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

Prevalence and associated factors of infection in children with nephrotic syndrome aged 2-18 years in the northwest and east Amhara region, Ethiopia: a multi-center cross-sectional retrospective study

BACKGROUND

Infection is the most common complication of pediatric patients with nephrotic syndrome. The factors associated with infection in nephrotic syndrome are lacking. The objective of the study was to identify the prevalence and associated factors among children with nephrotic syndrome aged 2 to 18 years.

METHODS

We conducted a hospital-based retrospective cross-sectional study. The data collector installed an Epi5 collector electronic data-collecting tool from Google Play. Then, we exported the data to Stata version 15.1 for analysis. The mean, standard deviation, frequency, and percentage were used for descriptive statistics. The logistic regression model was used to identify the factors associated with infection.

RESULTS

In this study, the prevalence of infection among nephrotic syndrome children is 39.8% (95%CI: 30.7, 49.7). The types of infection identified were pneumonia, urinary tract infection, diarrheal disease, cutaneous fungal infection, intestinal parasitic infection, and sepsis. The presence of hematuria increased the odds of infection by 5-times. On the other hand, low level of serum albumin increased the odds of infection by 7%. Being a rural resident increased the odds of infection by 3.3-times as compared to urban.

CONCLUSIONS

Serum albumin level, presence of hematuria, and rural residence were significantly associated with infection. We recommended a longitudinal incidence study on large sample size at multicenter to strengthen this finding.

Prevalence of intestinal parasitic infections and associated risk factors among patients attending Debarq Primary Hospital, northwest Ethiopia

Intestinal parasitic infections (IPIs) are major public health problems in developing countries. This study was conducted to determine the prevalence and associated risk factors of IPIs at Debarq Primary Hospital in northwest Ethiopia. A health facility-based cross-sectional study was conducted from March 2022 to June 2022. The study participants were recruited from patients who visited Debarq Primary Hospital during the study period. Stool samples were collected from each participant and examined for intestinal parasites using direct wet-mount and formal-ether concentration techniques. Socio-demographic data were collected using a structured questionnaire. Out of 422 individuals examined, 33.64% were infected with at least one intestinal parasite species. Entamoeba histolytica/dispar, Giardia intestinalis, Ascaris lumbricoides, and hookworm were found in 12.79%, 8.53%, 7.10%, and 1.65% of the participants, respectively. Double and triple parasite infections were found in 2.37% and 0.23% of the participants, respectively. A habit of eating unwashed vegetables (Adjusted odds ratio (AOR) = 9.98, 95% confidence interval (CI) = 2.68-37.14) and low income (AOR = 6.66, 95% CI = 1.87-23.70) were associated with increased odds of IPIs. Participants with a habit of hand washing after using the toilet had 0.05 (95% CI = 0.13-0.22) lower odds of IPIs than those who did not. In conclusion, IPIs are common among Debarq Primary Hospital patients and are associated with factors such as low income, not washing hands after using the toilet, and eating unwashed vegetation, necessitating control and prevention efforts in the study area that include health education and the provision and use of sanitary facilities.

Intestinal parasitic infections and risk analysis among urban refugees in the Klang Valley, Malaysia

BACKGROUND

Global studies show intestinal parasitic infections (IPIs) have been introduced and spread with refugee inflows from low to high socio-economic countries. However, there is relatively limited information on the prevalence of infections among the community.

METHODS

A 2-year cross-sectional study was conducted to determine the prevalence and associated risk factors for infections among urban refugees in the Klang Valley, Malaysia. A total of 418 faecal samples were collected and examined by microscopy.

RESULTS

Faecal screening revealed moderate levels (32.3%) of infections in the community. Three nematode (Ascaris lumbricoides, Trichuris trichiura and hookworm) and three protozoan species (Entamoeba, Giardia and Cryptosporidium) were recorded, with the highest prevalence being A. lumbricoides (20.6%) followed by T. trichiura (10.3%), while other infections were <5%. Statistical analysis found that young males with less education were more likely to be infected with helminths. Additionally, living near waste disposal sites, the presence of stray animals, eating with bare hands, bare footedness, poor handwashing practices and no anthelmintic treatment constituted significant risk factors for helminth infections. Protozoan infections were linked to drinking tap water or from water dispensers and poor handwashing practices.

CONCLUSIONS

These findings emphasize the importance of health education in addition to introduction of biannual anthelmintic treatment to promote community health and well-being.

Endoscopic Diagnosis of Hookworm Disease in a Patient with Severe Iron Deficiency Anemia: A Case Report

Hookworm infection is an important cause of iron deficiency anemia, especially in heavily infected high-risk populations residing in underdeveloped tropical countries. Stool examination is the main method used for hookworm diagnosis; however, its sensitivity is relatively low. Hookworm infections have been incidentally diagnosed during routine upper gastrointestinal endoscopies. We present the case of a 60-year-old Ethiopian farmer who had severe iron deficiency anemia and positive occult blood in the stool. Repeated stool examinations revealed no ova or parasites. Esophagogastroduodenoscopy revealed the presence of hookworms in the duodenum. The patient was treated with albendazole and ferrous sulfate. Careful endoscopic examination of the duodenum is crucial for identifying unsuspected hookworm infection responsible for chronic gastrointestinal bleeding and iron deficiency anemia.

The Association of Sanitation and Hygiene Practices With Intestinal Parasitic Infections Among Under-14 Children in Rural Dire Dawa, Eastern Ethiopia: A Community Based Cross-sectional Study

Background

Intestinal parasitic infections (IPIs) are neglected tropical diseases. Sanitation and hygiene are vital components for achieving sustainable control of intestinal parasitic infections. Children are the most vulnerable to intestinal parasitic infections because of their immature immune systems and frequent exposure to unsanitary environments. The aim of this study was to assess the magnitude of IPIs and associated risk factors, including sanitation and hygiene practices, among under-14-year-old children in rural Dire Dawa, eastern Ethiopia.

Methods

This community-based cross-sectional 'study included 778 subjects aged 1 to 14 years. Data were collected using questionnaires and stool examinations. The direct wet-mount method and formol-ether concentration techniques were performed to identify IPIs. Data Analysis: A descriptive statistic was used to show the prevalence of IPIs. Bi-variable and multivariable analysis using the logistic regression model was carried out.

Results

The outputs are presented using an adjusted odds ratio (aOR) with 95% confidence intervals (CIs). The prevalence of 5 intestinal parasites was 33.7% (95% CI = 30.4%-37%). Giardia intestinalis (15.2%) and Hymenolepis nana (11.6%) had the highest prevalence. The odds of IPIs among children of illiterate mothers were 13.1 times higher when compared with children of mothers with secondary education (aOR = 13.1, P = .02), and the odds of IPIs among children from households that have unclean latrines were 1.8 times higher when compared with children from households that have clean latrines. (aOR = 1.8, P = .03). Children from households that discard solid waste in open fields had 1.7 times higher odds of having a positive result than children from households that burn their waste (aOR = 1.7, P = .03). However, children without a swimming habit (aOR = 0.4, P = .000) and asymptomatic children (aOR = 0.3, P = .000) were protective against IPIs.

Conclusions

IPIs continue to be a public health problem in rural parts of Dire Dawa. The prevalence of Giardia intestinalis and H. nana could be of public health importance in this setting. Solid waste management, latrine cleanliness, mothers' level of education, and child swimming habits in unclean accumulated water were significantly associated with IPIs. Therefore, efforts should be made to ensure intervention, considering such risks.

Change in the incidence of intestinal diseases caused by parasitic protozoa in the Mexican population during the period (2015-2019) and its association with environmental and socioeconomic risk factors

Diarrheal diseases are one of the main health problems worldwide, especially in developing countries with poor health systems, high rates of poverty, and poor nutrition. The main causative agents of diarrheal disease are bacteria, viruses, and parasites; among the latter, the intestinal protozoa Giardia and Entamoeba stand out. In the present work, a observational analysis of the national surveillance data of amebiasis, giardiasis, and other protozoan intestinal infections was carried out. The data issued by the Directorate General of Epidemiology was analyzed to establish its relationship with geography, socioeconomic, and environmental conditions in Mexico during the 2015-2019 period. New cases of amebiasis decreased by 25.03% between 2015 and 2019, while giardiasis and other protozoan intestinal infections remained constant; in all cases, incidence was higher in females than in males, and children under 5 years of age were the most affected. The contribution of environmental conditions (seasonality, temperature, and humidity) and socioeconomic factors in the number of protozoan intestinal infection cases was assessed by a multivariable regression model using a backward selection procedure. Peaks in cases were observed in spring and summer, which are characterized by warm and humid climates. Additionally, states with high humidity and annual average temperature contribute to a notably higher incidence of these parasites, especially annual average temperature, as demonstrated through multivariable linear regression models. Moreover, the majority of these states have the largest population living in poverty with inadequate measures for the distribution, dispensing, and sanitation of water. These data are essential to incidence rate monitoring and focus efforts on eliminating risk factors and improving health programs in Mexico.

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.

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

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

Assessment of prevalence and associated factors of intestinal parasite infections among school children at Amber Primary School, Northwest Ethiopia

OBJECTIVE

This study is aimed to assess the prevalence and associated factors of intestinal parasitic infections among school children at Amber Primary School, Northwest Ethiopia.

METHODS

A school-based cross-sectional study was conducted at Amber Primary School from December 2019 to January 2020. Semi-structured questionnaire was used to collect socio-demographic data and clinical characteristics. Direct wet mount technique was applied for detection and identification of intestinal parasites.

RESULT

A total of 384 participants were included in this study of which 50.3% were males and 65.4% were in the age group 9-12 years. The prevalence of at least one intestinal parasite was 26.8% (n = 103), of which 13.6% (n = 14) were mixed infections. Hymenolepis nana was the most prevalent intestinal parasite (5.2%) followed by Entamoeba histolytica/dispar (4.9%) and hookworm (4.7%). Male children (adjusted odds ratio = 0.624; 95% confidence interval: 0.392-0.993) and those whose mother completed elementary school (adjusted odds ratio = 2.171; 95% confidence interval: 1.012-4.658) were significantly associated with intestinal parasite infections (p < 0.05).

CONCLUSION

Intestinal parasitic infections remained an important health problem among school children in the study area. Appropriate intervention measures should be taken to reduce the burden and related morbidities.

Assessing the prevalence and risk factors associated with Entamoeba complex infection among the Orang Asli school children in Perak, Malaysia through molecular approach

This study performed a cross-sectional investigation on the prevalence of Entamoeba complex infection comprising Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii and their associated risk factors among the Orang Asli school children in three districts in Perak, Malaysia. Stool samples collected from 544 school children aged between 7 and 12 years old were examined through the nested multiplex PCR assay. The univariate and multivariate regression analyses were then carried out to determine the risk factor associated with Entamoeba complex infection. The overall prevalence of Entamoeba complex infections (E. histolytica, E. dispar and E. moshkovskii) was 21.3% (116/544). Most positive school children were infected with E. moshkovskii (10.7%; 58/544), followed by E. dispar (9.0%; 49/544) and E. histolytica (5.0%; 27/544). Not washing their hands after using the toilet was identified as the only significant risk factor for E. histolytica. The significant risk factors associated with E. moshkovskii infection included children within the age of 10-12 years old, with high BMI, living with working and non-educated mothers, no toilet in the house, not washing their hands after using the toilet, and fever. On the other hand, drinking water from the river, well, and rain was associated with a decreased risk of E. dispar infection. In conclusion, this study showed a high prevalence of Entamoeba spp. infections among the Orang Asli school children in Perak, Malaysia. Addressing the identified risk factors coupled with a holistic approach in breaking the transmission of Entamoeba complex can help improve their quality of life.

Intestinal Parasitic Infections Among Patients Who Visited Woldia Comprehensive Specialized Hospital's Emergency Department Over a Six-Year Period, Woldia, Ethiopia: A Retrospective Study

Background

Despite ongoing intensive public health intervention efforts, intestinal parasitic infections (IPIs) remain a major public health problem in developing countries, including Ethiopia. Having updated epidemiological data focusing on the top common IPIs that cause emergency visits is crucial for implementing area-specific and evidence-based intervention strategies. Hence, this study aimed to determine the prevalence of IPIs in Woldia Comprehensive Specialized Hospital's (WCSH) emergency laboratory over a six-year period.

Methods

An institutional-based retrospective study was conducted to assess the prevalence of IPIs over a six-year period (2014-2019) using a recorded saline wet-mount stool sample examination result in the laboratory logbook at WCSH's emergency department.

Results

In this study, of the total of 11,281 clinically suspected individuals who were requested for stool sample examination, 3908 (34.6%) individuals were diagnosed with IPs. The majority of confirmed cases were caused by protozoan parasites (32.9%), followed by helminth infections (1.7%). A slight fluctuating trend in the prevalence of IPs was observed in the six-year study period, with the highest prevalence documented in the year of 2014 (41.3%) and the lowest in 2017 (28.0%). Entamoeba histolytica/dispar and Giardia lamblia accounts for 95% of the IPs. The prevalence of protozoan infection was significantly higher in females (p-value = 0.0101), while H. nana (p-value =0.0138) and E. vermicularis (p-value = 0.0201) infections were higher in males. The highest and the lowest IP prevalence were reported in the age groups of 45-54 years (40%) and under five years (25.6%), respectively.

Conclusion and Recommendations

In the study area, nearly one-third of patients with emergency visits due to gastrointestinal symptoms were infected with IPs. This underlines the severity of the problem in the study area, which requires a collaborative effort of concerned bodies to minimize the burden of IP to the level where it is no longer a public health threat.

Prevalence of Giardiasis and Entamoeba Species in Two of the Six Governorates of Kuwait

Intestinal parasitic infections are a global concern owing to elevated rates of morbidity and mortality in many parts of the world. Increased rates of intestinal parasitic infections are observed in developing and low-income countries. In Kuwait, many expatriates and foreigners hail from endemic countries, thus increasing the rate and risk factor of infection. This retrospective study is aimed at assessing the prevalence of Giardia lamblia and Entamoeba sp. in stool samples handled by two of Kuwait's general hospitals during the period from January 2018 to July 2019: Mubarak Al Kabeer (serving Hawalli governorate population) and Aladan hospitals (serving Mubarak Al Kabeer governorate population) serving 27% of total Kuwait population with Kuwaitis making up only 32%. A total of 9,653 samples were tested for consistency and the availability of any parasitic particles using visual, direct wet mount, and concentration method. Statistical analysis was implemented using SPSS statistical program, at p < 0.05. Of all the 9,653 tested stool samples, 74 were positive for G. lamblia or Entamoeba sp. This represented a mere 1% rate of infection and showed no significant correlation to the prevalence of intestinal parasite infections in Kuwait. On the other hand, comparing the rate of infection in different seasons revealed an increased rate of infection during spring compared to other seasons (p = 0.03). Findings revealed low rates of intestinal parasitic infection within the two governorates of Kuwait representing no statistical significance to the distribution of the investigated parasites in Kuwait. This may be attributed to improved living conditions and healthcare. Elevated infection rates in spring in relation to other seasons raised the importance of increasing public awareness during camping season for maintaining proper personal hygiene and waste management to contain and decrease the rate on infection.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Prevalence of intestinal protozoan parasites among school children in africa: A systematic review and meta-analysis

Introduction

Parasitic infections, especially intestinal protozoan parasites (IPPs) remain a significant public health issue in Africa, where many conditions favour the transmission and children are the primary victims. This systematic review and meta-analysis was carried out with the objective of assessing the prevalence of IPPs among school children in Africa.

Methods

Relevant studies published between January 2000 and December 2020 were identified by systematic online search on PubMed, Web of Science, Embase and Scopus databases without language restriction. Pooled prevalence was estimated using a random-effects model. Heterogeneity of studies were assessed using Cochrane Q test and I² test, while publication bias was evaluated using Egger’s test.

Results

Of the 1,645 articles identified through our searches, 46 cross-sectional studies matched our inclusion criteria, reported data from 29,968 school children of Africa. The pooled prevalence of intestinal protozoan parasites amongst African school children was 25.8% (95% CI: 21.2%-30.3%) with E. histolytica/ dispar (13.3%; 95% CI: 10.9%-15.9%) and Giardia spp. (12%; 95% CI: 9.8%-14.3%) were the most predominant pathogenic parasites amongst the study participants. While E. coli was the most common non-pathogenic protozoa (17.1%; 95% CI: 10.9%-23.2%).

Conclusions

This study revealed a relatively high prevalence of IPPs in school children, especially in northern and western Africa. Thus, poverty reduction, improvement of sanitation and hygiene and attention to preventive control measures will be the key to reducing protozoan parasite transmission.

Pathogenic intestinal protozoan parasites (IPPs) remain a major public health concern. Studies have documented that, the prevalence rates of protozoan infections are quite high in developing regions, particularly Africa and children are the primary victims. Despite numerous studies have been conducted on IPPs in school children in African countries, data on the burden of these infections in African school children have not yet been synthesised. This systematic review and meta-analysis was conducted to provide continent-wide prevalence of IPPs amongst African school children. Our study found that about 25.8% of the children had one or more species of intestinal protozoan parasites in their faecal specimens. E. histolytica/ dispar and Giardia spp. were the most predominant parasites amongst the study participants. The relatively high prevalence estimate of IPPs amongst African children and the considerable variation in the disease prevalence over the years, between and within countries and regions clearly indicates the needs to improve sanitation and hygiene, paying more attention to preventive control measures as well as poverty reduction which are the key to reducing protozoan parasite transmission.

ENTEROPARASITES IN A POPULATION IN DEPRIVED CONDITIONS FROM PROVINCE OF VALENCIA (SPAIN)

The autonomous Valencian Community (Spain) has experienced intense population growth with economic difficulties or deprivation in basic goods, ranking as the sixth Spanish autonomous region with the highest percentage of a population at risk of poverty or social exclusion. The objective of this work is to assess the level of enteroparasites in a Valencian population that meets certain deprivation conditions. A coproparasitological analysis was carried out in 460 users (children and adult relatives) of the 3 Casa Caridad schools in the province of Valencia. The parasite prevalence reached 31.7%, with a higher frequency of pathogens/potentially pathogenic species (66.4%) than non-pathogenic species (33.5%), although symptoms only appeared in 10.3% of those with pathogens/potentially pathogenic species. Of those parasitized, the presence of pathogens/potentially pathogenic species reached 20.6% in individuals living in crowded conditions and 17.5% in those living with pets. Presenting pathogens/potentially pathogenic species infection increased almost fourfold in those of southern European origin. In family groups, infection occurred among all their members, showing interpersonal parasitic transmission linked to both material deprivation and a lack of health education. Improving epidemiological surveillance, health education, and hygiene/sanitation facilities is essential to reduce or eliminate parasitic transmission among those who suffer from certain deprivation conditions.

Intestinal Parasite Infection and Its Association with Undernutrition among Early Adolescents in Hawassa University Technology Village, Southern Ethiopia

Background. Different studies presented negating findings of the association between intestinal parasite infections (IPIs) and undernutrition among early adolescents in Ethiopia. This study was aimed at assessing intestinal parasite infection and its association with undernutrition among early adolescents in four selected districts of the Sidama region. Method. An institution-based cross-sectional study was conducted in October 2020 among 792 early adolescents. The multistage stage sampling was applied to select 16 primary schools. Simple random sampling was applied to select study participants. Trained data collectors administered questionnaires. Stool samples were collected and analyzed. Anthropometric measurements were taken and indices were calculated using AnthroPlus software. Data were entered into and analyzed by SPSS version 25 software. Association between IPI and undernutrition was measured using multivariable analysis. The outputs are presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CIs). Result. The prevalence of IPI, thinness, and stunting was 32% (95% CI: 28.7%, 35.3%), 17.5% (95% CI: 14.8%, 20.2%), and 21.5% (95 CI: 18.6%, 24.4%), respectively. The higher odds of IPIs were observed among adolescents stunted (AOR = 3.61; 95% CI: 2.44–5.33), those who are thin (AOR = 3.07; 95% CI: 2.02–4.66), those who did not wash their hands after toilet (AOR = 1.89; 95% CI: 1.35–2.66), those who ate raw meat (AOR = 1.50; 95% CI: 1.03–2.14), and those whose family did not own toilet (AOR = 1.71; 95% CI: 1.18–2.46). Conclusion. The prevalence of IPI, thinness, and stunting was high and has public health significance in the study area. IPIs were associated with stunting, thinness, lack of toilets, not washing hands after a toilet visit, and eating raw meat. Strengthening nutrition interventions, deworming programs, and health education on personal and environmental hygiene and sanitation are recommended.

Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan

Present study was conducted among school children to recognize the prevalence of IPIs in rural communities of district Dir Lower, Pakistan. A sum of 324 samples of stool were collected (210 boys and 114 girls). Used direct smear method and formol ether sedimentation concentration technique for processing the samples. The result shows that 82% (n=266) were found infected comprised 64.8% male and 35.1% females. Children of the age group 10 to 12 years were found extremely infected 94.2% while 4-6 year age group were having minimum ratio of infection 72%. Current study shows mono parasitism in 50.6% of the students while 22.2% were infected with 2 species and 7.40% were infected with three species of parasites. Seven species of intestinal parasites were reported include Ascaris lumbricoid in male (n=122) 58.0% and in female (n=65) 57.0% followed by Hook worm (n=88) 41.9% and (n=44) 38.5%; Tania saginata (n=44) 20.9% and (n=24) 21.0%; Entrobius vermicularis (n=32) 15.2% and (n=16) 14.0%; Trichuris trichura (n=25) 11.9% and (n=22) 19.2%; Hymenolepis nana (n=24) 11.4% and (n=18) 15.7% and Entameoba histolytica (n=16) 7.61% and (n=14) 12.2% in male and females respectively. The study indicates that most occurring intestinal parasite in the current study were Ascaris lumbricoides 58.0% (n=122) followed by hookworms 41.9% (n=88). Male students were more infected than females in the present study.

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

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

Prevalence and Risk Factors Associated with Intestinal Parasitic Infection among Primary School Children in Dera District, Northwest Ethiopia

BACKGROUND

Globally, over 600 million school children are living with intestinal parasites. The prevalence of intestinal parasitic infections (IPIs) among school children in Ethiopia and the Amhara region is 52% and 51%, respectively. The present study aimed to determine the prevalence and associated risk factors of IPIs among primary school children in Dera district, Northwest Ethiopia.

METHODS

A school-based cross-sectional study was conducted from December 2019 to February 2020. The study used a structured pretested questionnaire and stool tests to obtain epidemiological and disease data. Data were analyzed using appropriate univariate and multivariable logistic regression methods by statistical package for social science (SPSS) version 25.0.

RESULTS

Of the 382 students who were examined for IPIs, 238 (62.3%) (61.8% males, 62.8% females) were positive for one or more IPIs. One hundred thirty-six (35.6%), 98 (25.7%), and 4 (1.05%) were single, double, and triple infections, respectively. Out of the nine species of IPIs detected, Entamoeba sp. was the predominant species (29.6%) followed by hookworm (21.7%), Schistosoma mansoni (11.3%), Taenia sp. (9.2%), Giardia lamblia (5.2%), and Ascaris lumbricoides, Hymenolepis nana, and Enterobius vermicularis (4.2%) each, and Trichuris trichiura (0.5%). Family size greater than five (AOR = 1.8; 95% CI: 1.004, 3.13), open field school waste disposal (AOR = 15.88; 95% CI: 1.91, 132.1), and lack of knowledge about intestinal parasitic infection (AOR = 1.8; 95% CI: 1.1, 3.2) were the independent risk factors associated with the overall prevalence of IPIs.

CONCLUSIONS

The prevalence of intestinal parasitic infection was high in the Dera district. Health education, extending school-based deworming, and mass treatments are recommended.

Human Intestinal Parasites: Prevalence and Associated Risk Factors among Grade School Children in Maksegnit, Northwest Ethiopia

This study was aimed to assess the prevalence and associated risk factors of intestinal parasitic infections in grade school children in Maksegnit, Northwest Ethiopia. Five species of intestinal parasites were identified with an overall prevalence of 155 (40.4%). Among these, Ascaris lumbricoides 122 (31.8%) and Entamoeba histolytica 18 (4.7%) were predominant. Of the total 155 (40.4%) positive individuals, 149 (39%) had a single infection and the rest 6 (1.6%) had double parasitic infections. Of the different variables assessed, age, gender, shoe wearing, and eating raw or undercooked vegetables were not significantly associated with the prevalence of intestinal parasites (P > 0.05). However, a statistically significant association (P < 0.05) was observed between infected children and variables including defecation habit (AOR = 0.216), cleanliness of fingernails (AOR = 0.146), drinking river water (AOR = 0.124), and hand washing habit after defecation (AOR = 0.236) (P < 0.05). Regular deworming, education on personal hygiene, and environmental sanitation to both students and their parents shall be implemented to reduce the prevalence rate of intestinal parasitic infections in the study area.

Application of Dendrimers for Treating Parasitic Diseases

Despite advances in medical knowledge, parasitic diseases remain a significant global health burden and their pharmacological treatment is often hampered by drug toxicity. Therefore, drug delivery systems may provide useful advantages when used in combination with conventional therapeutic compounds. Dendrimers are three-dimensional polymeric structures, characterized by a central core, branches and terminal functional groups. These nanostructures are known for their defined structure, great water solubility, biocompatibility and high encapsulation ability against a wide range of molecules. Furthermore, the high ratio between terminal groups and molecular volume render them a hopeful vector for drug delivery. These nanostructures offer several advantages compared to conventional drugs for the treatment of parasitic infection. Dendrimers deliver drugs to target sites with reduced dosage, solving side effects that occur with accepted marketed drugs. In recent years, extensive progress has been made towards the use of dendrimers for therapeutic, prophylactic and diagnostic purposes for the management of parasitic infections. The present review highlights the potential of several dendrimers in the management of parasitic diseases.

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

Background

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

Methods

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

Results

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

Conclusion

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

Analysis of D-A locus of tRNA-linked short tandem repeats reveals transmission of Entamoeba histolytica and E. dispar among students in the Thai-Myanmar border region of northwest Thailand

Intestinal parasitic infections, including those caused by Entamoeba species, are a persistent problem in rural areas of Thailand. The aims of this study were to identify pathogenic Entamoeba species and to analyze their genotypic diversity. Stool samples were collected from 1,233 students of three schools located in the Thai-Myanmar border region of Tak Province, Thailand. The prevalence of Entamoeba infection was measured by polymerase chain reaction (PCR) using species-specific primers. Thirty-one (2.5%) positive cases were detected for E. histolytica, 55 (4.5%) for E. dispar, and 271 (22.0%) for E. coli. Positive samples for E. histolytica and E. dispar were exclusively obtained from a few school classes, whereas E. coli was detected in all grades. No infections caused by E. moshkovskii, E. nuttalli, E. chattoni, and E. polecki were detected in the students studied. The D-A locus of tRNA-linked short tandem repeats was analyzed in samples of E. histolytica (n = 13) and E. dispar (n = 47) to investigate their diversity and potential modes of transmission. Five genotypes of E. histolytica and 13 genotypes of E. dispar were identified. Sequences of the D-A were divergent, but several unique genotypes were significantly prevalent in limited classes, indicating that intra-classroom transmission has occurred. As it was unlikely that infection would have been limited within school classes if the mode of transmission of E. histolytica and E. dispar had been through the intake of contaminated drinking water or food, these results suggest a direct or indirect person-to-person transmission mode within school classes. Positive rates for three Entamoeba species were 2-fold higher in students who had siblings in the schools than in those without siblings, suggesting that transmission occurred even at home due to heavy contacts among siblings.

Transmissions in endemic areas of the pathogen Entamoeba histolytica and other non-pathogenic Entamoeba species such as E. dispar and E. coli are caused by ingestion of drinking water and foods contaminated with cysts of the parasites. Cases of Entamoeba infections among school-aged children have been reported in several countries. However, it has not been demonstrated that transmission of protozoa of the Entamoeba genus occurs within school facilities. In addition, genetic information on E. histolytica and other morphologically indistinguishable species, including E. dispar and E. moshkovskii, in Thailand remains scarce. In the present study, we demonstrated that E. histolytica and/or E. dispar are prevalent among school-aged children, but limited to few classes in three rural schools in the Thai-Myanmar border region of northwest Thailand. Although various genotypes of these Entamoeba species were identified, identical genotypes were significantly more prevalent in certain school classes and also among siblings, suggesting that transmission occurred within the classrooms and at home. The possibility of person-to-person transmission among these students via direct or indirect contact during daily activities in classrooms and home is proposed.

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

Prevalence of Intestinal Parasitic Infection and Associated Factors Among HAART Initiated Children Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

BACKGROUND

Human immunodeficiency virus (HIV) and intestinal parasites co-infections are the most common causes of clinical illness and death, especially for children living in resource constrained setting. Therefore, the aim of this study was to determine the prevalence and associated factors of intestinal parasites among highly active anti-retroviral therapy (HAART) initiated children.

METHODS

Cross-sectional study was conducted among 255 HAART initiated HIV-infected children at the University of Gondar Comprehensive Specialized Hospital from January to April 2020. Socio-demographic characteristics were collected using a structured questionnaire via a face-to-face interview. Clinical data of the children were collected by reviewing the medical records. Venous blood was collected for complete blood counts, viral load determination, and blood film examination. Flotation concentration technique was done in addition to direct wet mount for parasitological examination. Bi-variable and multi-variable logistic regression analysis were used to check the presence of significant association, and P-value<0.05 was considered as statistically significant.

RESULTS

The overall prevalence of intestinal parasite infection (IPI) among the study participants was 22.4% (95% CI=17-28%). The presence of opportunistic infection (AOR=2.09 95% CI=1.81-5.43), no eating under-cooked animal products (AOR=0.38 95% CI=0.16-0.94), male sex (AOR=0.45 95% CI=0.22-0.90), viral load rate >1,000 copies/mL (AOR=1.80 95% CI=1.67-4.19), and cytopenia (AOR=2.71 95% CI=1.59-12.25) showed significant association with the prevalence of IPI.

CONCLUSION

Entamoeba histolytica and Ascaris lumbricoides were the most prevalent intestinal parasites among HAART initiated children. Among HAART initiated children, IPI were associated with gender, cytopenia, viral load, undercooked animal products, and the presence of opportunistic infections. Therefore, health education, prompt treatment, and regular deworming should be implemented to alleviate the burden of intestinal parasites in HIV-infected children.

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

Background

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

Methods

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

Results

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

Conclusion

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

Supplementary Information

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

Knowledge, Attitudes, and Practices of Hand Washing among Aderash Primary Schoolchildren in Yirgalem Town, Southern Ethiopia

Background

Hand washing is a simple, convenient, and cost-effective means to limit the transmission of communicable diseases. Improving the practice of hand washing is vital to decrease hygiene-related morbidity and mortality, particularly in developing countries. As such, this study aimed to assess knowledge, attitudes, and practices of hand washing among schoolchildren in Aderash primary school, Yirgalem town.

Methods

A cross-sectional study was conducted on 279 schoolchildren from March to May 2019. A pretested structured questionnaire was applied to collect all relevant information using simple random sampling. Data entry and clearance was done with Epi-Info version 7 and exported to SPSS version 20 for analysis. Adjusted ORs with 95% CI were used to assess statistically significant variables (p<0.05).

Results

Overall, 62.7% of schoolchildren had adequate knowledge of hand washing, 61.3% exhibited positive attitudes toward hand washing and 39.1% had good hand-washing practices. Over three quarters (89%) of them had good knowledge of washing hands with soap. About 24%, 56.6%, 9.3%, 6.5%, and 3.6% of children reported washing hands after defecation, before meals, after meals, after work, and after play, respectively. In addition, 73.8% of them reported washing hands with soap if their hands looked dirty or smelled bad. Urban dwelling increased knowledge of hand washing of 1.3-fold (95% CI 1.2–2.85).

Conclusion

Even though >60% of children had adequate knowledge and exhibited positive attitudes toward hand washing, proper hand-washing practices was <40%. Therefore, much effort should be directed toward improving children’s understanding of the benefits of proper hand washing in schools.