Correlation of School-based Albendazole Mass Drug Administration on Malaria and Soil Transmitted Helminths Co-infection in School-aged Children

Abstract

Background: Malaria and Soil-Transmitted Helminth (STH) infections present a significant public health challenge in endemic regions, often occurring together and worsening health outcomes. This cross-sectional study examined the prevalence of the co-infection among school-aged children in the Unwana Community, Ebonyi State, and showed the effects of school-based Albendazole Mass Drug Administration (MDA). Methods: A total of 249 pupils from three constituencies in the community were sampled between June and August 2025. Malaria was diagnosed using Rapid Diagnostic Tests (RDTs), while STH infections were identified in stool samples using standard techniques. Data on MDA receipt, socio-economic factors, and preventive measures were gathered through a questionnaire. Additionally, health center records on community MDA were collected. Results: The overall prevalence of infections was 38.6% (n=96) for malaria, 36.5% (n=91) for STH, and 7.2% (n=18) for co-infection. The STHs identified included Ascaris lumbricoides, Trichuris trichiura, and hookworm. A. lumbricoides had the highest prevalence at 16.5% (n=41). Double STH infections included A. lumbricoides-hookworm (2.4%, n=6), A. lumbricoides-T. trichiura (2.8%, n=7), and T. trichiura-hookworm (1.2%, n=3). Significant associations were found between malaria, STH infections, and the demographics of the schoolchildren (P<0.05); however, there was no association between co-infection and the demographics of the children (P>0.05). Not receiving Albendazole at school was identified as the only significant factor influencing malaria-STH co-infection (Adjusted Odds Ratio = 3.760, P = 0.042). Analysis of health center records revealed inconsistencies in community-level Albendazole MDA, with only the U.C.P.S 2 constituency receiving doses in 2021, 2022, and 2023. Conclusion: The prevalence of co-infection indicates an ongoing public health challenge within the community. Additionally, the significant risk factor identified for malaria and STH co-infection suggests that implementing school-based mass drug administration (MDA) could be a more effective strategy for controlling STH among school-aged children in Unwana.