Prevalence of intestinal helminthic infections and malnutrition among schoolchildren of the Zegie Peninsula, northwestern Ethiopia

Prevalence of Soil-Transmitted Helminth Infections and Associated Risk Factors Among School Children in Dembecha Town, Ethiopia

Soil-transmitted helminth (STH) infections are among the most common infections that affect the poorest and most deprived communities. In most developing countries, children aged 5 to 15 years are at risk for chronic helminth infection and associated morbidity. This study aimed to determine the prevalence of STH infections and associated risk factors among three government elementary schools in Dembecha town, Ethiopia. We conducted a school-based cross-sectional study involving 316 participants between November 2019 and March 2020. A systematic random sampling method was used to select study participants from the study schools. Data related to the sociodemographic characteristics of the study participants and risk factors for STH infections were collected using a pretested questionnaire survey. Parasitological examinations of stool samples were performed using the formal-ether concentration method. Study participants aged 5 to 15 years were enrolled in this study. The overall prevalence of STH infection was 21.5% (68/316). Ascaris lumbricoides ranked highest, with a prevalence of 11.4%, followed by hookworms 7.3%, Trichuris trichiura 1.9%, and Strongloides stercoralis 0.9%. Age groups of 10-15 years (AOR =3.109; 95% CI: 1.033, 9.350), residence in Kebele 2 (AOR =2.990; 95% CI: 1.082, 8.264), illiterate mothers (AOR =4.689; 95% CI: 1.410, 15.59), and a family size of 4-6 (AOR =3.286; 95% CI: 1.299, 8.313) were significantly associated with STH infections. The prevalence of STH infections remains an important health issue for study participants. Therefore, school deworming programs twice a year are crucially needed until the prevalence falls below the level of public health importance.

Efficacy and safety of prazequantel for the treatment of Schistosoma mansoni infection across different transmission settings in Amhara Regional State, northwest Ethiopia

BACKGROUND

Schistosoma mansoni and S. haematobium infections have been public health problems in Ethiopia, S. mansoni being more prevalent. To reduce the burden of schistosomiasis, a national school-based prazequantel (PZQ) mass drug administration (MDA) program has been implemented since November 2015. Nevertheless, S. mansoni infection is still a major public health problem throughout the country. Reduced efficacy of PZQ is reported by a few studies in Ethiopia, but adequate data in different geographical settings is lacking. Hence, this study aimed to assess the efficacy and safety of PZQ for the treatment of S. mansoni infection across different transmission settings in Amhara Regional State, northwest Ethiopia.

METHODS

A school-based single-arm prospective cohort study was conducted from February to June, 2023 among 130 S. mansoni-infected school-aged children (SAC). Forty-two, 37, and 51 S. mansoni-infected SAC were recruited from purposely selected schools located in low, moderate, and high transmission districts, respectively. School-aged children who were tested positive both by Kato Katz (KK) using stool samples and by the point of care circulating cathodic antigen (POC-CCA) test using urine samples at baseline were treated with a standard dose of PZQ and followed for 21 days for the occurrence of adverse events. After three weeks post-treatment, stool and urine samples were re-tested using KK and POC-CCA. Then the cure rate (CR), egg reduction rate (ERR), and treatment-associated adverse events were determined. The data were analyzed using SPSS version 21.

RESULTS

Out of the total 130 study participants, 110 completed the follow-up. The CR and ERR of PZQ treatment were 88.2% (95%CI: 82.7-93.6) and 93.5% (95%CI: 85.4-98.5), respectively, by KK. The CR of PZQ based on the POC-CCA test was 70.9% (95%CI: 62.7-79.1) and 75.5% (95%CI: 67.3-83.6) depending on whether the interpretation of 'trace' results was made as positive or negative, respectively. After treatment on the 21st day, 78 and 83 participants tested negative both by KK and POC-CCA, with respective interpretations of 'trace' POC-CCA test results as positive or negative. The CR in low, moderate and high transmission settings was 91.7%, 91.2% and 82.5%, respectively (p = 0.377) when evaluated by KK. The CR among SAC with a light infection at baseline (95.7%) by KK was higher than that of moderate (81.5%) and heavy (64.3%) infections (χ2 = 12.53, p = 0.002). Twenty-six (23.6%) participants manifested at least one adverse event. Eleven (10.0%), eight (7.3%), six (5.5%), and three (2.7%) participants complained about abdominal pain, nausea, headache, and anorexia, respectively. All adverse events were mild, needing no intervention. Occurrence of adverse events was slightly higher in high endemic areas (32.5%) than moderate (23.5%) and low endemic areas (p = 0.279).

CONCLUSIONS

A single dose of 40 mg/kg PZQ was efficacious and safe for the treatment of S. mansoni infection when it was evaluated by the KK test, but a lower efficacy was recorded when it was evaluated by the POC-CCA test. However, the POC-CCA test's specificity, clearance time of CCA from urine after treatment, and interpretation of weakly reactive (trace) test results need further research.

Prevalence and associated risk factors of intestinal parasitic infections among children in pastoralist and agro-pastoralist communities in the Adadle woreda of the Somali Regional State of Ethiopia

BACKGROUND

Intestinal parasitic infections (IPIs) can cause illness, morbidity, and occasional mortality in children. Agro-pastoralist and pastoralist children in the Somali Regional State of Ethiopia (ESRS) are especially at risk for IPIs, as access to safe water, sanitation, and health services is lacking. Minimal data on the prevalence of IPIs and associated risk factors exists in this region.

METHODOLOGY

We assessed the prevalence of IPIs and associated risk factors during the wet season from May-June 2021 in 366 children aged 2 to 5 years in four agro-pastoralist and four pastoralist kebeles (wards) in Adadle woreda (district) of the Shebelle zone, ESRS. Household information, anthropometric measurements, and stool samples were obtained from included children. Parasites were identified microscopically using Kato-Katz and direct smear methods. Risk factors were assessed using general estimating equation models accounting for clustering.

PRINCIPAL FINDINGS

Overall prevalence of IPIs was 35%: 30.6% for single infections and 4.4% for poly-parasitic infections. Intestinal protozoan prevalence was 24.9%: 21.9% Giardia intestinalis, and 3.0% Entamoeba spp.. Intestinal helminth prevalence was 14.5%: 12.8% Ascaris lumbricoides, 1.4% hookworm (Ancylostoma duodenale /Necator americanus.), and 0.3% Hymenolepis nana. G. intestinalis infection was associated with drinking water sourced from the river (aOR 15.6, 95%CI 6.84, 35.4) and from collected rainwater (aOR 9.48, 95%CI 3.39, 26.5), with toilet sharing (aOR 2.93, 95%CI 1.36, 6.31) and with household ownership of cattle (1-5 cattle: aOR 1.65, 95%CI 1.13, 2.41; 6+ cattle: aOR 2.07, 95%CI 1.33, 3.21) and chickens (aOR 3.80, 95%CI 1.77, 8.17). A. lumbricoides infection was associated with children 36 to 47 months old (aOR 1.92, 95%CI 1.03, 3.58).

CONCLUSIONS/SIGNIFICANCE

Improving access to safe water, sanitation, and hygiene services in Adadle and employing a One Health approach would likely improve the health of children living in (agro-) pastoralist communities in Adadle and the ESRS; however, further studies are required.

Prevalence and Determinant Factors of Intestinal Parasitic Infections and Undernutrition among Primary School Children in North-Central Ethiopia: A School-Based Cross-Sectional Study

Background. Intestinal parasitic infections (IPIs) are a major public health problem with high morbidity and mortality in developing countries. Undernutrition is a major health problem among school children and affects their cognitive development, psychological development, motor skills, and academic achievements. Therefore, this study aimed to assess the prevalence and determinant factors of IPIs and undernutrition among primary school children. Method. Cross-sectional study was conducted among 450 children from February to March 2021 at selected primary schools in Dessie town, North-central Ethiopia. Participants were selected using a stratified sampling technique. Pretested questionnaires were used to collect sociodemographic and nutrition-related data. Stool samples were used to diagnose IPIs. Participants’ height and weight were measured and body mass index (BMI) was calculated. Nutritional assessment was done using WHO AnthroPlus software. Data were analyzed using SPSS version 26 software. $P$ -values <0.05 were considered statistically significant. Result. The overall prevalence of intestinal parasites was 28.9%. The prevalence of intestinal protozoa and helminths were 19.1% and 9.8%, respectively. Entamoeba histolytica/dispar was the most prevalent parasite (9.3%) followed by Giardia intestinalis (7.6%), Enterobius vermicularis (2.9%), and Ascaris lumbricoides (2.7%). The prevalence of intestinal parasites was higher in male (16.5%) than in female (12.4%) participants. Children whose mother’s level of education is illiterate, 6–11 years old, have a habit of eating raw/undercooked fruits and vegetables, untrimmed and dirty fingernails, and sickness in the past week were significantly associated with IPIs. The prevalence of underweight, stunting, and wasting were 22.4%, 26.2%, and 20.7%, respectively. Multivariable logistic regression showed gender, family size, meal frequency, and breakfast were significantly associated with undernutrition. IPIs had a statistically significant association with underweight, stunting, and wasting. Conclusion. The study showed that IPIs and undernutrition are still major health problems among children in North-central Ethiopia. Periodic deworming, community health, and school health education will be valuable to improve the health, growth, and educational outcome of children.

The prevalence of intestinal parasites, undernutrition and their associated risk factors among school-age children in Sekota Town, Northeast Ethiopia: A community-based cross-sectional study

Background and Aims

In developing countries, intestinal parasitic infections and malnutrition are among the most serious health issues affecting school-aged children. They have synergetic consequences. This study aimed to determine the prevalence of intestinal parasites, undernutrition, and their associated risk factors among school-age children.

Methods

A community-based cross-sectional study was conducted from April to June 2021 among school-age children in Sekota Town, Northeast Ethiopia. Households were selected using a systematic random sampling technique. Risk factor variables were collected using pretested questionnaires. Stool samples were collected from study participants and examined using a wet mount, formol-ether concentration, and modified acid-fast techniques. The height and weight of children were also measured using a meter and a standard calibrated balance, respectively. Data were analyzed using SPSS version 26.0 statistical software.

Results

The overall prevalence of intestinal parasites among school-age children was 44.3% (178/402). About seven species of intestinal parasites were identified. The predominant parasite identified was E. histolytica/dispar (11.2%), followed by H. nana (9.2%) and G. lamblia (6.7%). The well as a source of drinking water (adjusted odds ratio [AOR] = 7.93; 95% confidence interval [CI]: 4.38-14.36), habit of open-field defecation (AOR = 7.02; 95% CI: 13.05-12.06), and being undernourished (AOR = 5.67; 95% CI: 2.98-10.79) were independent predictors of intestinal parasitic infections. On the other hand, the overall prevalence of undernutrition was 46.3%. Undernutrition was significantly more likely in children with a dietary diversity score (DDS) of 3 (AOR = 3.73, 95% CI: 2.37-5.88), meal frequency of no more than three times per day (AOR = 2.00, 95% CI: 1.71-2.98), intestinal parasite infection (AOR = 5.25, 95% CI: 3.24-8.52), and no access to school-based feeding (AOR = 3.52, 95% CI: 2.17-7.96).

Conclusion

The prevalence of intestinal parasitic infections and undernutrition was high among school-age children in Sekota Town. The results imply the need for strengthening integrated strategies for the reduction of intestinal parasitic infections and undernutrition.

The epidemiology of Schistosoma mansoni in the Lake Tana Basin (Ethiopia): Review with retrospective data analyses

Schistosoma mansoni is one of the major waterborne diseases grouped underwater based Neglected Tropical Diseases in Africa. In Ethiopia, the Lake Tana Basin has favorable environment (temperature and water) for S. mansoni transmission. The prevalence of S. mansoni varies among regions based on environmental conditions and human water contact. Therefore, this review was conducted to identify hot spots districts and determine the prevailing S. mansoni prevalence in the Lake Tana Basin. Research articles published in English in the last 65 years were searched from Google scholar, PubMed, and Web of science. In addition, four-year S. mansoni data that were reported in health care facilities were extracted from health management information system in 61 districts of the Lake Tana Basin. In total, 43 research articles on S. mansoni that met the inclusion criteria and were published between 1957 and 2022. Over 98% of the articles were cross-sectional studies, while five articles addressed malacological studies. Among 61 districts, 19 (31%) were identified as hotspot districts for S. mansoni infection in the Lake Tana Basin. S. mansoni prevalence and the abundance of its host snail showed spatial and seasonal variations. On average 2000 school children/year attended health care facilities for S. mansoni infection. Swimming habits [adjusted odds ratio (AOR) = 3.2, p = 0.030], irrigation practice (AOR = 3:09, p ≤ 0.001), fishing (AOR = 2:43, p = 0.005) and being male (AOR = 1.74, p = 0.002) were risk factors for contributing to S. mansoni infection. This study showed the spatial and seasonal variations of S. mansoni prevalence and its endemicity in the hottest lowland areas of the Lake Tana Basin. The research articles on S. mansoni had poor geographical coverage. Malacological studies on water bodies, assessments on knowledge and attitude in the community towards S. mansoni transmission are areas of future studies.

Prevalence and Associated Risk Factors of Soil-Transmitted Helminth Infections among Schoolchildren around Lake Tana, Northwest Ethiopia

Background

Soil-transmitted helminths (STHs) are among the most common neglected tropical diseases widely distributed in tropical countries with poor socioeconomic development. Ascaris lumbricoides, Trichuris trichiura, and hookworm are the three major STHs. This study aimed to determine the prevalence of STHs and associated risk factors among schoolchildren in selected primary schools around Lake Tana, Northwestern Ethiopia.

Methods

A school-based cross-sectional study was conducted from February to May 2021 involving 337 study participants. A systematic random sampling method was utilized to select the study participants from the selected schools. Data related to sociodemographic characteristics of the study participants and risk factors for STH infections were collected using a pretested questionnaire. Stool samples were collected in sterile plastic containers from each participant and processed using Kato-Katz thick fecal smear and Ritchie's concentration techniques. The data were analyzed using the Statistical Package for Social Sciences software tool version 23, and factors with a p < 0.05 were considered as statistically significant.

Results

The overall prevalence of STH infection was 38.3% (95% CI: 33.1-43.7). Hookworm infection was the predominant STH infection, which was detected in 26.1% schoolchildren followed by A. lumbricoides (14.8%) and T. trichiura (1.5%). Most of the study subjects (34.1%) had single infections, whereas only 4.2% study subjects had multiple helminthic infections. Among the risk factors considered in the study, lack of shoe wearing habit (adjusted odds ratio [AOR]=29.5; 95% confidence interval [CI]=6.59-132.55; p < 0.001), lack of knowledge on the prevention and control methods (AOR = 5.41; 95% CI = 2.44-11.98; p < 0.001), engagement in irrigation activities (AOR = 2.14; 95% CI = 1.02-4.57, p = 0.049), lack of toilet (AOR = 3.06; 95% CI = 1.31-7.16; p = 0.01), children grades of 5-8 (AOR = 2.62; 95% CI = 1.26-5.43; p = 0.01), playing on soils (AOR = 5.90; 95% CI = 2.79-12.49; p < 0.001), lack of fingernail trimming habit (AOR = 3.21; 95% CI = 1.57-6.55; p = 0.001), and male gender (AOR = 2.28; 95% CI: 1.19-4.39; p = 0.013) were significant explanatory factors for STH infection among schoolchildren in the study area.

Conclusions

The present study showed that STHs were common among schoolchildren around Lake Tana. Therefore, education on personal and environmental hygiene should be taken into account to reduce the prevalence of STH infection in the study area.

Intestinal Parasitic Infection Among Rural Schoolchildren in Taiz, Yemen: School-based Assessment of The Prevalence and Associated Risk Factors

Yemen is an underdeveloped country plagued by poverty, disease, and social conflicts. Furthermore, most of the population lives in rural areas and is vulnerable to intestinal parasite infections (IPI). School-based cross-sectional studies were conducted between 1 February and 31 March 2019 among schoolchildren in rural communities in the Sabir Almawadim and Almawasit districts of Taiz, southwest Yemen. A structured questionnaire collected information regarding sociodemographic characteristics and risk factors. Wet mount and formol-ether concentration techniques were used to detect and identify intestinal parasites in stool specimens. The stool specimens were collected from each study participant using a clean, leak-proof, and adequately labeled stool cup. Statistical analysis of the data was performed using SPSS version 20. Of the 478 students screened for intestinal parasites, 245 (51.26 %) had at least one parasite. The prevalence of protozoa was higher than helminths (30.3 % versus 20.9 %, respectively). The percentages of single, double, and triple infections were 37.4 %, 4.4 %, and 1.7 %, respectively. Giardia lamblia was the most prevalent pathogen (15.5 %), followed by E. hisrolyrica/dispar (14.9 %), Schistosoma mansoni (13.3 %), Ascaris lumbricoides (3.8 %), Trichuris trichiura (2.9 %), and Enterobius vermicularis (1.3 %). Multivariate analysis confirmed that practicing unwashed hands before eating, open field defecation, unwashed fruits and vegetables, and dirty unclipped fingernails were the most significant predictors of high risk of IPIs (p <0.05). Regarding Schistosoma mansoni, multivariate analysis identified the behaviors of practicing swimming in the river/ponds and practicing open defecation, especially near water sources, as independent risk factors for Schistosoma mansoni infection among schoolchildren. The current study showed that rural areas in Taiz were significantly infected with IPIs, showing that IPIs remains a significant public health problem in low-income communities. Consequently, prevention efforts should focus on treating and deworming schoolchildren regularly, promoting health education in rural schools, conducting personal hygiene inspections for students, and ensuring that schools have sanitary facilities.

Intestinal Helminth Infection, Anemia, Undernutrition and Academic Performance among School Children in Northwestern Ethiopia

This study examined the prevalence and intensity of intestinal helminth infections and their association with anemia, undernutrition, and academic performance among school children in Maksegnit, northwestern Ethiopia. A total of 1205 school children, who attended Maksegnit Number Two Elementary School between May and July 2021, participated in this study. To determine helminth infection status, two thick Kato–Katz slides were examined for each child. Hemoglobin level was measured using a HemoCue machine. Academic performance was assessed using the mean score of all subjects children have taken for the Spring 2020/2021 academic term. Out of 1205 children examined, 45.4% were infected with at least one helminth species, 7.9% were anemic, and 35.8% were undernourished. The means for hemoglobin level and z-scores of weight for age, height for age, body mass index for age, and academic scores were lower among helminth-infected children than the uninfected. Children infected with intestinal helminths showed higher odds of anemia than those uninfected with helminths. In conclusion, there was a moderate prevalence of intestinal helminth infection and undernutrition among school children in Maksegnit. Intestinal helminth infection could increase the risk of anemia, undernutrition, and poor academic performance.

Evidence of reduced academic performance among schoolchildren with helminth infection

Background

Soil-transmitted helminths (STHs) pose a formidable health risk to school-age children in resource-limited settings. Unfortunately, mass deworming campaigns have been derailed since the onset of the coronavirus disease 2019 pandemic. The present study assessed the cross-sectional associations between STHs, nutritional status and academic performance of schoolchildren in the Banda District of Ghana.

Methods

Schoolchildren (5–16 y of age; n=275) were recruited through both school and household visits by community health workers using a multistage cluster sampling technique. In addition to school microscopy, anthropometric records were also taken.

Results

The prevalence of geohelminthiasis was 40.4% (95% confidence interval 34.6 to 46.2). STHs targeted for elimination by the World Health Organization and national programmes were detected among schoolchildren. Children with intestinal parasite infection (53.7 [standard deviation {SD} 11.5]) had lower mean academic scores compared with uninfected children (59.6 [SD 16.9]) (p=0.034). In multiple regression analysis, intestinal parasite infection status and z-scores for weight-for-age showed a collective significant effect on the academic score (F₁₁₁₇=8.169, p<0.001, R²=0.125).

Conclusions

Schoolchildren with STHs had poorer academic performance compared with uninfected children, despite their nutritional status. In addition to school feeding programmes, school-based mass drug administration campaigns may be critical for improving learning outcomes in young schoolchildren.

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

Background

Strongyloides stercoralis is an intestinal parasite that can cause chronic infection, hyperinfection and/or a dissemination syndrome in humans. The use of techniques targeting ova fails to detect S. stercoralis, as only larvae of the parasite are excreted in faeces. Due to the absence of “Gold” standard diagnostic method for S. stercoralis, there is a paucity of reported data worldwide.

Objective

This study aimed to evaluate the performance of diagnostic methods of S. stercoralis infection by taking the composite reference as a “Gold” standard.

Methods

A cross-sectional study was conducted among 844 schoolchildren in Amhara Region, Ethiopia, from April to December 2019. Stool samples were collected and processed with formol-ether concentration technique (FECT), spontaneous tube sedimentation technique (STST), Baermann concentration technique (BCT), agar plate culture (APC) and real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, positive predictive value, and negative predictive value of each diagnostic method were computed against the composite reference. The agreements of diagnostic methods were evaluated by Kappa value at 95% CI.

Results

The composite detection rate of S. stercoralis by the five diagnostic methods was 39.0% (329/844). The detection rate of the parasite from stool samples by FECT, STST, BCT, APC and RT-PCR was 2.0% (17/844), 4.0% (34/844), 10.2% (86/844), 10.9% (92/844) and 28.8% (243/844), respectively. The highest detection rate (37.8%; 319/844) of S. stercoralis was recorded by a combination of BCT, APC, and RT-PCR followed by a combination of STST, BCT, APC and RT-PCR (37.3%; 315/844). The sensitivity of FECT, STST, BCT, APC and RT-PCR against the composite reference was 5.2%, 10.3%, 26.4%, 28.0% and 73.9%, respectively. The diagnostic agreements of RT-PCR, APC, BCT, STST and FECT with the composite reference in detection of S. stercoralis were substantial (0.775), fair (0.321), fair (0.305), slight (0.123), and slight (0.062), respectively.

Conclusion

RT-PCR detected the highest number of S. stercoralis infections. A combination of RT-PCR with APC and/or BCT better detected S. stercoralis from stool samples compared to other combinations or single diagnostic methods. Therefore, RT-PCR and combination of RT-PCR with APC and/or BCT diagnostic methods should be advocated for detection of S. stercoralis infection.

Prevalence of soil-transmitted helminths infections among preschool and school-age children in Ethiopia: a systematic review and meta-analysis

BACKGROUND

There is a lack of comprehensive national data on prevalence, geographical distribution of different species, and temporal trends in soil-helminthiasis (STHs). Therefore, this study aimed to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia.

METHODS

The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar on data published between 1997 to February 2020 for studies describing the rate of STHs infection among preschool and school-age in Ethiopian. We followed the Patient, Intervention, Comparison, and Outcome (PICO) approach to identify the studies. Meta-regression was performed to understand the trends and to summarize the prevalence using the "metaprop" command using STATA software version 14.0 RESULTS: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48% (95% CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95% CI: 31-58%) in SNNPR, 34% (95% CI: 28-41%) in Amhara region, 31% (95% CI: 19-43%) in Oromia region and 10% (95% CI: 7-12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI: 30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI: 25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A lumbricoides was the predominant species with a prevalence of 17%.

CONCLUSION

Southern Nations Nationalities and Peoples Region, Amhara, and Oromia regions carry the highest-burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring MDA once annually with Albendazole or Mebendazole. The prevalence of STHs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia. The high prevalence of STHs observed in this review, underscores the need for better control and prevention strategies in Ethiopia.

Prevalence of Schistosoma mansoni and Associated Risk Factors in Human and Biomphalaria Snails in Ethiopia: A Systematic Review and Meta-analysis

PURPOSE

Schistosomiasis is one of the leading chronic parasitic diseases in Ethiopia. We aimed to summarize the prevalence of S. mansoni in human and Biomphalaria snails as well as risk factors in Ethiopia.

METHODS

Literature search was carried out from Scopus, Google Scholar, Science Direct and PubMed which reported Schistosoma mansoni infection in human and Biomphalaria snails in Ethiopia. The overall prevalence was estimated by a random-effect model and heterogeneities among studies were assessed by I² test.

RESULTS

A total of 178,251 participants and 1,097 snails were tested for the presence of S. mansoni in the eligible studies. The pooled prevalence of S. mansoni was 32.5% (95% CI 28.0-37.0) and 15.9% (95% CI - 5.6-37.5) in human and Biomphalaria snails in Ethiopia, respectively. The highest pooled prevalence was 43.2% (95% CI 27.3-59.1) in South Nations and National Peoples region while the lowest pooled prevalence was 25% (95% CI 19.3-30.7) observed in the Afar region. Interestingly, the pooled prevalence of S. mansoni declined from 40.7% (95% CI 33-48.4) to 22.4% (95% CI 18.5-26.3) after the launching of mass drug administration (MDA). The analysis of risk factors showed that swimming habit (OR, 2.78; 95% CI 2.35-3.21) and participation in irrigation (OR, 2.69; 95% CI 1.45-3.73) were independent predictors for S. mansoni infection.

CONCLUSION

This study revealed that about one-third of human and nearly 16% of Biomphalaria snails were infected with S. mansoni in Ethiopia. This review indicated that the prevalence of S. mansoni declined after the implementation of MDA. This study highlights the importance of further integrated approaches for better control of schistosomiasis in Ethiopia.

Helminth infections and allergic diseases: systematic review and meta-analysis of the global literature

INTRODUCTION

There is considerable research interest in the role of helminth infections in the development of allergic diseases. However, findings from previous studies are mixed. Existing systematic reviews of these studies are outdated. We performed a systematic review of the global literature on the association between helminth infections and development and clinical outcomes of allergic diseases.

METHODS

We searched Cochrane Library, MEDLINE, EMBASE, ISI Web of Science, PubMed, Global Index Medicus, Scielo, KoreaMed, Google Scholar, and Lilacs for studies published up to January 2020. We included observational epidemiological studies (cohort, case-control and cross-sectional studies) of children and adults reporting associations between helminth infections and asthma, allergic rhinitis, eczema and atopy. We performed random-effects meta-analysis to summarize the effect estimates.

RESULTS

We included 80 studies with 99,967 participants. In the meta-analyses, we did not observe an overall association between helminth infections and allergic diseases. There was, however, evidence that A. lumbricoides infections was associated with an increased risk of bronchial hyperreactivity in children (RR:1.41, 95%CI: 1.17-1.70; I²=50, p for I²=0.09), and was associated with an increased risk of atopy among helminth-infected adults (RR:1.37, 95%CI: 1.18-1.61; I²=52, p for I²=0.02). We found no study that addressed the association between helminth infection and clinical outcomes of allergic diseases. The overall strength of the underlying evidence was low to moderate.

CONCLUSION

Helminth infections may increase the risk of bronchial hyperreactivity in children and atopy in adults. Well-designed longitudinal cohorts may help clarify potential causal associations between chronic helminth infections and allergic diseases.

Prevalence and associated factors of soil transmitted helminthiasis among school-age children in wetland and non-wetland areas of Blue Nile Basins, northwest Ethiopia: A community-based comparative study

Introduction:

Different interventions have been done to reduce the burden of soil-transmitted helminths (STH). The available evidences in Ethiopia in either school or community-based school-aged children (SAC) have limitation in wetland areas. This study assessed the prevalence and associated factors of STH infection among SAC in wetland and non-wetland areas of Blue Nile Basins, Amhara Region, Northwest Ethiopia.

Method:

A community-based comparative study was conducted from October to November, 2019. Multistage stratified random sampling technique used to select 716 SAC. Data were collected using structured questionnaire and observational checklist. Stool samples were collected from children using tight-fitting plastic cups following the standard procedures. Data were coded and entered into Epi data version 4.6 and exported to SPSS version 20 software. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with STH.

Results:

The overall prevalence of STH was 30.30% (95% CI: 26.90, 33.90) and did not show significant variation between wetland (33.60% (95% CI: 28.80, 39.60%)) and non-wetland (27.0% (95% CI: (21.90, 31.60)) areas. Presence of human feces near the house and certain habits such as nail trimming and playing with mud/soil was not different between wetland and non-wetlands. Nonetheless, the presence of human feces near the house of respondents was found to be significantly associated with STH infection (p value < 0.001). Moreover, other factors significantly associated with STH infection were lack of nail trimming (p value < 0.001) and playing with mud/soil (p value < 0.01).

Conclusions:

The prevalence of STH was high and did not show significant variation between the two areas. Emphasis needs to be given for hygiene and lifestyle-related factors.

Prevalence of Schistosoma mansoni infection among children in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia. Schistosoma mansoni is a major public health problem in Ethiopia especially among children. This review is aimed to indicate the prevalence of Schistosoma mansoni among children at the national and regional levels.

METHODS AND MATERIAL

The PRISMA guidelines were followed. An electronic search of PubMed, Google Scholar, Web of Science, Scopus, MEDLINE, and Google search were carried out using key terms. Articles published from the proceeding of professional associations such as the Ethiopian medical laboratory association, the Ethiopian public health association, and annual national research conferences were also searched to find additional eligible studies. Data were extracted independently by two investigators, and cross-checked by a third reviewer. The quality of included studies was assessed using JBI quality assessment criteria. Data were extracted using Microsoft excel and finally analyzed using STATA version 12. The pooled prevalence was done using a random-effects model.

RESULT

Overall 49 studies involving 20,493 children (10,572 male and 9, 921 females) were included in this meta-analysis. The pooled prevalence of Schistosoma mansoni infection was 37.13% (95%CI:30.02-44.24). High heterogeneity was observed with I2 of 99.4%, P < 0.000. According to subgroup analysis, the pooled prevalence was high in the SNNPR (41.49%: 95%CI: 19.52-63.46) followed by the Amhara region (41.11%: 95%CI: 30.41-51.8), the Tigray region (31.40%: 95%CI:11.72-51.09), and the Oromia region (28.98%: 95%CI: 18.85-39.1). Year from 2011 to 2015 contributed to the highest prevalence of Schistosoma mansoni infection among children (46.31%: 95%:34.21-59.05).

CONCLUSION

This study revealed a 37.13% prevalence of Schistosoma mansoni infection among children. This is an alert to improve and implement appropriate control strategies such as mass drug administration in Ethiopia.

Trend of Soil-Transmitted Helminths in Ethiopian Children: A Systematic Review and Meta-Analysis (2000-2018)

Background

Ethiopia is one of the tropical countries with a heavy burden of soil-transmitted helminths. As a result, the nation has been implementing mass drug administration, water, sanitation, and hygiene and health extension programs to control those parasites. Hence, updated data about the prevalence and trend of parasites over time has a pivotal role to assess the success of existing control programs.

Methods

Studies conducted between 2000 and 2018 were searched from PubMed, Google Scholar, and local journals for systematic reviews and meta-analysis following the PRISMA guideline and checklists. Eligible studies were selected based on preset inclusion and exclusion criteria. The quality of the included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using the Cochran Q test and I² test statistics based on the random effect model. Comprehensive meta-analysis (CMA 2.0) was used to calculate the pooled prevalence, and metaregression was run to assess the trend of parasite prevalence over time.

Results

Thirty-eight studies recruiting 16,266 participants were included in the review. The pooled prevalence of intestinal parasites was 52.0% (95% CI: 44.4-59.5). Amhara region was with the highest prevalence (60.3%; 95% CI: 50.1-69.6). Among soil-transmitted helminths, Ascaris lumbricoides (11.2%; 95% CI: 8.4-14.8) was with the highest pooled prevalence followed by hookworms (10.4%; 95% CI: 7.9-13.7) and Trichuris trichiura (3.6%; 95% CI: 2.4-5.4). Metaregression analysis revealed that all soil-transmitted helminths did not show a significantly decreasing trend over time (p > 0.05).

Conclusion

Despite various control efforts having been made, soil-transmitted helminths are of high distribution, and their prevalence is not significantly decreasing in Ethiopia. Hence, other control approaches like community-led sanitation should be integrated with mass drug administration to achieve the national goal of soil-transmitted helminth elimination by 2025.

Prevalence, intensity and associated risk factors of Schistosoma mansoni infections among schoolchildren around Lake Tana, northwestern Ethiopia

BACKGROUND

Schistosomiasis is one of the widely distributed neglected tropical diseases. It is a serious public health problem in sub-Saharan Africa. The disease is highly prevalent and widely distributed in Ethiopia due to suitable environmental factors and human activities. The prevalence and infection intensity varied from locality to locality in the country. This study aimed to assess the prevalence and intensity of S. mansoni infection and associated risk factors among schoolchildren around Lake Tana.

METHODS

A school-based cross-sectional study was conducted among 710 schoolchildren from February to April 2021 in eight selected primary schools around Lake Tana. A questionnaire was used to collect data on socio-demographic information and potential risk factors of S. mansoni infection. After collecting socio-demographic information, students were requested to bring about 2grams of stool specimens for parasitological examination. The collected stool samples were processed using a single Kato-Katz and Ritchie's concentration techniques. The data were analyzed using SPSS software version 23 and factors with a p-value < 0.05 were considered as statistically significant.

RESULTS

The overall prevalence of S. mansoni was 34.9% (95% CI: 31.4-38.7) among schoolchildren in the study area. The eggs per gram (EPG) of stool ranged from 24 to 1659 with arithmetic and geometric mean values of 138.1 EPG and 85.1 EPG, respectively. The majority of S. mansoni infections (61.4%) were classified as low infection intensity. Among the different determinant factors being male (AOR = 1.74; 95%CI = 1.233-2.457; P-value = 0.002), bathing habits (AOR = 1.494; 95%CI = 1.013-2.199; P-value = 0.043) and students attending at Qunzela primary school (AOR = 10.545; 95%CI = 3.264-34.067; P-value = 0.001), Alabo primary school (AOR = 3.386; 95%CI = 1.084-10.572; P-value = 0.036) were significantly associated with S. mansoni infection.

CONCLUSION

This study revealed that more than one-third of schoolchildren were infected by S. mansoni in the study area. The majority of the infections were classified as low infection intensity. Being male, bathing habits and schools in which students attended were independent explanatory factors for S. mansoni infection. Therefore, integrated control strategies are needed to improve the health conditions of schoolchildren in the study area.

Prevalence and risk factors of human Balantidium coli infection and its association with haematological and biochemical parameters in Ga West Municipality, Ghana

Background

In Ghana, Balantidium coli (B. coli) has been identified in vegetables and in pigs, although there is a paucity of data regarding human balantidiosis. This study sought to assess human B. coli infection in Ghana, factors associated with the infection as well as its association with haematological and biochemical parameters.

Methods

Two pig rearing communities in the Ga West Municipality, Ghana, were involved in this study. Stool and blood samples were collected from pig farmers and their exposed household members as well as relevant information on potential associated factors. Eosin-saline wet preparation was done on the same day of stool samples were collected while formol ether concentration technique was performed later. Haematological, biochemical parameters and serum electrolytes were determined using Celltac MEK-6500 K, PKL-125 biochemical analyser, and FT-320 electrolyte analyser, respectively.

Results

The overall prevalence of balantidiosis was 10.4 %, significantly higher among farmers (21.7 %) than in exposed household members (5.8 %) (x² = 17.8, p = 0.000025). Of the 43 infected individuals, 20.9 % were co-infected with either Entamoeba histolytica, Giardia lamblia, or Schistosoma mansoni. In B. coli infection, mild to moderate anaemia together with a reduction in levels of platelet, albumin and, sodium, chloride, and bicarbonate ions were observed. However, white blood cells were significantly elevated in infected states. Poor farming practices such as free-range systems, improper disposal of pig faeces, lack of use of protective farming clothing, and unavailability of dedicated farming clothing were found to be associated with B. coli infection status. Finally, frequent diarrhea (OR = 12.30, p = 0.006) with occult blood (OR = 25.94, p < 0.0001) were found to be predictors of B. coli infection.

Conclusions

Human balantidiosis is endemic in Ga West Municipality, Ghana. Individuals living closed to pig rearing communities presenting with frequent diarrhea with occult blood in stool should be screened and treated for balantidiosis to mitigate the clinical consequences of the infection.

Prevalence of intestinal parasitic infections and their associated risk factors among preschool and school children in Egypt

Intestinal parasitic infections (IPIs) are among the major public health problems globally, particularly in developing countries like Egypt. This study aimed to evaluate prevalence and risk factors associated with IPIs among preschool and school children in Egypt. A cross-sectional study was conducted on 996 randomly selected preschool and school-aged children in Gharbia governorate during January to April 2018. Stool specimens were examined for the presence of the parasite by direct smear and the formol-ether concentration methods. The overall prevalence of IPIs was 46.2%. Entamoeba histolytica and Ascaris lumbricoides were the most predominant parasites (12.7% per each). This is followed by Enterobius vermicularis (8.6%), Giardia lamblia (7.1%), Cryptosporidium parvum (1.5%), Heterophyes heterophyes (1.4%), Hymenolepis nana (0.7%), Hookworms (0.6%), Fasciola hepatica (0.5%) and Dipylidium caninum (0.4%). Infected children with no symptoms (26.8%) were significantly (P < 0.001) more frequent than those with medical complaint (19.4%). Socio-demographic predictors of IPIs were preschool age (OR = 4.9; P < 0.001; 95%CI 3.3-7.3), living in rural dwellings (OR = 1.96; P < 0.001; 95%CI 1.5-2.5), and belonging to a low-income family (OR = 4.7; P < 0.001; 95%CI 2.3-9.3). The absence of safe drinking water, lack of hand washing (after soil contact, or before meals, or after toilet usage), and eating unwashed vegetables were risk factors for IPIs in the study region (OR = 1.3-6.9, P < 0.001 -P = 0.05). Higher odds for exposure to potential zoonotic parasites were evident in children with pets in their homes for G. lambia and D. caninum (OR = 2.1-8.3; P = 0.02 -P = 0.04), children having household reared ruminants for C. parvum (OR = 10.4; P < 0.001), and children that play with stray animals for E. histolytica and Hookworm (OR = 1.8-6.3; P = 0.04 -P = 0.05)compared to other children with no animal contact. The present study highlights the importance of periodic screening and treatment of IPIs in children, deworming companion animals, and public education for effective prevention of IPIs in children in Egypt.

Nutritional Status and Associated Factors among Primary Schoolchildren from Pastoral Communities, Mieso-Mulu District, Sitti Zone, Somali Regional State, Eastern Ethiopia: Institution-Based Cross-Sectional Study

BACKGROUND

Child undernourishment is the disturbance of body function arising from a dietary imbalance between body demand and supply, which is the most serious public health problem in developing countries.

OBJECTIVE

This study aimed to assess the magnitude of nutritional status and associated factors among full-cycle primary schoolchildren in pastoral communities in the Mieso-Mulu district, Sitti Zone, Somali Regional State of Ethiopia.

METHODS

An institution-based cross-sectional study design was used. Study participants were selected using two-stage sampling procedures. Data were collected using structured, translated, pretested, and interviewer-administered questionnaires. The weight and height were measured using a calibrated digital scale and a Seca Rod stadiometer, respectively. Microscopic identification of intestinal parasites was done. Multicollinearity was checked for independent variables. Height for age z scores (HAZ) and body mass index for age z scores (BAZ) were used to determine the nutritional status of children. Logistic regression with both bivariate analysis and multivariate analysis was applied to identify associated factors with the nutritional status of children. Adjusted odds ratios were reported and the level of statistical significance was declared at a P value <0.05.

RESULTS

The magnitudes of thinness and stunting were 13.1% [95% CI: 10.6%, 15.7%] and 24.6% [95% CI: 21.3%, 27.9%], respectively. Being male, not using a bed net, and the presence of intestinal parasitic infection were among the factors associated with thinness. Family size of less than five, household food insecurity, and unavailability of the latrine were among the factors associated with stunting.

CONCLUSION

This study revealed that stunting and thinness are major health problems among schoolchildren. Household food insecurity, intestinal parasitic infection, bed net utilization, and the availability of latrine were some of the major factors significantly associated with undernutrition. Local policymakers, health programmers, nutritionists, health practitioners, and nongovernmental organizations should enhance the nutritional status of schoolchildren by using information dissemination interventions, particularly in improving waste disposal, sanitation/hygiene, latrine facilities, and school-based deworming. Furthermore, awareness creation using nutrition promotion and encouraging communities to attempt to diversify locally available and low-cost nutritionally effective food items to improve food consumption and distribution within a household is recommended to reduce the prevalence of undernutrition among schoolchildren.

Prevalence and determinants of stunting among preschool and school-going children in the flood-affected areas of Pakistan

Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.

Prevalence and Predictors of Stunting among Primary School Children in Northeast Ethiopia

Background

Stunting is a major public health problem affecting children in low- and middle-income countries and has become one of the underlying causes of early childhood mortality. However, there is a paucity of information on the prevalence of stunting and its predictors among school children in these settings including Ethiopia.

Objective

The aim of this study was to assess the prevalence of stunting and its predictors among school children in Northeast Ethiopia.

Methods

A school-based cross-sectional study design was used among 341 primary school children in Northeast Ethiopia from October to December 2019. A simple random sampling technique was used to recruit the study subjects. A pretested structured questionnaire was used to collect sociodemographic and dietary data. Anthropometric data were generated using WHO AnthroPlus software version 1.0.4. Binary logistic regression analysis was used to see the association between independent variables and the outcome variable. Odds ratio along with 95% confidence interval was estimated to measure the strength of the association. The level of statistical significance was declared at p value ≤ 0.05.

Results

The prevalence of stunting was found to be 14.1% (95% CI: 10.1%, 18.1%). Family size of 6-9 (AOR = 2.43; 95% CI: (1.16, 4.58)), washing hands less frequently before eating (AOR = 3.96; 95% CI: (2.09, 11.66)), and intestinal parasitic infection (AOR = 2.66; 95% CI: (1.16, 4.95)) were significantly associated with stunting.

Conclusion

The prevalence of stunting among school-age children was a great public health concern. Large family size, poor handwashing practice before meals, and intestinal parasitosis were significant predictors of stunting. Thus, periodic deworming, health education on personal hygiene, and health promotion and counseling on family planning need to be strengthened by all relevant stakeholders.

Environmental characteristics around the household and their association with hookworm infection in rural communities from Bahir Dar, Amhara Region, Ethiopia

Soil-Transmitted Helminths (STH) are highly prevalent Neglected Tropical Disease in Ethiopia, an estimated 26 million are infected. Geographic Information Systems and Remote Sensing (RS) technologies assist data mapping and analysis, and the prediction of the spatial distribution of infection in relation to environmental variables. The influence of socioeconomic, environmental and soil characteristics on hookworm infection at the individual and household level is explored in order to identify spatial patterns of infection in rural villages from Zenzelema (Amhara region). Inhabitants greater than 5 years old were recruited in order to assess the presence of STH. Socioeconomic and hookworm infection variables at the household level and environmental variables and soil characteristics using RS were obtained. The dominant STH found was hookworm. Individuals which practiced open defecation and those without electricity had a significant higher number of hookworm eggs in their stool. Additionally, adults showed statistically higher hookworm egg counts than children. Nonetheless, the probability of hookworm infection was not determined by socioeconomic conditions but by environmental characteristics surrounding the households, including a combination of vigorous vegetation and bare soil, high temperatures, and compacted soils (high bulk density) with more acidic pH, given a pH of 6.0 is optimal for hatching of hookworm eggs. The identification of high-risk environmental areas provides a useful tool for planning, targeting and monitoring of control measures, including not only children but also adults when hookworm is concerned.

Lack of Consistent Association between Asthma, Allergic Diseases, and Intestinal Helminth Infection in School-Aged Children in the Province of Bengo, Angola

Epidemiological studies have shown conflicting findings on the relationship between asthma, atopy, and intestinal helminth infections. There are no such studies from Angola; therefore, we aimed to evaluate the relationship between asthma, allergic diseases, atopy, and intestinal helminth infection in Angolan schoolchildren. We performed a cross-sectional study of schoolchildren between September and November 2017. Five schools (three urban, two rural) were randomly selected. Asthma, rhinoconjunctivitis, and eczema were defined by appropriate symptoms in the previous 12 months: atopy was defined by positive skin prick tests (SPT) or aeroallergen-specific IgE; intestinal helminths were detected by faecal sample microscopy. In total, 1023 children were evaluated (48.4% female; 57.6% aged 10–14 years; 60.5% urban). Asthma, rhinoconjunctivitis, or eczema were present in 9%, 6%, and 16% of the studies children, respectively. Only 8% of children had positive SPT, but 64% had positive sIgE. Additionally, 40% were infected with any intestinal helminth (A. lumbricoides 25.9%, T. trichiura 7.6%, and H. nana 6.3%). There were no consistent associations between intestinal helminth infections and asthma, allergic diseases, or atopy, except for A. lumbricoides, which was inversely associated with rhinoconjuctivitis and directly associated with aeroallergen-specific IgE. We concluded that, overall, intestinal helminth infections were not consistently associated with allergic symptoms or atopy. Future, preferably longitudinal, studies should collect more detailed information on helminth infections as part of clusters of environmental determinants of allergies.

A community-based, cross-sectional study to assess interactions between income, nutritional status and enteric parasitism in two Brazilian cities: are we moving positively towards 2030?

BACKGROUND

This study assessed the interactions between income, nutritional status and intestinal parasitism in children in Brazil.

METHODS

A cross-sectional study (n = 421 children aged 1 to 14 years living in the states of Piauí (rural communities in the city of Teresina) and Rio de Janeiro (rural and periurban communities in the city of Cachoeiras de Macacu) was performed in order to obtain income and anthropometric data, as well as fecal samples for parasitological analyses through the Ritchie technique.

RESULTS

Children infected with Ascaris lumbricoides had significantly lower means of height-for-age z scores (- 1.36 ± 0.75 vs. - 0.11 ± 1.02; p < 0.001), weight-for-age z scores (- 1.23 ± 0.74 vs. 0.09 ± 1.15; p = 0.001), and weight-for-height z scores (- 0.68 ± 0.44 vs. 0.23 ± 1.25; p = 0.006) when compared with uninfected children. Infection with hookworm was also associated with lower means of height-for-age z scores (- 1.08 ± 1.17 vs. - 0.12 ± 1.02; p = 0.015) and weight-for-age z scores (- 1.03 ± 1.13 vs. 0.08 ± 1.15; p = 0.012). Children infected with Entamoeba coli presented significantly lower means of height-for-age z scores (- 0.54 ± 1.02 vs. - 0.09 ± 1.02; p = 0.005) and weight-for-age z scores (- 0.44 ± 1.15 vs. 0.12 ± 1.15; p = 0.002). The multivariate multiple linear regression analysis showed that height-for-age z scores are independently influenced by monthly per capita family income (β = 0.145; p = 0.003), female gender (β = 0.117; p = 0.015), and infections with A. lumbricoides (β = - 0.141; p = 0.006) and Entamoeba coli (β = - 0.100; p = 0.043). Weight-for-age z scores are influenced by monthly per capita family income (β = 0.175; p < 0.001), female gender (β = 0.123; p = 0.010), and infections with A. lumbricoides (β = - 0.127; p = 0.012), and Entamoeba coli (β = - 0.101; p = 0.039). Monthly per capita family income (β = 0.102; p = 0.039) and female gender (β = 0.134; p = 0.007) positively influences mid upper arm circumpherence.

CONCLUSIONS

Intestinal parasitism and low family income negatively influence the physical development of children in low-income communities in different Brazilian regions.

Prevalence and factors associated with intestinal schistosomiasis and human fascioliasis among school children in Amhara Regional State, Ethiopia

Background

Schistosomiasis and fascioliasis are digenean parasitic infections and are among the neglected tropical diseases that have both medical and veterinary importance. They are found mainly in areas having limited access to safe water supply and improved sanitation.

Methods

A cross-sectional study was conducted to determine the prevalence of Schistosoma mansoni and Fasciola species infections and to identify associated risk factors among school children in Amhara Regional State, Ethiopia. Stool specimens were collected from 798 children (419 males, 379 females) and processed using Kato-Katz and formol-ether concentration techniques. A semi-structured questionnaire was used to collect socio-demographic and other exposure information to explore potential risk factors for the infections.

Results

The overall prevalence of S. mansoni and Fasciola species infections was 25.6% (95% confidence interval (CI): 22.5-28.6) and 5.5% (95% CI: 3.9-7.1), respectively. S. mansoni was present in all surveyed schools with the prevalence ranging from 12.8% (16/125; 95% CI = 5.6-20.0) to 39.7% (64/161; 95% CI = 32.2-47.2) while Fasciola species was identified in five schools with the prevalence ranging from 2.5% (4/160; 95% CI = 0.001–4.9) to 9.8% (13/133; 95% CI = 4.7–14.8). The prevalence of S. mansoni infection was significantly associated with swimming in rivers (Adjusted odds ratio (AOR): 1.79, 95% CI, 1.22–2.62; P=0.003), bathing in open freshwater bodies (AOR, 2.02; 95% CI, 1.39–2.94; P<0.001) and engaging in irrigation activities (AOR, 1.69; 95% CI, 1.19-2.39; P=0.004), and was higher in children attending Addis Mender (AOR, 2.56; 95% CI, 1.20–5.46; P=0.015 ) and Harbu schools (AOR, 3.53; 95% CI, 1.64–7.59; P=0.001). Fasciola species infection was significantly associated with consumption of raw vegetables (AOR, 2.47; 95% CI, 1.23-4.97; P=0.011) and drinking water from unimproved sources (AOR, 2.28; 95% CI, 1.11–4.70; P=0.026).

Conclusion

Both intestinal schistosomiasis and human fascioliasis are prevalent in the study area, affecting school children. Behaviors and access to unimproved water and sanitation are among significant risk factors. The findings are instrumental for targeted interventions.

Prevalence of Schistosomiasis (S. mansoni and S. haematobium) and its association with gender of school age children in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Schistosomiasis (S. mansoni and S. haematobium) is an important neglected tropical disease in sub-Saharan Africa including Ethiopia. In Ethiopia, Schistosomiasis has been prioritized as neglected tropical disease and remained among major public health burden on school age children of the country. Few studies conducted on the association between prevalence of Schistosomiasis and gender of school age children have inconclusive finding about the association between these two variables. Therefore, this systematic review and meta-analysis was done to determine the pooled prevalence of Schistosomiasis and its association with gender of school age children in Ethiopia.

METHODS

In this systematic review and meta-analysis, databases such as: Medline/PubMed, EMBASE, CINAHL, Cochrane Central library, Google Scholar, and HINARI were systematically searched. STATA version 14 was used to estimate pooled prevalence of Schistosomiasis using random effects model with 95% confidence interval. The results were presented by using forest plot and statistical heterogeneity was checked by using the Cochran Q test (chi-squared statistic), I2 test statistic and by visual examination of the forest plot.

RESULTS

From the total of 427 studies identified for this review, 50 studies were included in the final analysis. The analysis noted that pooled prevalence of Schistosomiasis in Ethiopia was 28.78% (95% CI: 23.81, 33.74). The subgroup analysis indicated that extreme variability was observed in the prevalence of Schistosomiasis across the regions of the country. The highest (39.77%) prevalence of Schistosomiasis was reported from the southern region, whereas the lowest (14.95%) prevalence of Schistosomiasis was reported from Afar region. Male school age children were 58% more likely infected with Schistosomiasis than female school age children in Ethiopia (OR: 1.58, 95% CI: 1.33, 1.83).

CONCLUSIONS

The Prevalence of Schistosomiasis was higher than the 2018 report of the Ethiopian federal ministry of health. The prevalence of Schistosomiasis was predominant among male gender of the school age children. Therefore, sustainable control of Schistosomiasis requires the approaches that must go beyond current deworming program. Complementary prevention strategies including health education, safe water and adequate sanitary facilities provision should be simultaneously implemented. The underlining causes of variation in risk factors of Schistosomiasis among males and females should be further studied.

Prevalence of intestinal parasitic infection and its associated factors among primary school students in Ethiopia: A systematic review and meta-analysis

Introduction

Intestinal parasitic infection are a major public health concern affecting both children and adolescents in Ethiopia. The aim of this systematic review and meta-analysis was to determine pooled prevalence and associated factors of intestinal parasitic infection in this target group.

Method

We systematically retrieved available articles on the prevalence of intestinal parasitic infection following database searches using PubMed, Scopus, Cochrane Library, and Science Direct between March 1 and May 27, 2020. Two authors independently extracted all relevant data using a standardized Microsoft Excel data extraction form. Heterogeneity among included studies was assessed with the Higgins I² tests. The pooled estimates and associated factors were assessed with a random-effects model using Stata/se Version 14.

Result

We retrieved 30 eligible articles with a pooled sample size of 14,445 primary school children with response rate of 97.8%. Entamoeba spp (16.11%), Ascaris lumbricoides (13.98%), hookworm (12.51%) and Giardia lamblia (9.98%) are the top causes of intestinal parasitic infection among primary school children in Ethiopia. The pooled prevalence for at least one intestinal parasitic infection was 46.09 (95% CI: 38.50, 53.68). Heterogeneity was assessed by doing subgroup analysis by study province/region. Thus, the highest prevalence of 66.6% (95% CI: 55.5, 77.7) occurred in Tigray region, which was followed by Southern Nations, Nationalities, and Peoples’ Region at 50.8% (95% CI: 33.1, 68.5). No latrine availability (OR = 4.39: 2.50,7.73), no fingernail hygiene (OR = 2.37: 1.67, 3.35), open defecation (OR = 1.67:1.64,4.36), no formal maternal education (OR = 2.02: 1.18,3.47), rural residence (OR = 1.88: 1.46, 2.41), no habit of wearing shoes (OR = 2.66: 1.79, 3.96), non-pipe source of drinking water (OR = 1.99: 1.42,2.76), no regular hand washing practices (OR = 3.45:1.85,6.47), and no habit of washing fruits and vegetables (OR = 1.59:1.01,2.49) were associated with parasitic infection.

Conclusions

The prevalence of intestinal parasitic infection was high (46%). Attention should be given to promoting personal hygiene, latrine utilization, wearing shoes, avoiding eating raw food, creating awareness for those mothers who lack formal education. Moreover, future research ideally will expand on the topic by conducting research in regions which have no prior research.

Intestinal parasitic infections are distributed virtually with high prevalence rates in many regions, especially in low and middle income countries which intimately linked to age group, poverty and inadequate access to water, sanitation and hygiene. It is now a day’s one of the neglected tropical disease. We had searched different individual studies on intestinal parasitic infections to generate the pooled effect and recommend for the concerned body. We head included 30 different articles with a sample size of 14,445 and we have found a pooled prevalence of 46.09%. This finding indicates the prevalence of parasitic infection was almost near to half. Therefore every concerned body should give emphasize to prevent and control parasitic infection infestation.

Human Intestinal Parasitic Infections: Prevalence and Associated Risk Factors among Elementary School Children in Merawi Town, Northwest Ethiopia

Background

Intestinal parasitic infection is still common in Ethiopia. Periodic evaluation of the current status of human intestinal parasitic infections (HIPIs) is a prerequisite to controlling these health threats. This study is aimed at assessing the prevalence and determinant factors of HIPIs among elementary school-age children in Merawi town.

Methods

A school-based cross-sectional study design was used among 403 children. The direct wet mount method was used to diagnose the stool samples. The sociodemographic and behavioral characteristics of the respondents were collected using structured questionnaires. The data were analyzed using the chi-square test and logistic regression.

Results

Out of the 403 students, the overall prevalence of HIPIs was 173 (42.9%). The magnitudes of single and double infections were 39.7% and 3.2%, respectively. Seventy-two (17.9%) were positive for Entamoeba histolytica, 63 (15.4%) for Giardia lamblia, 28 (9.6%) for Ascaris lumbricoides, 22 (6.9%) for hookworm, and 1 (0.2%) for Schistosoma mansoni. The prevalence of intestinal parasites was high in the age group of 6–11 years compared to other age groups. The following were the risk factors associated with HIPIs: groups aging 6 to 11 (AOR = 9.581; 95% CI: 0.531-17.498; P = 0.008), aging 12 to 18 (AOR = 3.047; 95% CI: 0.055-1.828; P = 0.008), not washing of hands after defecation (AOR = 3.683; 95% CI; 1.577-8.598; P = 0.003), not regularly washing of hands after defecation (AOR = 2.417; 95% CI; 1.224-4.774; P = 0.003), dirty fingernails (AOR = 2.639; 95% CI: 1.388-5.020; P = 0.003), not wearing shoes (AOR = 2.779; 95% CI: 1.267-6.096; P = 0.011), rural residence (AOR = 6.6; 95% CI; 0.06-0.351; P < 0.0001), and a family size greater than or equal to five (AOR = 2.160; 95% CI: 1.179-3.956; P = 0.013).

Conclusion

The prevalence of HIPIs among elementary school children in Merawi town was very high. Thus, there is a need for intensive health education for behavioral changes related to personal hygiene and mass treatment for effective control of HIPIs in the study area.

Strongyloides Stercoralis Infection in Ethiopia: Systematic Review and Meta-analysis on Prevalence and Diagnostic Methods

Strongyloides stercoralis is a helminthic intestinal parasite that causes the disease strongyloidiasis. Its prevalence is high in tropics and sub-tropics due to poor sanitation and hygiene. However, its true prevalence is not well known in Ethiopia as most health institutions use low sensitive diagnostic methods. This review aimed to determine the pooled prevalence of S. stercoralis at country, and regional state levels. Papers published on S. stercoralis in Ethiopia from 2010 to 2020 were collected from PubMed, Google Scholar and Science direct databases and Addis Ababa repository. Identification, screening, checking the eligibility, and inclusion of the relevant literatures were done. Articles with S. stercoralis positive results from Ethiopian populations were included. Articles which focused on Strongyloides infection in foreigners, and other than stool samples were excluded. The pooled prevalence of S. stercoralis and heterogeneity between studies and across regions were computed. From the 43 articles, the overall prevalence of S. stercoralis in Ethiopia was 1.82 %. Across regions, relatively high prevalence of S. stercoralis (8.78 %) was recorded in Addis Ababa city. High prevalence of S. stercoralis was found to be 44.02 % with a combination of formol ether concentration, Baermann concentration, and molecular methods. Low prevalence of 0.26 %, 0.31 %, and 1.20 % was evidenced respectively with Kato-Katz, direct saline microscopy, and formol ether concentration methods. Using random effect analysis, the pooled prevalence of S. stercoralis in Ethiopia, across regions and across diagnostic methods was 2.1 % (95 %CI: 1.20 – 3.60), 2.6 % (95 %CI: 0.80 – 8.20) and 3.7 % (95 %CI: 1.10 – 11.70), respectively. The heterogeneity was high (P<0.001). This review revealed that Strongyloides infection is probably underreported and its prevalence could be higher than the reported in Ethiopia. Therefore, a revision of the best combination of diagnostic methods could be advisable as it gives better diagnostic results in routine diagnosis of Strongyloides infection in Ethiopia.

Prevalence of Schistosoma mansoni infection in Ethiopia: a systematic review and meta-analysis

Background

Schistosomiasis is a common helminthic infection in the tropics and subtropics, particularly in sub-Saharan African countries including Ethiopia. In these counties, Schistosoma mansoni infection is a significant public health problem due to the risk of reinfection and recurrent disease despite implementing several rounds preventive chemotherapy. This systematic review and meta-analysis aimed at assessing the pooled prevalence of schistosomiasis in Ethiopia.

Methods

The PRISMA guidelines were followed to perform the systematic review and meta-analysis. Published studies from January 1999 to June 2020 were searched in Medline, PubMed, Google Scholar, EMBASE, HINARI, and Cochrane Library using key words including: “prevalence”, “incidence”, “schistosomiasis” “Bilharziasis”, “Bilharzia”, “S. mansoni “, “Ethiopia”. Heterogeneity of included studies was assessed using Cochran’s Q test and I² test statistics while publication bias was assessed using Egger’s test.

Results

Ninety-four studies were included in the systematic review and meta-analysis. The pooled prevalence of S. mansoni in Ethiopia was 18.0% (95%CI: 14.0–23.0). The southern region of Ethiopia had a higher S. mansoni prevalence of 25.9% (995% CI, 14.9–41.1) than the national prevalence. The burden of S. mansoni infection was also higher than the national average in rural areas and among men with pooled prevalence of 20.2% (95% CI, 13.2–28.5) and 28.5% (95%CI, 22.7,35.1), respectively. The trend analysis showed that the prevalence of S. mansoni infection in Ethiopia decreased over the past 15 years, potentially because of the repeated preventive chemotherapy.

Conclusion

The review unveiled a moderate prevalence of S. mansoni infection in Ethiopia. Targeted treatment of at-risk population groups ad high burden areas coupled with implementation of integrated vector control strategies are critical to address the burden of Schistosomiasis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40794-020-00127-x.

Helminth infections among rural schoolchildren in Southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model

Although the prevalence of helminths infection among schoolchildren is known, there has been little progress in the application of count model for modelling the risk factors of helminths egg. Only a few studies applied multilevel analysis to explore the variation in helminths prevalence across schools and classes. This study aimed to assess the prevalence, intensity of helminths infection, and identify risk factors at the individual-, household-, and school-level among schoolchildren in Southern Ethiopia. Using multistage random sampling, we recruited 864 students in the Wonago District. We applied multilevel-logistic and zero-inflated negative binomial regression models (ZINB). Risk factors were concentrated at the individual level; school-level and class-level variables explained less than 5% of the variance. The overall helminths prevalence was 56% (479/850); Trichuris trichiura prevalence was 42.4% (360/850); and Ascaris lumbricoides prevalence was 18.7% (159/850). The rate of any helminths increased among thin children (AOR: 1.73 [95% CI: (1.04, 2.90]), anemic (AOR: 1.45 [95% CI: 1.04, 2.03]), mothers who had no formal education (AOR: 2.08 [95% CI: 1.25, 3.47]), and those in households using open containers for water storage (AOR: 2.06 [95% CI: 1.07, 3.99]). In the ZINB model, A. lumbricoides infection intensity increased with increasing age (AOR: 1.08 [95% CI: 1.01, 1.16]) and unclean fingernails (AOR: 1.47 [95% CI: 1.07, 2.03]). Handwashing with soap (AOR: 0.68 [95% CI: 0.48, 0.95]), de-worming treatment [AOR: 0.57 (95% CI: 0.33, 0.98)], and using water from protected sources [AOR: 0.46 (95% CI: 0.28, 0.77)] were found to be protective against helminths infection. After controlling for clustering effects at the school and class levels and accounting for excess zeros in fecal egg counts, we found an association between helminths infection and the following variables: age, thinness, anemia, unclean fingernails, handwashing, de-worming treatment, mother's education, household water source, and water storage protection. Improving hygiene behavior, providing safe water at school and home, and strengthening de-worming programs is required to improve the health of schoolchildren in rural Gedeo.

Prevalence and Determinants of Stunting and Thinness/Wasting Among Schoolchildren of Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

Several studies have been carried out assessing the prevalence of undernutrition and possible determinants among schoolchildren in Ethiopia, but there is a lack of systematically gathered and analyzed information.

OBJECTIVE

This systematic review and meta-analysis aimed to summarize epidemiological data on undernutrition and possible determinants among schoolchildren in Ethiopia.

METHODS

We conducted a systematic review using open access articles that report the prevalence of stunting and wasting/thinness among schoolchildren from PubMed Central, Scopus, and Science direct. The pooled prevalence was determined using a random-effect model while heterogeneities between studies were evaluated by I ² test.

RESULTS

A total of 24 716 schoolchildren were included in the 39 eligible articles. The prevalence of stunting and wasting/thinness among schoolchildren in Ethiopia were 23.1% (95% CI: 19.0-27.0) and 22% (95% CI: 17-26), respectively. There was a marked difference in the prevalence of stunting and wasting/thinness across regions of Ethiopia. The risk of stunting was increased with meal frequency ≤3 times a day (odds ratio [OR] = 3.02, 95% CI: 1.90-4.14), age >10 years (OR = 2.16, 95% CI: 1.47-2.85), and family size ≥5 (OR = 1.88, 95% CI: 1.40-2.35). Similarly, the risk of wasting/thinness was increased with male sex (OR = 2.06, 95% CI: 1.54-2.58), low family income (OR = 2.16, 95% CI: 1.30-3.01), and age >10 years (OR = 1.78, 95% CI: 0.74-2.82).

CONCLUSION

This study revealed that more than one-fifth of schoolchildren are stunted or wasted/thin in Ethiopia. Large family size, male sex, and student age were consistently associated with stunting and wasting/thinness among schoolchildren. This study highlights the importance of an integrated effort to reduce undernutrition in Ethiopia.

Strongyloidiasis in Africa: Systematic Review and Meta-Analysis on Prevalence, Diagnostic Methods, and Study Settings

Background

Strongyloidiasis is an intestinal parasitic infection mainly caused by Strongyloides stercoralis. Although it is a predominant parasite in tropics and subtropics where sanitation and hygiene are poorly practiced, the true prevalence of strongyloidiasis is not known due to low-sensitivity diagnostic methods.

Objective

This systematic review and meta-analysis is aimed at determining the pooled prevalence of strongyloidiasis in African countries, stratified by diagnostic methods, study settings, and patients.

Methods

Cross-sectional studies on strongyloidiasis published in African countries from the year 2008 up to 2018 in PubMed and Google Scholar databases and which reported at least one Strongyloides spp. infection were included. Identification and screening of eligible articles were also done. Articles whose focus was on strongyloidiasis in animals, soil, and foreigners infected by Strongyloides spp. in Africa were excluded. The random effects model was used to calculate the pooled prevalence of strongyloidiasis across African countries as well as by diagnostic methods and study settings. The heterogeneity between studies was also computed.

Result

A total of 82 studies were included. The overall pooled prevalence of strongyloidiasis was 2.7%. By individual techniques, the pooled prevalence of strongyloidiasis was 0.4%, 1.0%, 3.4%, 9.3%, 9.6%, and 19.4% by the respective direct saline microscopy, Kato-Katz, formol ether concentration, polymerase chain reaction, Baermann concentration, and culture diagnostic techniques. The prevalence rates of strongyloidiasis among rural community, school, and health institution studies were 6.8%, 6.4%, and 0.9%, respectively. The variation on the effect size comparing African countries, diagnostic methods, study settings, and patients was significant (P ≤ 0.001).

Conclusions

This review shows that strongyloidiasis is overlooked and its prevalence is estimated to be low in Africa due to the use of diagnostic methods with low sensitivity. Therefore, there is a need for using a combination of appropriate diagnostic methods to approach the actual strongyloidiasis rates in Africa.

Dietary Diversity and Nutritional Status of Preschool Children in North West Province, South Africa: A Cross Sectional Study

Preschool children consume diets inadequate to meet their macro and micronutrient requirements, which ultimately affect their nutritional status due to lack of dietary diversity. A cross sectional study was conducted to investigate the association between dietary diversity scores (DDS) and the nutritional status of 379 preschool children in North West Province of South Africa. A 24 h qualitative recall by mothers of their children's food consumption was used to calculate DDS based on 12-foods groups following Food and Agriculture Organization protocols. DDS was calculated by counting each of 12-food groups and classified as low (≤4), medium (5-8) and high (9-12). The weight and height of children were measured and height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BAZ) z-scores were calculated based on 2006 WHO standards. Stunting, underweight and thinness were defined as HAZ, WAZ and BAZ < -2SD, respectively. Linear and logistic regression analyses were used to assess the association between DDS and the nutritional indicators. Mean age for children was 4 ± 0.7 years, and the prevalence of stunting (29%), underweight (13%) and thinness (6%) was observed. Mean DDS was 4.39 ± 1.55 out of 12-food groups, with a prevalence of 61% and 39% for low and medium DDS, respectively. Cereals (100%) accounted for the main food group consumed, while fish and other seafood (17%) were the least consumed. Consumption of a diversified diet was associated with lower odds of being stunted [AOR = 0.25, 95%CI: 0.10 to 0.92] among the four-year olds, while in the unadjusted model, 5-year-olds had lower odds of being underweight [OR = -0.32, 95%CI: -0.57 to 0.07]. The findings of this study reinforce the importance of continued nutrition education of mothers, caregivers and preschool staff on the need to ensure consumption of diverse food sources in order to improve the nutritional status of children. Further studies are recommended on the association of DDS with the nutritional status, and factors associated with low dietary diversity among preschool children.

Enteroparasitism in Hard-to-Reach Community Dwellers: A Cross-Sectional Study in Ga West Municipality in Ghana

Ga West Municipality in Ghana is predominantly rural with about forty-eight hard-to-reach communities. Several infectious diseases such as Buruli ulcer, tuberculosis, yaws, schistosomiasis, and malaria are prevalent in the municipality. However, the prevalence and characteristics of enteroparasites in the municipality are unknown. Therefore, this cross-sectional study determined the prevalence of enteroparasites in these hard-to-reach communities. Samples were collected from five communities, namely, Opah, Otuaplem, Dedeman, Onyansana, and Manchie. A total of 538 stool samples were collected from the community dwellers. Each sample was examined with eosin-saline wet preparation and formol-ether concentration technique. Body mass index, haemoglobin, and albumin concentrations were used to assess nutritional status. Seven different parasite species were identified in 178 community dwellers (33.1% prevalence (95% CI: 0.29–0.37)). The individual prevalence of the identified parasites was Schistosoma mansoni (13.4%), Entamoeba histolytica (7.2%), Ascaris lumbricoides (6.9%), Giardia lamblia (5.0%), hookworm (4.8%), Strongyloides stercoralis (4.8%), and Balantidium coli (1.6%). Among the 178 parasitized individuals, 68.0% were singly infected while 31.5% had dual parasitism. Significantly higher infections were associated with Onyansana dwellers (p = 0.019), participants aged 16–20 years (p = 0.006), unmarried participants (p < 0.001), those without formal education (p = 0.044), and crop farmers (p = 0.044). However, among the Akan tribe (p = 0.015), Christians (p = 0.03), and participants with higher incomes (p = 0.012), infections were found to be lower. Compared to monoparasitism, dual parasitism was significantly associated with underweight (17.8 vs. 20.3 kg/m²), anaemia (7.7 vs. 9.8 g/dL), and malnutrition (27.6 vs. 31.9 g/L of albumin concentration). These findings underscore the fact that the Ga West Municipality is heavily burdened with different species of enteroparasites. Therefore, education on personal hygiene to reduce parasitic infections must be intensified while implementing regular mass deworming exercise in the municipality.

Prevalence of soil-transmitted helminthes and its association with water, sanitation, hygiene among schoolchildren and barriers for schools level prevention in technology villages of Hawassa University: Mixed design

BACKGROUND

Soil-transmitted helminths (STH) remain one of the most common causes of morbidity among children in Ethiopia. Assessment of the magnitude of STH and its association with water, sanitation, and hygiene (WASH) and identify barriers for school-level prevention assist public health planners to prioritize promotion strategies and is a basic step for intervention. However, there is a lack of evidence on the prevalence of STH and its association with WASH and barriers for school-level prevention among schoolchildren.

OBJECTIVE

To assess the prevalence of STH and its association with WASH and identify barriers for school level prevention in technology village of Hawassa University; 2019.

METHODS

An institution-based analytical cross-sectional study was conducted on a sample of 1080 schoolchildren from September 5 to October 15, 2019. A two-stage cluster and purposive sampling technique were used to draw the study participants. A pretested, structured questionnaire, observation checklist, and in-depth interview were used to collect the data. Two grams of stool samples were collected from each study participant and examined using direct wet mount and Kato-Katz technique. Data were entered into Epi Info version 7 and analyzed using SPSS version 25. Both bi-variable and multivariable logistic regression analyses were done. Qualitative data were analyzed using thematic content analysis method by Atlas-Ti software and presented in narratives.

RESULTS

The overall prevalence of STHs was 23.1% (95% CI = 21.4, 27.6). The identified predictors of STHs were large family size (AOR = 2.03; 95% CI = 1.53-3.99), absence of separate toilet room for male and female (AOR = 3.33; 95% CI = 1.91-5.79), toilet not easy to clean (AOR = 2.17; 95% CI = 1.44-3.33), inadequate knowledge about STHs (AOR = 2.08; 95% CI = 1.07-3.44) and children who had travelled greater than 100 meters to access toilet (AOR = 3.45; 95% CI = 2.24-8.92). These results were supported by the individual, institutional, socio-economic and cultural qualitative results.

CONCLUSION

The STHs was moderate public health concerns. Reinforcing the existing fragile water, sanitation and hygiene programs and regular deworming of schoolchildren may support to reduce the burden of STHs. Also, increasing modern family planning methods utilization to decrease family size is recommended.

Soil-transmitted helminth infections and nutritional status of school children in government elementary schools in Jimma Town, Southwestern Ethiopia

Introduction

Soil-transmitted helminth infections and malnutrition are major health problems of school-age children in developing countries. Malnutrition and soil-transmitted helminth infections often co-exist with synergetic consequences.

Objective

The aim of this study was to determine the prevalence and intensity of soil-transmitted helminths and its association with nutritional status of school-age children.

Methods

School-based cross-sectional study was carried out from April to May 2014 among 404 elementary school-age children in Jimma Town, Southwest Ethiopia. Data on background characteristics were collected using structured interviewer administered questionnaire. Anthropometric measurements were taken according to World Health Organization standard. Fresh single stool sample was collected from each study participant and examined using direct wet mount and McMaster techniques. Anthropometric indices were generated using WHO AnthroPlus software. Multivariable logistic regression models were fitted to isolate independent predictors of intestinal parasitic infection and nutritional status using STATA-MP software. All tests were two-sided and P < 0.05 was used to declare statistical significance.

Results

The overall prevalence of intestinal parasites and soil-transmitted helminths were 68.6% (n = 277) and 55.0% (n = 222), respectively. A total of eight species of intestinal parasites were identified in this study, Trichuris trichiura being the most common parasite identified followed by Ascaris lumbricoides. Study participants who had a habit of open defecation were two times more likely to be infected with soil-transmitted helminths (adjusted odds ratio = 1.9, 95% confidence interval: 1.0-3.4). The overall prevalence of stunting and thinness were 21.0% (n = 85) and 6.9% (n = 28), respectively. The odds of stunting was significantly high (adjusted odds ratio = 4.0, 95% confidence interval: 1.7-9.7) among children who had fathers working as daily labourers and children with personal dietary diversity score of ⩽3 (adjusted odds ratio = 3.5, 95% confidence interval: 1.5-8.0). T. trichiura infection (adjusted odds ratio = 9.4, 95% confidence interval: 2.0-44.8) was identified as an independent predictor of stunting among school-age children.

Conclusion

Both the prevalence of soil-transmitted helminths and stunting are high among school-age children in Jimma Town. Although there was no statistically significant association between the STHs, in general, T. trichiura was reported as predictor of stunting. The results imply the need for strengthening strategies for reduction of parasitic infection to curb the pervasively high prevalence of stunting.

Community-level epidemiology of intestinal helminth infections and anemia in Harbu Town, northeastern Ethiopia

Anemia and intestinal helminth infections are overlapping health problems in developing countries. This study examined the determinants of intestinal helminth infection and anemia in a human population in Harbu Town, northeastern Ethiopia. A total of 484 individuals provided stool and blood samples as well as information about their sociodemographic characteristics and living practices in a community-based cross-sectional survey conducted between May and June, 2013. Stool specimens were examined for intestinal helminth infections using the Kato-Katz method. While a HemoCue machine was used to measure blood hemoglobin levels, a CareStart^TM malaria Pf/Pv combo test was used to test the blood specimens for Plasmodium infection. Out of 484 individuals examined, 15.5% were anemic and 32.0% were infected with intestinal helminths. Plasmodium infection was not detected in any of the study participants. Schistosoma mansoni infection was most common (26.7%) followed by Hymenolepis nana (4.1%). The prevalence of S. mansoni and H. nana infection was greater among school-age children than in pre-school-age children and adults. The prevalence of helminth infection decreased with an increase in monthly income (P = 0.048) and varied among different occupations (P = 0.023). The odds of anemia increased with an increase in the age of individuals (adjusted odds ratio = 1.03, 95% CI = 1.01, 1.06). Hookworm infection was associated with anemia (P = 0.029). In conclusion, intestinal helminth infections and anemia were public health problems among the community of Harbu Town. Increasing age and hookworm infection may increase susceptibility to anemia. Controlling helminth infection may help to reduce the burden of anemia in Harbu Town, Ethiopia.

Epidemiology of Schistosomiasis and Soil-Transmitted Helminth Coinfections among Schoolchildren Living in Lambaréné, Gabon

Schistosomiasis is a parasitic infection highly prevalent in Central Africa where it is co-endemic with many other parasitic infections, including soil-transmitted helminths (STHs). For its optimal control, there is a need of descriptive epidemiological data for each endemic region. The objective of the present study was to determine the epidemiological situation around schistosomiasis in Lambaréné, Gabon. A cross-sectional study was conducted among schoolchildren. One urine sample per day was collected on three consecutive days for the diagnosis of schistosomiasis using a urine filtration technique. One stool sample was collected for the detection of Schistosoma spp. and STH spp. eggs using the Kato-Katz technique, and for larvae, using the coproculture technique. A total of 614 schoolchildren were included in the analysis. The overall prevalence of schistosomiasis and STH infections was 26% (159/614) and 15% (70/473), respectively. Human-freshwater contact was the main risk factor for schistosomiasis in the area (relative risk (RR) = 2.96 [2.20-4.00], P < 0.001). Hematuria (RR = 5.53 [4.30-7.10], P < 0.001) and proteinuria (RR = 2.12 [1.63-2.75], P < 0.001) as well as infection with Trichuris trichiura (RR = 1.86 [1.33-2.61], P = 0.002) and Ascaris lumbricoides (RR = 1.96 [1.19-3.21], P = 0.039) were associated with an increased risk of schistosomiasis. Trichuris trichiura was the highest prevalent STH species in the area. Our study reports a moderate prevalence for schistosomiasis with human-water contact as the main risk factor, whereas the prevalence of STH infections appears to be low. Our results stress the need for the implementation of WHO recommendations for schistosomiasis control.

Prevalence of Intestinal Parasitic Infection and Its Associated Factors Among School Children in Two Primary Schools in Harbu Town, North East Ethiopia: Cross-Sectional Study

Background

Intestinal parasitic infections (IPIs) are major health problems in many developing countries. School children between the ages of 5 and 15 years suffer the highest infection rate and parasitic burden that are attributed to poor sanitation and hygiene. In Ethiopia, the prevalence of IPIs among school children is high (ranging from 66.7% to 83.8%).

Methods

School-based cross-sectional study was conducted in two primary schools at Harbu Town, Northeast Ethiopia from February to May, 2018. Systematic random sampling technique was employed to select study participants from the two school compounds. The sample size was determined by a single population proportion statistical formula and the minimum numbers of study participants defined were 400 school children. Socio-demographic and risk factor-related information were collected using structured questionnaire. Data about detection and identification of intestinal parasites were obtained from laboratory examination of stool specimen by using wet mount and formol-ether concentration techniques. Stool specimen from each study participant was collected using clean, properly labeled and leak-proof stool cup. The data were processed and analyzed using SPSS version 20 software.

Results

Out of a total of 400 study participants, 86 (21.5%) were found with one or more IPIs. Six different types of intestinal parasites were identified, Entamoeba histolytica was the most 33 (8.3%) detected parasite followed by Hymenolopis nana 19 (4.8%) and Schistosoma mansoni 19 (4.8%). The least identified parasite was Giardia lamblia, detected only from four study participants. Male study participants showed 2.42 times risk (AOR = 2.42, 95% CI = 1.25–4.7, P = 0.009) of acquiring parasitic infection than female. Presence of water body near to home and having contact with water bodies showed 7.64 (AOR= 7.64, 95% CI= 3.3–17.8, P= 0.000) and 4.6 (AOR=4.6, 95% CI: 2.04–10.57, P= 0.000) times risk of infection with parasitic infection among school children, respectively.

Conclusion

IPIs were highly prevalent health problem among the two primary school children in Harbu Town. Sex, availability of water bodies near to house and contact with water bodies were having significant association with the prevalence of IPIs.

Helminth infections, atopy, asthma and allergic diseases: protocol for a systematic review of observational studies worldwide

INTRODUCTION

Childhood infections, particularly those caused by helminths are considered to be important environmental exposures influencing the development of allergic diseases. However, epidemiological studies focusing on the relationship between helminth infections and risk of allergic diseases, performed worldwide, show inconsistent findings. Previous systematic reviews of observational studies published 10 or more years ago showed conflicting findings for effects of helminths on allergic diseases. Over the past 10 years there has been growing literature addressing this research area and these need to be considered in order to appreciate the most contemporary evidence. The objective of the current systematic review will be to provide an up-to-date synthesis of findings of observational studies investigating the influence of helminth infections on atopy, and allergic diseases.

METHODS AND ANALYSIS

This systematic review protocol was registered at PROSPERO. We will search Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, ISI Web of Science, WHO Global Health Library, Scielo, IndMed, PakMediNet, KoreaMed, Ichushi for published studies from 1970 to January 2020. Bibliographies of all eligible studies will be reviewed to identify additional studies. Unpublished and ongoing research will also be searched in key databases. There will be no language or geographical restrictions regarding publications. Critical Appraisal Skills Programme quality assessment tool will be used to appraise methodological quality of included studies. A descriptive summary with data tables will be constructed, and if adequate, meta-analysis using random-effects will be performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed for reporting of the systematic review.

ETHICS AND DISSEMINATION

Since this systematic review will be only based on published and retrievable literature, no ethics approval will be sought. The multidisciplinary team performing this systematic review will participate in relevant dissemination activities. Findings will be presented at scientific meetings and publish the systematic review in international, peer-reviewed, open-access journals.

PROSPERO REGISTRATION NUMBER

CRD42020167249.

Prevalence of Intestinal Parasitic Infections and Associated Risk Factors among the First-Cycle Primary Schoolchildren in Sasiga District, Southwest Ethiopia

Intestinal parasitic infections (IPIs) have been major public health burdens in low-income countries like Ethiopia. Studies in different areas of Ethiopia have shown a high prevalence of IPIs in poor families. A similar study has not been conducted in Sasiga District given that the area is possibly at high-risk of IPIs due to the prevailing risk factors. This study is aimed at assessing the prevalence of IPIs and associated risk factors among schoolchildren in Sasiga District, southwest Ethiopia. A school-based cross-sectional study was conducted from December 2018 to March 2019 to estimate the prevalence of IPIs and associated risk factors among the study participants. A total of 383 children were selected using resident-type and grade-level stratified systematic random sampling technique. Stool samples were examined microscopically using direct wet mount and formal-ether concentration techniques. A structured questionnaire was used to get information on the associated risk factors. Data were analyzed using SPSS version 20 and p value of ≤0.05 was taken as statistically significant. The overall prevalence of IPIs among the children was 62.4% (239/383). Single, double, and triple infections were 49.9%, 10.7%, and 1.83%, respectively. Residence, family income, place of defecation, source of drinking water, shoe-wearing habit, handwashing habit after toilet use, ways of waste disposal, and cleanliness of fingernail were the most important predictors of IPIs (p < 0.05). Ascaris lumbricoides (22.7% (87/383)) and hookworms (20.6% (79/383)) were the most prevalent parasites, followed by Entamoeba histolytica (8.1%), Trichuris trichiura (7.6%), Giardia intestinalis (6.5%), Hymenolepis nana (5.7%), and Schistosoma mansoni (4.4%), in that order. Sasiga District primary schoolchildren are likely at a high burden of IPIs. Intensive health education on personal hygiene and environmental sanitation is needed.

Dynamics of stunting from childhood to youthhood in Ethiopia: Evidence from the Young Lives panel data

Introduction

Stunting continues to be a public health challenge with grave health, cognitive and economic consequences. Yet, its dynamics along the life course remain not well investigated in Ethiopia and beyond.

Methods

Longitudinal data generated by following two (younger and older) cohorts of about 3000 children for nearly 15 years were analyzed to investigate the longitudinal dynamics of stunting in Ethiopia. The cross-sectional prevalence of stunting in each round, longitudinal prevalence, and transition probabilities were determined. Multilevel mixed effects ordinal regression was applied to identify the determinants of stunting accounting for child-level and cluster-level variations.

Results

The cross-sectional prevalence of severe stunting for the younger cohort fluctuated between 21% and 6%, while for the older cohort it fluctuated between 12% and 3%. Moderate stunting fluctuated between 23% and 16% for the younger cohort and between 22% and 8% for the older cohort. The longitudinal prevalence of severe stunting was 10% in both the younger and older cohorts, whereas that of moderate stunting was 20% for the younger cohort and 18% for the older cohort. Children not stunted at baseline had very high probabilities of remaining not stunted through youthhood (87% for the younger and 90% for the older cohorts). Conversely, children with moderate stunting at baseline had high probabilities either remaining moderately stunted or progressing to severe stunting. Furthermore, children who had severe stunting at baseline had high probabilities of either remaining severely stunted or transitioning to moderate stunting. In both cohorts, older age of the child, female sex, having an educated mother, and being from a household with educated head significantly reduced the risk of stunting. Children from households in the top wealth tertile had a significantly lower risk of stunting in the younger cohort, but not in the older cohort. Similarly, Productive Safety Net Programme reduced the risk of stunting in the younger cohort, but not in the older cohort.

Conclusion

Children not stunted early in life are highly likely to grow into non-stunted adults while children stunted early in life are highly likely to grow into stunted adults. Several child-level, maternal, household and programmatic factors affect the risk of stunting. Efforts to prevent stunting shall commence early in life.

Nutritional status and intestinal parasites among young children from pastoralist communities of the Ethiopian Somali region

Pastoralist children in the Ethiopian Somali Regional State (ESRS) are at high risk for undernutrition and intestinal parasitic infections (IPIs). We assessed the nutritional status and its association with IPIs in 500 children <5 years of age in a clustered cross‐sectional study in Adadle district, ESRS. Stool samples were microscopically examined for IPIs and biomarkers for iron and vitamin A status, anthropometry, and food variety score (FVS) were assessed. Median (interquartile range [IQR]) FVS was 2.0 (2.0, 4.0), and 35% of children were exclusively breastfed up to age 6 months. Prevalence of stunting, wasting, underweight and mid‐upper arm circumference (MUAC) <12.5 cm was 30, 34, 40, and 16%, respectively. Median (IQR) haemoglobin, ferritin, and retinol‐binding protein concentrations were 9.5 g dL^‐1 (8.2, 10.9), 6.2 μg L^‐1 (4.0, 10.2), and 0.8 μmol L⁻¹ (0.67, 0.91), respectively. Prevalence of anaemia, iron, and vitamin A deficiency was 75, 91, and 30%, respectively. IPIs' prevalence was 47%; the most prevalent IPIs were Giardia lamblia (22%) and Ascaris lumbricoides (15%). Giardial infections but not A. lumbricoides increased the risk for MUAC <12.5 cm (adjusted odds ratio [aOR]: 3.50, 95% confidence interval [CI] [2.21, 5.54]). The odds for anaemia were 97% (aOR: 0.03, 95% CI [0.03, 0.07]) and 89% (aOR: 0.11, 95% CI [0.11, 0.23]) less for children with FVS >2 or with exclusive breastfeeding up to 6 months, respectively. Undernutrition and IPIs are alarmingly high in <5 years of age children in ESRS. Giardial infections and low nutritional adequacy of the diet seem to be major contributing factors to the precarious nutritional status and should be addressed by appropriate interventions.

Prevalence of Soil-Transmitted Helminth and Schistosoma mansoni Infection and Their Associated Factors among Hiruy Abaregawi Primary School Children, Rural Debre Tabor, North West Ethiopia: A Cross-Sectional Study

Background

In Ethiopia, 25.3 and 12.3 million school-age children are living in soil-transmitted helminth and schistosomiasis endemic areas, respectively. The school children are at risk for both soil-transmitted helminths and Schistosoma mansoni due to juvenile activities like walking barefoot, playing with dirty objects that might be contaminated with feces, and fetching of unclean water for drinking. There are no data that indicate the status of soil-transmitted helminths and Schistosoma mansoni among children at Hiruy Abaregawi primary school. Therefore, the main objective of this study was to determine the prevalence of soil-transmitted helminth and Schistosoma mansoni infection among Hiruy Abaregawi primary school children.

Methods

A cross-sectional study was conducted from March to April, 2019, at Hiruy Abaregawi primary school, Rural Debre Tabor, North West Ethiopia. A total of 340 students were included in the study. Informed written consent was obtained from the children's parent. Systematic sampling technique was used to select the children. About 2 grams of stool samples was collected and transported to Debre Tabor University Microbiology and Parasitology Teaching Laboratory to conduct the Kato-Katz technique. Data were analyzed using SPSS version 23. Variables with a p value < 0.05 were considered statistically significant.

Results

The prevalence of soil-transmitted helminths and Schistosoma mansoni was 51/340 (15%). Among the identified parasites, Ascaris lumbricoides accounts for 28 (8.2%), hookworm 13 (3.8%), Trichuris trichiura 4 (1.2%), and Schistosoma mansoni 6 (1.8%). In this study, 24 (7%) of Ascaris lumbricoides-, 11 (3.2%) of hookworm-, 4 (1.2%) of Trichuris trichiura-, and 5 (1.5%) of Schistosoma mansoni-infected children showed light infections and no heavy infection in both soil-transmitted helminths and Schistosoma mansoni was observed. Finger nail trimming status, hand washing before eating, availability of toilet at home, educational level of students, and sex of students were factors associated with soil-transmitted helminth infection. Conclusion and Recommendations. In this study, the low prevalence of soil-transmitted helminths and Schistosoma mansoni was observed. The combination of regular mass deworming program and health information on risk factors should be strengthened for the prevention and control of soil-transmitted helminth infection.

Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: a systematic review and meta-analysis

BACKGROUND

Numerous studies have been carried out on assessing the prevalence of intestinal parasites infections (IPIs) amongpreschool and school-age children in Ethiopia, but there is lack of study systematically gathered and analyzedinformation for policymakers. Therefore, the aim of this systematic review and meta-analysis was to provide a summary on prevalence, geographical distribution and trends of IPIs among preschool and school-age childrenin Ethiopia.

METHODS

The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar from 1996to July2019 for studies describing prevalence of IPIs among preschooland school-age children. We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14.

RESULTS

Eighty-three(83) studies examining 56,786 fecal specimens were included. The prevalence of IPIs was 48%(95%CI: 42 to 53%) and showedsignificantly decreasing trends 17% (95% CI: 2.5 to 32%) for each consecutive 6 years) and was similar in males and females. The pooled prevalence in years 1997-2002, 2003-2008, 2009-2014 and > 2014 was 71% (95% CI: 57 to 86%), 42% (95% CI: 27 to 56%), 48% (95% CI: 40 to 56%) and 42% (95% CI: 34 to 49%), respectively. Poly-parasitism was observed in 16% (95% CI: 13 to 19%,) of the cases.

CONCLUSION

Intestinal parasite infections are highly prevalent among preschool and school-age children and well distributed across the regional states of Ethiopia. Southern and Amhara regional states carry the highest burden. We observed significant decreasing trends in prevalence of IPIs among preschool and school-ageEthiopian children over the last two decades. Therefore, this study is important to locate the geographical distribution and identified high risk areas that should be prioritized further interventions, which complement global efforts towards elimination of IPIs infections by 2020.

Assessment on the prevalence and risk factors of gastrointestinal parasites on schoolchildren at Bochesa Elementary School, around Lake Zwai, Ethiopia

Objectives

This study was aimed to assess the prevalence and risk factors of gastrointestinal parasites on schoolchildren at Bochesa Elementary School around Lake Zwai, Ethiopia. Cross-sectional study was conducted on 384 schoolchildren in May 2016. The gastrointestinal parasites were examined with wet mount and formol-ether concentration techniques. Chi-square (χ²) test was used to evaluate the association between categorical variables and infection prevalence. Binary logistic regression on SPSS version 21 was used, values were considered significant when the p-value was less than 0.05.

Results

The overall prevalence of gastrointestinal parasites was 22.6%. Males, 54 (14.1%) were more infected than females, 32 (8.3%), and 1–4 grade category, 64 (16.7%) were more infected than 5–8 grade category, 22 (5.7%). Age groups of 7–14, 78 (20.3%) were also more infected than > 15, 8 (2.1%); however, the variation was not significant (p > 0.05). In this study, parasitic coinfection was common; however, single gastrointestinal parasites were more dominant. The overall rate of gastrointestinal parasites shows that the environmental conditions where students pass their times are conducive to water-related diseases. Health education on personal and environmental hygiene keeping should be given to schoolchildren and safe wetland playing grounds should be prepared.

Strongyloidiasis in Ethiopia: systematic review on risk factors, diagnosis, prevalence and clinical outcomes

Background

Strongyloidiasis is a gastrointestinal infection caused by the parasitic nematode Strongyloides stercoralis. It is estimated to infect up to 370 million people globally and is predominately found in tropical and subtropical areas of socioeconomic disadvantage.

Main body

This systematic literature review identified studies published in the last ten years on the risk factors, diagnosis, prevalence and/or clinical outcomes of strongyloidiasis in Ethiopia. The prevalence of S. stercoralis ranged from 0.2 to 11.1% in adults, 0.3% to 20.7% in children, 1.5% to 17.3% in HIV positive adults and 5% in HIV positive children. The identified studies primarily used microscopy based techniques that potentially underestimated the prevalence four fold compared with serology and PCR. Strongyloidiasis in children presents a particularly significant issue in Ethiopia as children often presented with anemia, which is associated with impaired mental and cognitive development. The most significant risk factor for strongyloidiasis was HIV status and although other risk factors were identified for helminth infections, none were statistically significant for S. stercoralis specifically. Several studies detected S. stercoralis in dogs and non-biting cyclorrhaphan flies. However, future research is needed to explore the role of these reservoirs in disease transmission.

Conclusions

This review demonstrated that strongyloidiasis is an overlooked and neglected disease in Ethiopia. There is a need for a systematic approach using a combination of molecular and serology based diagnostic methods to ascertain the true incidence and burden of strongyloidiasis in Ethiopia. Further research is also needed to break the cycle of transmission by identifying environmental reservoirs, risk factors and exploring the potential for zoonotic transfer.

Electronic supplementary material

The online version of this article (10.1186/s40249-019-0555-3) contains supplementary material, which is available to authorized users.