Nutritional Status and Intestinal Parasite in School Age Children: A Comparative Cross-Sectional Study

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.

A Five-Year Retrospective Investigation of the Prevalence of Intestinal Parasites at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Background

Intestinal parasites are responsible for a significant amount of disease and mortality around the world. In developing nations, intestinal parasites are a severe public health issue. Intestinal parasite infections are one of the most common illnesses in the world. They're frequently linked to poor personal and environmental cleanliness, as well as low-quality drinking water. The aim of this study is to investigate the prevalence of intestinal parasites and their shifting trends during a five-year period at Mizan-Tepi University of Teaching Hospital (MTUTH).

Methods

A cross-sectional retrospective survey using the past five years' (2017 to 2021) clinical records obtained from MTUTH Mizan-Aman town Southern west Ethiopia. Patients with complete age, sex, and stool parasite examination (direct wet mount or concentration techniques) records on the parasitology registration book were included. Data were entered and analysed using a Microsoft Excel sheet. The parasite prevalence was calculated using frequency and percentages.

Results

Overall, 17,030 patient records of the past five years were reviewed from the registration books of parasitology laboratory departments at MTUTH and only 546 records were taken for this study. Of these 336 (61.50%) were female and the rest 210 (38.50%) were males. One hundred eighty-two (182) 33.33% of patients had one or more intestinal parasites over five years from 2017 to 2021. From total of 546 patients' records 17.77% in 2017, 18.89% in 2018, 23.44% in 2019, 19.96% in 2020 and 19.96% in 2021 had complete information.

Conclusion

Intestinal parasite prevalence was high among patients who visited the Mizan-Tepi University of Teaching Hospital during the five-year period. Helminthes and protozoan parasites prevalence was higher in the 15-45 years age category. In order to avoid intestinal parasite-related disease, strategies other than mass drug administration are required.

Prevalence, correlates of undernutrition and intestinal parasitic infection among children below 5 years living in the forest community of Ndelele, East Region of Cameroon: A cross-sectional assessment

In low- and middle-income countries, undernutrition often co-exists with intestinal parasites, especially Soil Transmitted Helminth (STH) infections in children. The collective impact of both conditions result in undernutrition and can exacerbate the general poor health status of children. A cross-sectional survey of 422 mother-child (12-59 months old) pairs from 14 villages in the District of Ndelele, East Region of Cameroon, was carried out to assess the magnitude and correlates of undernutrition and intestinal parasites. Socio-demographic data were collected from mothers and anthropometric data were collected from children. Parasitological assessment was performed using a combination of direct microscopy flotation, sedimentation and centrifugation techniques. Correlates of undernutrition and intestinal parasites were identified using multinomial logistic regression at individual and household levels. 83.77% of the children assessed for undernutrition were undernourished and 66.82% were positive for one or more intestinal parasites. It was not uncommon for the study participants to be concurrently infected with two or more intestinal parasites. The most common intestinal parasitic infections detected in the study were A. lumbricoides, E. histolytica/dispar and Hookworm infection. Multinomial logistic regression using Nutritional status as outcome showed that, children who were not exclusively breastfed were 106% (RR = 2.06; C.I = 1.12-3.80) more likely to be underweight compared to those who were exclusively breastfed. The household size of 4 to 6 persons also significantly impacted wasting (p-value = 0.007) at 7% (RR = 1.07, C.I = 0.49-2.32). Analysis by a logistic regression model with STH infection as outcome revealed that, Fingernail cleanness (p-value = 0.044; AOR = 1.75; CI = 1.09-2.78) and household size (p-value = 0.038; AOR = 0.55; CI = 0.32-0.92) were positively associated with intestinal parasite infection at the 5% significant level. This study reveals that intestinal helminthic parasitic infections (STH) and undernutrition are serious health problems in children below five in the study area. To address this dire situation, concerted efforts are needed to improve sanitation, hygiene education access, community deworming programs, and improve diets.

Spatial variation and determinants of childhood anemia among children aged 6 to 59 months in Ethiopia: further analysis of Ethiopian demographic and health survey 2016

BACKGROUND

The magnitude of childhood anemia was increased from time to time. Thus, Even if the Ethiopian government applied tremendous efforts, anemia in children continues as a major public health problem. There is limited evidence on the spatial variation of and determinant factors of childhood anemia at the national level. Therefore, this study aimed to explore spatial distribution and determinants of anemia among children aged 6 to 59 months in Ethiopia.

METHOD

A stratified two-stage cluster sampling technique was used in Ethiopian Demographic Health Survey 2016 data. In this study 8602 children aged 6-59 months were included. Bernoulli model was used to explore the presence of purely spatial clusters of Anemia in children in age 6-59 months using Sat scan. ArcGIS version 10.3 was used to know the distribution of anemia cases across the country. A mixed-effects Logistic regression model was used to identify determinant factors of anemia.

RESULTS

The finding indicates that the spatial distribution of childhood anemia was non-random in the country with Moran's I: 0.65, p < 0.001. The SaT scan analysis identified a total of 180 significant primary clusters located in the Somali and Afar regions (LLR = 14.47, P-value< 0.001, RR = 1.47). Age of child 12-23 months (AOR = 0, 68, 95%CI: 0.55, 0.85), 24-35 months (AOR = 0.38, 95%CI: 0.31, 0.47), and36-47 months (AOR = 0.25, 95%CI, 0.20, 0.31), working mother (AOR = 0.87, 95%CI: 0.76, 0.99), anemic mother (AOR = 1.53, 95%CI, 1.35, 1.73), had fever in the last 2 weeks (AOR = 1.36,95%CI:1.13, 1.65), moderate stunting (AOR = 1.31,95%CI: 1.13, 1.50),Severely stunting (AOR = 1.82,95%CI: 1.54, 2.16), religion, wealth index, and number of under-five children in the household were statistically significant associated with childhood anemia.

CONCLUSION

Spatial variation of childhood anemia across the country was non-random. Age of the child, wealth index, stunting, religion, number of under-five children in the household, fever in the last 2 weeks, anemic mother, and working status of the mother were determinants of childhood anemia. Therefore, interventions should be a priority concern for high-risk (hot spot) areas regarding allocation of resources and improved access to health facilities, and to reduce the consequence of anemia among the generation policymakers and concerned bodies should be implemented these specific determinant factors.

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.

Prevalence of Intestinal Parasites and Associated Factors Among Psychiatric Patients Attending Felege Hiwot Comprehensive Specialized Referral Hospital, Northwest Ethiopia

Background

Intestinal parasitic infections are among the major public health problems in resource-poor countries such as Ethiopia. Certain segments of the population such as psychiatric patients are believed to be at higher risk of infection because of their poor hygiene practices. However, information on the prevalence and contributing factors among psychiatric patients is limited in Ethiopia.

Methods

A facility-based cross-sectional study was conducted among 432 psychiatric patients attending Felege Hiwot Comprehensive Specialized Referral Hospital, Northwest Ethiopia from May to July 2020. Participants were selected using a systematic random sampling technique. Data on socio-demography and associated factors were collected using a pre-tested structured questionnaire. Stool sample was collected and processed for parasitological examination using direct wet mount, modified Richie’s concentration, Kato-Katz and modified Ziehl-Neelsen staining techniques following standard protocols. Data were entered and analyzed using Statistical Package for the Social Sciences software version 20. The prevalence of intestinal parasitosis and associated factors were computed by descriptive statistics and binary logistic regression at 95% confidence interval (CI), respectively. Association between variables was considered statistically significant only if P-value <0.05 at 95% confidence level.

Results

A total of 168 (38.9%) participants were positive for at least a single species of intestinal parasite. Hookworm, Entamoeba histolytica/Entamoeba dispar and Ascaris lumbricoides were the most frequent parasites, detected in 74 (17.1%), 47 (10.9%) and 37 (8.6%) participants, respectively. Double infection was detected in 16 (9.5%) participants where 8 (4.8%) had hookworm and Ascaris lumbricoides co-infections. Not washing raw fruits and vegetables before eating (adjusted odds ratio = 8.402; 95% CI: 3.055–23.109; P <0.001) and having a psychiatric diagnosis other than bipolar disorder (adjusted odds ratio = 3.104; 95% CI: 1.334–7.222; P = 0.009) were significantly associated with intestinal parasitic infections.

Conclusion

The prevalence of intestinal parasites among psychiatric patients was significant. Therefore, improving hygiene practice and implementing regular screening for intestinal parasitic infection among psychiatric patients are recommended so as to control parasite transmission and improve the health of psychiatric patients.

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.

Spatial variations and determinants of anemia among under-five children in Ethiopia, EDHS 2005-2016

BACKGROUND

Anemia has severe public health significance in sub-Saharan Africa. In Ethiopia, anemia has been increasing in the last two decades, reaching the highest national level in 2016, however, the geospatial distribution and determinants of anemia in children weren't well explored at a national level.

METHODS

We used the Ethiopian Demographic and Health Survey(EDHS) data from 2005-2016. The data consists of samples of households (HHs) obtained through a two-stage stratified sampling procedure. Our analysis included 19,699 children. Descriptive statistics, geospatial analysis, and Generalized Linear Mixed Model (GLMMs) were used.

RESULTS

The overall prevalence of anemia was 51.5%; the spatial distribution of anemia significantly different across clusters in each survey. Children from 6 to 11 months had higher odds of anemia compared to 24-59 months (Adjusted Odds ratio (AOR) = 3.4, 95%Confidence level (CI): 2.99-3.76). Children with the first and second birth order were less likely to be anemic compared to fifth and above (AOR = 0.60, 95%CI: 0.38-0.95, and AOR = 0.83, 95%C: 0.73-0.93) respectively. Mothers' age 15 to 24 years was associated with higher odds of anemia compared to 35 to 49 years (AOR = 1.37, 95%CI: 1.20-1.55). Children from HHs with the poorest and poorer wealth category showed a higher odds of anemia compared to the richest (AOR = 1.67, 95%CI: 1.45-1.93, and AOR = 1.25, 95%CI: 1.08-1.45) respectively. Moreover, children from HHs with one to two under-five children were less likely to be anemic compared to those three and more (AOR = 0.83, 95%CI: 0.76-0.91).

CONCLUSIONS

The geospatial distribution of anemia among children varies in Ethiopia; it was highest in the East, Northeast, and Western regions of the country. Several factors were associated with anemia; therefore, interventions targeting the hotspots areas and specific determinant factors should be implemented by the concerned bodies to reduce the consequences of anemia on the generation.

Development of a Decision-Making Approach for Mass Deworming Campaigns on Intestinal Parasites among Primary School Children in Egypt

Intestinal parasitic infections are widespread and cause considerable morbidity. Although mortality from such infections is low, most intestinal parasitic infections interfere with nutrition, growth, development and cognitive progress of children, in addition to interference with productivity and quality of life of adults.   Study Aim: Reduction of intestinal parasites prevalence among primary school children.   Methods: this is a three-phased study; Desk review on current prevention and control methods including mass deworming in the light of global guidelines. Cross-sectional field study on 522 school children from 8 Governorates, and interviews with 168 members of the health team running the deworming campaign at these Governorates in 2017. Development of decision making approach to guide future consideration of mass deworming campaigns   Results: National mass deworming campaigns were effective in reducing prevalence of intestinal worms among primary school children in Egypt, and provided a nationwide awareness on the issue. However, unless these campaigns are combined with sustainable measures of clean drinking water, sewage disposal in schools and households the success of these campaigns in reducing intestinal worms' prevalence will be transient.   Conclusion and Recommendations: The national mass deworming campaigns ranged an alarm bell in the community about dangers of intestinal parasites. However, it's recommended to include other susceptible groups like preschool children, adolescent girls and women of childbearing age while focusing the deworming only on infected individuals. It's also recommended to convert the deworming campaigns into a program to ensure sustainability of resources and continuous monitoring and evaluation of intestinal parasitic burden among populations at risk.   Key Words: Intestinal Parasites – Primary School Children – Mass Deworming Campaigns – Egypt

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.

Micronutrient levels and their effects on the prognosis of visceral leishmaniasis treatment, a prospective cohort study

BACKGROUND

Micronutrients are minerals and vitamins and they are essential for normal physiological activities. The objectives of the study were to describe the progress and determinants of micronutrient levels and to assess the effects of micronutrients in the treatment outcome of kalazar.

METHODS

A prospective cohort study design was used. The data were collected using patient interviews, measuring anthropometric indicators, and collecting laboratory samples. The blood samples were collected at five different periods during the leishmaniasis treatments: before starting anti-leishmaniasis treatments, in the first week, in the second week, in the third week, and in the 4th week of anti-leishmaniasis treatments. Descriptive statistics were used to describe the profile of patients and to compare the treatment success rate. The generalized estimating equation was used to identify the determinants of serum micronutrients.

RESULTS

The mean age of the patients were 32.88 years [SD (standard deviation) ±15.95]. Male constitute 62.3% of the patients and problematic alcohol use was present in 11.5% of the patients. The serum zinc level of visceral leishmaniasis patients was affected by alcohol (B - 2.7 [95% CI: - 4.01 - -1.5]), DDS (B 9.75 [95% CI: 7.71-11.79]), family size (B -1.63 [95% CI: - 2.68 - -0.58]), HIV (B -2.95 [95% CI: - 4.97 - -0.92]), and sex (B - 1.28 [95% CI: - 2.5 - -0.07]). The serum iron level of visceral leishmaniasis patients was affected by alcohol (B 7.6 [95% CI: 5.86-9.35]), family size (B -5.14 [95% CI: - 7.01 - -3.28]), malaria (B -12.69 [95% CI: - 14.53 - -10.87]), Hookworm (- 4.48 [- 6.82 - -2.14]), chronic diseases (B -7.44 [95% CI: - 9.75 - -5.13]), and HIV (B -5.51 [95% CI: - 8.23 - -2.78]). The serum selenium level of visceral leishmaniasis patient was affected by HIV (B -18.1 [95% CI: - 20.63 - -15.58]) and family size (B -11.36 [95% CI: - 13.02 - -9.7]). The iodine level of visceral leishmaniasis patient was affected by HIV (B -38.02 [95% CI: - 41.98 - -34.06]), DDS (B 25 .84 [95% CI: 22.57-29.1]), smoking (B -12.34 [95% CI: - 15.98 - -8.7]), chronic illness (B -5.14 [95% CI: - 7.82 - -2.46]), and regular physical exercise (B 5.82 [95% CI: 0.39-11.26]). The serum vitamin D level of visceral leishmaniasis patient was affected by HIV (B -9.43 [95% CI: - 10.92 - -7.94]), DDS (B 16.24 [95% CI: 14.89-17.58]), malaria (B -0.61 [95% CI: - 3.37 - -3.37]), and family size (B -1.15 [95% CI: - 2.03 - -0.28]). The serum vitamin A level of visceral leishmaniasis patient was affected by residence (B 0.81 [95% CI: 0.08-1.54]), BMI (B 1.52 [95% CI: 0.42-2.6]), DDS (B 1.62 [95% CI: 0.36-2.88]), family size (B -5.03 [95% CI: - 5.83 - -4.22]), HIV (B -2.89 [95% CI: - 4.44 - -1.34]),MUAC (B 0.86 [95% CI: 0.52-1.21]), and age (B 0.09 [95% CI: 0.07-0.12]).

CONCLUSION

The micronutrient levels of visceral leishmaniasis patients were significantly lower. The anti-leishmaniasis treatment did not increase the serum micronutrient level of the patients.

Human intestinal parasitic infection: a narrative review on global prevalence and epidemiological insights on preventive, therapeutic and diagnostic strategies for future perspectives

INTRODUCTION

Intestinal parasitic infection (IPI) is a global health concern among socioeconomically deprived communities in many developing countries. Many preventative strategies have been deployed to control IPI, however, there is a lack in standards on the techniques used to diagnose and monitor the prevalence of IPI.

AREAS COVERED

The present article will review the diseases associated with IPI and discuss the current IPI control strategies such as the water, sanitation, and hygiene (WASH) interventions, community-led total sanitation (CLTS) approach, and regular anthelminthic treatments. For the first time, this review will also evaluate all currently practised diagnostic techniques for the detection of intestinal parasites and provide insights on future IPI control strategies.

EXPERT OPINION

Advanced and improved diagnostic methods such as qPCR coupled with a high-resolution melting curve, aptamers, biosensors, and detection of extracellular vesicles can be used for detection of IPI. Vaccination against intestinal parasites can be made available to increase antibodies to interfere with the blood-feeding process by the parasites, which subsequently reduces the reproductive rates of the parasites. These methods collectively can serve as future management strategies for intestinal parasitic infections.

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.

High burden of undernutrition among primary school-aged children and its determinant factors in Ethiopia; a systematic review and meta-analysis

BACKGROUND

Undernutrition remains a major public health concern affecting both children and adolescents in Ethiopia. However, little attention has been given to the undernutrition of primary school-aged children, with their exclusion within national surveys. Therefore, this systematic review and meta-analysis was conducted to determine pooled estimate and determinant factors of undernutrition among primary school-aged children (6 to 15 years of age) in Ethiopia.

METHOD

We systematically retrieved available articles on the prevalence of undernutrition in primary school-aged children in Ethiopia by using a number of computerized databases, including PubMed, Scopus, Cochrane Library, Google Scholar, and Science Direct between September 1 and November 25, 2019. Two authors independently extracted relevant data using a standardized data extraction form. Heterogeneity among included studies was assessed with the Cochrane Q test statistics and Higgins I2 tests. The pooled estimates and determinant factors of school-aged undernutrition were assessed with random-effects model using Stata/se Version 14.

RESULT

We have retrieved 30 eligible articles with pooled sample size of 16,642 primary school- aged children to determine the prevalence of undernutrition in Ethiopia. Hence, the pooled prevalence of stunting, underweight, and wasting were found to be 21.3% (95% CI: 17.0, 25.5), 18.2% (95% CI: 14.4, 22.0) and 17.7% (95% CI, 13.5, 21.8) respectively. Heterogeneity was assessed by doing subgroup analysis for study province/region. Thus, the highest prevalence of stunting was 27.6% (95% CI, 20.7, 34.5) and underweight 22.7% (95% CI, 19.2, 26.3) in Amhara Region while, in the instance of wasting, it was 19.3%(95% CI: 5.1, 33.4) in Southern Nations, Nationalities and People's Region. Maternal educational status (OR = 1.91, 95% CI: 1.33, 2.73), age of school-aged child (OR = 0.56, 95% CI: 0.44, 0.72) and sex of school-aged child (OR = 0.73, 95% CI: 0.62, 0.85) were found to be significantly associated with stunting. Maternal educational status (OR = 0.6, 95% CI: 0.36, 0.9) and age of school-aged child (OR = 2.74, 95% CI: 1.81, 4.14) were associated with thinness/wasting. Parasitic infection (OR = 2.02, 95% CI: 1.10, 3.73) were associated with underweight of school age children.

CONCLUSION

The prevalence of stunting and underweight among primary school-aged children are moderately high while acute undernutrition (wasting) is more critical than under-five national average as reported in the 2016 Ethiopian Demography and Health Survey. Therefore, this finding warrants the need to design a school-aged children nutrition survey and expand school feeding programs to improve the nutritional status of primary school-aged children in the country. In addition, emphasis should be given to female school-aged children in the early school years, creating awareness for those mothers who lack formal education, and preventing and treating/deworming parasitic infection. Moreover, researchers must conduct research in province/regions which have not yet studied school aged children's nutritional status to date.

Prevalence of intestinal parasitosis and associated risk factors among school children of Saptari district, Nepal: a cross-sectional study

BACKGROUND

Intestinal parasitosis, caused by both helminths and protozoans, are among the most prevalent infections, especially in developing countries. Enteric parasites continue to be a major cause of parasitic diseases which is the most common among street and school going children with poor sanitation. This cross-sectional study was carried out to determine the prevalence and potential risk factors of intestinal parasitosis among school going children of two schools of Saptari district of southern Nepal. Stool samples were collected in a clean, dry, screw-capped, and wide-mouthed plastic container, fixed with 10% formal-saline solution, and transported to the laboratory for further microscopic analysis by following concentration technique.

RESULTS

Out of the 285 stool samples analysed, 94 (33%) were positive for the parasitosis. Presence of intestinal parasites was marginally more in rural school (44.6%) than in urban (30%) (P < 0.05). Giardia lamblia was highly prevalent (15.4%) followed by Entamoeba histolytica-like (7.7%), E. coli (7%), Ascaris lumbricoides (1.8%), and Hymenolepis nana (1.08%), respectively. Children of the age group 11-15 years were highly affected (44.2%) compared to younger age groups. The findings of intestinal parasitosis in the study population were statistically significant with family income, hand-washing habit, type of drinking water, and availability of a toilet facility at home (P < 0.05). Over 85% of infection was associated with parasitosis that indicated mainly waterborne infection rather than soil-borne helminths.

CONCLUSIONS

Poor hygiene measures and farming occupation are identified as major risk factors of parasitic infections, so sanitation especially focusing on safe drinking water along with multi intervention strategies must be emphasized in the Saptari district of Nepal to reduce the burden of parasitic diseases in school children.

Health Education to Reduce Helminthiasis: Deficits in Diets in Children and Achievement of Students of Elementary Schools at Pontianak, West Kalimantan

Worms are still a serious problem for poor and developing countries. Children, especially school-age children, are more at risk of infection. Efforts need to be made to prevent the effects of worms. Prevention can be done through a promotive approach. This observational study with a pre-posttest and cross-sectional approach is aimed at evaluating the effectiveness of health education on healthy and helminthic behavior and analyzing the impact of helminthiasis on the deficit in the diet and children's learning achievement. The number of samples is 60 students from five grade 3 and 4 elementary schools in North Pontianak, West Kalimantan. The sampling technique was carried out by proportional random sampling. Worm infection in elementary school students was 16.7%, anemia was 55%, and learning achievement scores were less than the average grade of 55%. There was a significant difference in health counseling towards a decrease in the worm number (p = 0.046). There was a significant relationship between healthy living behavior and helminthiasis (p = 0.005). There was a significant relationship between helminthiasis and anemia (p = 0.017). There is a relationship between helminthiasis and learning achievement in elementary school children (p = 0.017). There is a relationship between anemia and learning achievement (p = 0.005). It is necessary for public health centers to provide treatment services for worms and health education about the effects of helminthiasis on health and learning achievement. The school should provide hand washing facilities in schools, and parents should play an active role in improving clean and healthy lifestyle habits at home.

Prevalence of intestinal parasites and associated factors among children from child centres in Bahir Dar city, northwest Ethiopia

Data concerning the burden of parasites among populations living in overcrowded circumstances have paramount importance for the success of interventions aimed at eliminating such disease. A cross-sectional study was therefore conducted from February to May 2019 among 217 children at child centres in Bahir Dar city. Data were collected using a structured questionnaire and stool samples were processed for parasitological investigation.A total of 53 (24.4%) children were infected with at least a single species of intestinal parasite. Giardia lamblia (7.8%) was the most frequent, followed by Hymenolepis nana (6%). Children with untrimmed fingernails (adjusted odds ratio [AOR] = 2.422, P = 0.027) were significantly more prone to infection. Similarly, children with no habit of hand washing after soil contact (AOR = 2.752, P = 0.014) or after defecation (AOR = 3.087, P = 0.026) were significantly associated with parasitic infection. The prevalence of intestinal parasites at child centres in Bahir Dar is of public health importance; therefore, control programmes should target these children.

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.

Intestinal parasitic infection among household contacts of primary cases, a comparative cross-sectional study

Background

Intestinal parasitic infection affects 3.5 billion people in the world and mostly affecting the low socio-economic groups. The objectives of this research works were to estimate the prevalence and determinants of intestinal parasitic infection among family members of known intestinal parasite infected patients.

Methods and materials

A comparative cross-sectional study design was implemented in the urban and rural settings of Mecha district. The data were collected from August 2017toMarch 2019 from intestinal parasite infected patient household members. Epi-info software was used to calculate the sample size, 4531 household members were estimated to be included. Data were collected using interview technique, and collecting stool samples from each household contact of intestinal parasite patients. Descriptive statistics were used to estimate the prevalence of intestinal parasites among known contacts of intestinal parasite patients/family members. Binary logistic regression was used to identify the determinant factors of intestinal parasitic infection among family members.

Results

The prevalence of intestinal parasite among household contacts of intestinal parasite-infected family members was 86.14% [95% CI: 86.14% - 87.15%]. Hookworm infection was the predominant type of infection (18.8%). Intestinal parasitic infection was associated with sex, environmental sanitation, overcrowding, personal hygiene, residence, substandard house, role in the household, source of light for the house, trimmed fingernails, family size, regular handwashing practice. Protozoa infection was associated with habit of ingesting raw vegetable, playing with domestic animals, water source and the presence of household water filtering materials.

Conclusion

High prevalence of intestinal parasitic infection was observed among household contacts of primary cases.

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.

Intestinal parasitic infections and associated factors among mentally disabled and non-disabled primary school students, Bahir Dar, Amhara regional state, Ethiopia, 2018: a comparative cross-sectional study

Background

Intestinal parasitic infections are still common in low-income countries including Ethiopia, particularly in children due to low-quality drinking water, poor personal and environmental sanitation. Disabled individuals are excluded from most academic, economic, social and cultural opportunities, they are among the poorest and most marginalized of the whole world’s people.

The aim of this study was to assess the prevalence of intestinal parasitic infections and associated factors among mentally disabled and non-disabled students at primary schools in Bahir Dar city, Amhara regional state, Ethiopia, 2018.

Methods

A school-based Comparative cross-sectional study design was conducted from November 1–30, 2018. A total of 418 study participants, 104 mentally disabled and 314 non-disabled students were recruited through a simple random sampling technique. The collected data were coded, entered and cleaned with EpiData version 3.1 and analyzed using SPSS version 23. Multivariable logistic regression was conducted to identify factors associated with intestinal parasitic infections. The adjusted odds ratio with a 95% Confidence interval at a 5% level of significance was used to measure the strength of association.

Results

The mean age of study participants was 14.05 ± 3.66 and 11.96 ± 2.94 for mentally disabled students and non-disabled students. Prevalence of parasitic infection was 56.70% (n = 59) for mentally disabled students whereas 41.10%(n = 129) for non-disabled students. Unclean fingernails [AOR = 2.42; 1.40,4.17], health checkups [AOR = 1.87;1.16,3.02], hand washing with water only [AOR = 2.48; 1.49,4.12], cooking and sanitation source of water [AOR = 4.40;2.32,8.36], Grade [ (1–4)] [AOR = 2.27;1.41,3.67], sex [AOR = 1.64;1.03,2.63] and Family size> = 7 [AOR = 2.74;1.25,5.99] were variables which showed statistically significant association with intestinal parasitic infections.

Conclusion

The prevalence of intestinal parasitic infection was higher among mentally disabled students than non-disabled students. Unclean fingernails, health checkups, hand washing habits, source of water, family size, sex and Grade of students have had a statistically significant association with intestinal parasitic infections. Periodic medicinal treatment was needed twice a year for mentally disabled and once a year for non-disabled students.

Electronic supplementary material

The online version of this article (10.1186/s12879-019-4165-2) contains supplementary material, which is available to authorized users.

Prevalence of intestinal parasitic infections and associated risk factors among students at Dona Berber primary school, Bahir Dar, Ethiopia

BACKGROUND

Intestinal parasitic infections are still one of the major health concerns in developing countries. Monitoring of intestinal parasitic infection and associated risk factors are essential for intervention strategies. Therefore, the aim of this study was to assess the prevalence of intestinal parasitic infection and associated risk factors among students at Dona Berber primary school, Bahir Dar, Ethiopia.

METHODS

School based cross-sectional study was conducted among students at Dona Berber primary school from October 2015 to June 2016. Three hundred fifty nine students were involved in the study by providing stool specimens and detailed personal information. Students were selected by stratified and systematic random sampling method. Fresh stool samples were collected from each student and processed by formal-ether fecal concentration technique. Data were analyzed using SPSS version 20.0 statistical software and p value <0.05 were used as statistically significant.

RESULTS

Among the 359 students participated in the study, 235 (65.5%) were infected by one or more intestinal parasites. The rates of single and double parasitic infections among students were 49.6% and 16.2%, respectively. The most prevalent parasite detected in the study was E. histolytica/dispar (24.5%) followed by hookworm (22.8%). Among the different variables assessed in the study, family size of 6 (AOR = 4.90; 95% CI, 2.03-11.83), irregularly shoe wearing habit (AOR = 2.85; 95% CI, 1.53-5.32) and unclean finger nail (AOR = 3.68; 95% CI, 1.87-7.26) were independently predict intestinal parasitic infections. Student drinking well water (AOR = 2.51; 95% CI, 2.30-4.86) and unclean finger nail (AOR = 4.42; 95% CI, 2.55-7.65) were strongly associated with E. histolytica/dispar infection. Likewise, irregular shoe wearing habit (AOR = 14.13; 95% CI, 7.06-28.29) was strongly associated with hookworm infections.

CONCLUSION

High prevalence of intestinal parasitic infection among the study participants demands improvement of health education, environmental sanitation and quality of water sources.