Intestinal helminth infection among school-aged children and adolescents in Khammouane province: A neglected public health concern.

Intestinal helminth infection in children remains a significant public health concern. In Lao People's Democratic Republic various water (Lao PDR), sanitation and hygiene (WASH) interventions were implemented. This study aims to assess the infection burden of intestinal helminths in children and adolescents and explore association with different WASH levels in Khammouane province. A cross-sectional study was conducted in 81 villages across three districts with prior WASH interventions in Khammouane province. Stool samples were collected from households members aged 5 - 17 years. Data was collected from parents/caregivers regarding demography, and potential risk factors. Intestinal helminth infections were detected using formalin-ethyl acetate concentration technique (FECT). Random effect logistic regression identified factors associated with infections. Among 512 participants, 12.5% had multiple intestinal helminth species infections. Opisthorchis viverrini was the most prevalent infection (35.4%), followed by hookworm (30.3%) and minute intestinal flukes (11.3%). District of residence, sex and wealth index measurement were significantly associated with intestinal helminth infection, e.g. O. viverrini was significantly associated with living in Boualapha (OR = 5.9, 95% CI = 2.2 - 20.9) or Mahaxai district (OR = 12.8, 95%CI =4.9 - 44.1). WASH levels were not statistically significant predictors of helminth infections. Children and adolescents in Khammouane province, Lao PDR, have a high burden of intestinal helminth infection, particularly O. viverrini and hookworm. Socio-demographics factors (district, sex and wealth measurement) were the most important predictors of helminth infections. Comprehensive control programs, including species-specific strategies such as safe food handling and proper cooking, are essential to reduce infection risk in this vulnerable population.