Belyhun et al. BMC Public Health 2010, 10:21 http://www.biomedcentral.com/1471-2458/10/21 R E S E A R C H A R T I C L E Open Access Prevalence and risk factors for soil-transmitted helminth infection in mothers and their infants in Butajira, Ethiopia: a population based study Yeshambel Belyhun1, Girmay Medhin1, Alemayehu Amberbir2,3*, Berhanu Erko1, Charlotte Hanlon4, Atalay Alem4, Andrea Venn3, John Britton3, Gail Davey2 Abstract Background: Soil-transmitted helminths (STHs) are widespread in underdeveloped countries. In Ethiopia, the prevalence and distribution of helminth infection varies by place and with age. We therefore investigated the prevalence of and risk factors for STH infection in mothers and their one year-old children living in Butajira town and surrounding rural areas in southern Ethiopia. Methods: In 2005-2006, 1065 pregnant women were recruited in their third trimester of pregnancy. In 2006-2007, when children reached their first birthdays, data on the infants and their mothers were collected, including stool samples for qualitative STH analysis. Questionnaire data on various demographic, housing and lifestyle variables were available. Logistic regression analysis was employed to determine the independent risk factors for STH infection in the mothers and children. Results: 908 mothers and 905 infants provided complete data for analysis. Prevalence of any STH infection was 43.5% (95% confidence interval (CI) 40.2-46.8%) in mothers and 4.9% (95%CI 3.6-6.5%) in children. In the fully adjusted regression model, infrequent use of soap by the mother was associated with increased risk (odds ratio (OR) 1.40, 95% CI 1.04-1.88, and 1.66, 95% CI 0.92-2.99, for use at least once a week and less frequent than once a week respectively, relative to daily use; p for trend = 0.018), and urban place of residence (OR 0.45, 95% CI 0.28- 0.73, p = 0.001) was associated with reduced risk of maternal STH infection. The only factor associated with STH infection in infants was household source of water, with the greatest risk in those using piped water inside the compound (OR 0.09, 95% CI 0.02-0.38 for river water, 0.20, 95% CI 0.56-0.69 for either well or stream water and 0.21, 95% CI 0.09-0.51 for piped water outside compared with piped water inside the compound, overall p = 0.002) Conclusion: In this rural Ethiopian community with a relatively high prevalence of STH infection, we found a reduced risk of infection in relation to maternal hygiene and urban living. Daily use of soap and a safe supply of water are likely to reduce the risk of STH infection. Background Soil-transmitted helminths (STHs) are a group of nema- todes that infect more than a billion people worldwide [1]. Of particular public health importance are Ascaris lumbricoides, Trichuris trichiura and hookworms [1,2]. Strongyloides stercoralis is also a STH [3], although detailed information on the prevalence is lacking. In Ethiopia the prevalence of hookworm is estimated to be 16% and the prevalences of A. lumbricoides and T. * Correspondence: alamwo1@yahoo.com 2School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia trichiura are 37% and 30% respectively [4]. STH infec- tions have not been targeted for control in Ethiopia [4], though mass de-worming as a component of the Enhanced Outreach Strategy (EOS) targeting under five children started in 2004 [5]. In developing countries, where control measures are often difficult to implement, STHs remain a significant health problem [6,7]. It is estimated that between a quarter and a third of pregnant women in sub-Saharan Africa are infected with hookworm and are at risk of preventable hookworm-related anemia [8]. Many © 2010 Belyhun et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.