Published in PLOS One on 2026-08-13, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Benjamin Mbonshi, Evans Mwape Kabemba, Collins Bowa
Source: PLOS One • DOI 10.1371/journal.pone.0356060
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Soil-transmitted helminth (STH) infections are a major public health challenge in regions where they overlap with HIV/AIDS. Children with HIV may be especially vulnerable to STHs due to immunosuppression, yet the burden and drivers of this co-infection among those on antiretroviral therapy (ART) in Zambia are not well documented. This study aimed to determine the prevalence and identify the key determinants of STH infections among ART-treated children in Western (Mulobezi and Sesheke districts) Zambia.
We conducted a cross-sectional study with a retrospective clinical review in the Mulobezi and Sesheke districts. From a total population of 487 eligible children, a sample of 103 ART-initiated children aged 5–15 years was enrolled. Participants were selected using stratified random sampling: the sample was first proportionally allocated to six health facilities (strata), and then individual children were randomly selected from clinic lists within each facility. Data was collected using questionnaires, medical records, and laboratory analysis of blood and stool samples (using the Kato-Katz technique). Bivariate analyses used Chi-square/Fisher’s exact and Mann-Whitney U tests. Viral load was log₁₀-transformed for analysis. Variables significant at *p* < 0.1, along with key clinical factors, were entered into a multivariable logistic regression model built via backward stepwise elimination to identify independent predictors. Model fit was assessed using the Hosmer-Lemeshow test.
The prevalence of any STH infection was 11.7% (12/103), with Ascaris lumbricoides (6.8%) being the most common species. In the final adjusted model, independent predictors of STH infection were a lower CD4 + count (aOR=3.25 per 100 cells/mm³ decrease; 95% CI: 1.82–5.80), a higher log₁₀ viral load (aOR=2.40 per unit increase; 95% CI: 1.45–3.96), and suboptimal ART adherence, with occasional misses conferring the highest risk (aOR=15.82; 95% CI: 2.98–84.02) compared to very consistent adherence. Lack of clean water access was not retained in the final model.
A notable prevalence of STH infection persists among ART-treated children in this setting, driven primarily by immunological and treatment-adherence factors. These findings support integrating routine STH screening and targeted deworming into paediatric HIV care programs, alongside interventions to optimize ART adherence and immunological recovery.
Introduction
Soil-transmitted helminths (STHs)—including Ascaris lumbricoides, Trichuris trichiura, and hookworms (Necator americanus, Ancylostoma duodenale)—affect over a billion people globally, primarily in low-income regions [1,2]. These infections contribute to a spectrum of clinical effects, including anemia, malnutrition, stunted growth, and impaired cognitive development, which perpetuate cycles of poverty and disease [1,2]. The public health impact is substantial, with infections linked to an estimated 1.38 million disability-adjusted life years (DALYs) worldwide [3].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Benjamin Mbonshi, Evans Mwape Kabemba, Collins Bowa. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
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