Intestinal Protozoan Infections in Elementary School Children in Indonesia: A Narrative Review of Knowledge and Risk Factors
DOI:
https://doi.org/10.53089/medula.v16i3.1782Keywords:
Elementary school children, intestinal protozoan infection, knowledgeAbstract
Intestinal protozoan infections are a prevalent public health problem among primary school children in Indonesia, contributing significantly to acute and chronic diarrhoea, malnutrition, and anaemia, which ultimately reduce cognitive performance and learning ability. This literature review aims to identify patterns of knowledge, hygiene behaviour, and environmental and socio-economic factors that serve as key risk predictors for intestinal protozoan infections in this population. Various cohort and cross-sectional studies in Indonesia highlight Giardia duodenalis, Entamoeba histolytica/dispar, and Blastocystis spp. as the dominant pathogens, with the highest prevalence in areas with poor sanitation, limited access to clean water, and high population density. Behavioural factors include a lack of consistency in handwashing with soap (HWS), nail hygiene, and healthy snacking habits, despite the widespread implementation of health education interventions. Multivariate analysis of the literature review indicates a synergistic interaction between low hygiene knowledge and inconsistent practices, coupled with suboptimal environmental sanitation, limited potable water infrastructure, and low socioeconomic status as key determinants. Overall, these findings emphasise the need for a multidimensional intervention approach that integrates behaviour-based education, improved sanitation infrastructure, and socio-economic support to reduce the burden of intestinal protozoan infections in primary school children in Indonesia. Further prospective research is needed to validate causality and evaluate the effectiveness of interventions.
References
Vafae A, Olfatifar M, Zaki L, Karimipour A, Barikbin F, Maleki A, et al. Global prevalence of intestinal protozoan parasites among food handlers : A systematic review and meta-analysis. 2023;145(July 2022):109466.
Rahmah NN, Mutiara H, Septiani L, Himayani R, Kedokteran F, Lampung U, et al. Infeksi Protozoa Usus dan Anemia Sebagai Ancaman Kesehatan Global : Literature Review Intestinal Protozoan Infections and Anemia as a Global Health Threat : Literature Review. 2025;15:1–5.
Yada TA, Dessie Y, Darghawth R, Wilfong T. Magnitude of Intestinal Parasitosis, Malnutrition, and Predictors of Anemia Among Nonpregnant Reproductive-Age Women Attending Healthcare Services in Olenchity General Hospital , Central Ethiopia. 2021;2(July):1–11.
Apaza C, Cuna W, Passera R, Rodriguez C. Frequency of Gastrointestinal Parasites , Anemia , and Nutritional Status among Children from Different Geographical Regions of Bolivia. 2023;2023.
Ahmed M. Intestinal Parasitic Infections in 2023. 2023;16(3):127–40.
Morán P, Serrano-Vázquez A, Rojas-Velázquez L, González E, Pérez-Juárez H, Hernández EG, et al. Amoebiasis: Advances in Diagnosis, Treatment, Immunology Features and the Interaction with the Intestinal Ecosystem. Vol. 24, International Journal of Molecular Sciences. 2023.
Sánchez A, Munoz M, Gómez N, Tabares J, Segura L. Molecular Epidemiology of Giardia , Blastocystis and Cryptosporidium among Indigenous Children from the Colombian Amazon Basin. 2017;8(February):1–14.
Sardinha-Silva A, Alves-Ferreira EVC, Grigg ME. Intestinal immune responses to commensal and pathogenic protozoa. Vol. 13, Frontiers in Immunology. 2022. p. 1–17.
Saputra IY, Sari MP, Gunardi WD. Artikel Penelitian Prevalensi Infeksi Protozoa Usus pada Siswa Sekolah Dasar Negeri Papanggo 01 Jakarta Utara Tahun 2016 Prevalence of Protozoa Infection in Elementary School Students of Papanggo 01 North Jakarta in 2016. 2016;23(61):41–7.
Kurniati M, Sulistyawati SW. Intestinal Protozoa Infections in Relation to Nutritional Status of the Mandangin Island Elementary School 6 Students in Sampang Regency. 2019;(01):10–3.
Rintik S, Ayu T, Haryati S, Sari Y, Handayani S. Relationship of Personal Hygiene and Nutritional Status to Intestinal Parasitic Infection in Simo, Boyolali. 2021;1(1):38–45.
Agustina R, Triwahyuni T, Putri DF, Destiani N. Hubungan Kecacingan dengan Kejadian Anemia pada Anak Sekolah Dasar di Kecamatan Tanjung Senang Bandar Lampung. MAHESA Malahayati Heal Student J. 2021;1(4):445–52.
Korpe P, Ni Z, Kabir M, Alam M, Ferdous T, Ara R, et al. Prospective Cohort Study of Cryptosporidium Infection and Shedding in Infants and Their Households. Clin Infect Dis [Internet]. 2023;76(12):2178–86.
Tamara C. Perilaku Masyarakat Dalam Pencegahan Penularan Covid-19 di Kelurahan Setia Kota Binjai. Keperawatan [Internet]. 2021;1–158.
Tharmaratnam T, Kumanan T, Iskandar MA, D’Urzo K, Gopee-Ramanan P, Loganathan M, et al. Entamoeba histolytica and amoebic liver abscess in northern Sri Lanka: A public health problem. Vol. 48, Tropical Medicine and Health. Tropical Medicine and Health; 2020. p. 1–13.
Safitri S. Literature Review : Hubungan Sanitasi Lingkungan Dan Higiene Terhadap Infeksi Protozoa Usus Pada Fakultas Ilmu Kesehatan Universitas ‘ Aisyiyah Yogyakarta. J Univ ‘Aisyiyah Yogyakarta. 2021;2:10.
Hemphill A, Müller N, Müller J. Comparative pathobiology of the intestinal protozoan parasites giardia lamblia, entamoeba histolytica, and cryptosporidium parvum. Vol. 8, Pathogens. 2019.
Febriana E, Solikhah MP, Rahmawati Y. TERHADAP INFEKSI PROTOZOA USUS PADA PENDUDUK. 2024;5(September):7441–9.
Septian HN, Sulistyaningsih E, Raharjo AM, Hermansyah B, Utami WS, Armiyanti Y. Environmental Sanitation as Risk Factors for Intestinal Protozoa Infection among Stunted Children in Sugerkidul Village, Indonesia. Al-Sihah Public Heal Sci J. 2023;15(69):44–52.
Abdoli A, Olfatifar M, Vafae A, Zeinab E, Oskar M, Majid N. Prevalence of intestinal protozoan parasites among Asian schoolchildren : a systematic review and meta ‑ analysis [Internet]. Vol. 52, Infection. Springer Berlin Heidelberg; 2024. 2097–2133 p.
Hajissa K, Id AI, Id AMS, Id ZM. Prevalence of intestinal protozoan parasites among school children in africa : A systematic review and meta-analysis. 2022;1–20.
Hardiyanti LT, Umniyati SR. Higiene buruk dan infeksi parasit usus pada anak sekolah dasar di tepi sungai Batanghari. Ber Kedokt Masy [Internet]. 2017;33(11):521–8.
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