Is pinworm infection still a public health concern among children in resource-rich region? The prevalence and time-trend analysis of pinworm infection among school-aged children in Hualien County, Taiwan: A retrospective longitudinal study

Abstract Background: Enterobius vermicularis (pinworm) is a common parasitic intestinal infection in children. A gradual decrease in prevalence of pinworm infection has been noted in resource-rich settings, such as Taiwan. However, the influence of socio-demographic factors on the temporal trend in pinworm infection rates in children under the current pinworm infection prevention policy in Taiwan is not well characterized. This study aimed to evaluate the trend of pinworm infection prevalence and the associated socio-demographic risk factors among children in Hualien County, Taiwan. Methodology: This retrospective longitudinal study included school-aged children in Hualien during 2009–2018. Children were screened for pinworm infection using adhesive cellophane perianal swabs while they were in grades 1 and 4 in school. The factors associated with pinworm infection were analyzed. Trend analysis of pinworm infection rate stratified by sex and residential setting (urban, suburban, and rural) were also performed. Results: A total of 90,730 school-aged children from grades 1 and 4 during 2009–2018 were included. Young age and male sex were risk factors for pinworm infection ( P < 0.001). Negative correlation between body mass index (BMI) and enterobiasis was observed and decreased pinworm infection was noted during the study reference period. Children in suburban and rural areas had higher odds ratio for pinworm infection than those in urban areas (suburban: 1.45; rural: 5.27; P < 0.001 for both). Trend analysis revealed a significant decrease in the overall pinworm prevalence rate during 2009–2018 ( P for trend: <0.001). However, there was no obvious change of pinworm infection rate in rural areas during this period ( P = 0.953), and it was higher than that in urban and suburban areas. Conclusions: Risk factors for pinworm infection included young age, male, and BMI. High pinworm infection among school-age children in rural areas of Hualien is still an important issue.