Geospatial Analysis of Hymenolepis (Rodentolepis) nana Infection Transmission in Schools among Children in Cusco, Peru

Hymenolepis nana is an emergent parasitosis, and the role of schools in infection transmission is unclear. Data from a cross-sectional study evaluating children for H. nana infection in schools in three districts of Anta province in Peru were analyzed. Geospatial information from the children's residence and school was obtained. A total of 2,961 children were included from 51 different schools. The median age was 9.6 years old (interquartile range [IQR]: 6.8-12.4), 1,479 (50%) were female, and the median H. nana prevalence per school was 15% (IQR: 3.61-24.20). Regression analysis demonstrated that those living in Ancahuasi and Zurite and those with higher poverty score and higher residence altitude were more likely to reside on a hot spot than a cold spot based on residence distribution, whereas being of school age was protective. Children living in low-risk areas (nonhot spots) who were attending schools with higher prevalence of H. nana ($15%) were less likely to reside in Ancahuasi or Zurite than in Anta, had lower paternal education, and were older than 6 years of age. Our study shows that schools have a role in infection transmission among children in the highlands of Peru.