wor
m
infecti
on
a
nd
20
of
them
hav
e
w
orm
infecti
on
in
this
st
ud
y.
A
stu
dy
of
ST
H
rein
fecti
on
is
perform
ed
by
J
ia
T
W
in
2012
and
it
s
hows
t
ha
t
eve
n
a
fter
t
r
eatm
ent,
the
risk
of
rei
nf
ect
io
n
from
26
-
94
%
3,
6
and
12
m
on
ths
afterward
[
11
]
.
Re
infecti
on
is
li
kely
occu
r
s
in
childre
n
if
th
ey
cann
ot
im
pl
e
m
ent
al
l
aspects
of
healt
h
be
ha
viour
for
exam
ple
nail
cl
ipp
in
g.
In
the
st
ud
y
of
Ma
hm
ud
in
2015
s
hows
that
reinf
ect
io
n
of
STH
after
6
m
on
th
s
for
the
gro
up
“h
an
dwash
with
s
oap
”
is
14.28%
a
nd
c
om
bin
at
ion
of
hand
was
h
an
d
nai
l
cl
ipp
in
g
is
13.
82
%
eve
ntho
ught
is
no
t
si
gnific
ant
(
p=0.06
9)
[12]
.
Our
s
tud
y
s
hows
t
he
re
is
no
c
or
el
at
ion
betwee
n
pr
e
vi
ou
s
w
orm
infecti
on
a
nd
the
worm
infecti
on
at
this
tim
e
(p
=0
.76
8).
T
his
m
igh
t
be
the
eff
ect
of
m
ul
ti
ple f
act
ors su
c
h
as
oral
pro
phyl
axis,
know
le
dg
e
and
s
ani
ta
ti
on
.
On
ly
40
stu
de
nts
ha
ve
ade
qu
at
e
know
le
dg
e
about
w
or
m
i
nf
ect
io
n.
T
he
auth
or
fou
nd
t
hat
ade
qu
at
e
pr
i
or
knowle
dge
is
no
t
sigin
ific
antly
cor
el
at
ed
with
w
or
m
infecti
on
(
p=
0.659
)
Stu
dy
by
Sit
ti
Cha
di
j
ah
i
n
2014
al
so
s
up
port
this
fi
nd
i
ng
(p=0
.46
6)
[
13
]
.
T
h
e
ca
us
e
of
t
his
fin
ding
pe
r
hap
s
is
t
he
im
ple
m
enta
ti
on
of
their
knowle
dge
in
daily
li
f
e.
At
schools,
stud
ents
ca
n
perform
han
d
wash
bu
t
not
at
ho
m
e
or
any
oth
e
r
po
s
sibil
it
ie
s w
hich
ca
nnot enforce t
hem
to
app
ly
their
knowle
dge, s
uc
h
a
s n
o
t
ru
st
worth
y ro
le
m
o
del (
par
e
nts
,
fam
i
ly
)
or
lac
k o
f
facil
it
ie
s such as
sin
k
to
do han
dwas
h or
la
ck
of
obedie
nt it
sel
f.
As
m
entione
d
above,
the
“
Y
oung
Do
ct
or
P
rogr
am
”
is
a
tr
ai
nin
g
hel
d
a
nual
ly
by
P
HC
to
prom
ote
healt
h
be
ha
viour
in
sc
ho
ols.
Teacher
a
ppoi
n
t
s
certai
n
num
ber
of
stu
de
nts
as
Y
oung
Do
ct
or
a
nd
be
com
e
the
healt
h
pi
on
e
er/
ro
le
m
od
el
for
their
f
rien
ds
af
te
r
pass
t
he
tra
ining.
Be
side
t
hat,
s
om
e
sp
eci
fic
healt
h
cam
paig
n
to
prom
ote
“1
0
Peri
laku
Hi
dup
Bersi
h
dan
Se
ha
t
”
(“
10
Hea
lt
h
be
hav
i
our”
)
al
so
held
by
P
HC
an
ually
suc
h
a
s
hand
was
h
ca
m
paign
.
But
la
te
ly
the
sp
eci
fic
worm
infecti
on
c
onte
nt
is
not
inclu
de
d
or
deep
ly
trai
ne
d
in
this
pro
gr
am
.
On
ly
on
e
sch
ools
he
ld
a
sp
e
sific
worm
erad
ic
at
ion
cam
paig
n
in
Distric
t
North.
Our
stu
dy
s
how
s
that
eve
ry
stu
de
nts
that
e
ver
join
s
uc
h
act
ivi
ti
es
te
nd
to
ha
ve
lo
wer
ris
k
of
in
fecti
on
(
p=
0.016
OR
0.324
95
%
CI
0.129
-
0.8
14)
.
Seve
ral
stu
dies
are
sho
wing
s
om
e
si
m
ilar
res
ults
that
healt
h
prom
otion
ca
n
re
du
c
e
wor
m
infecti
on
su
c
h
as
researc
h
pe
rfor
m
ed
by
Gyork
os
in
2013
s
hows
t
ha
t
healt
h
pro
m
ot
ion
inter
ve
ntion
is
asscoiat
ed
wit
h
w
or
m
infectio
n
a
nd
te
nd
to
lower
the
ris
k
of
infecti
on
e
sp
eci
al
ly
fo
r
Ascar
ia
sis
up
to
58%
[14]
.
In
our
stud
y
we
ca
n
assum
e
that
the
healt
h
prom
otion
perform
ed
by
healt
h
sta
ff
can
gu
a
ran
t
ee
the
correct
inf
orm
at
ion
a
bout
ho
w
to
a
pply
the
“Healt
h
Be
ha
vi
our”
in
desira
ble
way.
T
he
a
uthor
e
xam
ine
furthe
r
that
com
m
un
it
y
healt
h
ca
re
pe
rfor
m
ed
by
t
he
PH
C
sta
ffs
i
nclu
ding
sa
nitary
ins
pecti
on,
direct
public
healt
h
interve
ntio
n
and
healt
h
pro
m
ot
ion
d
irect
l
y
to
peo
ple
is
sta
ti
st
ic
al
l
y
si
gn
i
ficant
(p
=
0.000
)
Diff
e
re
nt
resu
lt
s
rev
eal
e
d
by
T
ho
m
as
Cl
asen
that
t
he
interv
ention
c
onsist
ed
of
la
trine
pr
om
otion
an
d
con
st
ru
ct
io
n)
ar
e
no
t
sign
ific
a
ntly
red
uce
t
he
eg
g
-
c
ount
pre
valenc
e
of
S
TH
i
n
I
ndia
[
15
]
.
B
ut
Sti
l
l,
the
researc
her
s
rec
omm
e
nd
t
he
PH
C
sa
nitari
an
to
f
ocu
s
on
prom
o
t
ing
go
od
sa
nitat
ion
to
il
et
and
re
duc
e
the
ope
n
de
fecati
on
be
ha
vi
or
as
cl
early
sta
te
d
i
n
a
stud
y
of
A
sh
e
naf
i
that
op
en
de
fecati
on
will
con
trib
ute
to
worm
infec
ti
on
5
.
T
his
pro
blem
is
obviously
seen
in
Distric
t
West
and
East
.
An
urge
act
ion
sh
ould
be
done
as
ty
pe
of
toil
et
is
cor
el
at
ed
wit
h
worm
infecti
on
e
ven
t
hought
the
od
d
rati
o
in
this
st
ud
y
ca
nnot
be
cal
cul
at
ed
(
p=0.04
8).
The
sou
rce
of
cl
e
a
n
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N: 22
52
-
8806
So
il
-
Trans
mitt
ed Hel
mint
hs
I
nfect
ion
a
mon
g
Pri
ma
r
y
Schoo
l
Stude
nts…
(
Bum
i
Zu
l
heri
Herma
n
)
135
water
at
ho
m
e
is
no
t
as
so
ci
a
te
d
with
w
orm
infecti
o
n
(p=0.
361).
Diff
e
ren
t
resu
lt
s
r
e
vealed
by
Str
unz
a
nd
Worell
that treat
ed
water m
ay
hav
e
protect
iv
e eff
ect
on S
T
H
infe
ct
ion
[7
]
, [
16]
. Most
o
f st
ud
e
nts h
a
ve
t
reate
d
water
s
upplied
from
local
co
m
pan
y.
Few
of
them
sti
ll
us
e
well
an
d
t
he
a
uthor
sti
ll
fo
un
d
s
o
m
e
su
bject
w
ho
dont
hav
e
s
our
ce o
f
cl
ean
w
at
er.
T
hey m
igh
t get
from
their n
ei
ghbo
ur or c
ollec
t water
fro
m
r
ai
n.
Or
al
pr
ophyla
xi
s taken
b
y st
udents
was
ide
nt
ifie
d
an
d
there
w
ere
63
from
101
stu
de
nt d
i
d.
T
hey take
on
ce
in
t
heir
li
fetim
e
and
som
e
oth
er
was
r
o
utinely
ta
ke
n
twic
e
annuall
y
as
m
entioned
in
resu
lt
s.
All
par
e
nts
choose
Pyr
ant
el
Pa
m
oate
wh
ic
h
is
exte
ns
ively
known
,
r
at
her
tha
n
al
be
nd
az
ole.
T
he
eff
ic
acy
of
py
ran
te
l
pam
oate
co
m
par
e
to
Al
benda
zole
is
32
%
ve
rsu
s
72%
res
pe
ct
ively
fo
r
hookw
or
m
infecti
on
[
17
]
.
S
peic
h
et
al
2012
e
xpresse
d
that
al
bend
azole
an
d
m
ebendaz
ole,
as
well
as
pyra
ntel
pam
oate
and
le
vam
isole
are
reco
m
m
end
ed
dru
gs
again
st
infecti
ons
with
so
il
-
tra
ns
m
itte
d
helm
inths
[18]
.
Hence
,
the
auth
or
sti
ll
be
able
to
fin
d
31
from
6
3
stu
de
nts
with
p
re
vi
ou
s
oral
pro
ph
yl
axis
ge
t i
nf
ect
ed
at thi
s tim
e. D
ew
orm
ing
ef
fort
us
ing o
ral
pro
ph
yl
axis
ba
sed
on
a
stu
dy
of
Tay
lo
r
i
n
2012
s
hows
t
hat
a
sin
gle
dose
of
de
wor
m
ing
dru
gs
pr
ob
a
bly
increase
d
weigh
t
a
nd
haem
og
l
ob
i
n
(l
ow
qu
al
it
y
evide
nc
e),
bu
t
le
ss
evi
de
nce
of
e
ff
ect
on
c
ogni
ti
ve
functi
onin
g
[19]
.
O
ur
st
ud
y
rev
eal
s
that
or
al
pr
ophyla
xis
show
s
sti
ll
hav
e
pr
om
is
ing
protect
ive
eff
ect
(p
=
0.0
0
1
OR
0.1
82
95%
CI
0.067
-
0.4
95).
As
m
entioned
above
t
hat
the
re
wa
s
no
s
pe
ci
fic
pr
e
ve
ntio
n
program
of
worm
infecti
on
,
sc
ree
ning,
and
oral
pr
ophy
la
xis
co
nduct
ed
by
PH
C
.
Se
le
ct
ive
treatm
e
nt
was
do
ne
with
pyra
ntel
pa
m
oate
or
al
be
ndazole.
Accor
ding
to
t
he
natio
nal
ST
H
gu
i
delines
t
her
e
sho
uld
be
a
s
pecific
pro
gr
am
and
pe
rs
on
in
cha
rge
f
or
are
a
with
higher
in
f
ect
ion
(>50%
)
an
d
this
guide
li
nes
is
al
so
str
eng
t
hen
e
d
by
t
he
Mi
nistry
Of
Healt
h
Re
gula
ti
on
nu
m
ber
75
ye
ar
20
14
ap
pe
ndix
sect
ion
cl
early
sta
te
d
that
in
a
ci
ty
,
the
S
TH
e
rad
ic
at
io
n
pro
gr
am
sh
ou
ld
be
est
ablished
b
y
the prim
ary healt
h
care
[
20]
.
The
aut
hor
s
in
vestigat
e
the
r
o
le
of
gove
rnm
ent
insti
tuti
on
(
S
ub
-
d
ist
rict
Office
)
in
a
quest
ionnaire.
A
cl
us
te
r/sub
distr
ic
t
is
def
ine
d
a
s
an
a
rea
of
50
fam
i
li
es
li
ve
su
bse
que
ntly
in
certai
n.
As
2016
,
12
6
f
r
om
1360
cl
us
te
r
a
re
a
pply
ing
“C
le
an
G
reen
an
d
Healt
hy
(C
GH)”.
T
he
CG
H
pro
gra
m
te
nd
to
ha
ve
lowe
r
risk
of
w
or
m
infecti
on
(
p=0.03
7
OR
0.3
95
95%
CI
0.1
67
-
0.930),
esp
eci
al
ly
the
so
ci
al
wo
r
king
m
o
m
ent
to
clean
th
e
env
i
ronm
ent.
The
a
uthor
noti
ce
that
this
pro
gr
am
is
not
integrate
d
w
it
h
PH
C
poli
cy
.
Mostl
y
the
CG
H
pro
gr
am
is
an
inn
at
e
ef
f
or
t
f
r
om
peo
ple
it
se
lf.
I
f
the
C
GH
is
integrate
d
w
it
h
Com
m
un
ity
Healt
h
Ca
re,
ther
e
will
b
e str
ong
po
s
sibil
it
ie
s to e
rad
ic
at
e
wor
m
infecti
on.
The
lo
gisti
c
reg
ressi
on
te
st
sh
o
ws
that
com
m
un
it
y
healt
h
care
an
d
or
al
pro
ph
yl
axis
ar
e
the
m
os
t
influ
e
ncin
g
fa
ct
or
.
T
her
e
for
e,
reco
m
m
end
at
ion
shou
l
d
be
fo
cu
sed
on
these
facto
rs.
A
stud
y
of
Ma
scarin
a
Serr
a
i
n
20
11
and
Jia
T
W
in
2012
rev
e
al
ed
that
an
STH
poli
ci
es
sh
oul
d
at
le
ast
con
sist
s
o
f
regula
r
anthelm
inthic
treatm
ent,
healt
h
ed
ucati
on,
s
anita
ti
on
a
nd
per
s
onal
hygie
ne
an
d
oth
e
r
m
eans
of
prev
ention.
Th
os
e
po
li
ci
es
are li
nier
w
it
h
our res
ults
[
11
]
, [2
1].
5.
CONCL
US
I
O
N
AND REC
OM
MEN
D
A
TION
This
stud
y
sti
ll
has
so
m
e
la
ck
and
nee
d
to
be
i
m
pr
ov
e
d
es
pecial
ly
fo
r
fur
ther
stu
dy.
The
sever
it
y
of
infecti
on
ca
n
be
identifie
d
us
i
ng
eg
g
pe
r
gr
a
m
s
of
sto
ol
ev
enth
ought
it
wi
ll
no
t
a
ff
ect
t
he
ty
pe
of
m
edicat
ion
.
Cl
inica
l
m
anif
est
at
ion
can
be
identifie
d
to
pr
e
dict
the
sever
it
y
of
in
f
ect
ion
an
d
at
tem
pting
ap
p
ropr
ia
t
e
treatm
ent.
A
la
rg
e
r
sam
ple is
exp
ect
e
d for ac
cur
acy
.
Ba
sed
on
this
s
tud
y
resu
lt
s,
the
auth
or
reco
m
m
end
a
n
i
ntegrat
ed
pr
ogram
t
o
dim
inish
ST
H.
The
fir
st
is
creati
ng
s
pe
ci
fic
program
and
a
ppoi
nting
per
s
on
inc
harge
to
be
res
po
ns
ible
f
or
the
pro
gr
am
in
Pr
im
ary
Healt
h
Ca
re.
S
econdly
,
the
pe
rson
in
cha
rge
sh
ould
buil
d
a
pr
ogram
con
sist
of
healt
h
pr
om
otion
of
worm
infecti
on
espec
ia
ll
y
in
school
age.
The
“
Young
D
octo
r”
pro
gr
am
sh
ould
be
rev
ise
d
to
add
worm
infecti
on
con
t
e
nt,
ha
nd
wash
dem
on
str
at
ion
a
nd
the
use
of
footwea
r.
The
P
HC
s
hould
m
ake
a
n
in
te
gr
at
ive
c
omm
un
it
y
healt
h
care
an
d
CGH
pro
gr
a
m
.
The
per
s
on
in
charge
will
identify
the
risk
facto
r
in
po
pu
la
ti
on
an
d
be
com
e
the
ro
le
m
od
el
in
pr
om
oting
healt
h
be
hav
i
our
.
A
sugg
e
sti
on
f
r
om
distri
c
So
ut
h
sai
d,
that
there
sho
ul
d
be
“Hand
Hygien
e”
m
o
m
ent
in
CGH
pro
gr
am
,
so
w
he
n
pe
ople
at
te
nd
ing
m
eet
ing
,
gathe
ring,
sho
uld
begi
n
by
a
br
ie
f
dem
on
str
at
ion
ho
w
to
perform
ro
utin
e
hand
was
h
as
trai
ned
by
the
PH
C
sta
f
f
s.
In
le
vel
of
early
d
et
ect
ion
a
nd
prom
pt
treatm
ent,
the
an
nual
scree
ning
f
or
stud
e
nts
in
ne
w
e
nrolm
ent
sh
ould
inclu
de
t
he
sto
ol
exam
inati
on
if
possi
ble
an
d
f
ollo
wed
by
giv
in
g
pro
ph
yl
axis
dose
with
Albe
ndazole.
An
i
ntegr
at
e
d
Com
m
un
it
y
Healt
h
Ca
re
and
CGH
pro
gra
m
sh
ou
l
d
be
e
xten
ded
t
o
ent
ire
ci
ty
.
The
annual
rate
of
wor
m
infecti
on
can
be
us
ed
a
s
an
e
va
luati
on
of
s
uc
cess
pro
gr
am
.
And
the
a
uthor
cannot
de
ny
that
a
will
ingne
ss
an
d
colle
ct
ive ef
for
t from
ind
ivid
ua
l/
sect
or
in
in
ve
sti
ng
good sa
nitat
ion
play
im
po
rtant role
.
ACKN
OWLE
D
GE
MENTS
The
a
uthor
w
ould
li
ke
t
o
a
ppreciat
e
for
s
upports
a
nd
pe
rm
issi
on
t
o
P
ub
li
c
Healt
h
Office
Ba
li
kp
ap
a
n
Ci
ty
,
The
Pr
im
ary
Healt
h
Ca
r
e,
Sub
-
district
office,
Sc
hools
,
Stud
e
nts
an
d
Pare
nts
that
inv
ol
ved
i
n
this
stud
y
.
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
7
,
No.
2
,
J
une
20
18
:
13
0
–
136
136
Highest
ap
prec
ia
ti
on
is
gi
ven
to
Pr
im
ary
Healt
h
Ca
re
Ma
ngga
r
Ba
r
u
Ba
li
kp
a
pa
n
f
or
bec
om
ing
the
cent
re
f
or
our
st
ud
y.
T
he
se stu
dies are
funde
d
s
olely
by
the au
t
hors
a
nd d
ecl
a
re
no c
onflic
t of inte
r
est
.
REFERE
NCE
S
[1]
W
orld
Hea
lt
h
Or
gani
z
at
ion
.
Soi
l
-
tra
ns
m
it
te
d
hel
m
int
hia
sis
Indone
s
ia
.
htt
p://ww
w.who.i
nt/
neg
lecte
d_d
i
sea
ses/pre
ven
ti
v
e_c
hemother
ap
y/sth/
db/
?
un
it
s=m
ini
m
al
®ion
=a
l
l
&c
ountr
y
=
idn&c
ountri
es=
idn&y
e
ar=
2014
(
acce
ss
ed
27
June
2016
).
[2]
Free
m
an
MC,
Chard
AN
,
Nik
olay
B,
Gar
n
J
V,
Oko
y
o
C
,
K
iha
ra
J
et
al.
“
As
socia
ti
ons
betw
ee
n
school
an
d
household
-
le
v
el
wate
r,
san
it
a
ti
on
and
h
y
gi
ene
co
ndit
ions
and
soi
l
-
tra
n
sm
it
t
ed
helm
int
h
infe
cti
on
among
Ken
y
an
school
ch
il
dre
n
”
,
Journa
l
Of
Parasite
s A
nd
V
ec
to
rs
8,
412
,
2012
.
[3]
Ta
raf
d
er
M,
C
ar
abi
n
H,
Jos
eph
L,
B
al
olong
E,
Olveda
R
,
McG
arv
e
y
S.
,
“
Esti
m
at
ing
th
e
sensi
tivit
y
and
spec
if
ici
t
y
of
Kato
-
Katz
sto
ol
exa
m
ina
t
ion
te
chni
qu
e
for
detec
t
ion
of
hookw
orm
s,
A
sca
ris
lumbricoi
des
and
Tri
chur
is t
ric
hiu
ra
infe
c
ti
ons
in
hum
ans
in
the
abse
nce
of
a
“
gold
standard"
”,
I
nte
rnat
io
na
l
Journal
F
or
Parasitol
ogy
(40):399
-
404
,
20
10.
[4]
Idris
MA
,
Al
-
Jabri
AM
.
,
“
Us
efu
lne
ss
of
Kato
-
Katz
and
tri
chr
om
e
stai
ning
as
dia
gnostic
m
e
t
hods
for
par
asitic
infe
c
ti
ons
in
cl
i
nic
a
l
la
bora
torie
s”
Journal
for
scie
n
ti
fic
researc
h
Me
dic
al
sci
e
nce
s/
Sult
an
Qa
boos
Unive
rs
it
y
,
3(2):65
-
68
,
2002
.
[5]
As
hena
fi
A,
Seid
M.
,
“
Assess
me
nt
of
the
pre
va
le
nc
e
of
int
esti
n
al
par
asi
tosis
and
associa
te
d
ris
k
fac
tor
s
among
primar
y
school
c
hil
dre
n
in
Ch
encha
town
”
,
South
ern
E
thi
opi
a. B
MC Public
(14)
:
166
,
2014
.
[6]
Zi
eg
el
bau
er
K,
Speic
h
B,
Mäusez
ah
l
D,
Bos
R
,
Keise
r
J,
Utzi
nger
J.
,
“
Eff
ec
t
of
sanit
at
ion
on
soil
-
tra
nsm
it
te
d
hel
m
int
h
infe
c
tion: s
y
st
ematic
r
e
vie
w a
nd
m
et
a
-
a
naly
s
is
”,
Hal
es
S,
ed
.
PLoS
Me
d
i
ci
ne
,
9(1)
,
2012
.
[7]
Strunz
EC
,
Add
iss
DG
,
Stocks
ME,
Ogden
S,
Utzi
nger
J,
Fre
e
m
an
MC.
,
“
W
ater,
san
itati
on
,
h
y
gi
ene,
and
soil
-
tra
nsm
it
te
d
hel
m
int
h
Inf
ec
t
ion: A s
y
st
emati
c
rev
iew
and
m
eta
-
an
aly
sis”
,
PLoS
Me
d
(11);3
,
2014.
[8]
Alel
ign
T,
Dega
reg
e
A,
Erko
B.
,
“
Soil
-
tra
nsm
it
t
ed
he
lminth
inf
e
ct
ions
and
assoc
ia
t
ed
risk
f
actor
s
among
school
chi
ldr
en
in
Durb
et
e
Town,
North
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