Migrant Workers in Malaysia: Current Implications of Sociodemographic and Environmental Characteristics in the Transmission of Intestinal Parasitic Infections

A cross-sectional study of intestinal parasitic infections amongst migrant workers in Malaysia was conducted. A total of 388 workers were recruited from five sectors including manufacturing, construction, plantation, domestic and food services. The majority were recruited from Indonesia (n = 167, 43.3%), followed by Nepal (n = 81, 20.9%), Bangladesh (n = 70, 18%), India (n = 47, 12.1%) and Myanmar (n = 23, 5.9.2%). A total of four nematode species (Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis and hookworms), one cestode (Hymenolepis nana) and three protozoan species (Entamoeba histolytica/dispar, Giardia sp. and Cryptosporidium spp.) were identified. High prevalence of infections with A. lumbricoides (43.3%) was recorded followed by hookworms (13.1%), E. histolytica/dispar (11.6%), Giardia sp. (10.8%), T. trichura (9.5%), Cryptosporodium spp. (3.1%), H. nana (1.8%) and E. vermicularis (0.5%). Infections were significantly influenced by socio-demographic (nationality), and environmental characteristics (length of working years in the country, employment sector and educational level). Up to 84.0% of migrant workers from Nepal and 83.0% from India were infected with intestinal parasites, with the ascarid nematode A. lumbricoides occurring in 72.8% of the Nepalese and 68.1% of the Indian population. In addition, workers with an employment history of less than a year or newly arrived in Malaysia were most likely to show high levels of infection as prevalence of workers infected with A. lumbricoides was reduced from 58.2% to 35.4% following a year’s residence. These findings suggest that improvement is warranted in public health and should include mandatory medical screening upon entry into the country.Author Summary: Neglected intestinal parasitic infections (IPIs) such as soil-transmitted helminthes (STH) have been recognized as one of the main causes of illnesses especially among disadvantaged communities. The last survey of parasitic infections among migrant workers in Malaysia was conducted more than a decade ago. Although it provided useful methodological enquiries, the accrued data were not designed for policy recommendations. Over the last decade, the number of migrant workers has grown exponentially. There is an acute need for accurate information on the epidemiology of parasitic infections and infectious diseases especially as they affect urban communities in Malaysia. A particular gap has been identified in understanding the presence, persistence and epidemiology of infections among longer-term residents and immigrants who have settled in Malaysia. Hence, there is a need for a comprehensive study to establish the composition and transmission of parasitic infections in these communities with a view to developing effective methods of prevention, control and treatment of these infections. Therefore, this study is timely in adopting a scientific approach to address an important public health problem and to provide conclusions that can inform the design of effective public health policies.