Moderate to mild malnutrition in African children of 10-12 years: roles of dietary and non-dietary factors

Current status of intestinal parasitic infections and associated factors among primary school children in Birbir town, Southern Ethiopia

Background

Intestinal parasites still pose major public health problems in developing countries like Ethiopia. Local epidemiological data is indispensable in order to design and monitor prevention and control strategies. Therefore the present study aimed to assess the prevalence of intestinal parasitic infections and associated factors among students at Birbir town, Southern Ethiopia.

Methods

A school-based cross-sectional study was conducted from March to May 2018. Three hundred fifty-one students, who were selected by stratified followed by systematic random sampling, participated in the study. Socio-demographic information was collected using a structured questionnaire. Anthropometric measurements of height and weight were taken at the time of interview. Stool samples were collected and processed by direct wet mount and formol-ether concentration techniques for microscopic detection of intestinal parasites. Data was analyzed using SPSS version 20.

Results

Among 351 (180 male and 171 female) children participated, 135 (38.5%) and 216 (61.5%) were within the age groups of 5–9 and 10–14 respectively. Ninety five (27.1%; 95%CI: 22.2–31.9) of them were tested positive for intestinal parasites. Helminths and protozoa account 21.1 and 7.1% prevalences respectively. Seventy eight children were infected with a single parasite species while 17 were positive for double or triple infections. A. lumbricoides (31, 8.8%) was the most frequently detected parasite followed by T. trichiura (20, 5.7%) and hookworms (19, 5.4%). Age group of 10–14 years (AOR = 2.51; 95%CI: 1.41–4.45, p = 0.002) and absence of hand washing habit after toilet (AOR = 4.49; 95%CI: 2.00–10.1, p = 0.001) were significantly associated with intestinal parasitic infection.

Conclusions

The prevalence of intestinal parasitic infection among school age children is still unacceptably high. Age group of 10–14 year old and not having habit of hand washing after toilet were significantly associated with intestinal parasitic infection. The ongoing school based deworming should be strengthened and be integrated with school health programs.

Electronic supplementary material

The online version of this article (10.1186/s12879-019-3879-5) contains supplementary material, which is available to authorized users.

A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights

Food insecurity is an intractable problem in South Africa. The country has a tradition of evidence-based decision making, grounded in the findings of national surveys. However, the rich insights from sub-national surveys remain a largely untapped resource for understandings of the contextual experience of food insecurity. A web-based search identified 169 sub-national food insecurity studies conducted in the post-apartheid period between 1994 and 2014. The systematic review found that the studies used 27 different measures of food insecurity, confounding the comparative analysis of food insecurity at this level. While social grants have brought a measure of poverty relief at household level, unaffordable diets were the root cause of food insecurity. The increasing consumption of cheaper, more available and preferred 'globalised' foods with high energy content and low nutritional value lead to overweight and obesity alongside child stunting. Unless a comparable set of indicators is used in such surveys, they are not able to provide comparable information on the scope and scale of the problem. Policy makers should be engaging with researchers to learn from these studies, while researchers need to share this wealth of sub-national study findings with government to strengthen food security planning, monitoring, and evaluation at all levels.

Nutritional status, intestinal parasite infection and allergy among school children in northwest Ethiopia

BACKGROUND

Parasitic infections have been shown to have deleterious effects on host nutritional status. In addition, although helmintic infection can modulate the host inflammatory response directed against the parasite, a causal association between helminths and allergy remains uncertain. The present study was therefore designed to evaluate the relationship between nutritional status, parasite infection and prevalence of allergy among school children.

METHODS

A cross sectional study was performed involving school children in two elementary schools in Gondar, Ethiopia. Nutritional status of these children was determined using anthropometric parameters (weight-for-age, height-for-age and BMI-for-age). Epi-Info software was used to calculate z-scores. Stool samples were examined using standard parasitological procedures. The serum IgE levels were quantified by total IgE ELISA kit following the manufacturer's instruction.

RESULT

A total of 405 children (with mean age of 12.09.1 ± 2.54 years) completed a self-administered allergy questionnaire and provided stool samples for analysis. Overall prevalence of underweight, stunting and thinness/wasting was 15.1%, 25.2%, 8.9%, respectively. Of the total, 22.7% were found to be positive for intestinal parasites. The most prevalent intestinal parasite detected was Ascaris lumbricoides (31/405, 7.6%). There was no statistically significant association between prevalence of malnutrition and the prevalence of parasitic infections. Median total serum IgE level was 344 IU/ml (IQR 117-2076, n=80) and 610 IU/ml (143-1833, n=20), respectively, in children without and with intestinal parasite infection (Z=-0.198, P>0.8). The prevalence of self reported allergy among the subset was 8%. IgE concentration was not associated either with the presence of parasitic infection or history of allergy.

CONCLUSION

The prevalence of malnutrition, intestinal parasitism and allergy was not negligible in this population. In addition, there was no significant association between the prevalence of allergy and their nutritional status, and parasite infection. Further research prospective observational and intervention studies are required to address the question of causality between nutritional factors, parasites, and allergy.

Intestinal parasitic infections and malnutrition amongst first-cycle primary schoolchildren in Adama, Ethiopia

Background: A survey of intestinal parasitic infections and malnutrition in different regions or localities is a very important step in developing appropriate prevention and control strategies.Objectives: The objective of this study was to investigate the magnitude of intestinal parasitic infections and malnutrition amongst first-cycle primary schoolchildren in Adama town,Ethiopia.Method: A total of 358 children from four primary schools in Adama town were included for stool examination, weight for age, height for age, weight for height and socio-economic status of the family.Results: The result of stool examinations showed that 127 (35.5%) of the study subjects were infected by one or more parasite. The most frequent parasites were Entamoeba histolytica/dispar (12.6%) and Hymenolopis nana (8.9%). The rate of intestinal parasitic infection was not significantly associated with sex, age or socio-economic factors and nutrition (P > 0.05). The overall prevalence of malnutrition was 21.2%. Those children whose families had a monthly income of less than 200 ETB (Ethiopian birr) were highly affected by malnutrition (P < 0.05),but family education was not identified as a factor for malnutrition amongst schoolchildren.Conclusion: The prevalence of E. histolytica/dispar and H. nana could be of public health importance and calls for appropriate control strategies, and the high prevalence of malnutrition amongst children from poor families requires intervention.

Rises in schoolchildren's anthropometry: what do they signify in developed and developing populations?

Recent reports indicate continuing rises in the height and weight of schoolchildren in both developed and developing populations. Also indicated are increases in the body mass index of children, and of adults, despite all public health warnings to the contrary, as well as personal desires of huge proportions of children, and of adults, to be slim. A little researched question concerns which level of schoolchildren's growth is consistent in later life with least occurrence of degenerative diseases. In developing populations, lack of knowledge prevails regarding the current and future health of the large proportions, and huge numbers, of schoolchildren who, judging from Western anthropometric standards, are categorized as suffering from mild to moderate malnutrition. It is questioned whether greater growth is essentially better. As to the future, in Western and in urban developing populations, attempts to control greater attainment of weight for height in schoolchildren, as well as adults, are unlikely to be rewarding, due to unpopularity of a 'prudent' diet on the one hand, and the still diminishing physical activity on the other. Notwithstanding, educational and other efforts to improve the composition of diets and encourage greater physical activity must be energetically pursued.