Current status of soil transmitted helminths and Schistosoma mansoni infection among children in two primary schools in North Gondar, Northwest Ethiopia: a cross sectional study

High prevalence of soil-transmitted helminths and schistosomiasis among primary schoolchildren in Southwest Ethiopia: the need for health strategies alongside mass drug administration

BACKGROUND

Soil-transmitted helminths (STH) and schistosomiasis remain widely prevalent in Ethiopia. The aim of this study was to evaluate the prevalence of STH and schistosomiasis among schoolchildren in Gidi Bench district (Southern Nations, Nationalities, and People's Republic, Southwest Ethiopia) and the association with knowledge and health-related behaviors.

METHODS

A cross-sectional study was conducted. Stool samples, analyzed by the Kato-Katz technique and a knowledge, attitudes and practices questionnaire, were collected.

RESULTS

Out of 611 participants (mean age 12.8±3.1 y), 129 (21.1%) were infected with schistosomiasis and 382 (62.5%) had STH. More than 30% (n=195, 31.9%) were infected with a single intestinal parasite, while 138 (22.6%) and 47 (7.7%) were infected with two or three parasitic infections, respectively. Boys and those who did not participate in school clubs had higher infection rates (p=0.05). Lower parasitic infection was associated with using a latrine when available, washing hands and vegetables and wearing shoes regularly. Higher rates of infection were found among those who reported swimming and washing cloths and utensils in the river regularly.

CONCLUSIONS

Schistosomiasis and STH were highly prevalent among schoolchildren in Gidi Bench district. Infection rates were associated with gender, lack of knowledge on parasitic infections and unhealthy behaviors. Findings from this study may assist in decision making regarding disease prevalence and methods of control alongside mass drug administration.

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

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

Schistosoma mansoni Epidemiology Among Snails, Rodents and Children: A One Health Approach

Background

Schistosoma is one of the prevalent parasitic infection in humans and animals. Schistosomiasis in children is particularly serious and results in liver and spleen enlargement, anemia, stunting, reduced ability to learn and death. The aim of this study was to measure the prevalence and distribution of schistosomiasis in children, rodents and snail populations in Aleffa and Takusa districts, north-west Ethiopia.

Methods

Disease status and exposure were simultaneously measured from December 2020 to December 2021. School children's stool specimens were collected for schistosomiasis examination by Kato Katz and formal-ether techniques. Live rodents and snails were trapped and collected in search of adult schistosoma, eggs, and cercariae, respectively. Multiple logistic regression analytic technique by using SPSS version 20 was conducted.

Results

Of 460 stool specimens examined, 116 (25.22) were found positive for S. mansoni infection. In the present finding, the possible determinants for the occurrence of intestinal schistosomiasis in school children were female sex (AOR = 1.09, 95% CI: 1.37–2.96); working with bare foot (AOR = 1.21, 95% CI: 1.08–1.52); skin cut/abrasion history (AOR = 3.6, 95% CI: 1.08–7.43) and swimming habit (AOR = 1.58, 95% CI: 1.33–1.99). The overall (n = 108) rodent prevalence of S. mansoniwas 23 (21.3%). Only 6 snails were shedding the infective stage of schistosoma cercariae.

Conclusion

The study revealed that there is a moderate prevalence of schistosomiasis in different hosts. Thus, multi-host intervention is crucial to achieving the goal of interrupting transmission of schistosomiasis in the study area. Further research to better understand and exploit the broader environmental, ecological context and encompassing dynamic interactions between all hosts over time will be crucial for building predictive models beyond the known fact of having or not having reservoirs/hybridization of schistosoma in our study area.

Prevalence and Associated Risk Factors of Human Intestinal Helminths Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis

Background

Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce the pooled prevalence and associated risk factors of human intestinal helminth parasitic infections (HIHPIs) in Ethiopia.

Methods

Articles written in English were searched from online databases. Sixty-seven studies were included. Meta-analysis was computed using STATA version 14.

Result

The pooled prevalence of HIHPIs was (33.35%, 95% CI: 28.85%, 37.86%). Ascaris lumbricoides (10.84%, 95% CI: 9.34, 12.34), hookworm spp. (8.89%, 95% CI: 7.75, 10.04), Schistosoma mansoni (4.22%, 95% CI: 3.64, 4.81), Trichuris trichiura (2.51%, 95% CI: 2.17, 2.86), Hymenolepis nana (2.29%, 95% CI: 1.96, 2.63), Taenia species (1.01%, 95% CI: 0.80, 1.22), Strongyloides stercoralis (1.17%, 95% CI: 0.92, 1.41), and Enterobius vermicularis(0.71%, 95% CI: 0.52, 0.90) were recorded. Handwashing before food (OR: 5.22,95% CI: 3.49, 6.94), handwashing after toilet (OR: 3.03, 95%; CI: 1.01, 5.05), age (OR: 1.66, 95% CL. 1.09, 2.23), open defecation (OR: 2.42, 95% CI: 1.60, 3.24), eating raw and unwashed vegetables/fruits (OR: 1.98, 95%; CI: 1.30, 2.66), maternal education (OR: 1.81, 95% CI: 0.91, 2.72), family income (OR: 2.00, 95% CI: 0.87, 3.31), source of drinking water (OR: 3.12, 95% CI: 1.96, 4.27), swimming/contact with river water (OR: 1.90, 95% CI: 1.11, 2.69), barefoot (OR: 3.28, 95% CI: 1.67, 4.88), playing with soil (OR: 2.64, 95% CI: 1.40, 3.88), and family size (OR: 3.75, 95% CI: 2.03, 5.46) were factors associated with HIHPIs in Ethiopia. High heterogeneity of the prevalence of HIHPIs was observed among the studies within and among regions (I² > 99.6% and P ≤ 0.001).

Conclusion

HIHPIs in Ethiopia were significantly high. Therefore, special attention should be given by all stakeholders to minimize HIHPIs in Ethiopia.

Fine mapping of Ascaris lumbricoides, Trichuris trichiura and hookworm infections in sub-districts of Makenene in Centre Region of Cameroun

Preventive chemotherapy (PC) that remains the main control strategy recommended by the World Health Organization to achieve the elimination of soil-transmitted helminth (STH) infections as a public health problem must be strengthened by identifying the remaining transmission hot-spots for the deployment of appropriate control measures. This study was designed to assess the prevalence and infections intensities of soil-transmitted helminths and perform micro scale mapping in order to identify transmission hot-spots for targeted control operations. Stool samples were collected from 1775 children in ten primary schools of eight sub-districts of Makenene in Cameroon. Kato Katz technique was used to process and examine stool samples to detect the eggs of soil-transmitted nematodes. The prevalence of soil-transmitted helminth species as well as the infection intensities was compared. Data visualizations in forms of maps were made using Quantum geographic information system (QGIS) software. The overall prevalence of soil-transmitted helminth infections was 4.8% with a 95% confidence interval (CI) of 3.8–5.9%: 3.0% (95% CI 2.2–3.9) for Ascaris lumbricoides, 1.4% (95% CI 0.9–2.0) for Trichuris trichiura and 0.8% (95% CI 0.5–1.4) for hookworms. The prevalence of soil-transmitted helminth species differ significantly between schools and sub-districts. The intensity of infections was light (2.4%, 1.1% and 0.8%), moderate (0.4%, 0.1% and 0.1%) and heavy (0.2%, 0.2% and 0%) for A. lumbricoides, T. trichiura and hookworm respectively. The mean intensity of infections was 7255 EPG for A. lumbricoides, 2900 EPG for T. trichiura and 298 EPG for hookworm. Between schools, significant difference was recorded in the means of infection intensities of T. Trichiura and hookworms but not for A. lumbricoides. This difference was also significant for T. Trichiura when comparison were between sex. No significant difference were recorded when the comparison were between age. Fine mapping revealed that children harbouring heavy infections were clustered in the same sub-districts; highlighting the presence of high endemicity sub-districts and hot-spots for the transmission of different soil-transmitted helminth species. This study showed a diversity in the prevalence and transmission of different soil-transmitted helminth species. It also hightlighted the need for micro scale mapping to enable the localisation of high endemicity sub-districts and transmission hot-spot sites where targeted control operations must be deployed to achieve STH elimination.

Soil-transmitted helminthes and Schistosoma mansoni infections among primary school children at Ambasame primary school, North-West Ethiopia: a cross-sectional study

BACKGROUND

Schistosomiasis and soil-transmitted helminthiasis (STHs) are the major public health problem in the world especially in school age children. Therefore, this study aimed to determine the burden of soil transmitted helminths and Schistosoma mansoni among Ambesame primary school children, North-West Ethiopia.

METHOD

A cross sectional study was carried out at Ambasame primary school children from March to May, 2019. Study participants were selected using systematic random sampling technique. Socio-demographic characteristics and other factors were collected using structured questionnaire. Moreover, stool samples were examined microscopically using wet mount and formol ether concentration techniques. Data were entered and analyzed using SPSS version 20. Logistic regression analysis was done to investigate the association between dependent and independent variables. P-value less than 0.05 was considered as statistically significant.

RESULT

The overall prevalence of intestinal parasites was 117(31.2%). The prevalence of soil-transmitted helminthes and S.mansoni was 110 (29.3%) using formol ether concentration technique. The most predominant parasite was S. mansoni (10.7%), followed by hookworm (5.6%). Multivariate logistic regression analysis revealed that, helminthic infection was associated with children less than 7 years of age (P-value = 0.019, AOR = 3.29, 95% CI (1.21-8.91)); fathers who are able to read and write (P-value< 0.001, AOR = 5.4, 95% CI (2.37-12.33)); absence of latrine (P-value = 0.016, AOR = 12.96, 95% CI (1.60-104.87)) and untrimmed nail (P-value = 0.043, AOR = 2.09, 95% CI (1.02-4.27)).

CONCLUSION

This study revealed that the prevalence of intestinal helminthes among Ambasame primary school children was relatively high. The lower educational status of father, absence of latrine and untrimmed finger nail showed statistically significant association with intestinal helminthic infection. This indicates the school community, health offices and other stakeholders should plan a strategy to tackle problems associated with sanitary condition. Furthermore, Health policy makers, healthcare workers and health extension workers should enhance their effort of awareness creation for school children, parents, school community about personal hygiene, environmental sanitation, intestinal parasites transmission, prevention and control. Moreover, mass deworming of school children and periodic screening for parasitic infection should be done.

Efficacy of Praziquantel Treatment and Schistosoma Mansoni Infection among Primary School Children in Kemisse Town, Northeast Ethiopia

Background

Schistosoma mansoni infection is endemic in Ethiopia. The epidemiology of S. mansoni and the efficacy of praziquantel among schoolchildren have not been well documented in different parts of the country including our study area. Therefore, this study aimed to determine the status of S. mansoni infection and evaluate the therapeutic efficacy of praziquantel among school children in northeast Ethiopia.

Methods

A comparative cross-sectional study was conducted among 499 children of two preschool children. Stool specimens were collected and microscopically examined using Kato-Katz (41.7 gram) methods. Positive children were treated with a single oral dose of praziquantel at 40 mg/kg body weight. Egg reduction and cure rates were assessed 4 weeks post-treatment to evaluate the therapeutic efficacy of praziquantel against S. mansoni infection.

Results

The overall prevalence of S. mansoni infection among the schoolchildren was 52.1% with a mean intensity of 546 eggs per gram of stool. Majorities of the S. mansoni infections were moderate to heavy intensity, with only 5.0% light infections. Praziquantel administered at a single oral dose of 40 mg/kg achieved a cure rate of 91.7% and reduced the egg rate by 86.8%. Twenty-one schoolchildren remained infected at 4 weeks post-treatment, among which 6 and 15 children had moderate and light infections, respectively.

Conclusions

S. mansoni prevalence among primary school children in Northeast Ethiopia was high, highlighting the need to implement school-based chemotherapy with annual frequency. The efficacy of praziquantel at 40 mg/kg is sufficient to permit continued use in treating S. mansoni-infected schoolchildren.

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

BACKGROUND

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

METHODS

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

CONCLUSION

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

Soil-transmitted helminthiasis and undernutrition among schoolchildren in Mettu town, Southwest Ethiopia

Soil-transmitted helminthiasis (STHs) and undernutrition are common health problems in developing countries. Several reports showed that STH and undernutrition are often associated. The main aim of this study was to determine the association of STH and undernutrition among schoolchildren in Mettu town, Southwest Ethiopia. A cross-sectional study design was employed. To collect socio-demographic data, semi-structured questionnaire and physical observation were used. Kato-Katz technique and Anthropometric measurements were also considered to see STH infection and determine the nutritional statuses of the study participants respectively. Then, the data generated from the study was managed using Chi-square test and logistic regression analysis to determine the association of demographic variables with infections of helminthes and assess the risk factors for nutritional status of the study participants respectively. As a result, among the 392 study schoolchildren, 331 (84.4%) children were positive for different species of STH and undernutrition accounted 32.6%. Ascaris lumbricoides (39.0%), Trichuris trichiura (32.9%) and hookworm (28.1%) are the predominant STH identified from the study participants. Age, maternal educational and occupation status, and fingernail status of children were found significantly associated (p < 0.05) with the risk of getting STH. Bivariate logistic regression analysis showed that, age (AOR 2.18, 95% CI 1.53, 6.59), maternal illiteracy (AOR 0.13, 95% CI 0.91, 0.34) and maternal occupation (AOR 1.67, 95% CI 1.08, 5.91) were major co-founding factors for the prevalence of STH among study participants. In addition, children with T. trichiura infection were more likely (P < 0.01) to suffer from undernutrition (AOR 0.52, 95% CI 0.31, 0.83). Thus, the findings revealed the high prevalence of STH and it has significant association with undernutrition among school age children in the study area. Anti-helminthic mass drug administration and maternal health education should be anticipated to curve the tragedy.

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

BACKGROUND

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

METHODS AND MATERIAL

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

RESULT

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

CONCLUSION

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Current status of Schistosoma mansoni infection among previously treated rural communities in the Abbey and Didessa Valleys, Western Ethiopia: Implications for sustainable control

Background

Schistosoma constitutes a major public health problem and developmental challenges in the majority of developing and subtropical regions. The World Health Organization has set guidelines for the control and elimination of schistosomiasis. Ethiopia is providing school-based Mass Drug Administration (MDA) at the study areas of the Abbey and Didessa Valleys of western Ethiopian since 2015. Moreover, mass treatment was already done in the same villages 30 years ago. However, the current Schistosoma mansoni infection status among humans and snails in the study areas is not known. Hence, the present study aims to determine the current status.

Methods

A community-based cross-sectional study was conducted in the three communities; Chessega, Agallu Metti and Shimala in Schistosoma mansoni endemic areas of the Abbey and Didessa valleys in Western Ethiopia. Using the list of households obtained from the Kebele administration, a systematic sampling technique was used to select households in each village.

Results

Even though the area is under the Ethiopian national Mass Drug Administration campaign, the present study reports prevalence above 50%. Although the majority of the infections were moderate, we found that 13% had heavy infection, above 400 eggs per gram of stool, which is at the same level as before the treatment campaign 30 years ago. The infection was significantly higher among those below 12 years of age, among non-attending school-age children and daily laborers.

Conclusion

Schistosoma mansoni infection is still a public health problem in the study areas, despite control efforts already 30 years ago and present mass treatment in the last years. We suggest making the mass treatment campaign just early after the rainy season, when the snails are washed away. This should be supplemented with provisions of clean water, sanitation, and hygiene (WASH) and reduction of water contact and possible snail control efforts’ to prevent reinfection.

Prevalence, Infection Intensity and Associated Factors of Soil-Transmitted Helminthiasis Among School-Aged Children from Selected Districts in Northwest Ethiopia

Background

Globally, soil-transmitted helminths affect beyond a billion people and cause 1.9 million disability-adjusted life years worldwide. It affects children disproportionately due to their unaware activities like walking barefoot, playing with dirty objects that might be contaminated with feces. The control of soil-transmitted helminths principally relies on periodic deworming using either a single dose of albendazole/mebendazole. To assure the effectiveness of this measure, performing continuous parasitological survey is necessary. Herein, the prevalence, intensity and associated factors of soil-transmitted helminth infections were assessed among school-aged children in northwest Ethiopia.

Methods

A cross-sectional study design was conducted among school-aged children (6–14 years old) from January 21st to February 21st/2019. Multistage sampling technique was employed. A Kato-Katz concentration technique was utilized to detect STHs in stool samples. Moreover, risk factors for STH infections were assessed using well-structured questionnaire. Bivariate and multivariate analyses were used to assess the association between explanatory and the outcome variables. The magnitude of the association was measured using the adjusted odds ratio (AOR) and 95% confidence interval (CI). A P-value <0.05 was considered statistically significant.

Results

The overall STHs prevalence in this study was 32.3% (95% CI: 29–35.6%) with Ascaris lumbricoides being the predominant species (24.3%) followed by hookworm (8.9%) and Trichuris trichiura (1%). Most (80.3%) of the infected school-aged children had light-intensity infections. Age of 11 years and above (AOR, 12.9, 95% CI, 1.6–103.6, P=0.004), being residing in Chuahit district (AOR, 3.9, 95% CI, 2.3–6.5, P<0.001), and untreated water supply (AOR, 1.7, 95% CI, 1.1–2.7, P=0.018) were identified as predictors for the overall STH prevalence.

Conclusion

Our findings revealed STH infections are considerable health problems in the study areas. Thus, public health interventions such as provision of safe water supply, health education, and de-worming programs should be regularly implemented in the study areas.

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.

Prevalence, Intensity, and Associated Factors of Schistosoma mansoni among School Children in Northwest Ethiopia

Background

Schistosomiasis is one of the Neglected Tropical Diseases in Ethiopia, and its burden may show variations from time to time across different regions. Thus, this study was aimed at determining the prevalence, intensity, and associated risk factors of Schistosoma mansoni (S. mansoni) among schoolchildren in Northwest Ethiopia.

Methods

A school-based cross-sectional study was conducted. A multistage sampling technique was used to select the study participants. Stool specimens were collected and examined using two-slide Kato-Katz method. Data were analyzed using SPSS version 20 software. Multivariate logistic regression analysis was used to identify risk factors. p values less than 0.05 were taken as statistically significant.

Result

A total of 786 schoolchildren were participated in this study. The prevalence of S. mansoni was 33.5%. The mean egg count of the parasite among the infected study participants was 523.665 eggs per gram (epg) of stool. Thirty-seven, 42, and 21 percent of the study participant's infection were due to light, moderate, and heavy infection intensities, respectively. Age of 8-11 years old (AOR = 1,687, 95%CI = 1.163, 2.892), 5^th-8^th grade level (AOR = 2.280, 95%CI = 1.348, 3.856), residing in Chuahit District (AOR = 95.559, 95%CI = 12.945, 705.419), and using untreated water for domestic supply (AOR = 1.724, 95%CI = 1.457, 2.148) were found to be risk factors for S. mansoni infection.

Conclusion

High prevalence of S. mansoni and relatively higher proportion of moderate intensity of infection in this study imply that schistosomiasis is still one of the major public health problems in Northwest Ethiopia. It is also highlighted that study sites, provision of water supply, age, and grade level of the schoolchildren were identified as a risk factors for the disease.

The Prevalence of Soil-Transmitted Helminths and Associated Risk Factors among School Children at Sekela Primary School, Western Ethiopia

Soil-transmitted helminth (STH) infections are a major public health problem in tropical and developing countries in relation to poverty, inadequate hygiene, and sanitation. This study was aimed at assessing the status of STH and associated risk factors among school children in the case of Sekela primary school. Cross-sectional descriptive studies were conducted in May 2019 and from 384 children, both males and females of equal proportion were used. A stool sample was collected randomly and examined in the laboratory under a microscope. The quantitative data were analyzed using SPSS version 20. The difference was considered statistically significant at p value = 0.05. The overall STH infections observed in the study area were about 25.78% and were moderate transmission. The predominant helminth was A. lumbricoides (9.86%) followed by hookworm 6.25%, T. trichiura 5%, H. nana 3.10%, and H. diminuta 1.56%. Infections were generally more in males than females, in which 15.36% males and 10.41% females. In the case of age group, age groups between 7-8 years were more infected (13.28%). Infection rate decreases with increasing ages. Multivariate logistic regression analysis result indicated that wearing shoes, hand washing practice, family member, and residence were found to be associated risk factors for STH infections. Being urban dwellers and having family members with less than 2 children were found to be preventive. Lack of latrine, playing barefoot, untrimmed fingernail, eating raw vegetables, and absence of hand washing were major risk factors. In conclusion, the study showed that there was moderate transmission of infection among the study participants. Community-based health education using media, morbidity control through deworming, and improving sanitation should be strengthened as a measurement to control the transmission rate.

Prevalence of Soil-Transmitted Helminth Infection Among School-Aged Children of Ethiopia: A Systematic Review and Meta-Analysis

Background:

Soil-transmitted helminths (STH) are still major health problems in resource-poor countries. Despite several epidemiological studies were available in Ethiopia, summarized data on the prevalence of STH among school-aged children (SAC) is lacking in the country.

Objective:

This study was aimed to summarize the existing published studies of STH among SAC children in Ethiopia.

Methods:

The search was carried out in open access databases such as Science Direct, Scopus, and PubMed Central which reported STH in Ethiopia. Open access articles published between 2000 and 2019 were included in this meta-analysis. The pooled prevalence was determined using a random-effect model while heterogeneities between studies were evaluated by I² test.

Results:

A total of 46 338 children (Male = 23 374 and Female = 22 964) were included in the 70 eligible studies for this meta-analysis. The pooled prevalence of STH among SAC was 33.4%; 95% CI, 29.3% to 37.7% in Ethiopia. Ascaris lumbricoides (19.9%; 95% CI, 17.2%-22.6%) was the most prevalent STH followed by Trichuris trichiura (12.4%; 95% CI, 10.6%-14.1%), and hookworm (7.9%; 95% CI, 6.9%-8.9%) infection in the country. High prevalence of STH was observed in Oromia (42.5%; 95% CI, 31.6%-53.4%) followed by SNNPR (38.3%; 95% CI, 27.7%-48.8%) and Amhara (32.9%; 95% CI, 27.0%-38.8%) regional states. High heterogeneity on the prevalence of STH was observed across studies within and among regions (I² > 96% and P < .001).

Conclusion:

This review showed that more than one-third of the Ethiopian SAC were infected with STH. The high prevalence of STH observed in this review highlight the needs of improved control and prevention strategies in Ethiopia.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

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

Gender-based differences in water, sanitation and hygiene-related diarrheal disease and helminthic infections: a systematic review and meta-analysis

BACKGROUND

Qualitative evidence suggests that inadequate water, sanitation and hygiene (WASH) may affect diarrheal and helminthic infection in women disproportionately. We systematically searched PubMed in June 2014 (updated 2016) and the WHO website, for relevant articles.

METHODS

Articles dealing with the public health relevance of helminthic and diarrheal diseases, and highlighting the role of gender in WASH were included. Where possible, we carried out a meta-analysis.

RESULTS

In studies of individuals 5 years or older, cholera showed lower prevalence in males (OR 0.56; 95% CI 0.34-0.94), while Schistosoma mansoni (1.38; 95% CI 1.14-1.67), Schistosoma japonicum (1.52; 95% CI 1.13-2.05), hookworm (1.43; 95% CI 1.07-1.89) and all forms of infectious diarrhea (1.21; 95% CI 1.06-1.38) showed a higher prevalence in males. When studies included all participants, S. mansoni and S. japonicum showed higher prevalence with males (OR 1.40; 95% CI 1.27-1.55 and 1.84; 95% CI 1.27-2.67, respectively). Prevalence of Trichiuris and hookworm infection showed effect modification with continent.

CONCLUSIONS

Evidence of gender differences in infection may reflect differences in gender norms, suggesting that policy changes at the regional level may help ameliorate gender related disparities in helminthic and diarrheal disease prevalence.

Epidemiology of Schistosoma mansoni infection and associated risk factors among school children attending primary schools nearby rivers in Jimma town, an urban setting, Southwest Ethiopia

Background

Schistosomiasis is one of the most neglected tropical parasitic disease which is common in Ethiopia. It is disease of rural areas for decades but now days there are reports of schistosomiasis from urban settings. Therefore, this study aimed to determine epidemiology of Schistosoma mansoni (S. mansoni) infection and associated determinant factors among school children attending primary schools nearby rivers in Jimma town, an urban setting, southwest Ethiopia.

Methodology

A cross sectional study was conducted among 328 school children aged between 7–17 years in selected primary schools nearby rivers in Jimma town from March to April 2017. For the diagnosis of S. mansoni, a single stool sample was obtained from each child and processed using double Kato Katz thick smear for quantification of S. mansoni ova examined using light microscope. A questionnaire was used to collect socio demographic data and associated determinant factors for S. mansoni infection. Data were analyzed using SPSS version 20.0. Variables with P-value < 0.05 were significantly associated with S. mansoni infection.

Results

The overall prevalence of S. mansoni infection was found to be 28.7%. Majority of infection intensities were categorized as light with maximum egg per gram of stool (epg) was 1728. The geometric mean of infection intensity was 102.3epg. Schools distance from river (p = 0.001), swimming habit in rivers (p = 0.001) and crossing river on bare foot (p = 0.001) were independent risk factors for S. mansoni infection.

Conclusions

The study revealed S. mansoni infection is prevalent in Jimma town. The school children were at moderate risk of morbidity caused by S. mansoni (prevalence ≥ 10% and < 50% according to WHO threshold), hence a biannual mass drug administration with praziquantel is required once every two years in the study area and promote health information on prevention, control, transmission and risk factors for S. mansoni infection.

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

Background

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

Methods

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

Results

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Prevalence and factors associated with intestinal parasites among children of age 6 to 59 months in, Boricha district, South Ethiopia, in 2018

BACKGROUND

Intestinal parasites are the commonest cause of childhood diarrhea and malnutrition in Ethiopia. Information about intestinal parasites is the first fundamental step for designing intervention strategies against them. Hence, health planners can maximize their efforts. Information is scarce about intestinal parasites among children of under-five years of age in Boricha district. Therefore, this study aimed at assessing prevalence and factors associated with intestinal parasites among children of age 6 to 59 months in Boricha district, South Ethiopia.

METHODS

A community based analytical cross sectional study was conducted among 624 children of age 6 to 59 months from January 1 to 30; in 2018. We have utilized two stage stratified sampling method. Firstly, simple random sampling was used to select sample Kebeles. Secondly, systematic random sampling method was used to select the study participants. Structured and interviewer administrated questionnaire was used to collect data. Parasitological examination of children's stool was conducted microscopically. Data were entered into Epi-info, exported and analyzed by SPSS version 22. Logistic regression analysis was conducted to identify association between explanatory variables and outcome variable. Adjusted Odds Ratio (AOR) with 95% confidence interval (95%CI) was computed, and P-value < 0.05 was considered as statistically significant. Descriptive statistics was presented using texts, tables and figures.

RESULT

A total of 622 participants were included in the analysis which makes a response rate of 99.9%. Prevalence of intestinal parasites was 48.7% (95%CI, 44.8-52.6) in this study. Higher family size (AOR = 2.7, 95%CI = 1.5-5.0), medium family size (AOR = 2.3,95%CI,1.3-4.2), absence of laterine facility in the household (AOR = 2.9, 95% CI = 1.6-5.3), unable to put on shoes (AOR = 3.5,95%CI = 2.2-5.7), and eating raw vegetables (AOR = 2.6,95%CI = 1.6-4.7) were factors positively associated with intestinal parasites in this study.

CONCLUSION

Overall prevalence of intestinal parasites was almost high. Latrine facility, family size, shoes wearing habit and eating raw vegetables were significantly associated with intestinal parasites. Family planning service, sanitation and hygiene practices should be intensified through community education. Activate support of deworming program should be considered. Moreover, policy makers should give priority on creating awareness to prevent intestinal parasite.

Associations between intestinal parasitic infections, anaemia, and diarrhoea among school aged children, and the impact of hand-washing and nail clipping

Objective

In marginalized setting, under-nutrition and illnesses due to infectious agents create a vicious circle. In our previous study, we reported that easy-to-do hand hygiene interventions were effective in preventing intestinal parasite infections (IPIs) and reduce the rate of anaemia among school-aged children. The aim of this study was to assess the pattern of associations between IPIs, anaemia and diarrhoea among the school-aged children and to explore if the observed impact of hand-washing and nail clipping interventions in our findings was similar across children with different baseline demographic and disease characteristics. The study was based on the analysis of data that was collected during the randomized controlled trial and hence have used the same study participants and study area.

Results

Children with IPIs had a much higher chance of also being anaemic (AOR 2.09, 95% CI 1.15–3.80), having diarrhoea (AOR 2.83, 95% CI 1.57–5.09), and vice versa. Anaemia and diarrhoea were very strongly related (AOR 9.62, 95% CI 5.18–17.85). Overall, hand-washing with soap at key times and weekly nail clipping were efficacious in preventing intestinal parasite re-infection among children despite the differences in baseline demographic characteristics.

Trial registration: NCT01619254 (June 09/2012)

The extent, nature, and pathogenic consequences of helminth polyparasitism in humans: A meta-analysis

Background

Individual helminth infections are ubiquitous in the tropics; geographical overlaps in endemicity and epidemiological reports suggest areas endemic for multiple helminthiases are also burdened with high prevalences of intestinal protozoan infections, malaria, tuberculosis (TB), and human immunodeficiency virus (HIV). Despite this, pathogens tend to be studied in isolation, and there remains a need for a better understanding of the community ecology and health consequences of helminth polyparasitism to inform the design of effective parasite control programs.

Methodology

We performed meta-analyses to (i) evaluate the commonality of polyparasitism for helminth-helminth, helminth-intestinal protozoa, helminth-malaria, helminth-TB, and helminth-HIV co-infections, (ii) assess the potential for interspecies interactions among helminth-helminth and helminth-intestinal protozoan infections, and (iii) determine the presence and magnitude of association between specific parasite pairs. Additionally, we conducted a review of reported health consequences of multiply-infected individuals compared to singly- or not multiply-infected individuals.

Principal findings

We found that helminth-helminth and helminth-intestinal protozoan multiple infections were significantly more common than single infections, while individuals with malaria, TB, and HIV were more likely to be singly-infected with these infections than co-infected with at least one helminth. Most observed species density distributions significantly differed from the expected distributions, suggesting the potential presence of interspecies interactions. All significant associations between parasite pairs were positive in direction, irrespective of the combination of pathogens. Polyparasitized individuals largely exhibited lower hemoglobin levels and higher anemia prevalence, while the differences in growth-related variables were mostly statistically insignificant.

Conclusions

Our findings confirm that helminth polyparasitism and co-infection with major diseases is common in the tropics. A multitude of factors acting at various hierarchical levels, such as interspecies interactions at the within-host infra-parasite community level and environmental variables at the higher host community level, could explain the observed positive associations between pathogens; there remains a need to develop new frameworks which can consider these multilevel factors to better understand the processes structuring parasite communities to accomplish their control.

Helminth infections are a highly prevalent global health problem. These parasitic worm infections occur in areas also burdened with intestinal protozoan infections, malaria, tuberculosis, and human immunodeficiency virus. While these pathogens tend to be studied in isolation, there remains a need to better understand the nature, extent, and health consequences of helminth polyparasitism and co-infection with major diseases. Here, we reviewed the literature and performed meta-analyses to evaluate the commonality of helminth polyparasitism and co-infection, the potential for interspecies interactions between parasites, the association between parasite pairs, and the health consequences among multiply-infected individuals. We confirmed that polyparasitism and co-infection with major diseases are common in the global South and found that multiply-infected individuals experienced worse health consequences when compared to singly or not-multiply infected individuals. Our analysis suggested the potential presence of interspecies interactions and we identified the existence of positive associations between parasite pairs. These findings support the call for integrating deworming into malaria, TB, and HIV treatment protocols and suggest there remains a need to improve our understanding of the factors influencing co-transmission to achieve sustainable parasite control.

Intestinal Parasitosis and Their Associated Factors among People Living with HIV at University of Gondar Hospital, Northwest-Ethiopia

Background

Most HIV clients die of AIDS related intestinal parasitic infections rather than due to the HIV infection itself. Therefore, this study was aimed at determining the prevalence of intestinal parasite and their associated factors among HIV/AIDS clients at the University of Gondar Hospital, Northwest Ethiopia.

Methods

Institution based cross sectional study was conducted using systematic random sampling technique from March to May 2016. A semi-structured questionnaire was used to collect data. Stool samples were collected and processed using direct wet mount, formol-ether concentration and modified Ziehl-Neelson staining techniques. Besides, blood samples were collected for CD4+ count estimation. Both descriptive and logistic regression analyses were used in data analysis. P-values <0.05 were considered as statistically significant.

Results

A total of 223 participants were enrolled in this study, and the prevalence of intestinal parasitosis was found to be 29.1%. The most predominant intestinal parasite detected was cyst of Entamoeba histolytica (8.5%) followed by Ascaris lumbricoides (6.7%), Strongyloides sterocoralis (3.6%) and Cryptosporidium parvum (3.1%), whereas Schistosoma mansoni (0.9%) and Hymenolepis nana (0.9%) were the least detected. Absence of toilet (AOR= 19.4, CI: 6.46–58.3), improper hand washing before meal (AOR=11.23, 95% CI: 4.16–30.27 and CD4+ count < 200 cells/mm³ (AOR=33.31, 95% CI: 9.159–121.149) had significant association with prevalence of intestinal parasites.

Conclusion

The study indicated that intestinal parasites are still a problem among HIV/AIDS patients in the study area. Thus, routine examination for intestinal parasites and interventions should be carried out for better management of clients.

Prevalence of intestinal helminths and associated factors among school children of Medebay Zana wereda; North Western Tigray, Ethiopia 2017

Objective

To assess the prevalence of intestinal helminth infections and associated factors among primary school children of Medebay Zana wereda, a northwestern zone of Tigray, northern Ethiopia from March to April 2017.

Result

The prevalence of intestinal helminths was 12.7%. The highest prevalence of intestinal helminth infections was observed in the age group of 11–14 years old and the most prevalent helminths species were Schistosoma mansoni. Mothers’ level of education [AOR = 0.27 [0.13–0.58]], place of defecation [AOR = 2.63, 95% CI 1.14–6.02]], hand wash before meals [AOR = 9.0, 95% CI 3.72–21.74]], hand wash after defecation [AOR = 5.77 [1.78–18.63]] and eating unwashed vegetables [AOR = 5.67 [2.19–14.73]] were associated with higher risk of having intestinal helminths detected in stool. In the study area the risk of detecting intestinal helminths in their stool were more associated the improper personal hygiene of the children.

Prevalence and intensity of Schistosoma mansoni infections among schoolchildren attending primary schools in an urban setting in Southwest, Ethiopia

Objective

To determined both prevalence and intensity of Schistosoma mansoni infections among schoolchildren attending primary schools in Jimma town, an urban setting, Southwest, Ethiopia.

Results

The prevalence of S. mansoni infections was 8.4%. S. mansoni infections were found in all 17 schools, but the school prevalence ranged from 1.7 to 26.7%. This variation in prevalence could be explained by the proximity of the schools to the river crossing the town and water bodies near the schools. Boys were more infected compared to girls (χ² = 31.587, P value = 0.001; 95% CI), and the infection rate increased as a function of age (χ² = 21.187; P value = 0.001; 95 %CI). The majority of the infection intensities were of low intensity (57%), the mean number of eggs per stool equal to 17 eggs per gram of stool. Based on the prevalence (8.4%) school children in Jimma Town is considered as a low risk of morbidity caused by S. mansoni (prevalence ≤ 10% according to WHO threshold), for which it is recommended to implement MDA once every 3 years which should be supplemented with health information to create awareness about Schistosomiasis transmission. Male students were more infected than females with majority of the infection intensity were low.

Electronic supplementary material

The online version of this article (10.1186/s13104-017-3023-9) contains supplementary material, which is available to authorized users.

Schistosoma mansoni and other helminthes infections at Haike primary school children, North-East, Ethiopia: a cross-sectional study

Objectives

Schistosomiasis and soil-transmitted helminthes infections are among the widely distributed infections worldwide. In Ethiopia, parasitic helminthic infections and schistosomiasis are among the most predominant causes of outpatient morbidity. Hence there is still lack of epidemiological information in North-Eastern Ethiopia, this study aimed to determine the prevalence and associated factors of Schistosoma mansoni and other helminthes infections at Haike primary school children, Haike, North-East Ethiopia.

Results

The overall prevalence of S. mansoni and other helminthes infections using formol-ether concentration technique was 85/279 (30.5%). Schistosoma mansoni was the dominant parasites as detected by both direct wet mount and formol-ether concentration technique with 44/52 (84.6%) and 65/85 (76.5%) respectively. Chi square test showed significant association between parasitic infections and age of the school children (p = 0.003). The binary logistic regression analysis was showed strong statistical association (p = 0.00) between swimming habit and parasitic infections (AOR = 6.61, 95% CI 3.31–13.12). Family used lake as source of water showed statistically significant association (AOR = 5.35, 95% CI 2.97–12.32). Furthermore, those who get water from river (AOR = 1.24, 95% CI 0.33–4.66) were more likely to be infected with S. mansoni and geo-helminthes than those who used tap water.

Electronic supplementary material

The online version of this article (10.1186/s13104-017-2942-9) contains supplementary material, which is available to authorized users.

Soil transmitted Helminthiasis and associated risk factors among elementary school children in ambo town, western Ethiopia

Background

Soil-transmitted helminths (STHs) are widespread in underdeveloped countries. In Ethiopia, the prevalence and distribution of helminth infection varies by different exposing risk factors. We therefore investigated the prevalence of and risk factors of STHs infection in school children living in Ambo town, west Shoa Ethiopia.

Methods

In 2014/15, among 375 school children planed to be included in this study, only 321 school children were recruited in the study. Data onto school children from different schools were collected, including stool samples for qualitative STHs analysis. Questionnaire data on various demographic, housing and lifestyle variables were also available.

Results

Prevalence of any STHs infection was 12.6%. The respective prevalence of major soil-transmitted helminths is Ascaris (7.8%), Hookworm (2.8%) and Trichuris (2.2%). This study result shows STHs prevalence varies regards to age, sex, latrine use, family size and nail trimming.

Conclusion

The results of the present study indicated that the percentage of positive finding for STHs in Ambo area is low. Besides, Large Family size, not nail trimming and unavailability of improved latrine were identified as predisposing factor for STHs infections. All school children enrolled and not enrolled in this study should be treated twice a year until the prevalence falls below the level of public health importance.

Infections with Schistosoma mansoni and geohelminths among school children dwelling along the shore of the Lake Hawassa, southern Ethiopia

BACKGROUND

Infections with Schistosoma mansoni and soil-transmitted helminthes (STHs) are major public health problems in Ethiopia. However, information was scarce on the current status of these infections to guide an intervention in the study area. Therefore, this study was conducted to assess the prevalence of infections with S. mansoni and STHs and associated factors among school children in southern Ethiopia.

METHODS

This cross-sectional study investigated children who were attending the Finchawa and Tullo junior elementary schools and were residing along the shore of the lake Hawassa in January and February, 2015. A total of 374 students were selected using systematic random sampling technique. Data on socio-demography and related factors was collected using structured questionnaires. A single stool sample was collected from each child and processed using formol-ether concentration technique and examined microscopically for parasites' ova/larva.

RESULTS

The prevalence of parasitic infection with one or more than one helminthiasis was found to be 67.9%. Seven different types of helminths were identified and the most prevalent parasites were Ascaris lumbricoides (44.4%), followed by S. mansoni (31%), Trichuris trichiura (11%), and hookworms (7.7%). The rate of infection with STHs was 52.4%. Single, double, triple and quadruple infections were 42.2, 22.5, 2.4, and 0.8%, respectively. Children who practiced open-field defecation (AOR, 3.6; 95% CI 1.6-8.0; p = 0.001) and had not always washed their hands before eating a meal (AOR, 5.0; 95%CI 2.15-11.7; p <0.001) were more infected with STHs. Moreover, the rate of S. mansoni infection was significantly higher among children who were attending the Finchawa school (AOR, 2.13; 95% CI 1.31-3.46; p = 0.002), aged 11-15 years (AOR, 1.97; 95% CI 1.22-3.19; p = 0.006), had swum in the lake Hawassa (AOR, 2.73; 95%CI 1.20-6.17; p = 0.016), and had involved in irrigation-related activities (AOR, 1.68; 95%CI 1.04-2.71; p = 0.034).

CONCLUSION

The study showed high prevalence of STHs and moderate rate of schisotosomiasis. Mass deworming twice a year for STHs and once every two years for S. mansoni, further to strengthening other prevention measures, is critically needed to reduce these infections to inconsequential level.

Epidemiology of intestinal helminthiasis among school children with emphasis on Schistosoma mansoni infection in Wolaita zone, Southern Ethiopia

Background

Intestinal helminth infections are major parasitic diseases causing public health problems in Ethiopia. Although the epidemiology of these infections are well documented in Ethiopia, new transmission foci for schistosomiasis are being reported in different parts of the country. The objective of this study was to assess the prevalence of Schistosoma mansoni and other intestinal helminth infections among school children and determine the endemicity of schistosomiasis in Wolaita Zone, southern Ethiopia.

Methods

Cross-sectional parasitological and malacological surveys were conducted by collecting stool samples for microscopic examination and snails for intermediate host identification. Stool samples were collected from 503 children and processed for microscopic examination using Kato-Katz and formalin-ether concentration methods. Snails collected from aquatic environments in the study area were identified to species level and Biomphalaria pfeifferi snails, the intermediate host of S. mansoni,, were individually exposed to artificial light in order to induce cercariae shedding. Cercariae shed from snails were used to infect laboratory-bred Swiss albino mice in order to identify the schistosome to species level.

Results

The overall prevalence of intestinal helminth infections was 72.2% among school children. S. mansoni infection prevalence was 58.6%. The prevalence and intensity of S. mansoni infections varied among schools and sex of children. Swimming was the only factor reported to be significantly associated with S. mansoni infection (AOR = 2.954, 95% CI:1.962-4.449). Other intestinal helminth species identified were hookworms (27.6%), Ascaris lumbricoides (8.7%), E. vermicularis (2.8%), Taenia species (2.6%), T. trichiura (1.2%) and H. nana (0.6%). Only B. pfeifferi snails collected from streams shed schistosome cercariae and 792 adult S. mansoni worms were harvested from mice exposed to cercariae shed from B. pfeifferi on the 6th week post-exposure.

Conclusion

The present study found high level of intestinal helminth infections in the study area. The study also confirmed autochthonous transmission and endemicity of S. mansoni as evidenced by both parasitological and malacological findings as well as by further establishing infections in lab-bred mice. Therefore, there is a need to include the area in the control programs with anti-helminth drugs and also consider other complementary measures including sanitation, provision of clean water supply, and snail control.

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.

Soil-Transmitted Helminths and Schistosoma mansoni Infections in Ethiopian Orthodox Church Students around Lake Tana, Northwest Ethiopia

BACKGROUND

Soil-transmitted helminths (STH) and Schistosoma mansoni infections are the major neglected tropical diseases that result in serious consequences on health, education and nutrition in children in developing countries. The Ethiopian Orthodox church students, who are called Yekolotemari in Amharic, live in areas with poor sanitation and hygiene. Moreover, they are not included in the national STH control programs. Thus, STH and S. mansoni infections prevalence is unknown.

METHODS

A cross-sectional study was conducted on 384 students in June 2014 to determine STH and S. mansoni infections prevalence. Moreover, the knowledge of students about STH and S. mansoni was assessed. Data on knowledge and clinical symptoms were collected using structured questionnaires via face to face interview. Stool specimens were examined by formol-ether concentration method.

RESULTS

The overall prevalence of intestinal helminths infections was 85.9% (95% confidence interval (CI): 82.1-89%). STHs infections prevalence was 65.6% (95% CI: 60.7-70.2%). The prevalence of hookworm, Ascaris lumbricoides and Trichuris trichiura were 31.8% (95% CI: 27.3-36.6%), 29.4% (25-31%) and 3.1% (1.8-5.4%), respectively. On the other hand, S. mansoni prevalence was 14.3% (95% CI: 11.1-18.1%). Majority of students infected with S. mansoni had bloody stool with crud odds-ratio of 2.9 (95% CI: 1.5-5.5). Knowledge assessment showed that 50 (13%) and 18 (4.9%) of the respondents knew about transmission of STH and S. mansoni, respectively.

CONCLUSIONS

The prevalence of STH and S. mansoni infections were high thus de-worming program should include the students of Ethiopian Orthodox churches. Furthermore, provision and use of sanitary facilities, health education for students to create awareness of parasitic infections and improved personal hygiene should be in place.

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

A cross-sectional study involving 408 schoolchildren was performed from November 2013 to February 2014 to assess the prevalence of intestinal helminthic infections and malnutrition among schoolchildren of the Zegie Peninsula, northwestern Ethiopia. A structured questionnaire was used to gather data on the demographic and risk factors associated with intestinal helminthic infections. Stool samples were collected and examined for helminth eggs using the formalin-ether concentration technique. In addition, anthropometric measurements were performed to assess the nutritional status of the schoolchildren. The overall prevalence of intestinal helminthic infections in the study area was 69.1%. Single, double, triple, and quadruple infections were 42.2%, 18.4%, 5.9%, and 0.7%, respectively. The prevalence of hookworm, Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, Hymenolepis nana, and Strongyloides stercoralis infections were 43.4%, 29.9%, 12.7%, 10%, 4.6%, and 0.7%, respectively. The prevalence of malnutrition in terms of stunting, being underweight, and wasting were 15.3%, 18%, and 27.6%, respectively. However, no significant association was found between intestinal helminthic infections and stunting, being underweight and wasting (p>0.05). It can be concluded that intestinal helminthic infections, specifically infections due to hookworm and S. mansoni, are important health problems among schoolchildren of the Zegie Peninsula.

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

Background. The objectives of this study were to determine the burden of underweight and intestinal parasitic infection in the urban and rural elementary school children. Methods. A comparative cross-sectional study design was conducted. Binary logistic regression was used to identify the determinants of malnutrition or intestinal parasites. Two independent samples' t-test was used to identify the effect of malnutrition on school performance or hemoglobin level. Results. A total of 2372 students were included. Quarters (24.8%) of school children were underweight. Underweight was associated with sex [adjusted odds ratio (AOR) 0.61; 95% CI = 0.47-0.78], age [AOR = 0.21; 95% CI = 0.16-0.28], intestinal parasitic infection [AOR 2.67; 95% CI = 2-3.55], and family size [AOR 23; 95% CI = 17.67-30.02]. The prevalence of intestinal parasite among school children was 61.7% [95% CI = 60%-64%]. Shoe wearing practice [AOR 0.71; 95% CI = 0.58-0.87], personal hygiene [AOR 0.8; 95% CI = 0.65-0.99], availability of latrine [AOR 0.34; 95% CI = 0.27-0.44], age [AOR 0.58; 95% CI = 0.48-0.7], habit of eating raw vegetables [AOR 3.71; 95% CI = 3.01-4.46], and family size [AOR 1.96; 95% CI = 1.57-2.45] were the predictors of intestinal parasitic infection.

Helminthiasis: Hookworm Infection Remains a Public Health Problem in Dera District, South Gondar, Ethiopia

BACKGROUND

Intestinal parasitic infections are significant cause of morbidity and mortality in endemic countries. In Ethiopia, helminthiasis was the third leading cause of outpatient visits. Despite the health extension program was launched to address this problem, there is limited information on the burden of intestinal parasites after implementation of the program in our setting. Therefore, the aim of this study was to assess the intestinal helminthic infections among clients attending at Anbesame health center, South Gondar, Ethiopia.

METHODS

A cross sectional study was conducted at Anbesame health center from March to June 2015. A structured questionnaire was used to collect data from 464 study participants selected consecutively. Stool specimen collection, processing through formol-ether concentration technique and microscopic examination for presence of parasites were carried out. Data were entered, cleaned and analyzed using SPSS Version 20.

RESULTS

Among the total 464 study participants with median (±IQR) age of 25.0 (±21.75) years, 262 (56.5%) were females. Helminthic infection was found in 97 (20.9%) participants. Hookworm (68 [14.7%]) was the predominant parasite followed by S. mansoni (11 [2.4%]), E. vermicularis (9 [1.9%]) and S. stercoralis (5 [1.1%]). Patients with age group ≥15 years (AOR: 5.26; 95% CI: 2.05-13.46; P: 0.001) and walking barefoot (AOR: 2.20; 95% CI: 1.08-4.48; P: 0.031) were more vulnerable from the hookworm infections.

CONCLUSIONS

There was a high burden of hookworm infections in our setting. Hence, regular shoes wearing, considering all age groups in the albendazole deworming as mass treatment and environmental hygiene are important interventions to reduce the burden of such neglected tropical disease.

Intestinal parasitic infections among children under five years of age presenting with diarrhoeal diseases to two public health facilities in Hawassa, South Ethiopia

BACKGROUND

Diarrhoea is the leading cause of morbidity and mortality in children under 5 years of age in developing countries, including Ethiopia. It is caused by a wide range of pathogens, including parasites, bacteria and viruses. The aim of this study was to determine the prevalence of infection with intestinal parasites (IPs) (and types) among children under 5 years of age with diarrhoeal diseases.

METHODS

A cross-sectional study was conducted at Adare Hospital and Millennium Health Centre, both located in Hawassa, South Ethiopia, from June 6 to October 28, 2011. Children under 5 years of age with diarrhoea who visited these health facilities during the study period were included in the study. Data relating to demography and risk factors associated with intestinal parasitic infections (IPIs) were gathered using a structured questionnaire. Single, fresh stool specimens were examined for IPs using the direct wet mount examination, followed by Ziehl-Neelsen staining of formol-ether concentrated samples, as per standard procedures. Data were analysed using SPSS Statistics 20 software.

RESULTS

A total of 158 children (51.3 % male and 48.7 % female) participated in the study. Overall, the prevalence of IPs was 26.6 % (42/158). Two species of IPs were detected in six children (3.8 %). Entamoeba histolytica/dispar/moshkovskii was the predominant parasite identified (11.4 %), followed by Giardia duodenalis (7.0 %). The multivariable analysis revealed that the age group ≥24 months was significantly associated (AOR = 0.221, 95 %CI: 0.085-0.576) with prevalence of IPIs.

CONCLUSION

This study found that intestinal parasites are common among children with diarrheal diseases. The most frequently detected species was E. histolytica/dispar/moshkovskii. Health information about how to prevent diarrheal diseases in general and IPIs in particular should be provided to parents of young children.

High prevalence of Schistosoma mansoni and other intestinal parasites among elementary school children in Southwest Ethiopia: a cross-sectional study

BACKGROUND

Intestinal parasitic infections (IPIs) pose significant public health challenges in school children in developing countries. The aim of this study is to determine prevalence of intestinal parasites among elementary school children in Mizan-Aman town, southwest Ethiopia.

METHODS

Institution-based cross-sectional study involving 460 elementary school children in Mizan-Aman Town was conducted from May to June 2013. The school children were selected using multistage sampling technique. Data on demography and predisposing factors of IPIs were collected using pretested questionnaire. Moreover, single stool specimen was examined microscopically after wet mount and formol-ether sedimentation concentration procedures. Infection intensity of Schistosoma mansoni and soil-transmitted helminths (STHs) was estimated using Kato-Katz egg counting method.

RESULTS

Age of the children ranged from 5 to 17 years. Overall, 76.7% (95%CI: 72.8-80.6) of the children harbored at least one species of intestinal parasite. Eight species of intestinal parasites were detected with S. mansoni (44.8%) and Ascaris lumbricoides (28.7%) being predominant. Helminths and pathogenic intestinal protozoa were detected in 73.9 and 7.8% of the children, respectively. After adjusting for other variables, age between 5 and 9 years (AOR, 2.6, 95%CI, 1.552-4.298), male gender (AOR, 2.1, 95%CI, 1.222-3.526), attending public school (AOR, 0.1, 95%CI, 0.060-0.256), using river/well water (AOR, 2.4, 95%CI, 0.912-6.191), irregular washing of hands before meal (AOR, 0.5, 95%CI, 0.254-0.865), consuming street food (AOR, 2.3, 95%CI, 1.341-3.813) and raw vegetables (AOR, 2.7, 95%CI, 1.594-4.540) were significantly associated with IPIs in the study participants.

CONCLUSION

Prevalence of intestinal parasites among the school children was high. Deworming of the school children and continuous follow up is required.

Soil-transmitted helminths in pre-school-aged and school-aged children in an urban slum: a cross-sectional study of prevalence, distribution, and associated exposures

Soil-transmitted helminths (STHs) are controlled by regular mass drug administration. Current practice targets school-age children (SAC) preferentially over pre-school age children (PSAC) and treats large areas as having uniform prevalence. We assessed infection prevalence in SAC and PSAC and spatial infection heterogeneity, using a cross-sectional study in two slum villages in Kibera, Nairobi. Nairobi has low reported STH prevalence. The SAC and PSAC were randomly selected from the International Emerging Infections Program's surveillance platform. Data included residence location and three stools tested by Kato-Katz for STHs. Prevalences among 692 analyzable children were any STH: PSAC 40.5%, SAC 40.7%; Ascaris: PSAC 24.1%, SAC 22.7%; Trichuris: PSAC 24.0%, SAC 28.8%; hookworm < 0.1%. The STH infection prevalence ranged from 22% to 71% between sub-village sectors. The PSAC have similar STH prevalences to SAC and should receive deworming. Small areas can contain heterogeneous prevalences; determinants of STH infection should be characterized and slums should be assessed separately in STH mapping.