Tracing Strongyloides stercoralis transmission and risk factors from schoolchildren to household in Northwest Ethiopia
5 affiliations
- 1Department of Medical Parasitology and Entomology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia
- 2Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia
- 3Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia
- 4Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia
- 5Department of Biology, Science College, Bahir Dar University, Bahir Dar City, Ethiopia
Abstract
Background: Strongyloides stercoralis is a neglected soil-transmitted helminth with a complex life cycle that enables both autoinfection and environmental transmission. Despite its public health importance, the burden and transmission dynamics of strongyloidiasis remain poorly understood in endemic settings such as Ethiopia, particularly at the household level. Hence, this study aimed to trace the transmission of S. stercoralis and associated factors from infected schoolchildren to their households in Northwest Ethiopia. Methodology: A school-based cross-sectional study was conducted from 2024 to 2025 in Northwest Ethiopia. A total of 273 schoolchildren were randomly selected from three schools and screened for S. stercoralis. Children who tested positive were considered index cases, and all consenting household members were subsequently screened. Stool samples were examined using Kato-Katz, the Baermann concentration technique, and agar plate culture. Data on socio-demographic characteristics and potential risk factors were collected using structured questionnaires. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with infection. Findings: Out of 273 school children screened, the prevalence of S. stercoralis was 22.7%. Among 80 household members examined, 71.3% were infected with S. stercoralis. School children who lived in houses with mud floors (AOR = 2.91; p = 0.019), had close contact with dogs (AOR = 2.54; p = 0.006), lived in areas with clay soil (AOR = 2.98; p = 0.036), participated in irrigation activities (AOR = 3.72; p = 0.008) and wore shoes (AOR = 3.67; p = 0.017) were significantly associated with S. stercoralis infection. Conclusions: This study demonstrates a substantial burden of S. stercoralis infection among schoolchildren and an exceptionally high prevalence among their household members. The findings underscore the importance of environmental, behavioral, and zoonotic factors in sustaining transmission. These results emphasize the urgent need for integrated control strategies to include household-level screening and treatment. Author summary: This study aimed to investigate the transmission dynamics and risk factors of Strongyloides stercoralis infection among schoolchildren and family members of infected children in Northwest Ethiopia. Samples of stool were collected from both groups and examined by standard parasitological diagnostic techniques. Results showed a high infection burden in schoolchildren and a significantly higher prevalence in their household members, providing strong evidence for household clustering of infection. Several risk factors were identified, including living in houses with mud floors, close contact with dogs, playing with soil, and types of soil. Moreover, important behavioral determinants that contributed to exposure included lack of proper frequency of latrine utilization, participation in irrigation activities, and inconsistent shoe wearing. The findings underscore that a combination of environmental contamination and behavioural practices within households and communities contributes to transmission of S. stercoralis. The study indicates the need for integrated control strategies, including sanitation improvement, health education, and behavioural change accompanied by community-based deworming interventions targeting children and their family members.
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BibTeX
@article{hailu2026tracing,
title = {{Tracing Strongyloides stercoralis transmission and risk factors from schoolchildren to household in Northwest Ethiopia}},
author = {Tadesse Hailu and Getaneh Alemu and Anemen Ayehu and Hiwot Tadesse and Zelalem Mehari and Hilina Motbainore and Genet Gedamu and Endalkachew Nibret},
journal = {PLOS Neglected Tropical Diseases},
year = {2026},
month = nov,
doi = {10.1371/journal.pntd.0014857},
url = {https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014857},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Tracing Strongyloides stercoralis transmission and risk factors from schoolchildren to household in Northwest Ethiopia
AU - Tadesse Hailu
AU - Getaneh Alemu
AU - Anemen Ayehu
AU - Hiwot Tadesse
AU - Zelalem Mehari
AU - Hilina Motbainore
AU - Genet Gedamu
AU - Endalkachew Nibret
PY - 2026
DA - 2026/11/02
JO - PLOS Neglected Tropical Diseases
DO - 10.1371/journal.pntd.0014857
UR - https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014857
AB - Background: Strongyloides stercoralis is a neglected soil-transmitted helminth with a complex life cycle that enables both autoinfection and environmental transmission. Despite its public health importance, the burden and transmission dynamics of strongyloidiasis remain poorly understood in endemic settings such as Ethiopia, particularly at the household level. Hence, this study aimed to trace the transmission of S. stercoralis and associated factors from infected schoolchildren to their households in Northwest Ethiopia. Methodology: A school-based cross-sectional study was conducted from 2024 to 2025 in Northwest Ethiopia. A total of 273 schoolchildren were randomly selected from three schools and screened for S. stercoralis. Children who tested positive were considered index cases, and all consenting household members were subsequently screened. Stool samples were examined using Kato-Katz, the Baermann concentration technique, and agar plate culture. Data on socio-demographic characteristics and potential risk factors were collected using structured questionnaires. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with infection. Findings: Out of 273 school children screened, the prevalence of S. stercoralis was 22.7%. Among 80 household members examined, 71.3% were infected with S. stercoralis. School children who lived in houses with mud floors (AOR = 2.91; p = 0.019), had close contact with dogs (AOR = 2.54; p = 0.006), lived in areas with clay soil (AOR = 2.98; p = 0.036), participated in irrigation activities (AOR = 3.72; p = 0.008) and wore shoes (AOR = 3.67; p = 0.017) were significantly associated with S. stercoralis infection. Conclusions: This study demonstrates a substantial burden of S. stercoralis infection among schoolchildren and an exceptionally high prevalence among their household members. The findings underscore the importance of environmental, behavioral, and zoonotic factors in sustaining transmission. These results emphasize the urgent need for integrated control strategies to include household-level screening and treatment. Author summary: This study aimed to investigate the transmission dynamics and risk factors of Strongyloides stercoralis infection among schoolchildren and family members of infected children in Northwest Ethiopia. Samples of stool were collected from both groups and examined by standard parasitological diagnostic techniques. Results showed a high infection burden in schoolchildren and a significantly higher prevalence in their household members, providing strong evidence for household clustering of infection. Several risk factors were identified, including living in houses with mud floors, close contact with dogs, playing with soil, and types of soil. Moreover, important behavioral determinants that contributed to exposure included lack of proper frequency of latrine utilization, participation in irrigation activities, and inconsistent shoe wearing. The findings underscore that a combination of environmental contamination and behavioural practices within households and communities contributes to transmission of S. stercoralis. The study indicates the need for integrated control strategies, including sanitation improvement, health education, and behavioural change accompanied by community-based deworming interventions targeting children and their family members.
SN - 1935-2735
ER -