Heavy burden of soil-transmitted helminth infections in a remote and impoverished indigenous community of Honduras revealed by real time polymerase chain reaction

BACKGROUND: Soil-transmitted helminths (STH) remain highly prevalent in Honduras, disproportionately affecting rural and underserved populations. Diagnostic limitations, particularly for Necator americanus and Strongyloides stercoralis, hinder accurate burden estimation. This study aimed to determine the prevalence and species distribution of STH infections using real-time polymerase chain reaction (PCR) in a remote, resource-limited setting. METHODS: A rapid, non-representative cross-sectional survey was conducted among children and adults in a remote community in the Honduran Moskitia. Stool samples were analyzed using multiplex real-time PCR. Prevalence was estimated with 95% confidence intervals. Differences between groups were assessed using Fisher's exact test, and logistic regression models were used to explore associations of infection with age and sex. Ct values were summarized using medians and interquartile ranges. RESULTS: Overall community STH prevalence was 85.2% [95% confidence intervals (CI): 78.6-92.3], with 72.2% (95% CI: 58.4-83.5) in adults and 98.1% (95% CI: 90.1-100) in school-aged children, who were predominantly infected with Trichuris trichiura (77.8%, 95% CI: 69.9-85.7), followed by Ascaris lumbricoides (50.0%, 95% CI: 40.6-59.4), N. americanus (29.6%, 95% CI: 21.0-38.2), and S. stercoralis (3.7%, 95% CI: 0.1-7.3). Younger age and female sex were identified as significant risk factors for T. trichiura. CONCLUSIONS: The extreme hyperendemicity of STH infections in the study community poses a serious health risk to its population, particularly children. These findings support the need for larger, systematically designed parasitological surveys that integrate sensitive diagnostic molecular tools to help precisely map STH epidemiology and guide control efforts in this and other underserved regions.