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

Prevalence of Intestinal Parasitic Infections and Associated Factors among Presumptive Pulmonary Tuberculosis Patients at Debre Tabor Referral Hospital, South Gondar, Northwest Ethiopia: A Cross-Sectional Study

Background

In developing countries, intestinal parasitic infections (IPIs) and tuberculosis (TB) coinfections have been perceived to be high. The geographic distributions of helminths and TB overlap substantially. Parasitic infections affect the outcome of TB by changing the cell-mediated immune response to a humoral response, while Mycobacterium infection favors the immune escape of helminths. There are limited studies on the epidemiology of intestinal parasites among presumptive pulmonary TB (PTB) patients in Ethiopia. Therefore, this study is aimed at determining the prevalence of intestinal parasitic infections and associated factors among patients with presumptive pulmonary tuberculosis at Debre Tabor Referral Hospital.

Methods and Materials

A hospital-based cross-sectional study was conducted from March to June 2021. The sociodemographic data and associated factors were collected using a structured questionnaire, and stool samples were collected by convenient sampling technique and processed for the detection of intestinal parasites using a direct wet mount saline preparation and formal ether concentration technique. The data was coded, cleaned, and analyzed by SPSS version 23. Bivariate and multivariable analyses were conducted to determine an adjusted odds ratio (AOR). p value < 0.05 was considered statistically significant.

Result

The overall prevalence of intestinal parasitosis was 25.6% (81/316); of these, 12.9% (41/316) were protozoan infections and 12.7% (40/316) were helminth infections. Multivariable logistic regression analysis showed that being older than 36 years (AOR: 4.35; 95% CI: 1.26, 13.91; p = 0.001), rural residence (AOR: 3.46; 95% CI: 1.18, 9.97; p < 0.001), unable to read and write (AOR = 2.62; 95%CI = 2.15, 8.43; p = 0.004), and use of river water (AOR: 3.47; 95% CI: 1.62, 8.21; p < 0.001) were associated with intestinal parasitic infections.

Conclusion

The present study showed that the prevalence of intestinal parasitosis among presumptive pulmonary tuberculosis patients was high in the study area. Age, residence, educational status, and source of water were significant factors in IPIs among presumptive TB patients. Moreover, our findings suggest a proper health education program for good personal hygiene habits, the coloration of water, avoiding open-field defecation, and also preventative measures to avoid the acquisition of IPIs in patients with TB. Presumptive tuberculosis patients should be screened and treated accordingly. Additionally, it needs further research and recommends more assessment for intestinal parasitic infection in PTB patients.

Intestinal parasitic infections and risk factors for infection in Kenyan children with and without HIV infection

It has been reported that HIV infection is not a risk factor for Entamoeba species infection but is for Giardia intestinalis assemblage B in children living in Western Kenya. This study aimed to investigate the prevalence of and the risk factors for Entamoeba spp. and G. intestinalis infection in children living in Nairobi, Kenya. This cross-sectional study included 87 children with HIV [HIV(+)] and 85 without HIV [HIV(-)]. Stool and blood samples were collected for the detection of the parasites by PCR and immunological analyses using flow cytometry. Sociobehavioral and hygienic data were collected using questionnaires and analyzed statistically. The prevalence of Entamoeba spp. infection was significantly lower in the HIV(+) than in the HIV(-) children (63.2% vs. 78.8%, P = 0.024), whereas the prevalence of G. intestinalis infection was not (27.6% vs. 32.9%, P = 0.445). "Not boiling drinking water" (adjusted odds ratio [aOR]: 3.8, P = 0.044) and "helping in nursery care" (aOR: 2.8, P = 0.009) were related to G. intestinalis assemblage B infection, and "CD4/CD8 ratio ≥1" was related to Entamoeba spp. infection (aOR: 3.3, P = 0.005). In stratified regression analyses, HIV infection was negatively associated with G. intestinalis assemblage B infection in females (aOR: 0.3, P = 0.022), but positively associated in males (aOR 3.8, P = 0.04). These results suggest that G. intestinalis assemblage B infection is related to hygienic conditions, while Entamoeba spp. infection is an indicator of better immunological status, and that the role of HIV infection in Giardia infection may differ between Kenyan boys and girls.

Prevalence of Ascaris lumbricoides infections among elementary school children and associated risk factors from Southern Ethiopia

Intestinal parasitic infections are distributed virtually throughout the world, with high prevalence rates in tropical and sub-tropical parts of the world as well as in Ethiopia. Children between age groups of 5-10 years are at the highest risk of infection. The intestinal nematode Ascaris lumbricoides infects approximately 25% of the world's population annually. Hence, this study was the first attempt to assess the prevalence and associated factors of A. lumbricoides infection among the school children from Offa district, Ethiopia. A cross-sectional study was conducted from January to April, 2020 in three selected elementary school. Data were collected through questionnaires and stool samples examination. The overall prevalence of A. lumbricoides was noted as 41.4% and was the leading cause of intestinal parasitoids followed by Schistosoma mansoni (27.6%), Trichuris trichiura (18.1%) and Strongyloides stercoralis (4.1%). Children age group between 5 and 10 years found more susceptible to the infection. Eating habits like unwashed raw vegetables (P = 0.035), absence of toilets (P = 0.000), children who defecate in open field (P = 0.041), drinking unprotected water (P = 0.034), toilet without cover (P = 0.027), lack of hand washing before meal and after defecation (P = 0.000), (P = 0.048) were the key factors significantly associated with A. lumbricoides infection. The present study showed that A. lumbricoides was a major health problem among school children and requires annual de-worming to control morbidity associated with intestinal parasites.

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.

Nutritional and health status of a cohort of school-age children born to mothers treated for severe acute malnutrition in their childhood in The Democratic Republic of Congo

Background

Malnutrition is a public health problem, but outside the theoretical framework, little is known about the concrete intergenerational effects of malnutrition.

Objective

The objective of this study is to compare the nutritional status and health indicators of school children born to mothers who were treated for severe acute malnutrition (SAM).

Methodology

The study took place in Miti-Murhesa health zone in the Democratic Republic of Congo. This is a cohort study assessing the nutritional and health status of school children born to mothers who had been treated for SAM, based on WHZ or edema, in Lwiro hospital between 1988–2002 compared to children born to mothers who were not exposed to SAM. Stunting and thinness were evaluated by Height for Age Z-score (HAZ) and Body Mass Index by Age criteria (BMIAZ) respectively. On admission, blood samples were taken to assess anemia, HIV serology, hemogram and others biological indicators. Stool’s examinations were conducted by using Olympus optical microscope. Parametric and non-parametric tests were applied to compare the different variables in two groups.

Results

We identified 106 children aged 5–16 years (103 exposed and 58 unexposed) and we received 83.5% and 91.4% children respectively for anthropometric parameters. The mean of age was 7.9 ± 2.4 year in exposed group and 7.4 ± 2.1 year in unexposed group (p = 0.26). The prevalence of stunting was 68.3% in the exposed group and 67.3% in the unexposed group (p = 0.90). The prevalence of thinness was 12.8% in the exposed group and 9.6% in the unexposed group (p = 0.57). The biological profile (glycemia, urea, creatinine and hemogram) and the prevalence of intestinal parasites were similar in the two groups.

Conclusion

In this sample, in a malnutrition-endemic area, there was no statistically significant difference in nutrition and health indicators between school children born to mothers exposed to SAM and their community controls.

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.

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

Background

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

Methods

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

Results

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

Conclusion

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

Intestinal parasites among intellectually disabled individuals in Iran: a systematic review and meta-analysis

BACKGROUND

Poor self-care skills and personal hygiene resulted from limitations in learning and understanding, put intellectually disabled individuals at greater risk for intestinal parasitic infections (IPIs). Despite several regional reports in Iran, the overall burden on IPIs among intellectually disabled individuals is poorly understood. Hence, the present study aimed to estimate the pooled prevalence of IPIs among intellectually disabled individuals in Iran.

METHODS

Using the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from seven electronic databases (PubMed, Web of Science, Scopus, Embase, and ProQuest for English articles, as well as SID and Magiran for Persian) from their inception up to December 2020. Pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI) and depicted as a forest plot, while heterogeneity was evaluated using Cochran's Q-test.

RESULTS

Exactly 1263 of the 3004 intellectually disabled individuals examined by 14 studies across 10 provinces of Iran were positive for IPIs. Overall pooled prevalence estimate was 41% (95% CI 29-53%) with a range of 21% (95% CI 10-32%) to 68% (95% CI 55-80%) across sub-groups. Entamoeba coli (16.2%; 95% CI 10.3-22%), Blastocystis spp. (12.2%; 95% CI 7.2-17.2%), and Giardia duodenalis (11.9%; 95% CI 7.4-16.3%) were the most prevalent protozoan species. In terms of helminthic agents, the most prevalent species were Enterobius vermicularis (11.3%; 95% CI 6.3-16.3%) followed by Strongyloides stercoralis (10.9%; 95% CI 5.0-16.9%) and Hymenolepis nana (2.8%; 95% CI 0.4-5.2%) CONCLUSION: IPIs are highly prevalent among intellectually disabled individuals in Iran. Improving the health status and implementing infectious disease prevention strategies in rehabilitation centers, health promotion interventions to improve personal hygiene of intellectually disabled individuals, as well as utilize sensitive diagnostic methods besides routine stool examination techniques, and treatment of infected individuals will help in the control of these infections among intellectually disabled individuals.

Prevalence of intestinal parasitic infections and associated factors among patients attending at Sanja Primary Hospital, Northwest Ethiopia: An institutional-based cross-sectional study

BACKGROUND

Intestinal Parasitic Infections are the most prevalent diseases in the world, predominantly in developing countries. It is estimated that more than two billion people are affected globally, mostly in tropical and sub-tropical parts of the world. Ethiopia is one of the countries in Africa with a high prevalence of intestinal parasites. However, there is a limited study conducted in the study area. Hence, this study was to assess the prevalence and associated factors of intestinal parasitosis among patients attending at Sanja Primary Hospital, Northwest Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted at Sanja Primary Hospital from January 1 to August 20, 2019. Stool samples were collected from 1240 study participants and analyzed by direct wet mount and formal ether concentration techniques. Furthermore, sociodemographic and explanatory variables were collected using a face-to-face interview. Data were entered into Epi data version 4.4.2.1 and transferred to SPSS version 23 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of intestinal parasitic infections. Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was considered to ascertain the significance of the association.

RESULTS

The overall prevalence of intestinal parasitic infection was 52.9% (95% CI: 50.2%-55.5%). Entamoeba histolytica/dispar (21.5%) was the leading cause of intestinal parasitosis followed by Hookworm species (13.3%). Furthermore, the rate of double and triple parasitic infections was observed in 6.1% and 0.5% of study participants respectively. Being Illiterate (AOR: 2.87, 95% CI: 1.06-7.47, p = 0.038), swimming habits of more than 4 times a month (AOR = 2.91, 95% CI 1.62-5.24, p< 0.001) and not washing hands before a meal (AOR: 3.92, 95% CI: 1.74-8.83, p = 0.001) were the key factors significantly associated with intestinal parasitic infection.

CONCLUSIONS

The present study showed that the prevalence of intestinal parasitosis is high in the study area. Therefore, there is a need for an integrated control program, including improving personal, environmental sanitation and health education should be given to have a lasting impact on transmission.

Intestinal parasitic infections and determinant factors among school-age children in Ethiopia: a cross-sectional study

OBJECTIVE

This study aimed to determine the prevalence of intestinal parasitic infections and associated factors among school-age children in Sebeya primary school, northern Ethiopia, 2017.

RESULTS

The prevalence of intestinal parasites in school-age children was (29.9%). A total of six parasites were detected in this study. E. histolytica/dispar 19.43% (82/422) and G. lamblia 8.29% (35/422) were the predominant ones. Unclean fingernail (AOR = 1.72), defecating in the open field (AOR = 2.82), and being barefooted (AOR = 1.72) were the determinant factors for intestinal parasitic infections. Frequently washing hands reduced the chance of infections by 68%. Furthermore, children in grade 1-4 and 5-6 had higher odds developing the infections than those in grade 7-8 (AOR = 8.21 and AOR = 2.50, respectively).