• Adilah Aminuddin Department of Public Health, RCSI & UCD Malaysia Campus, 4, Jalan Sepoy Lines, Georgetown, Pulau Pinang, Malaysia; Klinik Kesihatan Bayan Lepas, Jalan Dato Ismail Hashim Bayan Lepas, 11900, Pulau Pinang, Malaysia
  • Hassan Basri Jahubar Sathik Department of Public Health, RCSI & UCD Malaysia Campus, 4, Jalan Sepoy Lines, Georgetown, Pulau Pinang, Malaysia; University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000, Cyberjaya, Malaysia
  • Hani Syifaa Mohd Hashim Department of Public Health, RCSI & UCD Malaysia Campus, 4, Jalan Sepoy Lines, Georgetown, Pulau Pinang, Malaysia
  • Abdul Rashid Khan Department of Public Health, RCSI & UCD Malaysia Campus, 4, Jalan Sepoy Lines, Georgetown, Pulau Pinang, Malaysia
  • Siti Fatimah Kaider Maideen Department of Public Health, RCSI & UCD Malaysia Campus, 4, Jalan Sepoy Lines, Georgetown, Pulau Pinang, Malaysia
Keywords: Soil transmitted helminth, Helminthiasis, Environmental factors, Boarding school, Children, Orang Asli, Prevalence, Malaysia


Soil transmitted helminth (STH) infection is a major public health concern among the indigenous children of Malaysia. Precarious living conditions at home including unavailability of water, drinking of contaminated water, poor sanitation and livestock presence, are known risk factors for the infection. In order to provide better living conditions, these children are enrolled in boarding schools. This study was conducted to determine whether boarding schools is a solution in reducing soil transmitted helminth infection among Orang Asli children in Sg Siput, Perak, Malaysia. An analytical cross-sectional study was conducted among 204 schoolchildren aged 7-17 years from three boarding schools in Sungai Siput, Perak from January to March 2017. Stool samples were collected and examined using direct smear and Kato-Katz technique. Information on sociodemographic and environmental conditions were collected using a modified Demographic Health Survey (DHS) questionnaire. Data analysis was done using IBM SPSS Statistics Processor 20.0.Out of a total of 204 children, only 48% (n= 97) were infected with at least one type of STH species which showed a reduced prevalence as compared to previous studies conducted among home dwelling schoolchildren with overall prevalence of 78-97%. Majority of the children had monoparasitism (31%; n=63) with moderate intensity by T trichuira (n=51, 25%). Univariate analysis shows that unavailability of water at home has a statistically significant association with STH infection among boarding school children (OR=0.73; 95% CI= 0.56-0.95 p=0.021). Multivariate analysis proves children who had unavailability of water at home has 2.1 times more likelihood of getting an STH infection (OR= 2.08; 95%CI= 1.07-4.07; p= 0.032).This study demonstrates a reduced STH prevalence among Orang Asli boarding school children as better living condition there limits the spread of STH infection among them.


WHO. 2016. Soil Transmitted Helminth Infections Fact Sheet. Available: (Accessed Nov 18 2016).

Kattula D, Sarkar R, Ajjampur SSR, et al. Prevalence & Risk Factors for Soil Transmitted Helminth Infection among School Children in South India. The Indian Journal of Medical Research, 2014; 139(1): 76–82.

Van Der Hoek W, De N, Konradsen F, et al. Current Status of Soil-Transmitted Helminths in Vietnam. The Southeast Asian Journal of Tropical Medicine and Public Health 2003; 34, 1-11.

Hotez PJ & Kamath A. Neglected Tropical Diseases in Sub-Saharan Africa: Review of Their Prevalence, Distribution, and Disease Burden. PLoS Neglected Tropical Diseases 2009; 3(8): e412

Bethony J, Brooker S, Albonico M, et al. Soil-transmitted Helminth Infections: Ascariasis, Trichuriasis, and Hookworm. Lancet 2006 367(9521):1521-32

Norfariza Hanim K. 2008. Department of Statistics, Malaysia. Orang Asli in Peninsular Malaysia, Population and Housing Census of Malaysia 2000. Monograph Series No.3 ed. Putrajaya: Department of Statistics

Anuar TS, Salleh FM & Moktar N. Soil-Transmitted Helminth Infections and Associated Risk Factors in Three Orang Asli tribes in Peninsular Malaysia. Sci Rep 2014 4; 4101.

Brooker S, Clements ACA & Bundy DAP. Global Epidemiology, Ecology And Control Of Soil-Transmitted Helminth Infections. Adv Parasitol 2006 62:221-61.

Al-Delaimy A, Hesham M, Lim Y, et al. Developing And Evaluating Health Education Learning Package (HELP) to Control Soil-Transmitted Helminth Infections Among Orang Asli Children in Malaysia. Parasites and Vectors 2014; 7:416

Hotez PJ, Bundy DA, Beegle K, et al. Helminth infections: Soil-Transmitted Helminth Infections And Schistosomiasis. In:Disease Control Priorities in Developing Countries. 2nd edition. Washington (DC): The International Bank for Reconstruction and Development, The World Bank; 2006. Chapter 24

Wang X, Zhang L, Luo R, et al. Soil-transmitted Helminth Infections and Correlated Risk Factors in Preschool and School-aged Children in Rural Southwest China. PLoS One 2012; 7(9), e45939.

Masron T, Masami F & Ismail N. Orang Asli in Peninsular Malaysia: Population, Spatial Distribution and Socio-Economic Condition. Journal of Ritsumeikan Social Sciences and Humanities 2013;6:75-115

Rusaslina I. 2013. Left Behind: The Orang Asli under the New Economic Policy, Singapore, NUS Press & SIRD & ISEAS Publishing.

JAKOA 2014. Bilangan Kampung dan Penduduk Orang Asli Mengikut Negeri, 2014. In: Jabatan Kemajuan Orang Asli. (assessed May 2017)

NguI R, Ishak S, Chuen CS, et al. Prevalence and Risk Factors of Intestinal Parasitism in Rural and Remote West Malaysia. PLoS Neglected Tropical Diseases, 2011; 1; 5(3):e974.

Noor Azian M, San Y, Gan C, et al. Prevalence of Intestinal Protozoa in an Aborigine Community in Pahang, Malaysia. Tropical Biomedicine, 2007;24(1):55-62

Ahmed A, Al-Mekhlafi HM, Al-Adhroey AH, et al. The Nutritional Impacts of Soil-Transmitted Helminths Infections Among Orang Asli Schoolchildren in Rural Malaysia. Parasites & vectors 2012 1;5(1):119.

Montresor A, Crompton DW, Hall A, et al. Guidelines for the Evaluation of Soil-Transmitted Helminthiasis and Schistosomiasis at Community Level. Geneva: World Health Organization, 1998; 1-49.

DHS 2016. Demographic and Health Surveys; (Accessed Nov 25 2016)

Loewenthal KM. An Introduction to Psychological Tests And Scales, Psychology Press.

Bendel RB & Afifi AA. Comparison of Stopping Rules in Forward "Stepwise" Regression. Journal of the American Statistical Association, 1977; 72:46-53.

Elyana FN, Al-Mekhlafi HM, Ithoi I, et al. A Tale Of Two Communities: Intestinal Polyparasitism Among Orang Asli and Malay Communities in rural Terengganu, Malaysia. Parasite Vectors 2016; 9:398.

Wong WK, Foo PC, Roze MNM, PIM CD, et al. Helminthic Infection and Nutritional Studies among Orang Asli Children in Sekolah Kebangsaan Pos Legap, Perak. Canadian Journal of Infectious Diseases and Medical Microbiology, 2016.

Al-Delaimy AK, Al-Mekhlafi HM, Nasr NA, et al. Epidemiology Of Intestinal Polyparasitism Among Orang Asli School Children in Rural Malaysia. PLoS Negl Trop Dis 2014 Aug 21;8(8):e3074

Nasr NA, Al-Mekhlafi HM, Ahmed A, et al. Towards an Effective Control Programme of Soil-Transmitted Helminth Infections among Orang Asli in Rural Malaysia. Part 1: Prevalence and associated key factors. Parasites & Vectors 2013; 6,27.

Ahmed A, Al-Mekhlafi H, Azam M, et al. Soil-Transmitted Helminthiasis: A Critical But Neglected Factor Influencing School Participation of Aboriginal children in rural Malaysia. Parasitology 2012; 139(6):802-8.

Kroeger A, Schulz S, Witte B, et al. Helminthiasis and Cultural Change in the Peruvian Rainforest. Journal of Tropical Medicine and Hygiene, 1992; 95(2):104-13

Monárrez-Espino J, Pérez-Espejo CR, Vázquez-Mendoza G, et al. Intervention to Prevent Intestinal Parasitic Reinfections among Tarahumara Indigenous Schoolchildren in Northern Mexico. Revista Panamericana de Salud Pública,2011; 30, 196-203.

Muslim A, Mohd Sofian S, Shaari SA, et al. Prevalence, Intensity and Associated Risk Factors of Soil Transmitted Helminth Infections: A Comparison between Negritos (indigenous) in Inland Jungle and those in Resettlement at Town Peripheries. PLOS Neglected Tropical Diseases 2019; 22;13(4):e0007331

Park MJ, Laksono B, Clements A, et al. Worm-free children: an Integrated Approach to Reduction Of Soil-Transmitted Helminth Infections in Central Java. Reviews on Environmental Health 2016; 31(1):111-113

Mohd-Shaharuddin N, Lim YAL, Hassan NA, et al. Soil-transmitted helminthiasis among indigenous communities in Malaysia: Is this the endless malady with no solution. Tropical Biomedicine, 2018; 35(1), pp.168-180.

Ngui R, Aziz S, Chua KH, et al. Patterns and risk factors of soil-transmitted Helminthiasis among Orang Asli subgroups in Peninsular Malaysia. The American Journal of Tropical Medicine and Hygiene, 2015; 93(2), pp.361-370

Freeman M, Chard A, Nikolay B, et al. Associations between School-and Household-Level Water, Sanitation And Hygiene Conditions And Soil-Transmitted Helminth Infection among Kenyan School Children. Parasites & vectors 2015; 8: 412.

Anuar TS, Al-Mekhlafi HM, Ghani MK, et al. Giardiasis among Different Tribes of Orang Asli in Malaysia: Highlighting the Presence of Other Family Members Infected with Giardia Intestinalis as a Main Risk Factor. International Journal for Parasitology, 2012; 1;42(9):871-80.35.

Khor G & Zalilah M. The Ecology of Health and Nutrition of Orang Asli (Indigenous People) Women and Children in Peninsular Malaysia. Tribes and Tribals, 2008; 2, 66-77.

Senay H, MacPherson D. Parasitology: Diagnostic Yield of Stool Examination. Canadian Medical Association Journal. 1989; 140:1329–1331

Atef H, Samia M, Ibrahim A, et al. Intestinal Parasite Infections and Accuracy of Direct Thin and Thick Smear, Formol- Ether Sedimentation, Centrifugal Flotation, and Mini FLOTAC Techniques Among Patients with Gastrointestinal Tract Disorders from the Greater Ciro Region, Egypt. The American Journal of Tropical Medicine and Hygiene, 2017; 96(3):589-594.

Oguoma V, Ekwunife C. The Need for a Better Method: Comparison of Direct Smear and Formol-Ether Concentration Techniques in Diagnosing Intestinal Parasites. International Journal of Tropical Medicine, 2006; 3:1–6.

How to Cite
Aminuddin, A., Jahubar Sathik, H. B., Mohd Hashim , H. S., Abdul Rashid Khan, & Kaider Maideen , S. F. (2020). BOARDING SCHOOL: A SIMPLE APPROACH TO REDUCE SOIL TRANSMITTED HELMINTH INFECTIONS IN ORANG ASLI CHILDREN OF SUNGAI SIPUT, PERAK, 2017. Malaysian Journal of Public Health Medicine, 20(3), 195-204.