{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:51:07Z","timestamp":1792788667949,"version":"4.5.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013800","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000}}],"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Jiangsu Commission of Health Medical Research Project","award":["M2022064"],"award-info":[{"award-number":["M2022064"]}]},{"name":"the Jiangsu Province Capability Improvement Project through Science, Technology, and Education","award":["ZDXYS202207"],"award-info":[{"award-number":["ZDXYS202207"]}]},{"name":"Jiangsu Provincial Health International (Regional) Exchange Support Program","award":["2023 Project"],"award-info":[{"award-number":["2023 Project"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Background<\/jats:title>\n \n Pinworm (\n \n Enterobius vermicularis<\/jats:italic>\n <\/jats:italic>\n ) remains the most prevalent helminth among preschool-aged children worldwide. Despite China\u2019s rapid development and decades of mass deworming, pinworm infection persists as a significant paediatric public-health problem. In this study, we aimed to understand the trends, clustering, and risk factors of pinworm infection in preschool settings of Jiangsu, China.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A repeated cross-sectional study was conducted in 45 counties of Jiangsu Province from 2019 to 2024. Multi-stage cluster convenience sampling was applied. Each year, one rural preschool and one urban preschool were selected per county. The sample size for each school was 229 to obtain a 5% margin of error, an arbitrary design effect of 1.5 for a prevalence estimate of 10%, and a 10% nonresponse rate. A total of 27,925 children were investigated. Adhesive cellophane tape swabs were collected for confirmation of pinworm infection. A preschool-level permutation approach was used to evaluate clustering effects of pinworm infections within preschools, measured by infection rate ratio (IRR). Risk factors of pinworm infections were assessed by multiple logistic regression. Mediation analysis was conducted between the risk factor and pinworm infection.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The overall pinworm infection rate was 0.48%, ranging form 1.22% in 2019 to 0.11% in 2024 and showing a downward trend (\u03c7\n 2<\/jats:sup>\n \u2009=\u200952.436,\n \n P<\/jats:italic>\n <\/jats:italic>\n \u2009<\u20090.001). Significant within-preschool clustering effect was observed in 2019 (IRR\u2009=\u20095.95, 95% lower CL\u2009=\u20093.77) and 2021 (IRR\u2009=\u20091.96, 95% lower CL\u2009=\u20091.35). Risk factors for preschool pinworm infection included migrant children (OR=3.911, 95%CI\u2009=\u20092.749-5.610) and older age (OR=1.443, 95%CI\u2009=\u20091.209-1.730). Mediation analysis indicated that parental education and family income collectively explain 55.2% of the association between migrant status and infection.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Pinworm infections among preschool children demonstrate a within-preschool clustering effect. Despite the observed decline in infection rate of pinworms, targeted interventions are necessary in preschools, especially for migrant children. This study contributes to the broader understanding of enterobiasis and support the development of strategies to protect children\u2019s health in preschools.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013800","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T18:50:21Z","timestamp":1764701421000},"page":"e0013800","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Understanding the trends, clustering, and risk factors of pinworm infection in preschool settings: A repeated cross-sectional multi-center study between 2019 and 2024"],"prefix":"10.1371","volume":"19","author":[{"given":"Fanzhen","family":"Mao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuecheng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bixian","family":"Ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9616-8948","authenticated-orcid":true,"given":"Yaobao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"issue":"11","key":"pntd.0013800.ref001","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.26719\/emhj.21.022","article-title":"Prevalence of and risk factors for Enterobius vermicularis infestation in preschool children, West Bank, Palestine, 2015","volume":"27","author":"R Khayyat","year":"2021","journal-title":"East Mediterr Health J"},{"issue":"1","key":"pntd.0013800.ref002","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1017\/S0950268809002660","article-title":"Enterobius vermicularis infection in schoolchildren: a large-scale survey 6 years after a population-based control","volume":"138","author":"L-C Wang","year":"2010","journal-title":"Epidemiol Infect"},{"issue":"6","key":"pntd.0013800.ref003","doi-asserted-by":"crossref","first-page":"441","DOI":"10.24171\/j.phrp.2023.0204","article-title":"Global prevalence of enterobiasis in young children over the past 20 years: a systematic review and meta-analysis","volume":"14","author":"EK Lashaki","year":"2023","journal-title":"Osong Public Health Res Perspect"},{"key":"pntd.0013800.ref004","article-title":"Pinworm (Enterobius vermicularis) infestation: an updated review","author":"AKC Leung","year":"2024","journal-title":"Curr Pediatr Rev"},{"issue":"9521","key":"pntd.0013800.ref005","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/S0140-6736(06)68653-4","article-title":"Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm","volume":"367","author":"J Bethony","year":"2006","journal-title":"Lancet"},{"issue":"2","key":"pntd.0013800.ref006","first-page":"88","article-title":"Prevalence of Enterobius vermicularis infection in preschool children in Wuhu areas and analysis on the influencing factors","volume":"13","author":"H Jia","year":"2015","journal-title":"J Trop Dis Parasitol"},{"issue":"2","key":"pntd.0013800.ref007","article-title":"Enterobius vermicularis Infestation: A Rare Cause of Appendicitis","volume":"17","author":"K Ponniah","year":"2025","journal-title":"Cureus"},{"issue":"2","key":"pntd.0013800.ref008","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1053\/j.sempedsurg.2012.01.009","article-title":"Parasitic infestations requiring surgical interventions","volume":"21","author":"AAJ Hesse","year":"2012","journal-title":"Semin Pediatr Surg"},{"issue":"1","key":"pntd.0013800.ref009","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1186\/s12887-023-04006-0","article-title":"Eosinophilia and potential antibody cross-reactivity between parasites in a child with pinworm and immune dysregulation: a case report","volume":"23","author":"M Di Cicco","year":"2023","journal-title":"BMC Pediatr"},{"key":"pntd.0013800.ref010","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2017-220473","article-title":"Enterobius vermicularis (pinworm) infestation in a child presenting with symptoms of acute appendicitis: a wriggly tale!","volume":"2017","author":"L Dunphy","year":"2017","journal-title":"BMJ Case Rep"},{"issue":"4","key":"pntd.0013800.ref011","doi-asserted-by":"crossref","first-page":"357","DOI":"10.2478\/helm-2022-0040","article-title":"Enterobius Vermicularis Infection: A Cross-sectional Study in Preschool and School Children in the North-Western Part of Slovenia","volume":"59","author":"M So\u010dan","year":"2022","journal-title":"Helminthologia"},{"issue":"6","key":"pntd.0013800.ref012","article-title":"National surveillance of hookworm disease in China: A population study","volume":"16","author":"H-H Zhu","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013800.ref013","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1186\/s12889-025-21883-5","article-title":"Unveiling the disparities between private and public preschools in the risk for pinworm infections in China: a multicentre cross-sectional study","volume":"25","author":"F Mao","year":"2025","journal-title":"BMC Public Health"},{"issue":"4","key":"pntd.0013800.ref014","article-title":"Monitoring of Enterobius vermicularis infection among children from 2006 to 2010 and SWOT analysis","volume":"26","author":"C Zhou","year":"2014","journal-title":"Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi"},{"issue":"12","key":"pntd.0013800.ref015","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.2105\/AJPH.2022.307067","article-title":"Knowledge and practice of pinworm infection in preschool children, Jiangsu province, China, 2019-2020","volume":"112","author":"F Mao","year":"2022","journal-title":"Am J Public Health"},{"key":"pntd.0013800.ref016","volume-title":"Policy target for common prosperity by 2025","author":"National Development and Reform Commission","year":"2022"},{"issue":"1","key":"pntd.0013800.ref017","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3390\/tropicalmed8010025","article-title":"Epidemiological Profile and Spatial Patterns of Enterobiasis in Children Aged 3-9 Years in China from 2016 to 2020","volume":"8","author":"J Huang","year":"2022","journal-title":"Trop Med Infect Dis"},{"issue":"1","key":"pntd.0013800.ref018","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3347\/PHD.22121","article-title":"Positive rates for Enterobius vermicularis eggs among preschool children in Yeosu-si, Jeollanam-do, Korea (2017-2021","volume":"61","author":"MR Lee","year":"2023","journal-title":"). Parasites Hosts Dis"},{"issue":"6","key":"pntd.0013800.ref019","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1179\/1364859411Y.0000000034","article-title":"Prevalence and epidemiology of intestinal parasitism, as revealed by three distinct techniques in an endemic area in the Brazilian Amazon","volume":"105","author":"JG Valverde","year":"2011","journal-title":"Ann Trop Med Parasitol"},{"key":"pntd.0013800.ref020","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s41182-020-00270-3","article-title":"Prevalence of Enterobius vermicularis infections and associated risk factors among schoolchildren in Nakhon Si Thammarat, Thailand","volume":"48","author":"P Laoraksawong","year":"2020","journal-title":"Trop Med Health"},{"key":"pntd.0013800.ref021","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1186\/1471-2458-6-225","article-title":"Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren","volume":"6","author":"L Quihui","year":"2006","journal-title":"BMC Public Health"},{"issue":"3","key":"pntd.0013800.ref022","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1017\/S0031182021001955","article-title":"Enterobiasis and its risk factors in urban, rural and indigenous children of subtropical Argentina","volume":"149","author":"MR Rivero","year":"2022","journal-title":"Parasitology"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013800","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T19:15:04Z","timestamp":1764962104000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013800"}},"subtitle":[],"editor":[{"given":"Mar\u00eda Victoria","family":"Periago","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":22,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013800","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,2]]}}}