title: Epidemiology of intestinal polyparasitism among Orang Asli school children in rural Malaysia.
abstract: BACKGROUND
  This cross-sectional study aimed to investigate the current prevalence and risk factors associated with intestinal polyparasitism (the concurrent infection with multiple intestinal parasite species) among Orang Asli school children in the Lipis district of Pahang state, Malaysia.
  
  
  RESULTS
  Fecal samples were collected from 498 school children (50.6% boys and 49.4% girls), and examined by using direct smear, formalin-ether sedimentation, trichrome stain, modified Ziehl Neelsen stain, Kato-Katz, and Harada Mori techniques. Demographic, socioeconomic, environmental, and personal hygiene information were collected by using a pre-tested questionnaire. Overall, 98.4% of the children were found to be infected by at least one parasite species. Of these, 71.4% had polyparasitism. The overall prevalence of Trichuris trichiura, Ascaris lumbricoides, hookworm, Giardia duodenalis, Entamoeba spp., and Cryptosporidium spp. infections were 95.6%, 47.8%, 28.3%, 28.3%, 14.1% and 5.2%, respectively. Univariate and multivariate analyses showed that using an unsafe water supply as a source for drinking water, presence of other family members infected with intestinal parasitic infections (IPI), not washing vegetables before consumption, absence of a toilet in the house, not wearing shoes when outside, not cutting nails periodically, and not washing hands before eating were significant risk factors associated with intestinal polyparasitism among these children.
  
  
  CONCLUSIONS
  Intestinal polyparasitism is highly prevalent among children in the peninsular Malaysian Aboriginal communities. Hence, effective and sustainable control measures, including school-based periodic chemotherapy, providing adequate health education focused on good personal hygiene practices and proper sanitation, as well as safe drinking water supply should be implemented to reduce the prevalence and consequences of these infections in this population.
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Community Medicine, Faculty of Medicine, University of Al-Anbar, Al-Anbar, Iraq.
authors.forename: Ahmed K
authors.initials: AK
authors.lastname: Al-Delaimy
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
authors.forename: Hesham M
authors.initials: HM
authors.lastname: Al-Mekhlafi
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Nasr
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Hany
authors.initials: H
authors.lastname: Sady
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wahib M
authors.initials: WM
authors.lastname: Atroosh
authors.affiliation: Institute of Medical Molecular Biotechnology, Faculty of Medicine, University Teknologi MARA, Jalan Hospital, Sungai Buloh, Selangor, Malaysia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Nashiry
authors.affiliation: Department of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia.
authors.forename: Tengku S
authors.initials: TS
authors.lastname: Anuar
authors.affiliation: Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.
authors.forename: Norhayati
authors.initials: N
authors.lastname: Moktar
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Yvonne A L
authors.initials: YA
authors.lastname: Lim
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Rohela
authors.initials: R
authors.lastname: Mahmud
mesh_terms: D000367:Age Factors; D000818:Animals; D002648:Child; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D006920:Hygiene; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology* / Q000209:etiology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors