Prevalence of intestinal parasitic infections among children under five years of age with emphasis on Schistosoma mansoni in Wonji Shoa Sugar Estate, Ethiopia

A 14-year review (2007-2020) of helminthiasis epidemiology in a hospital in Southern Madrid, Spain

PURPOSE

Vast majority of helminth diseases remain neglected tropical diseases (NTDs), causing significant morbidity. The widespread and periodic distribution of antiparasitic drugs, remains the cornerstone for controlling these diseases. In Spain, most helminthiasis cases are imported, and suspicion and diagnosis have become increasingly important. Our primary objective is to present the epidemiological landscape of helminthiasis diagnoses within our facility, while also detailing the demographic characteristics of the affected population.

METHODS

A retrospective study was conducted at the Hospital Universitario Severo Ochoa (HUSO) from January 1, 2007, to December 31, 2020, encompassing all diagnosed cases of helminthiasis during this period. Comprehensive epidemiological, clinical, and microbiological data were gathered for all diagnosed patients. The study population comprised patients receiving treatment at the HUSO, as well as those receiving treatment at the Leganés and Fuenlabrada Primary Care Units. Subsequently, descriptive and comparative statistics were performed, comparing Spanish and foreign patients.

RESULTS

During this period, a total of 952 patients were diagnosed with some form of helminthiasis. Among them, 495 were Spanish, and 457 were foreign. The total number of helminths identified, including patients with multiple infections, was 1,010. Significant differences were observed between Africans and Americans in terms of age distribution, with a higher prevalence among Africans in the 0-15 age range and among Americans in the 31-60 age range. Variations were noted in the distribution of helminths, with S. stercoralis significantly affecting Americans. For Spanish patients, the presence of Trichuris trichiura and S. stercoralis was significantly associated with eosinophilia, whereas among foreign patients, it was associated with Trichuris trichiura, Ascaris lumbricoides among others. Regarding symptoms, skin manifestations were more frequent among Spanish, while digestive were more common among foreigners.

CONCLUSIONS

This study offers crucial epidemiological insights into helminth infections observed over time in a Madrid hospital. Although the prevalence of helminth infections has been decreasing, there is still a need for screening and diagnosing foreign patients.

Magnitude and Determinants of Intestinal Parasites among Children under Five in Ethiopia During 2010-2023: A Systematic Review and Meta-Analysis

Background: Intestinal parasitic infection (IPI) poses a serious public health threat across the globe, particularly in children in low- and middle-income countries like Ethiopia. This study was to provide pooled estimates for the individually available data on IPI and its predictors among children under five in Ethiopia. Methods: Cochrane's Q, I2, sensitivity analysis, funnel plot, Begg's, and Egger's regression tests were used to check heterogeneity and publication bias. A random-effects model was used to calculate the pooled burden of IPI among children under five. Results: The pooled prevalence of IPI among children under five was 28.27% (95% CI = 20.52-36.03%). Of these, single and mixed infections contribute to 28.02% and 0.25%. Intestinal parasites were significantly associated with eating raw fruits and vegetables [AO = 3.21, 95% CI = 1.11, 5.31]. Conclusion: Under the present scenario, the IPI ranges from 17.78 to 40.05%, and the IPI is higher in community-based studies of children under five.

Prevalence and Associated Risk Factors of Intestinal Parasites among Children under Five Years of Age Attended at Bachuma Primary Hospital, West Omo Zone, Southwest Ethiopia: A Cross-Sectional Study

Background

In regions of the world with low resources, such as Ethiopia, intestinal parasite diseases are still highly prevalent, especially in children. Poor personal and environmental hygiene, as well as unsafe and low-quality drinking water, are the main causes of this. This investigation aimed to determine the frequency of intestinal parasites and risk factors among children under 5 years age at Bachuma Primary Hospital in 2022.

Materials and Methods

: A cross-sectional study was carried out from October 2022 to December 2022 at Bachuma Primary Hospital, West Omo Zone, Southwest Ethiopia. Stool sample was collected from randomly selected children who were ordered to have their stool examined at the hospital laboratory and wet mount was prepared using normal saline to detect the different stage of intestinal parasites microscopically. Moreover, data related to the sociodemographic and associated risk factors was collected using a structured questionnaire. Descriptive statistics were computed to describe the characteristics of the study participants and determine the prevalence of intestinal parasites. Data were entered into Epi-data manager and analysed using statistical packages for social sciences (SPSS) version 25.0, respectively. Bivariate and multivariate logistic regression analyses were performed, with variables with a p value of <0.05 considered statistically significant.

Result

: Infection with at least one intestinal parasite among children was 29.4% (95% CI: 24.5-34.7). Ascaris lumbricoide and Giardia lamblia were responsible for 8% (26/323) and 4% (13/323) of the prevalence of helminth and protozoans, respectively. A multivariate logistic regression analysis revealed that children whose residence was rural had an adjusted odds ratio (AOR) of 5.048 (p=0.001), those who did not wash their hands before meals had an AOR of 7.749 (p=0.001), a child with not trimmed fingernails had an AOR of 2.752 (p=0.010), a child who frequently experienced stomach pain and whose source of water was pond had an AOR of 2.415 (p=0.028) and 3.796 (p=0.040), respectively.

Conclusion

In this study, the prevalence of intestinal parasites recorded was low. Rural residency, absence of child hand washing practice before meal, and not trimming fingernail were among factors significantly associated with intestinal parasite infection.

Prevalence of Diarrhea, Intestinal Parasites, and Associated Factors Among Under-Five Children in Dabat District, Northwest Ethiopia: Multicenter Cross-sectional Study

Background

Despite global interventions to prevent and control diarrhea, it remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. According to the World Health Organization, data from 2021 indicated that diarrheal disease is responsible for 8% of deaths in children under the age of 5. In the world, more than 1 billion under-five children live in poverty, social exclusion, and discrimination affected by intestinal parasitic infections and diarrhea disease. In sub-Saharan African countries like Ethiopia, diarrheal diseases and parasite infections continue to cause significant and persistent morbidity and mortality in under-five children. Therefore, the purpose of this study was to assess the prevalence and associated factors of intestinal parasites and diarrheal diseases in children under the age of 5 years in Dabat District, Northwest Ethiopia in 2022.

Method

A community-based, cross-sectional study was carried out from September 16 to August 18th 2022. Four hundred households with at least one child under the age of 5 years were recruited by simple random sampling technique. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data was entered into Epi-data version 3.1 and exported to Statistical Package for Social Science (SPSS) version 25 for analysis. Binary logistic regression was performed to identify factors associated with diarrhea and intestinal parasitic infections. The level of significance was computed at a P-value ⩽ .05. Descriptive statistics such as frequency and other summary statistics were used for describing sociodemographic variables and determining the prevalence of diarrhea and intestinal parasites. Tables, figures, and texts were used to present the findings. The variables having a P-value of less than .2 in the bivariable analysis were entered into the multivariable analysis at a P-value of ⩽.5.

Results

According to this study, the prevalence of diarrhea and intestinal parasites among under-five children was 20.8% (95% CI: [16.8-37.8] and 32.5% (95% CI: [28.6, 37.8], respectively. In multivariable logistic analysis at a P-value of ⩽.5, the educational level of mothers (Adjusted odds ratio [AOR]: 3.7, 95% CI: [1.52, 8.95], residence (AOR: 4.7, 95% CI: [1.52, 8.09]), undernutrition (AOR: 3.6, 95% CI: [1.09, 11.3]), latrine availability (AOR:3.9, 95% CI: [1.23, 9.56]), types of the latrine (AOR: 5.9, 95% CI: [3.42, 11.66]), water treatment (AOR = 7.6; 95% CI: [6.4, 12.7]), eating uncooked vegetable or fruits (AOR = 4.6; 95% CI: [1.025, 15.2]), and source of water (AOR = 4.5; 95% CI: [2.32,8.92]) were significantly associated with diarrheal disease. Intestinal parasitic infection was also significantly associated with undernutrition (AOR = 3.9; 95% CI: [1.09, 9.67]), latrine availability (AOR = 2.1; 95% CI:[1.32, 9.32]), types of the latrine (AOR = 2.8; 95% CI: [1.92, 8.12]) residence (AOR = 4.7; 95% CI: [1.52, 8.09]), water treatment, source of water for drinking (AOR = 4.5; 95% CI: [2.32, 8.92]), eating uncooked vegetables or fruits (AOR = 6.7:95% CI: [3.9, 9.8]), and deworming children with anti-parasitic medication (AOR = 2.4; 95% CI: [1.34, 5.62]), washing hands after latrine used (AOR = 2.2: 95% CI: [1.06, 3.86]).

Conclusion

The prevalence of diarrhea and intestinal parasite among under-five children was 20.8% and 32.5%, respectively. Undernutrition, latrine availability, types of latrines, residence, eating uncooked vegetables or fruits, and source of water for drinking and water treatment were associated with intestinal parasitic infection and diarrheal disease. Deworming children with antiparasitic medications and washing hands after latrine use was also significantly associated with parasitic infection. Hence, awareness creation activities on latrine utilization and building, keeping personal hygiene, safe water supply, feeding cooked vegetables or fruits, taking anti-parasitic medications, practice hand washing habit after toilet use are strongly recommended.

Parasitological and malacological surveys to identify transmission sites for Schistosoma mansoni in Gomma District, south-western Ethiopia

Schistosomiasis is a neglected tropical disease that disproportionately affects the poorest people in tropical and subtropical countries. It is a major parasitic disease causing considerable morbidity in Ethiopia. Despite significant control efforts, schistosomiasis transmission is still widespread in many rural areas of the country. The aim of this study was to determine the prevalence and intensity of intestinal schistosomiasis among schoolchildren, as well as to identify schistosomiasis transmission sites in Gomma District, southwestern Ethiopia. Between October 2018 and September 2019, cross-sectional parasitological and malacological surveys were conducted in the study area. The study comprised 492 school-children aged 6 to 15 years old from four primary schools in Gomma District. To identify and quantify eggs of Schistosoma mansoni from the children, stool specimens were collected and processed using double Kato-Katz thick smears. Water bodies adjacent to human settlements in the study area were surveyed for snail intermediate hosts of S. mansoni. Morphological identification of collected snails was conducted, followed by examining their infection status using a dissecting microscope. The overall prevalence of S. mansoni infection was 73.8% (95%CI: 69.9-77.7%) and 41.6% of them had moderate-to-heavy infections. The prevalence of S. mansoni infection differed considerably by age group, with the older age groups (12-15) having a higher prevalence than the younger age groups (6-11) (p < 0.001). The prevalence of infection also varied significantly among schools; Dedo Ureche had the highest prevalence (86.9%) (p = 0.034), while Goga Kilole had relatively the lowest prevalence of S. mansoni infection (59.6%) (p = 0.003). A total of 1463 Biomphalaria pfeifferi snails were collected from 11 survey sites throughout the study area, with 357 (24.4%) of the snails shedding schistosomes cercariae. Despite intensified efforts to scale up mass drug administration in Ethiopia, this study reported high levels of S. mansoni infection among schoolchildren and snail intermediate hosts in rural communities in Gomma. Such a high infection rate warrants pressing needs for targeted and integrated interventions to control the disease in the area.

Prevalence and Associated Risk Factors of Endoparasites among Under-Five Children in Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Northwest Ethiopia: A Cross-Sectional Study

Many endoparasites are still considered neglected tropical illnesses. The term “endoparasites” refers to infections caused by both helminths and protozoa. In many places in Ethiopia, particularly Debre Tabor, epidemiological data on the prevalence and associated variables of endoparasites among under-five children is unavailable. Thus, the aim of this study was to gather baseline data on the prevalence of endoparasites and their associated variables among under-five children who visited the Debre Tabor comprehensive specialized hospital in Northwest Ethiopia. A hospital-based quantitative cross-sectional study was used. The study was carried out from May 1 to November 30, 2021. Study participants were selected by a systematic sampling technique. The stool specimen was examined for the presence of different stages of intestinal parasites (adult, trophozoite, larvae, cysts, and ova) using direct wet mount, modified formal-ether sedimentation, and modified Ziehl–Neelsen methods. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The data was summarized using frequency tables and a bar chart. The adjusted odds ratio and $p$ value <0.05 were used to declare the final association. In the present study, a total of 258 under-five children and their mothers/guardians were involved in the study, with a response rate of 100%. More than half of the respondents, 137 (53.10%), were females, and 159 (61.63%) were in the age group of 24 to 59 months. The overall prevalence of one or more endoparasites among under-five children was 45 (17.44%). Multivariate logistic regression analysis showed that health supervision, child food freshness, regular trimming of fingernails, and children’s playground cleanliness were significantly associated with childhood endoparasites. The present study demonstrated a higher prevalence of endoparasites among under-five children. Health supervision, child food freshness, regular trimming of fingernails, and children’s playground cleanliness were significantly associated with endoparasites. Thus, strengthening health education about food, personal, and environmental hygiene for both children and their mothers/guardians is crucial.

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.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Evaluation of Strongyloides stercoralis infection in patients with HTLV-1

INTRODUCTION

Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis infection with low therapeutic response.

OBJECTIVE

To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1 attending the Reference Center for HTLV-1 (CHTLV) in Salvador, Bahia, Brazil.

MATERIALS AND METHODS

We conducted a cross-sectional study in 178 HTLV-1-infected individuals treated at the HTLV specialized center between January, 2014, and December, 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture, and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed using an in house enzyme-linked immunosorbent assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot.

RESULTS

The frequency of S. stercoralis infection was 3.4% (6/178). Individuals infected with S. stercoralis from rural areas (50.0%; 3/6) also showed S. stercoralis hyperinfection (>3,000 larvae/gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178).

CONCLUSIONS

HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.

Fecal indicator bacteria along multiple environmental exposure pathways (water, food, and soil) and intestinal parasites among children in the rural northwest Ethiopia

Background

Children in low-resource settings are exposed to multiple risk factors for enteropathogens. However, the probability of exposures may be different across exposure pathways. Accordingly, this study was conducted to assess environmental exposures of children to intestinal parasites in the east Dembiya district of Ethiopia.

Methods

A cross-sectional study was conducted for 372 households with children aged 24–59 months. The potential for external exposure of children to intestinal parasites was assessed by determining the presence of fecal indicator organism (Escherichia coli (E. coli)) in drinking water at point of use, ready-to-eat foods, and courtyard soil from children’s outdoor play areas. For internal exposure assessment, ova of parasites in stool samples was detected using wet mount and Kato-Katz techniques to estimate exposure to intestinal parasites. The external and internal exposure assessments were also complemented using questionnaire and spot-check observations to assess behaviors that result in high risk of exposure. Individual and community-level predictors of intestinal parasites were identified using a multilevel logistic regression model. Statistically significant variables were identified on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value < 0.05.

Results

Ova of one or more intestinal parasites was detected among 178 (47.8%) (95% CI 42.8, 52.6%) of the children. The most common intestinal parasites were A. lumbricoides (20.7%) and S. mansoni (19.1%). Furthermore, E. coli was detected in 69.1% of drinking water samples at point of use, 67.5% of ready-to-eat food samples, and 83.1% of courtyard soil samples from children’s outdoor play areas. Exposure of children to intestinal parasites among children in the studied region was associated with poor hand hygiene of mothers (AOR 1.98, 95% CI (1.07, 3.66), poor hand hygiene of children (AOR 3.20, 95% CI (1.77, 5.77), mouthing of soil contaminated materials (AOR 2.31, 95% CI (1.26, 4.24), open defecation practices (AOR 2.22, 95% CI (1.20, 4.10), limited access to water (AOR 2.38, 95% CI (1.13, 5.01), water contamination (AOR 2.51, 95% CI (1.31, 4.80), food contamination (AOR 3.21, 95% CI (1.69, 6.09), and soil contamination (AOR 2.56, 95% CI (1.34, 4.90).

Conclusion

An extensive E. coli contamination of water, foods, and courtyard soil was found in the studied region and the potential sources of contamination were open defecation practices, unhygienic disposal of wastes, poor animal husbandry and keeping practices, and poor water and food safety measures at household level. Moreover, fecal contamination of water, foods, and soil linked to exposure of children to intestinal parasites in the studied region. Thus, it is critical to implement individual-level interventions (such as latrine utilization, hand hygiene promotion, food safety, home-based water treatment, and containment of domestic animals), plus community-level interventions (such as protecting water sources from contamination, source-based water treatment, and community-driven sanitation).

Asymptomatic Intestinal Parasitic Infestations among Children Under Five Years in Selected Communities in the Ho Municipality, Ghana

Background

The study investigated intestinal parasitic infestations (IPIs) and possible risk factors associated with asymptomatic children under five (5) years in five (5) selected communities in the Ho Municipality.

Methods

The study design was cross- sectional, with a simple random sampling technique involving 150 asymptomatic children under 5 years from 5 selected communities (Klave, Hoe, Freetown, Dave and Godokpe) in the Ho Municipality. A questionnaire was used to obtain socio-demographics and other relevant parameters. Direct wet preparation, formol-ether concentration and Modified ZN staining techniques were used for the identification of intestinal parasites from participants' stool samples. The Fisher's exact test and binary logistic regression analysis were used to determine the difference in IPIs proportions and assess the risk factors associated with IPIs respectively.

Results

The overall IPIs cases was 14% (21/150). Cryptosporidium spp was most predominant [5.3% (8/150)], followed by Entamoeba spp [3.3% (5/150)], Cyclospora cayetenensis [2.7% (4/150)], Ascaris lumbricoides [1.3% (2/150)], Giardia lamblia [0.7% (1/150)] and Strongyloides stercoralis [0.7% (1/150)]. Children in rural communities (23.4%) recorded significantly higher case rate compared to those in urban communities (9.8%0), (p=0.04). Lower educational attainment of mother [OR=0.55, 95% CI (0.37 – 0.83), p-value = 0.015] and residence in rural communities [OR = 0.53, 95% CI (0.33–0.88)], p-value = 0.025] were significantly associated with IPIs.

Conclusion

Asymptomatic IPIs are quite prevalent among children under 5 years in the Ho Municipality. The study thus recommends active sensitization programs for parents/guardians on preventive measures and school health programs should be instituted in rural communities.

Prevalence of Intestinal Parasitosis and Its Associated Factors Among Children Aged 6 to 59 months Attending Mekane Eyesus Primary Hospital, Northcentral Ethiopia

Background. Intestinal parasites are still a serious public health problem and important cause of morbidity and mortality all over the world, particularly in developing countries. Unfortunately, pre-school children are more susceptible to infection. However, information is scarce in the study area. Thus, this study aimed to assess the prevalence of intestinal parasitosis and associated factors among children aged 6 to 59 months in Northcentral Ethiopia. Methods. An institutional-based cross-sectional study was carried out at Mekane Eyesus primary hospital from June 10 to November 30, 2020. Stool samples were collected from 322 children and examined by using direct wet mount and formal ether concentration techniques. The data were entered and analyzed using EPI Info v7 and SPSS v23 statistical software, respectively. Both bivariable and multivariable logistic analysis was carried out and potential associated factors were identified based on adjusted odds ratio with 95% confidence interval and P-value <.05. Results. The prevalence of intestinal parasitosis was 18.0% (95% CI: 14.0%-22.0%). A total of 4 parasites were examined and the dominant parasite was E. histolytica/dispar (8.1%) followed by A. limbricoide (4.7%). Children with irregular trimming of fingernails (AOR = 3.14, 95% CI: 1.59-6.21), and child who have habit of eating unwashed fruits/vegetables (AOR = 3.80, 95% CI: 1.14-12.82) were strongly associated with IPIs. Conclusions. Protozoa parasites are most common cause of diseases in children. The study identified some preventable and modifiable factors to address the prevalence of IPIs. Additionally, improving mothers/guardians awareness about source of infection and mode of transmission is necessary.

Biogeographical characteristics of Schistosoma mansoni endemic areas in Ethiopia: a systematic review and meta analysis

BACKGROUND

In Ethiopia, schistosomiasis is caused by Schistosoma mansoni and S. haematobium with the former being widespread and more than 4 million people are estimated to be infected by S. mansoni annually with 35 million at risk of infection. Although many school- and community-based epidemiological surveys were conducted over the past decades, the national distribution of schistosomiasis endemic areas and associated socio-environmental determinants remain less well understood. In this paper, we review S. mansoni prevalence of infections and describe key biogeographical characteristics in the endemic areas in Ethiopia.

METHODS

We developed a database of S. mansoni infection surveys in Ethiopia through a systematic review by searching articles published between 1975 and 2019 on electronic online databases including PubMed, ScienceDirect, and Web of Science. A total of 62 studies involving 95 survey locations were included in the analysis. We estimated adjusted prevalence of infection from each survey by considering sensitivity and specificity of diagnostic tests using Bayesian approach. All survey locations were georeferenced and associated environmental and geographical characteristics (e.g. elevation, normalized difference vegetation index, soil properties, wealth index, and climatic data) were described using descriptive statistics and meta-analysis.

RESULTS

The results showed that the surveys exhibited a wide range of adjusted prevalence of infections from 0.5% to 99.5%, and 36.8% of the survey sites had adjusted prevalence of infection higher than 50%. S. mansoni endemic areas were distributed in six regional states with the majority of surveys being in Amhara and Oromia. Endemic sites were found at altitudes from 847.6 to 3141.8 m above sea level, annual mean temperatures between 17.9 and 29.8 ℃, annual cumulative precipitation between 1400 and 1898 mm, normalized difference vegetation index between 0.03 and 0.8, wealth index score between -68 857 and 179 756; and sand, silt, and clay fraction in soil between 19.1-47.2, 23.0-36.7, and 20.0-52.8 g/100 g, respectively.

CONCLUSIONS

The distribution of S. mansoni endemic areas and prevalence of infections exhibit remarked environmental and ecological heterogeneities. Future research is needed to understand how much these heterogeneities drive the parasite distribution and transmission in the region.

Prevalence and factors associated with intestinal schistosomiasis and human fascioliasis among school children in Amhara Regional State, Ethiopia

Background

Schistosomiasis and fascioliasis are digenean parasitic infections and are among the neglected tropical diseases that have both medical and veterinary importance. They are found mainly in areas having limited access to safe water supply and improved sanitation.

Methods

A cross-sectional study was conducted to determine the prevalence of Schistosoma mansoni and Fasciola species infections and to identify associated risk factors among school children in Amhara Regional State, Ethiopia. Stool specimens were collected from 798 children (419 males, 379 females) and processed using Kato-Katz and formol-ether concentration techniques. A semi-structured questionnaire was used to collect socio-demographic and other exposure information to explore potential risk factors for the infections.

Results

The overall prevalence of S. mansoni and Fasciola species infections was 25.6% (95% confidence interval (CI): 22.5-28.6) and 5.5% (95% CI: 3.9-7.1), respectively. S. mansoni was present in all surveyed schools with the prevalence ranging from 12.8% (16/125; 95% CI = 5.6-20.0) to 39.7% (64/161; 95% CI = 32.2-47.2) while Fasciola species was identified in five schools with the prevalence ranging from 2.5% (4/160; 95% CI = 0.001–4.9) to 9.8% (13/133; 95% CI = 4.7–14.8). The prevalence of S. mansoni infection was significantly associated with swimming in rivers (Adjusted odds ratio (AOR): 1.79, 95% CI, 1.22–2.62; P=0.003), bathing in open freshwater bodies (AOR, 2.02; 95% CI, 1.39–2.94; P<0.001) and engaging in irrigation activities (AOR, 1.69; 95% CI, 1.19-2.39; P=0.004), and was higher in children attending Addis Mender (AOR, 2.56; 95% CI, 1.20–5.46; P=0.015 ) and Harbu schools (AOR, 3.53; 95% CI, 1.64–7.59; P=0.001). Fasciola species infection was significantly associated with consumption of raw vegetables (AOR, 2.47; 95% CI, 1.23-4.97; P=0.011) and drinking water from unimproved sources (AOR, 2.28; 95% CI, 1.11–4.70; P=0.026).

Conclusion

Both intestinal schistosomiasis and human fascioliasis are prevalent in the study area, affecting school children. Behaviors and access to unimproved water and sanitation are among significant risk factors. The findings are instrumental for targeted interventions.

Prevalence of intestinal parasite infections and associated risk factors among patients of Jimma health center requested for stool examination, Jimma, Ethiopia

BACKGROUND

Intestinal parasitic infections are still a serious public health problem in poor and developing countries like Ethiopia. Local epidemiological data is crucial to design and monitor prevention and control strategies. This study aimed to determine the prevalence of intestinal parasite infections and associated risk factors among patients requested for stool examination at Jimma health center, Southwest, Ethiopia.

METHODS

A cross-sectional study was conducted among a total of 384 patients in Jimma health center, Southwest, Ethiopia. Stool samples were collected and examined using direct wet-mount and formal-ether concentration techniques. Data were analyzed using the Chi-Square (X2) test and SPPS Version 24 and P Value<0.05 was considered for statistically significance.

RESULTS

The overall prevalence of intestinal parasite infections was found to be 79(20.6%). The infection rate was slightly higher in females 261(68%) than in males 123(32%). Eight types of intestinal parasites were identified and the highest prevalence was Giardia lamblia 25(6.5%) followed by A. lumbricoides 22(5.7%). Single parasitic infection was found among 67(17.4%) of the patients and double infection was 12(3.1%). Shoe wearing habits, Status of fingernail, Handwashing before a meal and after defecation, Source of water for bathing and drinking were significant factors(p<0.05) for intestinal parasitic infection.

CONCLUSION

A relatively low prevalence of intestinal parasite infections was observed among patients of Jimma health center requested for the stool examination.

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.

A systematic review and meta-analysis quantifying schistosomiasis infection burden in pre-school aged children (PreSAC) in sub-Saharan Africa for the period 2000-2020

INTRODUCTION

Following the adoption of the World Health Assembly Resolution WHA 65.21 and Neglected Tropical Diseases road map 2021-2030, schistosomiasis control programmes have shifted from morbidity control to disease elimination. However, several gaps continue to be observed in the implementation of control programmes with certain age groups omitted from these campaigns increasing health inequalities and risks of reinfections to previously treated groups. We used the Inverse Variance Heterogeneity (IVhet) model to estimate the prevalence of schistosomiasis infection among preschool-aged children.

METHODS

We did a systematic review of peer-reviewed literature on schistosomiasis in sub-Saharan Africa for the period January 1, 2000 to November 30, 2020. Quantitative data for cases of schistosomiasis infection were extracted, including country and region where the studies were done, year of publication and specific schistosome species observed. The IVhet model was used to estimate the pooled prevalence estimate (PPE), the heterogeneity and publication bias.

RESULTS

We screened 2601 articles to obtain 47 eligible studies containing quantitative data on preschool-aged children. Of the selected studies, 44.7% (n = 22) were from East Africa while the least number of studies obtained (2.1%, n = 1) was from Central Africa. 21712 subjects were screened for infection due to Schistosoma spp; 13924 for S. mansoni and 7788 for S. haematobium. The PPE for schistosomiasis among PreSAC was 19% (95% CI: 11-28). Infection due to S. mansoni (IVhet PPE: 22% (95% CI: 9-36) was higher than that due to S. haematobium (15%; 95% CI: 6-25). A Luis Furuya-Kanamori index of 1.83 indicated a lack of publication bias. High level of heterogeneity was observed (I2 > 90%) and this could not be reduced through subgroup analysis.

CONCLUSION

Schistosomiasis infection among pre-school aged children 6 years old and below is high. This indicates the importance of including this age group in treatment programmes to reduce infection prevalence and long-term morbidities associated with prolonged schistosome infection.

Helminth infections among rural schoolchildren in Southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model

Although the prevalence of helminths infection among schoolchildren is known, there has been little progress in the application of count model for modelling the risk factors of helminths egg. Only a few studies applied multilevel analysis to explore the variation in helminths prevalence across schools and classes. This study aimed to assess the prevalence, intensity of helminths infection, and identify risk factors at the individual-, household-, and school-level among schoolchildren in Southern Ethiopia. Using multistage random sampling, we recruited 864 students in the Wonago District. We applied multilevel-logistic and zero-inflated negative binomial regression models (ZINB). Risk factors were concentrated at the individual level; school-level and class-level variables explained less than 5% of the variance. The overall helminths prevalence was 56% (479/850); Trichuris trichiura prevalence was 42.4% (360/850); and Ascaris lumbricoides prevalence was 18.7% (159/850). The rate of any helminths increased among thin children (AOR: 1.73 [95% CI: (1.04, 2.90]), anemic (AOR: 1.45 [95% CI: 1.04, 2.03]), mothers who had no formal education (AOR: 2.08 [95% CI: 1.25, 3.47]), and those in households using open containers for water storage (AOR: 2.06 [95% CI: 1.07, 3.99]). In the ZINB model, A. lumbricoides infection intensity increased with increasing age (AOR: 1.08 [95% CI: 1.01, 1.16]) and unclean fingernails (AOR: 1.47 [95% CI: 1.07, 2.03]). Handwashing with soap (AOR: 0.68 [95% CI: 0.48, 0.95]), de-worming treatment [AOR: 0.57 (95% CI: 0.33, 0.98)], and using water from protected sources [AOR: 0.46 (95% CI: 0.28, 0.77)] were found to be protective against helminths infection. After controlling for clustering effects at the school and class levels and accounting for excess zeros in fecal egg counts, we found an association between helminths infection and the following variables: age, thinness, anemia, unclean fingernails, handwashing, de-worming treatment, mother's education, household water source, and water storage protection. Improving hygiene behavior, providing safe water at school and home, and strengthening de-worming programs is required to improve the health of schoolchildren in rural Gedeo.

Soil-transmitted helminth infections among pre-school aged children in Gamo Gofa zone, Southern Ethiopia: Prevalence, intensity and intervention status

BACKGROUND

Soil-transmitted helminths (STH), i.e., Ascaris lumbricoides, Trichuris trichiura and hookworms are among the most prevalent Neglected Tropical Diseases (NTDs) in Ethiopia. Although pre-school aged children pay a high morbidity toll associated with STH infections, evidence on prevalence, intensity and intervention status is lacking in Ethiopia. This study, therefore, aimed to address these gaps to inform decision made on STH.

METHODS

We did a community-based cross-sectional study in five districts of Gamo Gofa zone, Southern Ethiopia; in January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites eggs in stool. Then, collected data were edited and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis.

RESULTS

A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462) (95% confidence interval (CI) = 21.8%-25.2%). As caris lumbricoides was the most prevalent (18.6%), followed by Trichuris trichiura (9.2%), and hookworms (3.1%). Of the total, 7.4% PSAC were infected with two STH species. Most of the positive cases with STH showed low infection intensities, while 15.1% ascariasis cases showed moderate infection intensities. The study found that 68.7% of PSAC were treated with albendazole. Also, household's level data showed that 39.4% used water from hand-dug well; 52.5% need to travel ≥30 minutes to collect water; 77.5% did not treat water, and 48.9% had no hand washing facility. In addition, almost 93% care givers achieved less than the mean knowledge and practice score (≤5) on STH prevention.

CONCLUSIONS

This study showed that significant proportions of pre-school aged children are suffering from STH infections despite preventive chemotherapy exist at the study area. Also, gaps in the interventions against STH were highlighted. Thus, a call for action is demanding to eliminate STH among PSAC in Ethiopia by 2030.

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.

Antimicrobial and micronutrient interventions for the management of infants under 6 months of age identified with severe malnutrition: a literature review

BACKGROUND

Infants under 6 months (U6M) contribute a significant proportion of the burden and mortality of severe malnutrition globally. Evidence of underlying aetiology in this population is sparse, but it is known that the group includes ex-preterm and low birthweight (LBW) infants. They represent a unique population given their dependence on breastmilk or a safe, secure alternative. Nutrition agencies and health providers struggle to make programming decisions on which interventions should be provided to this group based upon the 2013 WHO Guidelines for the 'Management of Severe Acute Malnutrition in Infants and Young Children' since there are no published interventional trial data focussed on this population. Interim guidance for this group might be informed by evidence of safety and efficacy in adjacent population groups.

METHODOLOGY

A narrative literature review was performed of systematic reviews, meta-analyses and randomised controlled trials of antimicrobial and micronutrient interventions (antibiotics, deworming, vitamin A, vitamin D, iron, zinc, folic acid and oral rehydration solution (ORS) for malnutrition) across the population groups of low birthweight/preterm infants, infants under 6 months, infants and children over 6 months with acute malnutrition or through supplementation to breastfeeding mothers. Outcomes of interest were safety and efficacy, in terms of mortality and morbidity.

RESULTS

Ninety-four articles were identified for inclusion within this review. None of these studied interventions exclusively in severely malnourished infants U6M. 64% reported on the safety of studied interventions. Significant heterogeneity was identified in definitions of study populations, interventions provided, and outcomes studied. The evidence for efficacy and safety across population groups is reviewed and presented for the interventions listed.

CONCLUSIONS

The direct evidence base for medical interventions for severely malnourished infants U6M is sparse. Our review identifies a specific need for accurate micronutrient profiling and interventional studies of micronutrients and oral fluid management of diarrhoea amongst infants U6M meeting anthropometric criteria for severe malnutrition. Indirect evidence presented in this review may help shape interim policy and programming decisions as well as the future research agenda for the management of infants U6M identified as malnourished.

The high prevalence of intestinal parasitic infections is associated with stunting among children aged 6-59 months in Boricha Woreda, Southern Ethiopia: a cross-sectional study

Background

Prior studies reported controversial results about the association between intestinal parasitic infections and childhood under-nutrition. We investigated the association of intestinal parasitic infections with under-nutrition among children aged 6–59 months in Boricha Woreda, Southern Ethiopia.

Methods

This community-based prospective cross-sectional study was carried out from January 1–30, 2019 among 622 children aged 6–59 months. A two-stage stratified sampling procedure was used. Data were collected using a structured, face-to-face interviewer-administered questionnaire and standard anthropometric measurements. The stool specimens were collected using standard technique and examined for the existence and species of intestinal parasites using direct wet mount, Kato Katz and staining technique. We have entered data using Epi Data 3.1 and WHO Anthro software and all analyses were conducted using SPSS version 20. The descriptive analyses were done to find descriptive measures for the socio-demographic and other important variables. Multivariable logistic regression analysis was used to identify factors associated with under-nutrition. Adjusted odds ratios (AORs) with a 95% confidence interval (CI) were computed to assess the presence and strength of associations.

Results

The total prevalence of intestinal parasitic infection was 48.7% (95% CI, 44.77–52.62). Approximately one-fourth (22%) of the children were infected with moderate intensity infections. Prevalence of stunting, underweight, wasting were 39.3, 24 and 11.6%, respectively. The prevalence of stunting among children infected with the intestinal parasite (59.4%) was significantly higher than the prevalence in non-infected children (20.6%) (p < 0.001). The absence of sanitation facility, living in medium and large family size, lack of shoes wearing practice, consuming raw vegetables and fruits were positively associated with intestinal parasitic infections. The presence of intestinal parasitic infections was positively associated with stunting (AOR = 2.18, 95% CI: 1.36–3.50) but not with wasting (AOR = 0.58, 95% CI: 0.3–1.13) and underweight (AOR: 0.92, 95% CI = 0.55–1.54).

Conclusions

Under-nutrition and intestinal parasitic infections were serious public health concerns. Consolidating the prevailing water, sanitation and hygiene packages and routine deworming of children aged 6–59 months may aid to decrease the burden of both stunting and intestinal parasitic infection in children. Also, improving modern contraceptive methods utilization to reduce family size is recommended.

Intestinal parasitosis, anaemia and risk factors among pre-school children in Tigray region, northern Ethiopia

BACKGROUND

Intestinal parasitic infections (IPIs) and anaemia are major health problems. This study assessed the prevalence of intestinal parasitic infections, anaemia and associated factors among pre-school children in rural areas of the Tigray region, northern Ethiopia.

METHODS

A community based cross-sectional study was conducted among 610 pre-school children in rural communities of Northern Ethiopia from June 2017 to August 2017. Stool specimens were examined for the presence of trophozoites, cysts, oocysts, and ova using direct, formal-ethyl acetate concentration, Kato-Katz, and Ziehl-Neelsen techniques. Haemoglobin was measured using a HemoCue spectrometer.

RESULTS

Among the 610 participating pre-school children in the study, the prevalence of IPIs and anaemia were 58% (95% conference interval (CI): 54.1-61.9%) and 21.6% (95% CI: 18.5-25.1%), respectively. Single, double, and triple parasitic infections were seen in 249 (41, 95% CI: 37-45%), 83 (14, 95% CI: 11-17%), and 22 (3.6, 95% CI: 2.4-5.4%) children, respectively. Of the seven intestinal parasitic organisms recorded from the participants, Entamoeba histolytica/dispar was the most prevalent 220 (36.1%) followed by Giardia lamblia 128 (20.1%), and Hymenolepis nana 102 (16.7%). Mixed infections were common among G. lamblia, E. histolytica/dispar and Cryptosporidium spp. oocyst. Intestinal parasitic infection prevalence increased from 47% in children aged 6-11 months to 66% in those aged 48-59 months; the prevalence ratio (PR) associated with a one-year increase in age was 1.08 (95% CI: 1.02-1.14, p = 0.009). Age-adjusted prevalence was higher in children who had been dewormed (PR = 1.2; 95% CI: 1.00-1.4, p = 0.045), and lower in households having two or more children aged under five (PR = 0.76, 95% CI: 0.61-0.95, p = 0.015). Anaemia rose from 28% in children aged 6-11 months to 43% in those aged 12-23 months, then fell continuously with age, reaching 7% in those aged 48-59 months. Age adjusted, anaemia was more prevalent in households using proper disposal of solid waste (PR = 1.5, 95% CI: 0.1-2.10, p = 0.009) while eating raw meat (PR = 0.49, 95% CI: 0.45-0.54, p = 0.000), any maternal education (PR = 0.64 95% CI: 0.52-0.79, p = 0.000), and household water treatment (PR = 0.75, 95% CI: 0.56-1.0, p = 0.044) were associated with lower prevalence of anaemia.

CONCLUSIONS

More than half of the children were infected with intestinal parasites, while anaemia prevalence was concentrated in the 12-23 month age group. This study has identified a number of potentially modifiable risk factors to address the significant prevalence of IPIs and anaemia in these children. Improvements in sanitation, clean water, hand hygiene, maternal education could address both short and long-term consequences of these conditions in this vulnerable population.

Development and evaluation of a loop-mediated isothermal amplification (LAMP) diagnostic test for detection of whipworm, Trichuris trichiura, in faecal samples

Whipworm infection or trichuriasis caused by Trichuris trichiura is of major public health concern in sub-Saharan Africa, particularly among pre-school and school-going children. It is among the neglected tropical diseases targeted for elimination through mass drug administration (MDA). One of the outcomes of MDA is a rapid decline in levels of infection intensity, making it difficult to monitor effectiveness of control measures using the conventional Kato-Katz procedure, which relies on the microscopic detection of parasite ova in faecal samples. In the present study, a loop-mediated isothermal amplification (LAMP) test was developed for the detection of T. trichiura infection in faecal samples. LAMP technology offers greater sensitivity and specificity than the microscopy-based tests. A set of four specific primers targeting the internal transcribed spacer 2 region of the ribosomal DNA were designed using Primer Explorer software. DNA was extracted from faecal samples using the alkaline lysis method (HotSHOT) and the LAMP reaction performed at 63°C for 1 h. The amplicons were visualized by both gel electrophoresis and with the naked eye following staining with SYBR green dye. Sensitivity and specificity tests were determined using the standard Kato-Katz diagnostic procedure as a reference test. The developed LAMP assay reliably detected T. trichiura DNA in faecal samples, with a specificity and sensitivity of 88% and 77%, respectively. No cross-reactivity was observed with several common helminth parasites. The developed LAMP assay is an appropriate diagnostic method for the detection of T. trichiura DNA in human faecal samples due to its simplicity, low cost, high sensitivity and specificity.

Synthesis and Bioactivity of Phthalimide Analogs as Potential Drugs to Treat Schistosomiasis, a Neglected Disease of Poverty

The neglected tropical disease, schistosomiasis, is caused by trematode blood flukes of the Schistosoma genus and infects approximately 200 million people worldwide. With just one partially effective drug available for disease treatment, new drugs are urgently needed. Herein, a series of 47 phthalimide (Pht) analogues possessing high-value bioactive scaffolds (i.e., benzimidazole and 1,2,3,-triazoles) was synthesized by click-chemistry. Compounds were evaluated for anti-schistosomal activity in culture against somules (post-infective larvae) and adults of Schistosoma mansoni, their predicted ADME (absorption, distribution, metabolism, and excretion) properties, and toxicity vs. HepG2 cells. The majority showed favorable parameters for surface area, lipophilicity, bioavailability and Lipinski score. Thirteen compounds were active at 10 µM against both somules and adults (6d, 6f, 6i–6l, 6n–6p, 6s, 6r’, 6t’ and 6w). Against somules, the majority caused degeneracy and/or death after 72 h; whereas against adult parasites, five compounds (6l, 6d, 6f, 6r’ and 6s) elicited degeneracy, tegumental (surface) damage and/or death. Strongest potency against both developmental stages was recorded for compounds possessing n-butyl or isobutyl as a linker, and a pentafluorophenyl group on triazole. Apart from five compounds for which anti-parasite activity tracked with toxicity to HepG2 cells, there was apparently no toxicity to HepG2 cells (EC₅₀ values ≥50 µM). The data overall suggest that phthaloyl-triazole compounds are favorable synthons for additional studies as anti-schistosomals.

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.

Socioeconomic Predictors of Intestinal Parasitic Infections Among Under-Five Children in Rural Dembiya, Northwest Ethiopia: A Community-Based Cross-sectional Study

BACKGROUND

Soil-transmitted helminths and protozoan parasitic infections are endemic throughout the world. The problem of intestinal parasitic infection is higher among developing countries where children are the most vulnerable groups. Although health information related to parasitic infections is available globally, it is often limited in rural setups in least developed countries. This study was, therefore, conducted to assess socioeconomic predictors of intestinal parasitic infections among under-five children in rural Dembiya, Northwest Ethiopia.

METHODS

This cross-sectional study was conducted among 224 randomly selected households with under-five children. We used questionnaire to collect data and direct stool examination to identify intestinal parasitic infections. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and P < .05 was used to identify socioeconomic predictors of parasitic infections.

RESULTS

We found that 25.4% (95% CI = [20.2, 31.1]) under-five children had intestinal parasitic infection. Ascaris lumbricoides was the leading infection, which accounted 44 of 224 (19.6%). The prevalence of childhood intestinal parasitic infections was higher among households with no members whose education level is secondary and above (AOR = 3.36, 95% CI = [1.23, 9.17]). Similarly, intestinal parasitic infections were statistically associated with presence of 2 under-five children in a household (AOR = 3.56, 95% CI = [1.29, 9.82]), absence of frequent health supervision (AOR = 3.49, 95% CI = [1.72, 7.09]), larger family size (AOR = 2.30, 95% CI = [1.09, 4.85]), and poor household economic status (AOR = 2.58, 95% CI = [1.23, 5.41]).

CONCLUSIONS

Significant proportion of children was infected with intestinal parasitic infection in rural Dembiya. Educational status of family members, number of under-five children in a household, health supervision, family size, and wealth index were statistically associated with parasitic infections. Provision of anthelmintic drugs, health supervision, and health education targeted with transmission and prevention of infections are recommended.

Prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Waghimra zone, Ethiopia

Background

Intestinal parasitic infestations triggered considerable gastrointestinal morbidity, malnutrition, and mortality worldwide. In particular, young children in developing countries affected most. Helminthiasis infestation accounts for 10–20% of prevalence on preschool children worldwide. Unfortunately, small children below 5 years are uniquely susceptible to intestinal parasitic infestations in poor communities. This is because of children’s behavior like playing with soil and putting hand -to- mouth habit. Thus, the aim of this study was to assess the prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Ethiopia.

Methods

A community-based cross-sectional study was carried out on 378 preschool children in Sekota town from February 15 – March 10/2019. Stool specimens were collected and examined for intestinal parasites using wet mount and formal ether concentration technique. The risk factors of intestinal parasites were assessed using a pretested structured questionnaire. The data were entered and analyzed using Epi-data version 4.2.0.0 and SPSS-version 23 statistical software respectively. Both bivariable and multivariable analysis was carried out, and potential co-linearity was tested for closely similar variables. Variables with P value less than 0.05 in multivariable analysis was considered as statistically significant and reported with 95% CI and odds ratio.

Results

The prevalence of intestinal parasitic infestations in Sekota town on wet mount and formal ether concentration techniques was 83(21.9%), (95% CI, 17.7–26.3%) and 113(29.9%), (95% CI, 25.1–34.8%) respectively.

In multivariable analysis, not taking medication as periodical deworming (AOR, 95% CI), (2.5, 1.5–4.3), presence of animals in the living room (AOR, 95% CI) (3.1, 1.8–5.3), and being a government employee as an occupation (AOR, 95% CI), (3.4, 1.1–10.0) were increasing the odds of intestinal parasitic infestations.

Conclusions

The prevalence of intestinal parasitic infestations in Sekota town is high, which is a public health problem. The risk factors that contributed to intestinal parasitic infestations in this study were preventable and modifiable. Therefore, the concerned bodies need to emphasis on periodical deworming and keeping animals in separate room.

Increased Prevalence of Cestode Infection Associated with History of Deworming among Primary School Children in Ethiopia

Mass deworming of school-aged children with anthelmintics has been recognized as an effective approach for reducing the burden of soil-transmitted helminth (STH) infections. However, the consequences of this intervention on nontargeted parasite populations sharing the same gastrointestinal niche are unclear. We conducted a cross-sectional survey among three primary schools in Sululta town, Ethiopia, to examine the association between students' histories of deworming treatment in the past 6 months and the prevalence of cestode and protozoan infections. An interviewer-led questionnaire administered to parents provided information on sociodemographic factors, and deworming status was ascertained from school records. Stool samples were collected from 525 children for microscopic examination. The independent associations of "any cestode" (positive either for Hymenolepis nana or Taenia spp. eggs) and "any protozoan" (positive either for Giardia lamblia or Entamoeba histolytica/Entamoeba dispar) with history of deworming were examined using logistic regression. Overall, 25.9% of children were infected with at least one intestinal parasite of which H. nana was the most common. In multivariate analyses, deworming in the past 6 months was positively associated with increased odds of both "any protozoan" and "any cestode" infections; the latter reached statistical significance (AOR = 1.83, 95% CI: 0.69-4.86, P = 0.220, AOR = 3.82, 95% CI: 1.17-12.73, P = 0.029, respectively). If this observed association is causal, a greater understanding of interspecies interactions within the gastrointestinal niche may elucidate possible consequences of mass deworming treatments against STHs on coexisting nontargeted parasites.

Prevalence of intestinal parasites and associated risk factors among inmates of Mekelle prison, Tigrai Region, Northern Ethiopia, 2017

BACKGROUND

In Ethiopia, like other developing countries, intestinal parasitic infections are the major public health problems affecting millions annually. Overcrowding and poor living conditions are the major risk factors. Prison inmates are among the most vulnerable groups to intestinal parasitic infections. However, there is scarcity of epidemiological data regarding intestinal parasites among prison inmates in Ethiopia, notably in Tigrai. Thus, we aimed to determine the prevalence of intestinal parasites and identify the associated factors among inmates of Mekelle prison, Tigrai, Northern Ethiopia.

METHODS

A cross sectional study involving 291 inmates was conducted from February to June 2017 among inmates of Mekelle prison. After systematically selecting subjects, stool specimens were examined using direct wet mount and formol-ether concentration techniques. We used SPSS version 21 for data analysis. We considered p-value less than 0.05 significant at 95% confidence level.

RESULTS

Of the 291 inmates enrolled in the study, 124 (42.6%) harbored one or more intestinal parasites. The protozoan Entamoeba histolytica/dispar/moshkovskii was the predominant parasite accounted for 68 (23.3%) of the infections followed by Giardia lamblia (10.3%) and Entamoeba coli (8.2%). Fourteen (4.8%) participants were co-infected with different parasite species. The co-infections of Entamoeba histolytica/dispar/moshkovskii and Giardia lamblia were detected among 3.1% of the participants. In bivariate analysis, hand fingernail status (COR 1.86, 95% CI, 1.08-3.20) and duration of stay in prison (COR 2.23, 95% CI 1.31-3.79) were statistically associated with intestinal parasite infections. In multivariable regression, inmates who stayed in the prison for one year or less were more likely to harbor intestinal parasitic infections (p = 0.013) than those who stayed longer. No other single predictor variable was found to be significantly associated with intestinal parasitic infections.

CONCLUSIONS

The result of this study showed that intestinal parasites are significant health problems among inmates of Mekelle prison.

Enteropathogens in Under-Five Children with Diarrhea in Health Facilities of Debre Berhan Town, North Shoa, Ethiopia

Background

Diarrheal disease is a major cause of mortality and morbidity for under-five children in Ethiopia. The purpose of this study was to investigate the behavioral and socioeconomic risk factors, etiology, and drug susceptibility of bacteria isolated from under-five children with acute diarrhea who were treated at Debre Berhan Referral Hospital or Health Center in Ethiopia.

Methods

A health facility based cross-sectional study design was used to investigate enteropathogens from 163 under-five children with acute diarrhea. After obtaining written consent from parents or guardians, data were collected using a standardized questionnaire. Freshly passed stool samples were collected for microbiological tests for bacteria and parasites. The chi-square test was used for assessing the relationships of variables.

Results

Enteropathogens were detected among 55.8% (91/163) participants. There was a 46%(75/163) bacterial culture positivity rate and a 9.8%(16/163) prevalence of parasites. The isolated enteropathogens were Escherchia coli, Klebsiella specie, Proteus species, Salmonella species, Shigella species, Enterobacter species, Giardia lamblia, Enteameba histolytica, Ascaris lumbricoides, Trichuris trichiura and Hymnoleps nana. Level of antimicrobial resistance of bacterial isolates ranged from 0 to 87.2%. Poor hand washing and poor cleaning of feeding utensils showed significant association with the presence of enteropathogens.

Conclusion

Bacterial enteropathogens with drug resistance were observed in this study. Continuous health education and promotion about diarrheal disease for mothers/caretakers and regular surveillance of entropathogenes are recommended to reduce under-five mortality.

Prevalence and Reinfection Rates of Schistosoma mansoni and Praziquantel Efficacy against the Parasite among Primary School Children in Sanja Town, Northwest Ethiopia

BACKGROUND

Schistosomiasis is among the most widespread chronic infections in the world. The magnitude of the infection may show variations across different areas with respect to time. Praziquantel is a first line drug of choice for the treatment of schistosomiasis although its low cure rate has been reported in different parts of the world. Thus, an assessment of the magnitude of the diseases, the efficacy of currently available drugs, and reinfection rates is crucial.

OBJECTIVE

Our principal objective is to determine the prevalence and reinfection rates of Schistosoma mansoni and to evaluate the efficacy of PZQ against Schistosoma mansoni.

METHOD

A school-based cross-sectional study was conducted on Sanja Elementary Schools, Sanja town, northwest Ethiopia. Stool specimens were examined using Kato-Katz method. Schoolchildren who tested positive for intestinal schistosomiasis and fulfilled the inclusion criteria took part in the efficacy and reinfection study. Positive participants were treated with 40 mg/kg of Praziquantel. Cure and egg reduction rates were evaluated three weeks after treatment. The intensity of infection was determined following the WHO's guideline. Moreover, the reinfection rate of those who were cured was evaluated after a six-month posttreatment period. Data were analyzed using SPSS version 20.

RESULTS

At baseline, 130 (35%) of the 372 schoolchildren were found infected with Schistosoma mansoni. Out of the 130 infected schoolchildren, 112 (86.2%) had moderate infection intensity. Among the S. mansoni positive schoolchildren, 80 were included as study participants for the evaluation of PZQ efficacy, based on the inclusion criteria established by WHO. The cure and egg reduction rates were found to be 90% (72/80) and 99.5%, respectively. Of the seventy-two schoolchildren considered for the determination of reinfection rate, after 6 months of posttreatment, 13.9% were found to be reinfected.

CONCLUSION

The schoolchildren in the three primary schools of Sanja are at moderate risk of the infection caused by S. mansoni. Although the therapeutic potency of PZQ at 40 mg/kg was efficient against S. mansoni, a high rate of reinfection was reported in the study site, suggesting the need for integrated schistosomiasis control measures.

Prevalence and factors associated with intestinal parasites among under-five children attending Woreta Health Center, Northwest Ethiopia

Background

Environmental, social, geographical, and other factors could affect the distribution of intestinal parasites. Parasitic infections would impose on health and social problems like mal-absorption, diarrhea, impaired work capacity, and reduced growth rate. However, there is a scarcity of information regarding the prevalence of intestinal parasites and associated factors in the study area.

Methods

Institution based cross-sectional study was conducted among 310 study participants from April–May, 2017. Study participants were selected using a systematic random sampling technique. EPI Info version 7 and SPSS version 20 were used to enter and analyze the data. Both bivariate and multivariate logistic regression analyses were computed. In multivariate analysis, variables with P-value < 0.05 were considered statistically significant.

Results

In this study, the mean age of participants was 29.25 Months. The overall prevalence of intestinal parasites was 18.7% (95% CI = 14.4–23.3). Children who rarely feed fresh meal (AOR = 7.74, 95% CI: 1.61, 7.84), Children whose nails were sometimes trimmed (AOR = 3.41, 95% CI: 2.20–10.28), children who had no clean playing ground (AOR = 2.43, 95% CI: 1.25–5.18), and children who had open defecation of the family (AOR = 3.40, 95% CI: 1.27–10.86) were significantly associated with intestinal parasitic infections. Among the intestinal parasites, 31(53.5%) were G.lamblia (Giardia lamblia) and 21(36.2%) were E. histolytica/E. dispar/E. moshkovskii.

Conclusion

In this study, the prevalence of intestinal parasites was found low compared with the WHO annual or biannual population prevalence and treatment. However, strengthening of health education about food, personal and environmental hygiene of both children and mothers/guardians is crucial to limit the transmission. Besides, improving mothers/guardian awareness about the mode of intestinal parasites transmission is necessary.

Effects of water, sanitation and hygiene (WASH) education on childhood intestinal parasitic infections in rural Dembiya, northwest Ethiopia: an uncontrolled before-and-after intervention study

BACKGROUND

Soil-transmitted helminthes (STH) infections are among the most common infections worldwide and affect the most deprived communities. Adequate water, sanitation, and hygiene (WASH) prevents environmental contamination, thereby preventing transmission of STH. Cognizant of this, WASH education was implemented in rural Dembiya to reduce intestinal parasitic infections. This study was, therefore, conducted to assess the impacts of the intervention on households' WASH conditions and prevalence of intestinal parasitic infections.

METHOD

An uncontrolled before-and-after intervention study was used. Cross-sectional studies were done before and after the intervention. Two hundred twenty-five and 302 under five children were recruited randomly at the baseline and endline, respectively. Data were collected using a structured questionnaire and observational checklists. Direct stool examination and Kato-Katz methods were used to identify parasites in the stool. We used percent point change and prevalence ratio (PR) to see the effects of the intervention on WASH conditions and prevalence of intestinal parasitic infections respectively. Pearson chi-squared and Fisher's exact tests were used to test for statistically significant percentage point changes of WASH conditions. The effect of the intervention on intestinal parasitic infections was statistically tested on the basis of PR with 95% confidence interval (CI).

RESULTS

The baseline prevalence of intestinal parasitic infections was 25.8%, and the endline prevalence was 23.8%. The prevalence of intestinal parasitic infections was not significantly decreased at the endline compared with the baseline [PR = 0.92, 95% CI = (0.62, 1.38)]. Ascaris Lumbricoides was the most prevalent parasitic infection both at the baseline and endline. The proportion of children who had good hygienic condition increased from 1.3% at the baseline to 34.4% at the end line (p <  0.05). The percentage of mothers/care givers who washed hands at different pick times was significantly increased from 24.4% at the baseline to 68.2% at the endline (p <  0.001). The proportion of households who practiced home-based water treatment was significantly increased from 7.6% at the baseline to 47% at the endline (p <  0.001). The proportion of households who used sanitary latrine was increased from 32% at the baseline to 49% at the endline (p <  0.05).

CONCLUSION

This before-and-after intervention study found that households' WASH performance was significantly improved at the endline compared with the baseline. The endline prevalence of intestinal parasitic infections was slightly lower than the baseline prevalence; however, the reduction was not statistically significant. The local health office needs to strengthen the WASH education program, mobilize the community to construct WASH facilities, and support the community to sustain households' WASH performance.

Prevalence of intestinal parasitic infection among children under 5 years of age at Dessie Referral Hospital: cross sectional study

Objective

Intestinal parasitic infection is a serious public health problem throughout the world particularly in developing countries. Like other countries in sub saran region epidemiological data regarding prevalence of intestinal parasites and their associated factors were limited in Ethiopia. So, the main objective of this study was to determine the prevalence of intestinal parasites and associated factors among under five children in Dessie Referral Hospital from August 1, 2017 to December 20, 2017.

Results

In this research a total of 232 under five children were involved. Out of these study subjects 36 (15.5%) were infected with at least one intestinal parasites. A total of five intestinal parasites were examined and the dominant parasite was E. histolytica 15/232 (6.5%) followed by H. nana 11/232 (4.7%). All age groups were affected by intestinal parasites but children who were at the age of below 2 years and at the age between 2 and 3 years were 4.7 times and 2.6 times at risk of acquiring infection with intestinal parasites in comparison at the age of 3–5 years children.

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3888-2) contains supplementary material, which is available to authorized users.

Prevalence, intensity and factors associated with soil-transmitted helminths infections among preschool-age children in Hoima district, rural western Uganda

Background

Over 80% of morbidity due to soil-transmitted helminthiasis (STH) occurs in low-income countries. Children under 5 account for 20–30% of the burden in endemic areas. This study assessed the prevalence, intensity and factors associated with STH infections among preschool-age children (PSAC) in Hoima district, Uganda. The PSAC are particularly vulnerable because the chronicity of this condition usually affects their physical and mental growth and development.

Methods

A cross-sectional study was carried out among 562 PSAC (1–5 years old) in 6 counties of Hoima district using Expanded Program on Immunization (EPI) method. Stool samples from children were examined using the formol ether concentration technique for STH egg detection. Egg counts were represented as egg per gram (EPG). A structured questionnaire was used to collect information on factors associated with STH infection. Generalized linear models were used to analyze relationships between STH infection and associated factors.

Results

Overall STH prevalence was 26.5%. Hookworm infection was the most prevalent (18.5%), followed by A.lumbricoides (9.8%) and T.trichiura (0.5%). Prevalence of STH infection was significantly higher in children aged 5 years (Pearson chi-square test, p = 0.009) than in children aged 1 year. The general geometric mean (GM) counts for Hookworm infection was (696.1 EPG; range (530.3–913.8)) with girls having a higher GM (789.8 EPG; range (120–13,200)) than boys. Eating uncooked or unwashed vegetables (adj. Prevalence Ratio (PR) = 1.9, 95% CI: 1.3–2.7) and fruits (adj.PR = 1.8, 95% CI: 1.1–2.8), indiscriminate disposal of young children’s faeces (adj.PR = 1.5, 95% CI: 1.1–2.0); not washing hands after defecation (adj.PR = 2.6, 95% CI: 1.9–3.6); and not deworming children regularly (adj.PR = 1.4, 95% CI: 1.1–1.8) were significantly associated with STH infection.

Conclusion

The prevalence of Soil transmitted helminths infection among preschool-age children in Hoima district significantly increased with age. Poor hygiene, inadequate sanitation and irregular deworming were associated with STH infections among PSAC in the study area. Intense health education on the importance of hygienic practices, improved sanitation and regular deworming of PSAC should be integrated into prevention and control programs.

Electronic supplementary material

The online version of this article (10.1186/s12879-018-3289-0) contains supplementary material, which is available to authorized users.

INTESTINAL PARASITES, NUTRITIONAL STATUS AND COGNITIVE FUNCTION AMONG PRIMARY SCHOOL PUPILS IN ILE-IFE, OSUN STATE, NIGERIA

Background:

Intestinal parasites are a cause of morbidity and mortality throughout the world particularly in developing countries and they are common health problems of children. This study determined the prevalence of intestinal parasites among primary school children, assessed risk factors predisposing to infection and the nutritional status with cognitive function of the pupils.

Materials and Methods:

It was a cross sectional study and 384 pupils from six public primary schools in Ile-Ife were enrolled. Anthropometric measurements were obtained using standard procedures. The intelligence quotients of the pupils were assessed using the Draw-a-person- test. Stool samples were collected and examined. Data was processed using SPSS Inc USA version 17. Statistical analysis was done using frequency, percentages, tables and Pearson’s chi-square was used to determine the association between intestinal parasites, nutritional status and cognitive function.

Results:

The prevalence of intestinal parasites in the study population was 24% with double infection occurring in 3.2%. Ascaris lumbricoides most prevalent 22.1%, Hookworm 3.4%, Hymenolepis nana 0.3%. Intestinal parasites were present in those that use bush and refuse dump for defeacation. The nutritional status of the pupils showed 95.8% normal weight, 3.6% underweight and 0.5% overweight. In terms of cognition, 65.4% mentally deficient, 14.3% mentally dull and 20.3% average.

Conclusion:

Intestinal parasites were prevalent among primary school children and use of bush or refuse dump for defeacation was a risk factor. There was no association between intestinal parasites, nutritional status and cognition.

Childhood intestinal parasitic infection and sanitation predictors in rural Dembiya, northwest Ethiopia

Background

Intestinal parasites are a common problem in the world. The greater proportion of infections is associated with poor water, sanitation, and hygiene (WASH). This study was conducted to assess intestinal parasites, WASH condition, and their association in rural Dembiya, northwest Ethiopia.

Methods

A cross-sectional study was employed. Two hundred twenty-five children aged 6–59 months were included. Mothers were interviewed using a structured questionnaire, and the living environment was observed using checklists. Kato-Katz technique was used to determine the intensity of parasitic infections. Escherichia coli (E. coli) was used as a biological indicator for drinking water quality. Multivariable binary logistic regression analysis was conducted to identify WASH predictors of parasites on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05.

Results

The prevalence of intestinal parasites was 25.8% (95% CI = 20.3–32.0%). Ascaris lumbricoides (78%), hookworm (12%), Hymenolepis nana (7%), Enterobius vermicularis (5%), Schistosoma mansoni (3%), Giardia lamblia (3%), and Trichuris trichiuria (2%) were identified infections. Intestinal parasites were associated with poor child hand washing practice [AOR = 3.86, 95% CI = 1.53, 9.75], unprotected water sources [AOR = 7.79, 95% CI = 3.30, 18.40], access to water below 20 l/c/d [AOR = 3.05, 95% CI = 1.28, 7.23], poor food safety[AOR = 4.33, 95% CI = 1.62, 11.58], and poor sanitation [AOR = 5.01, 95% CI = 1.56, 16.16].

Conclusion

A. lumbricoides, hookworm, H. nana, E. vermicularis, S. mansoni, G. lamblia, and T. trichiuria were identified. Child hand washing practice, service level of water supply, water sources, food safety, and sanitation were associated with intestinal parasites. WASH promotion is needed to prevent infections.

Schistosoma, other helminth infections, and associated risk factors in preschool-aged children in urban Tanzania

Background

Despite the high prevalence of helminth infections among preschool-aged children, control programs in sub-Saharan countries primarily focus on school-aged populations. We assessed the prevalence of helminth infections and determined risk factors for infection among preschool-aged children in the urban setting of Dar es Salaam, Tanzania.

Methodology

Starting in October 2015, we conducted a 12-month prospective study among tuberculosis (TB)-exposed children under the age of 5 years and unexposed controls from neighboring households. At the time of recruitment, we collected medical histories, assessed development and cognitive functions, and performed medical examinations. We performed full blood cell counts and screened for HIV and malaria. Point-of-care circulating cathodic antigen (POC-CCA), urine filtration, Kato-Katz, FLOTAC, and Baermann tests were employed to detect helminth infections in urine and stool. Helminth infections were stratified for Schistosoma and other helminths to identify risk factors, using logistic regression.

Principal findings

We included 310 children with a median age of 26 months (inter quartile range 17–42 months) in the study. Among these, 189 were TB-exposed and 121 TB-unexposed. Two thirds of the children were anemic (hemoglobin level <11 g/dl) and the HIV prevalence was 1.3%. Schistosoma spp. was the predominant helminth species (15.8%; 95% confidence interval [CI] 12.1–20.3%). Other helminth infections were less frequent (9.0%, 95% CI 6.3–12.8%). Poor hygiene, use of household water sources, and TB-exposure were not associated with helminth infection. Development and cognitive scores did not significantly differ in helminth-infected and uninfected peers, but hemoglobin levels were significantly lower in helminth-infected children (10.1 g/dl vs. 10.4 g/dl, p = 0.027).

Conclusions/significance

In Dar es Salaam, a city with more than 4 million inhabitants, the prevalence of Schistosoma spp. infection among preschool-aged children was unexpectedly high. Setting-specific interventions that target preschool-aged children and urban settlements should be considered to reduce the transmission of Schistosoma and other helminth infections and to improve children’s health.

In many African countries, children under the age of 5 years are at considerable risk of acquiring parasitic worm infections. Yet, most of the neglected tropical disease control programs in Africa do not include preschool-aged children in deworming campaigns. Chronic parasitic worm infections may impair children’s growth and their cognitive development. We conducted a 12-month prospective study of children younger than 5 years in the Temeke district, Dar es Salaam—the economic capital of Tanzania—to assess the prevalence of parasitic worm infections. Among 310 included children, we found that one in six children was infected with the blood fluke Schistosoma, while one in 11 children were infected with soil-transmitted helminths. Anemia was found among 65% of children, particularly among those infected with parasitic worms. The high prevalence of Schistosoma infection in this urban setting, despite improved water supply and sanitation as well as limited open freshwater contact shows the pressing need to identify parasitic worm transmission hotspots in urban areas. Setting-specific interventions targeting preschool-aged children and urban settlements, among others, should be considered to reduce the transmission of Schistosoma and other parasitic worm infections.

Schistosoma mansoni and soil-transmitted helminths among preschool-aged children in Chuahit, Dembia district, Northwest Ethiopia: prevalence, intensity of infection and associated risk factors

BACKGROUND

Intestinal schistosomiasis and soil-transmitted helminthiasis are the major public health problems globally. Compared with any other age group, pre-school aged children and school-aged children are the most exposed. There are few studies showing the burden of intestinal schistosomiasis, and soil-transmitted helminthiasis among pre-school aged children in Ethiopia. Hence, this study aimed to assess the prevalence of schistosoma mansoni and soil-transmitted helminths and associated risk factors among preschool aged children of Chuahit and surrounding Kebeles, Northwest Ethiopia.

METHODS

A community based cross sectional study was conducted from February 2 to March 27 2015. Four hundred one preschool-aged children were included in the study by using two stage cluster sampling technique. Pretested structured questionnaire was employed to collected data via face-to-face interview technique. A single stool specimen was collected, and a portion of the sample was processed by Kato Katz method.

RESULTS

Of the total children, 141 (35.2 %) harbored one or more intestinal helminthes. Schistosoma mansoni was found in 45 (11.2 %) of preschool age children. Ascaris lumbricoides was the predominant isolate, 77 (19.2 %) followed by S. mansoni, 45 (11.2 %). The least parasites isolated were Tania species, 2 (0.5 %). After adjusting for other variables, being mothers who did not have the habit of washing hands after toilet (AOR = 7.3, 95%CI: 2.97-17.95), being occupationally housewife mothers (AOR = 8.9, 95%CI: 2.27-25.4), using protected spring water as a main family source of water (AOR = 3.9, 95%CI: 1.2-12.3) and child habit of not wearing shoe (AOR = 1.91, 95%CI: 1.01-3.64) were significantly associated with high prevalence of soil-transmitted helminthiasis among preschool-age children in Chuahit.

CONCLUSION

The current study showed that relatively higher level of STH and S. mansoni among preschool-aged children in Chuahit. This finding calls for a need of public health education, promotion of women education and provision of safe water to reduce the burden of soil-transmitted intestinal helminthiasis and schistosomiaisis.

Screening for parasite infections in immigrant children from low-income countries

INTRODUCTION

In Spain, minors represent approximately 20% of the immigration flow. Many of these immigrants come from countries in the tropics and sub-tropics where intestinal parasitic infections caused by helminths and protozoa are one of the major causes of human disease. The main objective of the present work was to describe parasite infections in a group of immigrant children.

METHODS

A prospective evaluation was performed in 373 minors from Sub-Saharan Africa, North Africa, and Latin America. Details were collected from the medical records and physical examination. Urine, stool and peripheral blood samples were obtained for serological and routine laboratory tests. Direct and indirect parasitological tests were also performed.

RESULTS

At least 1 parasitic disease was diagnosed in 176 (47.1%) immigrant children, while 77 (20.6%) minors were infected with two or more parasites. The number of parasites was highest in children from Sub-Saharan Africa compared with the rest of the areas of origin (p<.001), and in children from urban areas compared with those from rural areas (OR 1.27 [1.059-1.552], p=.011). The most frequent causes of multiple parasite infection were filariasis plus strongyloidiasis and filariasis plus schistosomiasis. Intestinal parasite infection was diagnosed in 38 cases (13.8%). Logistic regression analysis revealed that for each month of stay, the probability of a positive finding in the stool sample decreased by 0.02% [β=-0.020, (p=.07)].

CONCLUSIONS

The high infection rates of parasite diseases in immigrant children point to the need for screening protocols for certain infectious diseases in these children according to their country of origin and their length of residence in Spain.