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Effect of Deworming Programmes on Soil-Transmitted Helminth Infection among Primary School Children in Nigeria

Abstract

Soil-transmitted helminth infections remain an important public health concern among children in many low- and middle-income countries, including Nigeria. These infections are transmitted through contact with soil contaminated with human faeces and may contribute to anaemia, malnutrition, impaired physical development, abdominal discomfort, weakness, and poor school performance among affected children. Primary school children are particularly vulnerable because of frequent exposure to contaminated environments and inadequate sanitation and hygiene practices. Deworming programmes provide an important public health strategy for reducing the burden of soil-transmitted helminth infections through the periodic administration of effective anthelmintic medicines to eligible populations. Deworming programmes may be implemented through schools, primary healthcare facilities, community outreach activities, and other organized public health platforms. Soil-transmitted helminth infection refers to infection caused by intestinal parasitic worms such as Ascaris lumbricoides, Trichuris trichiura, and hookworms. In Nigeria, persistent challenges related to inadequate sanitation, unsafe water, poor hygiene practices, limited access to healthcare, and inconsistent implementation of deworming programmes may contribute to continued transmission. Against this background, this study investigates the effect of deworming programmes on soil-transmitted helminth infection among primary school children in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Theory, and the Epidemiologic Triad Framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. Social Ecological Theory recognizes that infection prevention is influenced by individual, interpersonal, school, community, environmental, and broader societal factors. The Epidemiologic Triad Framework explains disease occurrence through interactions among the infectious agent, host, and environment and provides a basis for understanding the role of deworming in reducing the burden of parasitic infections. Collectively, these theoretical perspectives provide a suitable framework for explaining how deworming programmes may influence soil-transmitted helminth infection among primary school children in Nigeria. The study will adopt a quantitative quasi-experimental research design. Selected primary schools will participate in a structured deworming programme and will be assessed before and after the intervention. A multistage sampling technique will be used to select states, local government areas, communities, primary schools, and eligible pupils. The deworming programme will involve the administration of appropriate anthelmintic medicines according to established public health guidelines, documentation of treatment, health education, and follow-up assessment. Deworming programme exposure will be assessed using indicators such as programme participation, treatment coverage, frequency of deworming, treatment completion, availability of deworming medicines, programme implementation, and documentation of treated children. Soil-transmitted helminth infection will be assessed through appropriate parasitological testing of stool samples to identify intestinal helminth infections and determine infection prevalence and, where feasible, infection intensity. Laboratory procedures will be conducted using appropriate standard methods, with relevant quality-control procedures. Descriptive statistics will be used to summarize participants' characteristics, deworming coverage, and infection patterns. Inferential statistical techniques, including chi-square tests, paired-sample tests, correlation analysis, and regression analysis, will be used to determine the effect of deworming programmes on soil-transmitted helminth infection. Diagnostic tests will also be conducted to assess the reliability of research instruments and the robustness of the findings. The study is expected to find that effective deworming programmes have a significant positive effect on reducing soil-transmitted helminth infection among primary school children in Nigeria. Children who participate in regular and properly implemented deworming programmes are expected to have lower prevalence of soil-transmitted helminth infections than children with limited or no exposure to deworming interventions. Periodic administration of appropriate anthelmintic medicines may reduce the burden of intestinal worms and decrease the health consequences associated with infection. School-based delivery may also facilitate high treatment coverage by reaching large numbers of children through an established educational platform. Conversely, inadequate deworming coverage, irregular programme implementation, poor treatment documentation, and limited access to medicines may reduce programme effectiveness. However, deworming programmes alone may not eliminate soil-transmitted helminth transmission because reinfection may occur in environments characterized by poor sanitation, unsafe water, inadequate hygiene, and continued exposure to contaminated soil. Therefore, deworming should be implemented alongside sanitation improvement, safe water provision, hygiene education, and other preventive measures. The study is expected to contribute to the literature on deworming programmes, soil-transmitted helminth infections, school health, parasitic diseases, epidemiology, community health, environmental health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, state ministries of education, local government health authorities, primary schools, school health programme coordinators, community health workers, development partners, and policymakers regarding strategies for reducing the burden of intestinal parasitic infections among school-age children. The study will also provide evidence-based recommendations for strengthening school-based deworming programmes, improving treatment coverage, ensuring adequate availability of anthelmintic medicines, strengthening programme monitoring and documentation, conducting appropriate infection surveillance, improving sanitation and hygiene facilities in schools, promoting hand hygiene, and integrating deworming with broader school health and environmental health interventions in Nigeria.

Keywords: Deworming programmes, soil-transmitted helminth infection, primary school children, Nigeria, intestinal parasites, school health, parasitic infections, epidemiology, environmental health, anthelmintic treatment, public health.