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Andargie Y, Alelign A, Tekeste Z. Prevalence and associated risk factors of soil-transmitted helminth infections among schoolchildren in Mekan Eyesus town, northwestern Ethiopia. Parasite Epidemiol Control 2024; 27:e00379. [PMID: 39314209 PMCID: PMC11417321 DOI: 10.1016/j.parepi.2024.e00379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/19/2024] [Accepted: 09/03/2024] [Indexed: 09/25/2024] Open
Abstract
Background Little attention has been paid to determining the prevalence and associated factors of soil-transmitted helminth (STH) infections in some developing countries. This study was, therefore, carried out to determine the prevalence and associated factors of STH infections among schoolchildren attending three primary schools in Mekane Eyesus town, northwestern Ethiopia. Methods A school-based cross-sectional study was conducted from March to June 2023 in Mekane Eyesus town. Stool samples were collected from 401 children from three primary schools in the town. Wet-mount and formol ether concentration techniques were used to diagnose stool samples, and a structured questionnaire was used to collect data on socio-demographic characteristics and risk factors for STH infections. Results The overall prevalence of STH infection in this study was 18.2 % (73/401). The most common helminth species detected was Ascaris lumbricoides (A. lumbricoides) (7.5 % (30/401)). Not trimming fingernails regularly (adjusted odds ratio (AOR) = 3.75, 95 % CI = 1.87-7.50), having illiterate fathers (AOR = 2.29, 95 % CI = 1.18-4.44), and being aged 15-17 years (AOR = 2.37, 95 % CI = 1.06-5.30) were associated with increased odds of STH infection. Children who wash their hands after defecation (AOR = 0.43, 95 % CI = 0.21-0.88) and those whose mothers were housewives (AOR = 0.22, 95 % CI = 0.08-0.58) had lower odds of STH infection. Conclusion This study found a high prevalence of STH infection among schoolchildren in Mekane Eyesus town. Thus, STH infection preventive measures, including deworming of schoolchildren, should be implemented in the study area. Moreover, giving health-related knowledge about STH infection prevention strategies, such as regular fingernail trimming and hand washing after defecating, is vital for reducing the prevalence of STH infections in the study area.
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Affiliation(s)
- Yohannes Andargie
- Department of Biology, College of Natural and Computational Science, University of Gondar, Gondar, Ethiopia
| | - Amir Alelign
- Department of Biology, College of Natural and Computational Science, University of Gondar, Gondar, Ethiopia
| | - Zinaye Tekeste
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Prevalence of Schistosoma haematobium and Intestinal Helminth Infections among Nigerian School Children. Diagnostics (Basel) 2023; 13:diagnostics13040759. [PMID: 36832247 PMCID: PMC9955672 DOI: 10.3390/diagnostics13040759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Schistosomiasis and soil-transmitted helminthiases (STH) are two parasitic diseases mainly affecting school children. The purpose of this study was to estimate the current prevalence and infection intensity, in addition to the associations of these infections with age and sex, in children aged 4-17 years living in Osun State, Nigeria. From each participant (250 children), one urine and one stool sample were taken for the study, for the microscopic detection of eggs or larvae in faeces by means of the Kato-Katz method and eggs in filtrated urine. The overall prevalence of urinary schistosomiasis was 15.20%, with light infection. The intestinal helminthic species identified (and their prevalence) were S. stercoralis (10.80%), S. mansoni (8%), A. lumbricoides (7.20%), hookworm (1.20%), and T. trichiura (0.4%), all of them being classified as light infections. Single infections (67.95%) are more frequent than multiple infections (32.05%). With this study, schistosomiasis and STH are still endemic in Osun State, but with a light to moderate prevalence and light infection intensity. Urinary infection was the most prevalent, with higher prevalence in children over 10 years. The >10 years age group had the highest prevalence for all of the intestinal helminths. There were no statistically significant associations between gender and age and urogenital or intestinal parasites.
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Hajare ST, Mulu T, Upadhye VJ, Chauhan NM, Eriso F. Prevalence of Ascaris lumbricoides infections among elementary school children and associated risk factors from Southern Ethiopia. J Parasit Dis 2022; 46:643-652. [PMID: 36091269 PMCID: PMC9458788 DOI: 10.1007/s12639-022-01475-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 02/07/2022] [Indexed: 10/18/2022] Open
Abstract
Intestinal parasitic infections are distributed virtually throughout the world, with high prevalence rates in tropical and sub-tropical parts of the world as well as in Ethiopia. Children between age groups of 5-10 years are at the highest risk of infection. The intestinal nematode Ascaris lumbricoides infects approximately 25% of the world's population annually. Hence, this study was the first attempt to assess the prevalence and associated factors of A. lumbricoides infection among the school children from Offa district, Ethiopia. A cross-sectional study was conducted from January to April, 2020 in three selected elementary school. Data were collected through questionnaires and stool samples examination. The overall prevalence of A. lumbricoides was noted as 41.4% and was the leading cause of intestinal parasitoids followed by Schistosoma mansoni (27.6%), Trichuris trichiura (18.1%) and Strongyloides stercoralis (4.1%). Children age group between 5 and 10 years found more susceptible to the infection. Eating habits like unwashed raw vegetables (P = 0.035), absence of toilets (P = 0.000), children who defecate in open field (P = 0.041), drinking unprotected water (P = 0.034), toilet without cover (P = 0.027), lack of hand washing before meal and after defecation (P = 0.000), (P = 0.048) were the key factors significantly associated with A. lumbricoides infection. The present study showed that A. lumbricoides was a major health problem among school children and requires annual de-worming to control morbidity associated with intestinal parasites.
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Affiliation(s)
- Sunil Tulshiram Hajare
- Department of Biology, College of Natural and Computational Sciences, Dilla University, SNNPR, 419 Dilla, Ethiopia
| | - Tizazu Mulu
- Department of Biology, College of Natural and Computational Sciences, Dilla University, SNNPR, 419 Dilla, Ethiopia
| | - Vijay J. Upadhye
- Parul Institute of Applied Sciences, Parul University, 391760 Vadodara, Gujarat India
| | - Nitin Mahendra Chauhan
- Department of Biology, College of Natural and Computational Sciences, Dilla University, SNNPR, 419 Dilla, Ethiopia
| | - Feleke Eriso
- Department of Biology, College of Natural and Computational Sciences, Dilla University, SNNPR, 419 Dilla, Ethiopia
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Griswold E, Eigege A, Adelamo S, Mancha B, Kenrick N, Sambo Y, Ajiji J, Zam G, Solomon J, O. Urude R, Kadimbo J, Danboyi J, Miri E, Nute AW, Rakers L, Nebe O, Anyaike C, Weiss P, S. Noland G, Richards F. Impact of Three to Five Rounds of Mass Drug Administration on Schistosomiasis and Soil-Transmitted Helminths in School-Aged Children in North-Central Nigeria. Am J Trop Med Hyg 2022; 107:tpmd211207. [PMID: 35576949 PMCID: PMC9294711 DOI: 10.4269/ajtmh.21-1207] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
Nasarawa and Plateau states of north-central Nigeria have implemented programs to control schistosomiasis (SCH) and soil-transmitted helminths (STH) in children since the 1990s. Statewide mapping surveys were conducted in 2013, when 11,332 school-aged children were sampled from 226 schools. The local government areas (LGAs) then received varying combinations of mass drug administration (MDA) for the next 5 years. We revisited 196 (87%) schools in 2018 plus an additional six (202 schools in total), sampling 9,660 children. We calculated overall prevalence and intensity of infection and evaluated associations with gender; age; behaviors; water, sanitation, and hygiene (WASH); and treatment regimen. Urine heme detection dipsticks were used for Schistosoma hematobium in both surveys, with egg counts added in 2018. Stool samples were examined by Kato-Katz for Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, and hookworm. Schistosomiasis prevalence among sampled students dropped from 12.9% (95% confidence interval [CI]: 11.1-14.9%) to 9.0% (95% CI: 7.5-10.9%), a statistically significant change (P < 0.05). In 2018, eight LGAs still had > 1% of children with heavy-intensity schistosome infections. Prevalence of STH infection did not significantly change, with 10.8% (95% CI: 9.36-12.5%) of children positive in 2013 and 9.4% (95% CI: 8.0-10.9%) in 2018 (P = 0.182). Heavy-intensity STH infections were found in < 1% of children with hookworm, and none in children with A. lumbricoides or T. trichiura in either study. The WASH data were collected in 2018, indicating 43.6% of schools had a latrine and 14.4% had handwashing facilities. Although progress is evident, SCH remains a public health problem in Nasarawa and Plateau states.
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Affiliation(s)
| | | | | | | | | | | | | | - Gideon Zam
- Nasarawa State Ministry of Health, Lafia, Nigeria
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Genet A, Motbainor A, Samuel T, Azage M. 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. SAGE Open Med 2021; 9:20503121211063354. [PMID: 34917385 PMCID: PMC8669120 DOI: 10.1177/20503121211063354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Almaw Genet
- Dangila Woreda Health Office, Dangila, Ethiopia
| | - Achenef Motbainor
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tsion Samuel
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluken Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Soil-transmitted helminth infections among pre-school aged children in Gamo Gofa zone, Southern Ethiopia: Prevalence, intensity and intervention status. PLoS One 2020; 15:e0243946. [PMID: 33320918 PMCID: PMC7737900 DOI: 10.1371/journal.pone.0243946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/30/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH), i.e., Ascaris lumbricoides, Trichuris trichiura and hookworms are among the most prevalent Neglected Tropical Diseases (NTDs) in Ethiopia. Although pre-school aged children pay a high morbidity toll associated with STH infections, evidence on prevalence, intensity and intervention status is lacking in Ethiopia. This study, therefore, aimed to address these gaps to inform decision made on STH. METHODS We did a community-based cross-sectional study in five districts of Gamo Gofa zone, Southern Ethiopia; in January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites eggs in stool. Then, collected data were edited and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis. RESULTS A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462) (95% confidence interval (CI) = 21.8%-25.2%). As caris lumbricoides was the most prevalent (18.6%), followed by Trichuris trichiura (9.2%), and hookworms (3.1%). Of the total, 7.4% PSAC were infected with two STH species. Most of the positive cases with STH showed low infection intensities, while 15.1% ascariasis cases showed moderate infection intensities. The study found that 68.7% of PSAC were treated with albendazole. Also, household's level data showed that 39.4% used water from hand-dug well; 52.5% need to travel ≥30 minutes to collect water; 77.5% did not treat water, and 48.9% had no hand washing facility. In addition, almost 93% care givers achieved less than the mean knowledge and practice score (≤5) on STH prevention. CONCLUSIONS This study showed that significant proportions of pre-school aged children are suffering from STH infections despite preventive chemotherapy exist at the study area. Also, gaps in the interventions against STH were highlighted. Thus, a call for action is demanding to eliminate STH among PSAC in Ethiopia by 2030.
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Eze P, Agu UJ, Aniebo CL, Agu SA, Lawani LO. Perception and attitudinal factors contributing to periodic deworming of preschool children in an urban slum, Nigeria. BMC Public Health 2020; 20:1839. [PMID: 33261596 PMCID: PMC7708184 DOI: 10.1186/s12889-020-09958-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/22/2020] [Indexed: 12/21/2022] Open
Abstract
Background Over 20 million preschool-age children (PSAC) in Nigeria require periodic chemotherapy (PC) for soil-transmitted helminth (STH) infections. Persistently low coverage for this age group threatens the World Health Organization (WHO) 2030 target for eliminating STH infections. Current strategies for targeting PSAC have been largely ineffective. Hence, PSAC are mostly dewormed by their parents/caregivers. However, little is known of the perception and attitude of parents/caregivers of PSAC to deworming in this setting. Methods A mixed methods design, combining a community-based interviewer-administered questionnaire-survey (n = 433) and focus group discussions (FGD) (n = 43) was used to assess the perceptions and attitudes of mothers to periodic deworming of preschool children aged 2–5 years in Abakpa-Nike, Enugu, Nigeria. Results Coverage of periodic deworming in PSAC is 42% (95% CI: 37.3–46.8%). There is significant difference in the specific knowledge of transmission of STH (AOR = 0.62, 95% CI: 0.48–0.81, p = 0.000), complication of STH infections (AOR = 0.77, 95% CI: 0.61–0.98, p = 0.034), accurate knowledge of deworming frequency (AOR = 0.41, 95% CI: 0.18–0.90, p = 0.026), and knowledge of PC drug, mebendazole (AOR = 0.28, 95% CI: 0.09–0.90, p = 0.031), and pyrantel (AOR = 8.03, 95% CI: 2.22–29.03, p = 0.001) between mothers who periodically deworm their PSAC and those who do not. There is no significant difference in specific knowledge of the symptoms of STH infections (AOR = 0.76, 95% CI: 0.57–1.02, p = 0.069) and PC drug, Albendazole (AOR = 1.00, 95% CI: 0.46–2.11, p = 0.972). FGD revealed misconceptions that are rooted in stark ignorance of the disease. Overall attitude to deworming is positive and favourable. Conclusions Poor coverage of periodic deworming for STH infections in PSAC in this setting are primarily driven by poor specific knowledge of the risks and burden of the infection. Focused health education on the burden and transmission of STH infections could complement existing strategies to improve periodic deworming of PSAC in this setting. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09958-x.
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Affiliation(s)
- Paul Eze
- Department of Health Policy and Administration, Penn State University, University Park, PA, 16802, USA.
| | - Ujunwa Justina Agu
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
| | - Chioma Lynda Aniebo
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
| | - Sergius Alex Agu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Lucky Osaheni Lawani
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5T 3M6, Canada
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Hailegebriel T, Nibret E, Munshea A. Prevalence of Soil-Transmitted Helminth Infection Among School-Aged Children of Ethiopia: A Systematic Review and Meta-Analysis. Infect Dis (Lond) 2020; 13:1178633720962812. [PMID: 33088182 PMCID: PMC7543112 DOI: 10.1177/1178633720962812] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/10/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Soil-transmitted helminths (STH) are still major health problems in resource-poor countries. Despite several epidemiological studies were available in Ethiopia, summarized data on the prevalence of STH among school-aged children (SAC) is lacking in the country. Objective: This study was aimed to summarize the existing published studies of STH among SAC children in Ethiopia. Methods: The search was carried out in open access databases such as Science Direct, Scopus, and PubMed Central which reported STH in Ethiopia. Open access articles published between 2000 and 2019 were included in this meta-analysis. The pooled prevalence was determined using a random-effect model while heterogeneities between studies were evaluated by I2 test. Results: A total of 46 338 children (Male = 23 374 and Female = 22 964) were included in the 70 eligible studies for this meta-analysis. The pooled prevalence of STH among SAC was 33.4%; 95% CI, 29.3% to 37.7% in Ethiopia. Ascaris lumbricoides (19.9%; 95% CI, 17.2%-22.6%) was the most prevalent STH followed by Trichuris trichiura (12.4%; 95% CI, 10.6%-14.1%), and hookworm (7.9%; 95% CI, 6.9%-8.9%) infection in the country. High prevalence of STH was observed in Oromia (42.5%; 95% CI, 31.6%-53.4%) followed by SNNPR (38.3%; 95% CI, 27.7%-48.8%) and Amhara (32.9%; 95% CI, 27.0%-38.8%) regional states. High heterogeneity on the prevalence of STH was observed across studies within and among regions (I2 > 96% and P < .001). Conclusion: This review showed that more than one-third of the Ethiopian SAC were infected with STH. The high prevalence of STH observed in this review highlight the needs of improved control and prevention strategies in Ethiopia.
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Affiliation(s)
- Tamirat Hailegebriel
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abaineh Munshea
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
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Gitore WA, Ali MM, Yoseph A, Mangesha AE, Debiso AT. 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. PLoS One 2020; 15:e0239557. [PMID: 32970747 PMCID: PMC7514018 DOI: 10.1371/journal.pone.0239557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/08/2020] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Wondwosen Abera Gitore
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Musa Mohammed Ali
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Amanuel Yoseph
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Adane Ermias Mangesha
- Department of Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Alemu Tamiso Debiso
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Masaku J, Njomo DW, Njoka A, Okoyo C, Mutungi FM, Njenga SM. Soil-transmitted helminths and schistosomiasis among pre-school age children in a rural setting of Busia County, Western Kenya: a cross-sectional study of prevalence, and associated exposures. BMC Public Health 2020; 20:356. [PMID: 32188444 PMCID: PMC7079432 DOI: 10.1186/s12889-020-08485-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background Soil-transmitted helminths (STH) and schistosomiasis continue to cause serious health problems among affected communities. To ensure that infection transmission levels are reduced, repeated mass drug administration at regular intervals has been recommended by World Health Organization. Pre-school age children (PSAC) have been neglected both in terms of research activities and in control programmes in the past for reasons that they carry insignificant infection levels. The current study determined risk factors that contribute to differences in infection prevalence among enrolled and non-enrolled PSAC in Busia County, western Kenya. Methods This was a comparative cross-sectional study that compared STH and Schistosoma mansoni infections among enrolled and non-enrolled PSAC in Busia County. Simple random sampling was used to select study participants. A total of 327 enrolled and 326 non-enrolled PSAC (n = 653) were recruited from five participating schools, and the neighboring villages. Statistical analysis was performed using STATA version 14 (STATA Corporation, College Station, TX, USA). Differences in proportions were assessed using the z-test statistic for testing sample proportions. Univariable and multivariable logistic regression were used to test the associations between the variables. Results The prevalence of STH and Schistosoma mansoni infection was 17.0% (95%CI: 13.1–22.1), and 11.8% (95%CI:11.0–12.9) respectively. Specific STH species prevalence were 12.9% (95%CI:7.0–23.5) for Trichuris trichiura, 8.3% (95%CI:8.2–8.3) for Ascaris lumbricoides, and 1.2% (95%CI:1.2–1.2) for hookworms. Prevalence of T. trichiura was higher among enrolled PSAC 16.9% (95%CI: 6.8–41.9); p = 0.003, compared to the non-enrolled 8.9% (95%CI:4.3–18.2). From univariable analysis, lack of improved water source for drinking OR 2.01, (95%CI:1.29–3.13); p = 0.002, and not wearing shoes OR 3.42, (95%CI:1.14–10.29); p = 0.028, were some of the significant factors associated with STH infection. While for multivariable analysis, bathing/swimming in a river daily, aOR 3.99 (95%CI:1.98–8.06); p = 0.001 was a key significant factor for S. mansoni infections. Conclusion There was high prevalence of STH infection among enrolled PSAC despite having participated in the national school-based deworming programme. Hence the need for continued mass drug administration to reduce the intensity of infections among these age group. In addition, further research maybe needed to identify drivers of STH infection particularly T. trichiura among PSAC.
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Affiliation(s)
- Janet Masaku
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Mbangathi road, P.O.Box 54840-00200, Nairobi, Kenya.
| | - Doris W Njomo
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Mbangathi road, P.O.Box 54840-00200, Nairobi, Kenya
| | - Ann Njoka
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Mbangathi road, P.O.Box 54840-00200, Nairobi, Kenya
| | - Collins Okoyo
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Mbangathi road, P.O.Box 54840-00200, Nairobi, Kenya
| | - Faith M Mutungi
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Mbangathi road, P.O.Box 54840-00200, Nairobi, Kenya
| | - Sammy M Njenga
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Mbangathi road, P.O.Box 54840-00200, Nairobi, Kenya
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11
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Abstract
Background: Soil-transmitted helminths (STH) have remained a major threat to humans, especially children in developing countries, including Nigeria. Interventions have always been geared towards school-aged children, neglecting preschool-aged children and occupational risk adults. The Soil-Transmitted Helminthiasis Advisory Committee (STHAC) recently suggested incorporating other at-risk groups. Objective: This study assessed the associated risk of STH infection among agrarian communities of Kogi State, Nigeria. Methods: A total of 310 individuals of all ages participated in the cross-sectional survey. Stool samples were analyzed using standard Kato-Katz method. Results: A total of 106 (34.2%) individuals were infected with at least one STH. Hookworm was the most prevalent (18.1%); followed by Ascaris lumbricoides (16.8%). Worm intensity was generally light. Prevalence of infection was similar between four age groups considered (preschool, school, ‘women of reproductive age’ and older at-risk group). Poor socio-economic status (SES) was a major risk for STH infection. Using a 20-asset based criteria, 68 (23.1%) and 73 (24.7%) of 295 questionnaire respondents were classified into first (poorest) and fifth (richest) wealth quintiles respectively. Risk of infection with STH was 60% significantly lower in the richest wealth quintile compared to the poorest (Prevalence Ratio [PR] = 0.4843, 95% CI = 0.2704–0.8678, p = 0.015). Open defecators were more likely to harbour STH than those who did not (PR = 1.7878, 95% CI = 1.236–2.5846, p = 0.00201). Pit latrine and water closet toilets each approximately reduced STH infection by 50% (p < 0.05). Conclusion: Preventive chemotherapy for all age groups, health education and provision of basic amenities especially toilets are needed in order to achieve the goal toward the 2020 target of STH control.
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Imam A, Farouk ZL, Hassan-Hanga F, Ihesiulor UG. A comparative cross-sectional study of prevalence and intensity of soil-transmitted helminthic infection between healthy and severe acutely malnourished pre-school aged children in Kano, Northern Nigeria. BMC Infect Dis 2019; 19:121. [PMID: 30727974 PMCID: PMC6364394 DOI: 10.1186/s12879-019-3755-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 01/29/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Soil-transmitted helminthic (STH) infections are common in Sub-Saharan Africa. One method used for control of these helminths is mass anti-helminthic administration in populations at risk of STH infections. In this regard, empiric treatment of children with Severe Acute Malnutrition (SAM) for STH infection is practiced in this region. It is however unclear if children with SAM suffer more from STH infection than healthy children. The objective of this study was to compare prevalence and intensity of STH infection between pre-school aged children with SAM and healthy children. METHODS We approached 1114 pre-school aged children attending care in two health facilities in Kano, Nigeria to partake in this study. Of this number, we recruited 620 (55.7%) children, comprising 310 well-nourished children from well-baby clinics and 310 children with SAM from Community Management for Acute Malnutrition (CMAM) centres in these facilities. We assessed their nutritional status using World Health Organisation (WHO) growth charts and collected stool samples which we analysed using Formal-Ether Concentration technique to identify STH infection and Stoll's technique to assess intensities of STH infection. We fitted a logistic regression model to determine if there was any association between nutrition status and helminthic infection, adjusting for the confounding effects of socio-economic status and age. We compared intensity of STH infection (measured as eggs per gram of faeces) between both nutrition groups using the independent t-test. RESULTS Overall STH prevalence in our population was low (2.7%) and we found no significant association between nutritional status and presence of STH infection (OR = 1.10, 95% CI 0.38 to 3.21). Majority of our study participants had either low or moderate (94.2%) and there was no statistically significant difference between intensity of STH infection (t value = - 1.52, P value = 0.13) in children with SAM and those who were well-nourished. CONCLUSIONS The overall STH prevalence among pre-school children was low in Kano and we did not find prevalence and intensity of STH infection to differ significantly between preschool children with SAM and well-nourished children. Our findings confirm the WHO recommendation that at low levels of prevalence and intensity, interventions to control STH are unnecessary.
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Affiliation(s)
- Abdulazeez Imam
- Department of Vaccines and Immunity, Medical Research Council Unit The Gambia at London school of Hygiene and Tropical Medicine, Atlantic Boulevard, P.O. Box 452, Fajara, Gambia.
| | - Zubaida L Farouk
- Department of Paediatrics, Bayero University Kano, Kano, Nigeria.,Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Fatimah Hassan-Hanga
- Department of Paediatrics, Bayero University Kano, Kano, Nigeria.,Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Uchechukwu G Ihesiulor
- Department of Medical Microbiology and Parasitology, Bayero University Kano, Kano, Nigeria
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13
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Tchakounté BN, Nkouayep VR, Poné JW. Soil Contamination Rate, Prevalence, Intensity of Infection of Geohelminths and Associated Risk Factors among Residents in Bazou (West Cameroon). Ethiop J Health Sci 2018; 28:63-72. [PMID: 29622908 PMCID: PMC5866290 DOI: 10.4314/ejhs.v28i1.8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Soil-transmitted helminths (STH) infections remain an important public health problem in the tropics. This study aimed to evaluate the soil contamination rate and prevalence of infestations of geohelminth among residents in Bazou. Methods Four hundred (400) soil samples and 182 stool specimens were collected respectively from four sites and from inhabitants aged 1 to 40 years and above in 12 households. A questionnaire was administered to evaluate risk factors of STH-infections. Soil samples were screened using sucrose centrifugal flotation method while stool specimens were analyzed using two techniques. Results Out of the 400 soil and 182 stool samples examined, 13(3.3%) and 9(4.95%) were positive respectively after analyses. Soil contamination rates were 2%, 1% and 0.3% for Ascaris, Trichuris and hookworm eggs respectively while 4.95% of stool samples were positive to one species nematode (Ascaris lumbricoides). The soil contamination rate observed (5%) in the rainy season was significantly different (p>0.05) from the one observed (1.5%) in the dry season. Irrespectively of the season, the most frequent parasite identified was Ascaris spp. Soils around houses were more contaminated 6(12%) as compared to those collected from markets 5(10%) and roads 2(4%) while those around classrooms were not contaminated. Participants in the age group of 1–10 were more infected. Factors such as no hand washing habit and untrimmed finger nails were found to be important risk factors for STH. Conclusion These results suggest the necessity to promote measures that could help to reduce STH infections.
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Affiliation(s)
- Blandine Ngatou Tchakounté
- Laboratory of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Vanessa Rosine Nkouayep
- Laboratory of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Josué Wabo Poné
- Laboratory of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
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Karshima SN. Prevalence and distribution of soil-transmitted helminth infections in Nigerian children: a systematic review and meta-analysis. Infect Dis Poverty 2018; 7:69. [PMID: 29983115 PMCID: PMC6036687 DOI: 10.1186/s40249-018-0451-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 06/14/2018] [Indexed: 01/20/2023] Open
Abstract
Background Soil transmitted helminth (STH) infections still remain a notable health problem in resource-limited countries due to difficulties in the implementation of control measures. In Nigeria for instance, despite several community-based and provincial reports, national data on prevalence, burdens and risk zones (RZs) for STH infections are lacking. Methods The present study employed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to determine the prevalence, distribution and RZs for STH infections among Nigerian children through a meta-analysis of data published between 1980 and 2015. Pooled prevalence estimate (PPE) was determined by the random-effects model while heterogeneity was evaluated using the Cochran’s Q-test. Results A total of 18 901 of the 34 518 Nigerian children aged 0–17 years examined across 19 Nigerian states during the period under review were infected with one or more species of STHs. The overall PPE for STH infections was 54.8% (95% CI: 54.2–55.3). PPEs for sub-groups ranged between 13.2% (95% CI: 11.5–15.1) and 80.9% (95% CI: 80.0–81.7). Highest PPEs for STH infections were observed among children within community settings (59.0%, 95% CI: 57.7–60.4) and school-aged children (54.9%, 95% CI: 54.3–55.5). Ascaris lumbricoides was the most prevalent species (44.6%, 95% CI: 44.0–45.2). Over 36% (15/41) of the studies were published from south-western Nigeria. South-western region was the only high risk zone (HRZ) for STH infections while the rest of the regions were low risk zones (LRZs). Conclusions STH infections involving Ascaris lumbricoides, Strongyloides stercoralis, Trichuris trichiura and hookworms are highly prevalent across Nigeria. Strategic use of anthelmintics, health education and adequate sanitation, taking into account this epidemiologic information will help in the control of these infections in Nigeria. Electronic supplementary material The online version of this article (10.1186/s40249-018-0451-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Solomon Ngutor Karshima
- Department of Veterinary Public Health and Preventive Medicine, University of Jos, PMB 2084, Jos, Nigeria.
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15
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Samuel F, Demsew A, Alem Y, Hailesilassie Y. Soil transmitted Helminthiasis and associated risk factors among elementary school children in ambo town, western Ethiopia. BMC Public Health 2017; 17:791. [PMID: 29017470 PMCID: PMC5634961 DOI: 10.1186/s12889-017-4809-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 09/29/2017] [Indexed: 12/20/2022] Open
Abstract
Background Soil-transmitted helminths (STHs) are widespread in underdeveloped countries. In Ethiopia, the prevalence and distribution of helminth infection varies by different exposing risk factors. We therefore investigated the prevalence of and risk factors of STHs infection in school children living in Ambo town, west Shoa Ethiopia. Methods In 2014/15, among 375 school children planed to be included in this study, only 321 school children were recruited in the study. Data onto school children from different schools were collected, including stool samples for qualitative STHs analysis. Questionnaire data on various demographic, housing and lifestyle variables were also available. Results Prevalence of any STHs infection was 12.6%. The respective prevalence of major soil-transmitted helminths is Ascaris (7.8%), Hookworm (2.8%) and Trichuris (2.2%). This study result shows STHs prevalence varies regards to age, sex, latrine use, family size and nail trimming. Conclusion The results of the present study indicated that the percentage of positive finding for STHs in Ambo area is low. Besides, Large Family size, not nail trimming and unavailability of improved latrine were identified as predisposing factor for STHs infections. All school children enrolled and not enrolled in this study should be treated twice a year until the prevalence falls below the level of public health importance.
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Shumbej T, Belay T, Mekonnen Z, Tefera T, Zemene E. Soil-Transmitted Helminths and Associated Factors among Pre-School Children in Butajira Town, South-Central Ethiopia: A Community-Based Cross-Sectional Study. PLoS One 2015; 10:e0136342. [PMID: 26305361 PMCID: PMC4548951 DOI: 10.1371/journal.pone.0136342] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 07/31/2015] [Indexed: 11/18/2022] Open
Abstract
Background Soil-transmitted helminths (STH) remain a major public health problem, particularly in tropical and sub-tropical regions of the world. Though infections are prevalent among all age groups, the world health organization (WHO) considers Pre-school age children (PSAC), school-aged children, and pregnant women as segments of population at high risk of STH morbidities. Objective This study aimed at determining the prevalence and infection intensity of STH and associated factors among PSAC in Butajira Town, south-central Ethiopia. Methods A community-based cross-sectional study was conducted from May to June, 2014 in Butajira Town. The PSAC were selected by systematic sampling technique and invited to participate in the present study. McMaster technique was employed for parasitological analysis of stool samples. Pearson’s Chi-square and Fisher’s exact tests were performed where appropriate to identify any association between STH infection and independent factors. Multivariate logistic regression model was fitted to identify independent predictors of STH among the PSAC. P-value less than 0.05 was considered statistically significant. Results A total of 377 (with 96% compliance rate) PSAC were able to provide complete data (socio-demographic information and stool sample). The study showed that 23.3% (88/377) PSAC were infected with one or more species of STH. Ascaris lumbricoides was the most prevalent STH (14.9%) followed by Trichuris trichiura (6.4%). The overall infection intensity, expressed as geometric mean for A. lumbricoides, T. trichiura, and hookworms were 229, 178, and 154 eggs per gram of stool, respectively. The multivariate logistic regression model estimated that being in the age group of 36–47 months (AOR: 2.5, 95% CI: 1.2–5.3, P = 0.016), untrimmed finger nail (AOR: 3.2, 95% CI: 1.8–5.5, P < 0.001), and not washing hands before a meal (AOR: 3.0, 95% CI: 1.7–5.4, P < 0.001) were independent predictors of STH infections among the children. Conclusion The present study showed that STH was a public health problem among PSAC in the study area necessitating annual deworming to control morbidities associated with STH. Besides, the existing health education program should also be strengthened to prevent re-infection.
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Affiliation(s)
- Teha Shumbej
- Department of Diagnostic Laboratory, Butajira Hospital, Butajira, Ethiopia
| | - Tariku Belay
- Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Zeleke Mekonnen
- Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Tamirat Tefera
- Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia
- * E-mail:
| | - Endalew Zemene
- Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia
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Valverde JG, Gomes-Silva A, De Carvalho Moreira CJ, Leles De Souza D, Jaeger LH, Martins PP, Meneses VF, Bóia MN, Carvalho-Costa FA. Prevalence and epidemiology of intestinal parasitism, as revealed by three distinct techniques in an endemic area in the Brazilian Amazon. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2011; 105:413-24. [PMID: 22117850 PMCID: PMC4100303 DOI: 10.1179/1364859411y.0000000034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 07/21/2011] [Accepted: 07/27/2011] [Indexed: 12/28/2022]
Abstract
This survey aims to estimate the prevalence of intestinal parasitic infections in Santa Isabel do Rio Negro, Amazonian Brazil, through three distinct techniques, correlating the prevalence rates with family income and age groups as well as assessing the household clustering of infections. Prevalence rates were assessed through Graham (n=113), Baermann-Moraes (n=232) and Ritchie (n=463) methods. The Graham method was adopted only for children under 5 years old, 15% of whom were positive for Enterobius vermicularis. By the Baermann-Moraes technique, 5·6% of the samples were positive for Strongyloides stercoralis larvae. The Ritchie technique disclosed the following results: Ascaris lumbricoides (26%), Trichuris trichiura (22·5%), hookworms (9·5%), Entamoeba histolytica/Entamoeba dispar (25·3%), Giardia lamblia (12·5%) and E. vermicularis (0·6%). Children aged 5-14 years presented the highest prevalence for pathogenic parasites. Giardiasis and hookworm infection rates were inversely related to family income. The presence of positive contacts in the same household substantially increased the risk of infection by enteric parasites: odds ratio (OR)=2·70, 95% confidence interval (CI)=1·69-4·29 for ascariasis; OR=2·17, 95% CI=1·34-3·51 for trichuriasis; OR=2·13, 95% CI=1·08-4·17 for hookworm disease; OR=3·42, 95% CI=1·86-6·30 for giardiasis; and OR=2·16, 95% CI=1·35-3·47 for amoebiasis, supporting infection clustering in the home. Intestinal parasitoses are extremely frequent in the studied area, and routine methods for diagnosis may underestimate the prevalence of enterobiasis and strongyloidiasis.
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Affiliation(s)
- J G Valverde
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz — Fiocruz, Rio de Janeiro, RJ, Brasil
| | - A Gomes-Silva
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz — Fiocruz, Rio de Janeiro, RJ, Brasil
| | - C J De Carvalho Moreira
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório de Doenças Parasitárias, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
| | - D Leles De Souza
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Macaé e Santos, RJ, Brasil
- Laboratório de Paleoparasitologia — Escola Nacional de Saúde Pública, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
| | - L H Jaeger
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz — Fiocruz, Rio de Janeiro, RJ, Brasil
| | - P P Martins
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
| | - V F Meneses
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
| | - M N Bóia
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz — Fiocruz, Rio de Janeiro, RJ, Brasil
| | - F A Carvalho-Costa
- Programa de Pós-graduação em Medicina Tropical, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
- Laboratório de Sistemática Bioquímica, Instituto Oswaldo Cruz — Fiocruz, Av. Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil
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