This study focused on the prevalence and determinants of soil-transmitted helminthiasis (STH) infestation among pregnant women attending ANC follow-up in the West Dembia district. Nearly one-fourth of the study subjects had STH in the Dembia district. According to the Ministry of Health (MoH) STH endemic area classification, there are three categories including high transmission areas (prevalence rate > 50%), moderate transmission areas (prevalence rate in between 20% − 50%), and low transmission areas (less than 20% prevalence). According to WHO recommendation, moderate transmission areas of soil-transmitted helminthiasis need annual treatment (11).
This finding is comparable with the global soil-transmitted helminthiasis (STH) prevalence (24%) report (12), studies finding obtained from Hosanna town (29.5%) (13), Felegehiwot Hospital (31.5%) (14), and Wollega district (24.7%)(15). However, the current finding is lower than studies conducted in Mecha district (70.6%) (16), and Maytsebri primary hospital (51%) (17).
The reason for this discrepancy might be attributed to hygiene sanitation activities and latrine coverage variation. Latrine coverage and handwashing with soap in Maytsebri was 50.9% and 22.3% respectively, whereas in the current study the coverage of latrine and handwashing with soap was 75.5% and 41.3% respectively. The current study finding is also lower than the studies result obtained from Bogota, Colombia (41%) (18), Lalo Kile, Oromia region (43.8%) (19), and West Gojjam, Amhara region (37.3%) (20). The reason for this discrepancy might be due to differences in environmental and socioeconomic characteristics of study participants. This finding is higher than studies obtained from Logos, Nigeria (8.3%) (21), Kilifi hospital, Kenya (16.75%) (22). The reason for this discrepancy might be the variation of latrine and proper handwashing practice coverage, which was 87% and 67% respectively in study Kenya, 100% and 92% in the study obtained from Nigeria, whereas 75.5% and 41% in the current study.
Residence, latrine utilization, using soap to hand washing, eating raw vegetables, and habit of soil eating were significantly associated with soil-transmitted helminthiasis infestation.
Being a rural resident was associated with increased odds of developing soil-transmitted helminthiasis infestation. This finding agrees with studies conducted in Mecha district (16), East Wollega, Oromia region (15), and West Gojam zone (20). This might be pregnant women in rural areas who always work on contaminated soil barefoot which is risky to STH infestation. Moreover, pregnant women living in rural areas had poor personal and environmental sanitation practices, low educational status, and lack of awareness as a result, the possibility of being infected by intestinal parasitic infection is high.
Latrine usage was significant associated with soil-transmitted helminthiasis in pregnant women. Pregnant women who had sometimes and never used latrine were more likely at risk to soil-transmitted helminthiasis infestation when compared to always latrine used. This finding in line with studies conducted in Kenya (22), West Gojam (20), and Wollega (15). That latrine utilization prevents the contamination of the soil with human faces which contain infective eggs or larvae.
The report of this study also revealed that using soap for handwashing is another determinant factor to soil-transmitted helminthiasis, women who did not use soap for handwashing were more likely to be infected, this result is consistent with studies done in Kenya (22), Maytsebri district (17), Mecha (16), and Lalo kilie (19). That proper handwashing practice breaks the chain of transmission for intestinal parasites.
The odds of soil-transmitted helminthiasis infestation were higher among pregnant women who had a habit of eating raw vegetables. This finding is comparable to the studies conducted in Kenya (22), Wollega (15), West Gojam, Amhara region (20), and Mecha district (16). This may be due to that raw vegetable acts as a vehicle for transporting the infective parasites. Similarly, the odds of infection were higher among pregnant women who have a habit of eating soil. This result is consistent with the studies conducted in Maytsebri district (17), Tigray region, and west Gojam zone, Amhara region (20). That the fecal contaminated soil may enter into the body and cause the disease (23).
Over 50% of pregnant women in low- and middle-income countries suffer from anemia, and helminthiasis is a major contributory cause in endemic areas. Soil-transmitted helminths cause iron deficiency anemia by feeding blood and reduce the absorption of iron and other nutrients by causing anorexia, vomiting, and diarrhea.
A single stool specimen was used to assess soil-transmitted helminthiasis infestation status which may underestimate the prevalence rate. The participant was only those pregnant women who came to health facilities to utilize the ANC service, this makes difficult for the generalization of the study findings.