Hidden in plain sight: Urban playgrounds as potential reservoirs of soil-transmitted helminths

Authors

  • Mohd Adilin Bin Yaacob Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia, No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia Author
  • Aqidah Kep Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia, No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia Author
  • Cheng Kheng Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia, No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia Author
  • Noorazian Md Yusuf Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia, No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia Author
  • Nurhainis Ogu Salim Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia, No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia Author
  • Adela Ida Anak Jiram Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia, No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia Author

DOI:

https://doi.org/10.63719/imrj.2026.01(SE).02

Keywords:

Soil Transmitted Helminths (STH), urban playground, Polymerase Chain Reaction (PCR)

Abstract

Neglected soil-transmitted helminthiases (STHs) remain an underrecognized public health concern in Malaysia, particularly in urban environments where exposure risks are often underestimated. This study assessed the prevalence and species diversity of helminth egg contamination in urban neighbourhood playgrounds in Shah Alam, Malaysia. A total of 84 soil samples and 15 faecal samples were collected and examined microscopically for helminth ova, followed by species-specific polymerase chain reaction (PCR) to identify parasites of public health significance. Helminth ova were detected in 50.0% (42/84) of soil samples, with contamination rates ranging from 47.0% to 60.0% across sampling sites. Faecal samples showed a higher positivity rate of 73.3% (11/15). Hookworms and unidentified helminth ova predominated in both sample types, with mixed infections more frequently observed in faecal samples. Among microscopy-positive soil samples, PCR detected Ascaris lumbricoides in one sample (2.4%) and Strongyloides stercoralis in one sample (2.4%), while most samples (95.2%) remained PCR-negative and were classified as unidentified species. In faecal samples, Ancylostoma duodenale was predominant (63.7%), followed by Trichuris trichiura (27.3%) and S. stercoralis (9.1%). Soil physicochemical analysis showed that most contaminated soils were acidic (85.7%, pH < 7.0) with low moisture content (61.9%, <10%), while loamy soils had the highest contamination rate (72.1%). These findings highlight urban playgrounds as potential reservoirs for STH transmission an emphasise the need for improved surveillance and targeted public health interventions in urban communities.

References

World Health Organization. Soil-transmitted helminth infections [Internet]. Geneva: World Health Organization; 2023 [cited 2026 Jan 16]. Available from: https://www.who.int/news-room/factsheets/detail/soil-transmitted-helminth-infections

Murphy E, Togbevi IC, Ibikounlé M, Avokpaho EFGA, Walson JL, Means AR. Soil-transmitted helminth surveillance in Benin: a mixed-methods analysis of factors influencing non-participation in longitudinal surveillance activities. PLoS Negl Trop Dis. 2023;17: e0010984. doi: 10.1371/journal.pntd.0010984.

Salam N, Azam S. Prevalence and distribution of soil-transmitted helminth infections in India. BMC Public Health. 2017; 17(1):201. doi: 10.1186/s12889-017-4113-2.

World Health Organization. Preventive chemotherapy in human helminthiasis. Coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers. Geneva: World Health Organization; 2006.

Parija SC, Chidambaram M, Mandal J. Epidemiology and clinical features of soil-transmitted

helminths. Trop Parasitol. 2017;7(2):81-85. doi: 10.4103/tp.TP_27_17.

Mohd Zain SN, Rahman R, Lewis JW. Stray animal and human defecation as sources of soiltransmitted helminth eggs in playgrounds of Peninsular Malaysia. J Helminthol. 2015;89(6):740-7. doi: 10.1017/S0022149X14000716.

Nisha M, Amira NA, Nadiah N, Davamani F. Detection of Ascaris lumbricoides and Trichuris trichiura in various soil types from an indigenous village in Malaysia. Trop Biomed. 2019;36(1):201-208.

Debbra M, Zary S, Erwana SAI, Azima Laili H, Nurulaini R, Adana M, et al. Contamination of soil with Toxocara eggs in several playgrounds of Ipoh Perak. Malays J Vet Res. 2018;9(2):74-82.

Oyebamiji DA, Ebisike AN, Egede JO, Hassan AA. Knowledge, attitude and practice with respect to soil contamination by soil-transmitted helminths in Ibadan, Southwestern Nigeria. Parasite Epidemiol Control. 2018;3(4): e00075. doi: 10.1016/j.parepi. 2018.e00075.

Matras A, Stasiak A, Chmielewski T, Kaczmarek A. Testing of sand from recreational areas and sandpits in Warsaw, for presence of Ascaris lumbricoides and Toxocara spp. Przegl Epidemiol. 2023;77(1):53-58. doi: 10.32394/pe.77.05.

Lorenzo-Rebenaque L, López-Fernández S, Marco-Jiménez F, Montoro-Dasi L, Marin C, Vega S, et al. Zoonotic parasites in playgrounds in Southern Spain: a One Health approach. Microorganisms. 2023;11(3):721. doi: 10.3390/microorganisms11030721.

Pacheco-Ortega GA, Chan-Pérez JI, Ortega-Pacheco A, Guzmán-Marín E, Edwards M, Brown MA, et al. Screening of zoonotic parasites in playground sandboxes of public parks from subtropical Mexico. J Parasitol Res. 2019; 2019:7409076. doi: 10.1155/2019/7409076.

Gharpure R, Perez A, Miller AD, Wikswo ME, Silver R, Hlavsa MC. Cryptosporidiosis outbreaks- United States, 2009-2017. MMWR Morb Mortal Wkly Rep. 2019;68(25):568-572. doi:10.15585/mmwr.mm6825a3.

Chatziprodromidou IP, Chatziantoniou S, Vantarakis G, Vantarakis A. Risk factor analysis of

children's exposure to microbial pathogens in playgrounds. Risk Anal. 2022;42(2):334-343. doi: 10.1111/risa.13752.

Azian MY, Sakhone L, Hakim SL, Yusri MY, Nurulsyamzawaty Y, Zuhaizam AH, Rodi IM, Maslawaty MN. Detection of helminth infections in dogs and soil contamination in rural and urban areas. Southeast Asian J Trop Med Public Health. 2008 Mar;39(2):205-12.

Paller VGV, de Chavez ERC. Toxocara (Nematoda: Ascaridida) and other soil-transmitted helminth eggs contaminating soils in selected urban and rural areas in the Philippines. Sci World J. 2014;2014: 386232 doi: 10.1155/2014/386232.

Lesikar BJ, Hallmark C, Melton R, Harris B. On-site wastewater treatment systems: soil particle analysis procedure. College Station (TX): Texas A&M University System; 2005. p. 9-12.

Olabiyi TI, Olayiwola AO, Oyediran GO. Influence of soil texture on distribution of phytonematodes in South Western Virginia. World J Agric Sci. 2009;5(5):557-560.

Ritchie LS. An ether sedimentation technique for routine stool examinations. Bull US Army Med Dep. 1948;8(4):326.

Hassan NA, Badi FAN, Mohd-Shaharuddin N, Yusoff WSW, Lim YAL, Chua KH, et al. A conventional multiplex PCR for the detection of four common soil-transmitted nematodes in human feces: development and validation. Trop Biomed. 2022;39(1):135-143. doi: 10.47665/tb.39.1.016.

Moghaddassani H, Mirhendi H, Hosseini M, Rokni M, Mowlavi G, Kia E. Molecular diagnosis of Strongyloides stercoralis infection by PCR detection of specific DNA in human fecal samples. Iran J Parasitol. 2011;6(2):23-30.

Wang Z, Shibata M, Nguyen YTH, Hayata Y, Nonaka N, Maruyama H, et al. Development of nested multiplex polymerase chain reaction (PCR) assay for the detection of Toxocara canis, Toxocara cati and Ascaris suum contamination in meat and organ meats. Parasitol Int. 2018;67(5):622-626. doi: 10.1016/j.parint.2018.06.006.

Jasim HJ, Al-Amery AM. Molecular detection and phylogenetic analysis of Fasciola gigantica

isolated from buffaloes at Al-Muthanna Province, Iraq. Iraqi J Agric Sci. 2025;56(4):1342-1351. doi: 10.36103/1q18gs38.

Sinniah B, Sabaridah I, Soe MM, Sabitha P, Awang IPR, Ong GP, et al. Determining the prevalence of intestinal parasites in three Orang Asli (Aborigines) communities in Perak, Malaysia. Trop Biomed. 2012;29(2):200-206.

Anuar TS, Salleh FM, Moktar N. Soil-transmitted helminth infections and associated risk factors in three Orang Asli tribes in Peninsular Malaysia. Sci Rep. 2014; 4:4101. doi: 10.1038/srep04101.

Ngui R, Aziz S, Chua KH, Roslan MA, Lee SC, Tan TK, et al. Patterns and risk factors of soil-transmitted helminthiasis among Orang Asli subgroups in Peninsular Malaysia. Am J Trop Med Hyg. 2015;93(2):361-370. doi: 10.4269/ajtmh.13-0677.

Gaspard P, Ambolet Y, Schwartzbrod J. Urban sludge reused for agricultural purposes: soils

contamination and model development for the parasitological risk assessment. Bull Acad Natl Med. 1997;181(1):43-57.

Gerba CP, Smith JE Jr. Sources of pathogenic microorganisms and their fate during land application of wastes. J Environ Qual. 2005;34(1):42-48.

Mawrie UG, Kharkongor R, Valladares MM, Kepha S, Ajjampur SSR, Sarkar R, et al. The occurrence of cross-host species soil-transmitted helminth infections in humans and domestic/livestock animals: a systematic review. PLOS Glob Public Health. 2025;5(8): e0004614. doi: 10.1371/journal.pgph.0004614.

Ko PP, Suzuki K, Canales-Ramos M, Htwe MPPTH, Htike WW, Yoshida A, et al. Phylogenetic relationships of Strongyloides species in carnivore hosts. Parasitol Int. 2020; 78:102151. doi: 10.1016/j.parint.2020.102151.

Barratt JLN, Lane M, Talundzic E, Richins T, Robertson G, Formenti F, et al. A global genotyping survey of Strongyloides stercoralis and Strongyloides fuelleborni using deep amplicon sequencing. PLoS Negl Trop Dis. 2019;13(9): e0007609. Doi: 10.1371/journal.pntd.0007609.

Eslahi AV, Badri M, Nahavandi KH, Houshmand E, Dalvand S, Riahi SM, et al. Prevalence of strongyloidiasis in the general population of the world: a systematic review and meta-analysis. Pathog Glob Health. 2021;115(1):7-20. doi: 10.1080/20477724.2020.1851922.

Al-Mekhlafi HM, Nasr NA, Lim YAL, Elyana FN, Sady H, Atroosh WM, et al. Prevalence and risk factors of Strongyloides stercoralis infection among Orang Asli schoolchildren: new insights into the epidemiology, transmission and diagnosis of strongyloidiasis in Malaysia. Parasitology. 2019;146(12):1602-1614. doi: 10.1017/S0031182019000945.

Barkati S, Naeem F, Hales L, Quan C, Libman M. Strongyloides stercoralis prevalence in solid-organ and haematopoietic stem cell transplant candidates and recipients: a systematic review and metaanalysis protocol. BMJ Open. 2022;12(8): e057649. doi: 10.1136/bmjopen-2021-057649.

Ngui R, Halim NAA, Rajoo Y, Lim YA, Ambu S, Rajoo K, et al. Epidemiological characteristics of strongyloidiasis in inhabitants of indigenous communities in Borneo Island, Malaysia. Korean J Parasitol. 2016;54(5):673-678. doi: 10.3347/kjp.2016.54.5.673.

Venturini E, Fusani L, Mantella A, Bianchi L, Antonelli A, Montagnani C, et al. Strongyloidiasis in children outside the tropics: do we need to increase awareness? Microorganisms. 2021;9(9):1905. doi: 10.3390/microorganisms9091905.

Barroso M, Salvador F, Sánchez-Montalvá A, Bosch-Nicolau P, Molina I. Strongyloides stercoralis infection: a systematic review of endemic cases in Spain. PLoS Negl Trop Dis. 2019;13(3):e0007230. doi: 10.1371/journal.pntd.0007230.

Schär F, Trostdorf U, Giardina F, Khieu V, Muth S, Marti H, et al. Strongyloides stercoralis: global distribution and risk factors. PLoS Negl Trop Dis. 2013;7(7): e2288. Doi: 10.1371/journal.pntd.0002288.

Buonfrate D, Bisanzio D, Giorli G, Odermatt P, Fürst T, Greenaway C, et al. The global prevalence of Strongyloides stercoralis infection. Pathogens. 2020;9(6):468. doi: 10.3390/pathogens9060468.

Brown HW. Studies on the rate of development and viability of the eggs of Ascaris lumbricoides and Trichuris trichiura under field conditions. J Parasitol. 1927;14(1):1-72. doi: 10.2307/3271397.

Hotez PJ. Hookworm and poverty. Ann N Y Acad Sci. 2008; 1136:38-44. doi: 10.1196/annals.1425.000.

Hotez P, de Silva N, Brooker S, Bethony J. Soil transmitted helminth infections: the nature, causes and the burden of the condition. Disease Control Priorities Project Working Paper, No.3. Bethesda (MD): Fogarty International Center, National Institutes of Health; 2003.

Medina H, Paller VGV. Soil-transmitted helminth ova collected from Bay and Los Baños Laguna and some environmental factors affecting their prevalence [undergraduate thesis]. Los Baños: Animal Biology Division, Institute of Biological Sciences, University of the Philippines Los Baños; 2011.

World Health Organization. Integrated Guide to Sanitary Parasitology. Cairo: WHO Regional Office for the Eastern Mediterranean; 2004.

Downloads

Published

31-08-2026

Issue

Section

Original Research Articles

How to Cite

Hidden in plain sight: Urban playgrounds as potential reservoirs of soil-transmitted helminths. (2026). International Medical Research Journal. https://doi.org/10.63719/imrj.2026.01(SE).02

Similar Articles

21-30 of 37

You may also start an advanced similarity search for this article.