Perceptions and treatment of intestinal worms in rural Bangladesh: local differences in knowledge and behaviour

Perceptions and practices of urban slum-dwelling women concerning soil-transmitted helminths infections in Bangladesh: A cross-sectional study

Introduction

Soil-transmitted helminths (STH) infections are still attributed to a significant part of mortality and disabilities in developing nations. This study aimed at exploring the perceptions and practices concerning STH and to assess the associated risk of infections among slum-dwelling women of Dhaka South City Corporations (DSCC), Bangladesh.

Materials and methods

A cross-sectional study was conducted in two selected slums (Malibagh and Lalbagh) of DSCC, Bangladesh, from September 2020 to February 2021. A total of 206 women participants were requested to provide stool samples, followed by a semi-structured questionnaire survey. Parasitological assessment was done by the formol-ether concentration (FEC) technique. Data were analyzed using descriptive statistics, and p-value < 0.05 was considered as statistically significant. An adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) was estimated using logistic regression analysis to examine the association between explanatory and outcome factors.

Results

In total, 36 (17.5%) STH infections were observed out of 206 examined participants. Among the STH, Trichuris trichiura showed the highest prevalence (10.7%), followed by Ascaris lumbricoides (5.3%). Lack of formal education, overcrowded living, large family sizes, and using shared toilets were significantly associated with STH infections. Irregular nail cutting (AOR = 3.12), irregular soap usage after toilet (AOR = 2.98), wearing no shoes (AOR = 4.64), and failing to teach kids to wash their hands (AOR = 3.87) were revealed as practice concerns linked to high STH prevalence. Women, who had never heard about STH (AOR = 2.42) and had no misconceptions regarding STH (AOR = 1.94) were positively related to STH infection in this study.

Conclusion

Slum-dwelling women in Bangladesh still had a substantial infection of STH. Most of the communities under study were unaware of parasite infection and its negative effects on health. Revision of the policy of ongoing anthelmintic distribution programs and widespread health education programs are recommended aimed at controlling STH.

Predictors Associated With Knowledge and Practice of Helminthic Infection Prevention Among Rural School-Aged Children's Parents in Bangladesh: A Cross-Sectional Study

Background: Parasitic infection has become a major public health concern in light of its increasing prevalence in developing countries, particularly in rural settings. Helminthic infections disproportionately affect children, and therefore appropriate parental knowledge and practical approaches to transmission prevention are essential. The objective of this study was to evaluate the level of knowledge and implementation measures aimed at preventing helminthic infection among rural school-aged children's parents in Bangladesh.

Methods: A cross-sectional survey was conducted among the parents of 449 rural school-aged children residing in 17 villages of the Cumilla district in Bangladesh. Participants completed the survey examining socio-demographic variables as well as questions regarding knowledge and practice of helminthic infection prevention (HIP).

Results: Local knowledge about children's HIP was inadequate among their parents (81.5%). Furthermore, actual implementation of HIP measures was poor (42.1%). Knowledge of HIP was significantly associated with parental religion, education, occupation, number of family members, family income, housing conditions, and sanitation system. In addition, practice of HIP was significantly associated with the aforementioned factors, as well as with water source and knowledge of HIP.

Conclusion: Lack of concern about parasitic infection among children's parents and their untoward effects on children's health is pervasive in rural parental settings, along with ignorance on helminthic transmission and its prevention. Public education programs aimed at addressing these glaring HIP awareness deficits are needed in Bangladesh.

Knowledge, practices and perceptions of geo-helminthes infection among parents of pre-school age children of coastal region, Kenya

BACKGROUND

Soil-transmitted helminthes (STHs) are common human parasitic diseases in most of the developing world particularly in Kenya. The ongoing National School-Based Deworming Programme (NSBDP) was launched in 2012 and is currently targeting 28 of the 47 endemic Counties. In an effort to improve treatment intervention strategies among Pre-School Age Children (PSAC) attending Early Childhood Development Centres (ECDC), we sought to assess parents' knowledge, perceptions and practices on worm infection.

METHODOLOGY

We conducted a qualitative cross-sectional study in four endemic sub-counties of two counties of coastal region of Kenya. A total of 20 focus group discussions (FGDs) categorized by gender were conducted among parents of pre-school age children. Participants were purposively selected based on homogenous characteristics with the saturation model determining the number of focus group discussions conducted. The data collected was analyzed manually by study themes.

FINDINGS

The majority of the parents had knowledge on worms and modes of transmission of the parasitic infections among the pre-school children. Also, most of the participants knew the causes of worm infection and the pre- disposing factors mentioned included poor hygiene and sanitation practices. Due to poor knowledge of signs and symptoms, misconceptions about the drugs administered during the NSBDP were common with a large majority of the parents indicating that the drugs were ineffective in worm control. The findings also indicated that most of the participants sought medical care on the onset of the signs and symptoms of worm infestation and preferred services provided at public health facilities as opposed to private health facilities or buying drugs from the local market citing mistrust of such services. Cultural beliefs, high cost of building and availability of vast pieces of land for human waste disposal were factors that contributed to low or lack of latrine ownership and usage by a large majority of the respondents.

CONCLUSIONS

Our results show that to a large extent the parents of the pre-school age children have information on worm infections. However, some cultural beliefs and practices on the pathology and mode of transmission mentioned could be a hindrance to prevention and control efforts. There is need to implement health promotion campaigns to strengthen the impact of control strategies and reduce infection.

Caregiver perspectives for the prevention, diagnosis and treatment of childhood giardiasis in Havana City, Cuba. A qualitative study

Although long considered a non-pathogenic protozoan, Giardia lamblia is now a well recognized cause of abdominal discomfort, diarrhoea and failure-to-thrive in children. The overall prevalence of this infection in Cuban population is about 7.2%; however, higher prevalences have been found among young children attending day-care centres and primary school in the country. Anecdotally, clinical giardiasis is generally considered to place a large burden on both diagnostic and treatment services in Cuba. In order to gain insight into caregivers' perspectives with respect to this infection in children, a qualitative study was carried out in a paediatric hospital in Cuba. Focus group discussions were conducted to gather information about the awareness of the giardiasis, their mode of transmission and symptoms, diagnosis process, treatment seeking behaviour, possible ways of prevention, and barriers for not adopting preventive behaviours, the source and channels of information about this disease. Caregivers have knowledge of giardiasis, although there were myths and misconceptions regarding giardiasis. Manifestations like diarrhoea, abdominal pain and nausea were cited; however, asymptomatic forms of these infections are hardly accepted. Boiling water and washing hands before eating and after defecation and washing vegetables were mentioned among the principal ways of preventing this infection. The most commonly mentioned reasons for not adopting preventive behaviours included lack of time due to outdoor activities and limitation of combustible distribution. Treatment-seeking behaviour when giardiasis suspected mainly included visiting the nearby family doctor. The findings of this study reveal the need for a health education intervention in areas of misperceptions and confusion.

Cognitive Behavior Change for the Improvement of Health Care, Cognitive Function and School Achievement in Helminth Infected Children

Overall helminth infection prevalence in Central Java in 2002 was high (20–100%). Unfortunately, the knowledge, attitude and practice (KAP) of children and their parent’s about worm infection were in general very low. Objective of this study was to determine the improvement of parents’ health care behavior on helminth infected children by improving their KAP, in order to decrease re-infection rate of helminth infestation and improving school achievement. Design study is quasi experiment with pre and post test control group design on community participation toward school aged children in Sragen sub-district in Central Java. A sample of one hundred and thirty one of children deriving from a systematic random sampling was used in the study and divided into 66 children for intervention population and 65 children for control population. During the study, the children in selected area were given with 400mg chewable albendazole, and after a month, their stools were examined to find out the negatives. Parent’s participation was needed in improving the KAP on re-infestation that was performed by an intervention using a module. Data were analysed using chi-square test to determine therelationship between variables among groups. Stools were examined for the presence of geohelminth’s egg using Kato-Katz Technique.Three subject matters (Mathematics, Indonesian Language and Natural Science) were obtained by a special tool. Digit Span, Codingand Stroop Test were used to determine the level of cognitive function. Monitoring and the ladder-snake game were use to observe the improvement of the behavior. It revealed that re-infestation of Ascaris lumbricoides, Trichuris trichhiura and Oxyuris vermicularisoccurs 2 times greater in control group, even there was no significant different. In both groups, there was no hookworm re-infestation.A good knowledge and attitude can be predicted to be a better practice to prevent the re-infestation. Oxyuris vermicularic re-infection could have adverse effect on study Achievement (Mathematics, Indonesian Language and Natural Science) and The Cognitive Function, such as memory, attention, visual-motoric co-ordination. The moshly affected cognitive function was memory-based and specifically represented the components of the working memory. From the monitoring of health care behavior, this study found that the more convinced the mothers in changing their degree of family’s health were, the higher the level of children’s health was.

Measures for the prevention and control of Taenia solium taeniosis and cysticercosis

Taeniosis and cysticercosis due to Taenia solium are public health problems in many developing countries. Many studies of this parasitic zoonosis have focused on clinical features, diagnosis, treatment, surveillance, epidemiology and risk factors analysis. More recently projects on community and mass intervention strategies had been conducted in several rural areas worldwide focused on pig vaccination, pig cysticercosis treatment, human mass treatment, infrastructure development, as well as health education campaigns. Their advantages, disadvantages and public health impact have been published. This document discusses the feasibility and limitations of these interventions in order to assist countries in selection the best strategy for the prevention and control of this disease; we emphasized the specific strategies that might be recommended in different demographical situations.

Prevalence and intensity of infections of Ascaris lumbricoides and Trichuris trichiura and associated socio-demographic variables in four rural Honduran communities

Between January and March 1998, a cross-sectional survey was carried out in four rural communities in Honduras, Central America. We examined the prevalence and intensity of Ascaris lumbricoides and Trichuris trichiura infections among 240 fecal specimens, and the association between selected socio-demographic variables and infection for 62 households. The overall prevalence of A. lumbricoides and T. trichiura was 45% (95% CI 39.0-51.9) and 38% (95% CI 31.8-44.4) respectively. The most intense infections for Ascaris and Trichuris were found in children aged 2-12 years old. By univariate analysis variables associated with infections of A. lumbricoides were: number of children 2-5 years old (p=0.001), level of formal education of respondents (p=0.01), reported site of defecation of children in households (p=0.02), households with children who had a recent history of diarrhea (p=0.002), and the location of households (p=0.03). Variables associated with both A. lumbricoides and T. trichiura infection included: number of children 6-14 years old (p=0.01, p=0.04, respectively), ownership of a latrine (p=0.04, p=0.03, respectively) and coinfection with either helminth (p=0.001, p=0.001, respectively). By multivariate analysis the number of children 2-5 years living in the household, (p=0.01, odds ratio (OR)=22.2), children with a recent history of diarrhea (p=0.0, OR=39.8), and infection of household members with T. trichiura (p=0.02, OR=16.0) were associated with A. lumbricoides infection. The number of children 6-14 years old in the household was associated with both A. lumbricoides and T. trichiura infection (p=0.04, p=0.01, OR=19.2, OR=5.2, respectively).

Attitudes towards helminthic infection in the Jirel population of eastern Nepal

Intestinal worm infections, including roundworm, hookworm, and whipworm, are major international health concerns, affecting approximately one fourth of the world's population. Many intervention schemes have been attempted to control these infections in heavily exposed populations, but success has been limited because individuals are readily reinfected upon renewed exposure. Few data are available concerning people's health beliefs about soil-transmitted helminthic infections in such populations. The purpose of this study was to assess health beliefs about common helminthiasis in a population experiencing moderate to high rates of infection. The focal population for the study was the Jirel population, a tribal group distributed across nine villages in the Jiri Region of Dolakha District, eastern Nepal. The results indicate that beliefs about the types, causes, and treatments of helminthic infections have been developed and reinforced by experience and empirical evidence. People's frequent inability to confirm the efficacy of drug therapy by observing worms in stools has led to dissatisfaction with biomedical approaches. Carefully planned education programs are required to alter prevailing attitudes and improve control of soil-transmitted helminthiasis in the region.