Differential Prevalence and Risk Architecture of Soil-transmitted Helminthiasis in a Slum–urban Dyad of Lagos Mainland, Nigeria: A Comparative Knowledge, Attitude, and Practice Survey with Parasitological Confirmation

Abstract

Background and Aims: This study compared the prevalence, intensity, and knowledge-attitude-practice (KAP) correlates of soil-transmitted helminth (STH) infection between a slum community (Shogunro) and an adjoining urban community (Iwaya) within a single local government area of Lagos State, Nigeria, to identify determinants associated with any observed disparity. Study Design: Comparative, cross-sectional, community-based parasitological and KAP survey. Place and Duration of Study: Shogunro (slum) and Iwaya (urban) communities, Lagos Mainland Local Government Area, Lagos State, Nigeria; study conducted 2024–2026. Methodology: A total of 142 consenting participants aged 5 years and above (71 per community) were enrolled by purposive sampling. Structured, interpreter-administered questionnaires captured sociodemographic and KAP data. Stool specimens were processed using the Kato–Katz thick-smear technique and examined under light microscopy by a qualified parasitologist. Data were analysed in SPSS version 23 using chi-square tests, with significance set at P = .05. Results: Of 142 stool specimens examined, 16 (11.3%) were positive for Ascaris lumbricoides, the sole species recovered. Prevalence was higher in Shogunro (16.9%) than in Iwaya (5.6%) (P = .063). Participants aged 5–18 years accounted for 75.0% of all positive cases, against 25.0% among those aged 19 years and above. Females recorded higher infection rates than males in both communities. Correct identification of STH causative agents was substantially poorer in Shogunro, where more than 60% of respondents could not name a causal helminth, compared with approximately 30–40% in Iwaya (P < .01 for several taxa). Sanitation infrastructure diverged sharply between settlements: pit latrines predominated in Shogunro (59.2%) versus water-cistern systems in Iwaya (73.2%) (P < .01). Conclusion: Residual STH infection in this urban local government area appeared higher in the slum enclave and was accompanied by deficits in sanitation infrastructure and STH-specific knowledge. Slum-prioritised mass drug administration and water, sanitation, and hygiene (WASH) investment, rather than generically urban-targeted deworming alone, may help reduce this intra-municipal equity gap.