Intestinal Parasitic Infections and Associated Risk Factors Among School-going Children of Age 1-5 years in Dharan, Eastern Nepal

Intestinal parasitic infections have been a major public health burden of developing countries, especially in children. Higher prevalence has been reported among school children, mostly in rural areas of Nepal where water, toilets, hygiene, and sanitation facilities are insufficient. This cross-sectional study was carried out from April to September 2019 to determine the prevalence of intestinal parasitic infections among school-going children1-5 years of Dharan, Nepal, and to assess the associated risk factors. Stool samples were collected in a clean, dry, screw-capped, and wide-mouthed plastic container, kept in an icebox, and transported to the laboratory. Data relating to different risk factors were collected from the parents of 116 participants using a structured questionnaire. The parasites were identified by using the direct wet mount method and formal-ether concentration method. Pearson’s chi-square test was carried out to establish associations between dependent and independent variables using SPSS version 20, and the test considered a greater than < 0.05% as statistically significant with a 95% confidence level. Out of the 116 stool samples, 9 (7.75%) tested positive for the parasitic infections in which 5 (55.5%) were protozoa and 4 (44.45%) were helminths. The prevalent parasites, were Entamoeba histolytica (23%), Hyamenolepis nana (22%), Giardia lamblia (11%), Hookworm (11%), Entamoeba coli (11%), Ascaris lumbricoides (11%), and Intestinal parasitic infections had a significant association with drinking water, bowel syndrome, bathing habit, toilet facility, and washing hands after toilets (p<0.05). Lack of toilets, poor hygiene, and unsafe drinking water were the main risk factors. Improved hygienic practices, safe drinking water, and the use of latrines could lower the rate of parasitic infections.

Burden of Intestinal Parasitic Infections among Children from Five Schools in Bhairahawa, Nepal: A Comparative Cross-Sectional Study

INTRODUCTION: Intestinal parasites cause significant morbidity and mortality, particularly in the tropics including Nepal. The main objective of this study was to explore the burden of intestinal parasitic infections among children in 5 different primary schools in Bhairahawa, Nepal. MATERIAL AND METHODS: This was a cross-sectional comparative study among 408 children from 5 schools in Bhirahawa, Nepal. Stool specimens collected in a plastic container were transported to microbiology laboratory in Universal College of Medical Sciences Teaching Hospital (UCMSTH) immediately. Each sample was examined macroscopically and microscopically for the evidence of parasitic infection. All samples were re-analysed by sedimentation and floatation concentration techniques one after another. RESULTS: The overall prevalence of the parasitic infection was 46.5%. The prevalence varied by the methods that included routine microscopy (23.2%), sedimentation (41.6%) and flotation (8.3%). Ascaris lumbricoides was the most common (29.1%) parasite followed by Entamoeba histolytica (6.1%). Mixed infection was also seen in 7.8% of the samples. Factors such as children’s academic year, age, religion, existing illness, household water sources, meat consumed, domestic animals at house, and recent history of taking anti-helminthics were significantly associated with the intestinal parasitic infections. Prevalence of intestinal parasitic infection was higher in public school (61.1%) compared to private school (37%). Male students had slightly more infections (47.3%) than females (45.7%). CONCLUSIONS: Enteric parasitic infection was very high among the primary schools’ students in Bhairahawa, Nepal. Integrating concentration techniques in routine test can help to detect most of the enteric parasites in stool specimens.

Prevalence of Intestinal Parasitic Infections and Associated Risk Factors among Pregnant Women Attending Prenatal Care in the Northwestern Ethiopia

Intestinal parasitic infections (IPIs) are the common health problems in developing countries with low socioeconomic and poor living conditions. IPIs affect millions of pregnant women worldwide and may lead to adverse maternal and fetal effects. The present study was aimed at determining the prevalence and associated risk factors of IPIs among pregnant women in Ethiopia. A hospital-based cross-sectional study involving 384 pregnant women was conducted from November 2018 to March 2019. Relevant information on potential risk factors associated with IPIs was gathered using a semistructured questionnaire. Stool samples were collected and examined using wet mount and formol-ether concentration techniques. Logistic regression was used to evaluate the possible association between dependent and independent variables. The overall prevalence of IPIs was 36.7%. Seven species of parasites were identified. The most prevalent intestinal protozoan parasite identified was Entamoeba histolytica/dispar (9.6%) followed by Giardia intestinalis (8.9%). The predominant helminth parasite identified was Ascaris lumbricoides (8.6%), followed by hookworm (5.2%), Taenia spp. (3.6%), Strongyloides stercoralis (1.3%), and Schistosoma mansoni (1.04%). Six pregnant women (1.56%) had infection by two parasite species. The odds of IPIs were higher among illiterates ( AOR = 4.63 ), lowest monthly income earners ( AOR = 3.49 ), primigravida (pregnant for the first time) ( AOR = 2.04 ), those who used unboiled well/stream/river water for drinking ( AOR = 14.55 ), ate soil ( AOR = 2.32 ), and consumed raw vegetables ( AOR = 1.91 ). The prevalence of IPIs in the study subjects was substantially high. Thus, screening of the women for IPIs and providing health education during their antenatal care (ANC) visit are recommended to prevent possible adverse maternal and fetal effects resulting from these infections.

Relationship between high rates of intestinal parasitic infections and knowledge, attitudes, and practices of Ndelele Health District populations (East Region, Cameroon): a cross-sectional mixed approach

BackgroundIntestinal parasitic infections remain of public health concern worldwide, especially among rural and poorest populations as a consequence of precariousness, lack of sanitation, non-availability of potable water and poor hygiene conditions. The present study aimed to better understand the epidemiology of intestinal parasitic infections in rural areas of forested Cameroon.MethodologyA cross-sectional survey was conducted in three Health Areas (Ndelele, Kentzou and Lolo) of the Ndelele Health District (East Region, Cameroon). Information on socio-demographic characteristics, knowledge, attitudes, and practices regarding intestinal parasitic infections were collected using a semi-structured questionnaire. Stool samples were collected and analyzed by the Kato-Katz and formalin-ether concentration techniques to complement simple direct examination.Principal FindingsA total of 406 individuals belonging to three main groups (Kako or Bantu, Baka or Pygmies and Central African Republic refugees) were enrolled in the study. The overall intestinal parasitic infection rate was 74.9%, including 57.2% cases of polyparasitism. Fourteen parasite species were identified, 89.1% being intestinal protozoa and 41.8% belonging to helminths. Infections with helminths were associated with Baka (P < 0.0001). Spring water consumption was associated with hookworm infection (OR = 3.87; P = 0.008). Garbage deposited near houses was positively associated with infection with Giardia lamblia (OR = 3.41; P = 0.003). Polyparasitism was positively linked to washing hand without soap before meal (OR= 11.64; p= 0.002).Conclusion/SignificanceIntestinal parasitic infections exhibited high rates in the Ndelele Health District, especially among indigenous and hard-to-reach populations (Pygmies). Hygiene measures appear as the main drivers sustaining transmission, and targeted strategies should be developed to efficiently fight against these debilitating diseases.Author summaryIntestinal parasitic infections such as soil transmitted helminthiasis and schistosomiasis, remain a public health concern in Cameroon. To better understand the epidemiology of these infections in hard-to-reach populations in rural areas, a cross-sectional study was carried out in three health areas of Ndelele health District in the Eastern-Cameroon. The rate of intestinal parasitic infections was high (74.9%) especially in indigenous populations (Baka-Pygmies) which exhibited high prevalence of soil transmitted helminth infections (83.3%). The study confirmed that the lack of sanitation and poor hygiene largely contribute to the endemicity of intestinal parasitic infections, particularly among indigenous populations. Targeted control strategies seem mandatory to reach these populations and offer them appropriate care to interrupt or reduce the transmission of these diseases.

Automated Diagnostics: Advances in the Diagnosis of Intestinal Parasitic Infections in Humans and Animals

The increasingly close proximity between people and animals is of great concern for public health, given the risk of exposure to infectious diseases transmitted through animals, which are carriers of more than 60 zoonotic agents. These diseases, which are included in the list of Neglected Tropical Diseases, cause losses in countries with tropical and subtropical climates, and in regions with temperate climates. Indeed, they affect more than a billion people around the world, a large proportion of which are infected by one or more parasitic helminths, causing annual losses of billions of dollars. Several studies are being conducted in search for differentiated, more sensitive diagnostics with fewer errors. These studies, which involve the automated examination of intestinal parasites, still face challenges that must be overcome in order to ensure the proper identification of parasites. This includes a protocol that allows for elimination of most of the debris in samples, satisfactory staining of parasite structures, and a robust image database. Our objective here is therefore to offer a critical description of the techniques currently in use for the automated diagnosis of intestinal parasites in fecal samples, as well as advances in these techniques.

Prevalence and Associated Risk Factors of Intestinal Parasitic Infections among Pregnant Women Attending Antenatal Care in Yifag Health Center, Northwest Ethiopia

Background. A cross-sectional study was conducted from November 2019 to March 2020 to determine the prevalence and associated risk factors of intestinal parasitic infections (IPIs) among pregnant women attending antenatal care (ANC) at Yifag Health Center. Methods. The data were collected by a questionnaire interview technique and collecting the stool samples from each pregnant woman. Wet-mount and formol-ether concentration techniques were applied to identify the IPIs. Data were analyzed using SPSS, version 25, and P -values < 0.05 were considered statistically significant. Results. Out of the total 280 pregnant women who were selected using a simple random sampling technique, 277 participated in the questionnaire survey and gave stool samples (a response rate of 98.9%). The prevalence of IPIs among pregnant women was 53.4% (95% CI: 47.37, 59.42). Taenia species (18.1%) was the predominant parasite followed by Giardia lamblia (12.6%), Entamoeba histolytica/dispar (9.4%), hookworms (9%), Ascaris lumbricoides (4%), Schistosoma mansoni (3.2%), Hymenolepis nana (0.7%), Strongyloides stercoralis (0.4%), and Enterobius vermicularis (0.4%). Eating raw vegetables (AOR = 2.721; 95% CI: 1.266, 5.849; P = 0.010 ) and poor personal hygiene (AOR = 4.015; 95% CI: 1.456, 11.07; P = 0.007 ) were associated risk factors for G. lamblia, while eating raw meat (AOR = 2.477; 95% CI: 1.252, 4.902; P = 0.009 ) for Taenia species infections. The prevalence of intestinal parasites was high and still a health burden to the pregnant women in the study area. We recommend avoiding eating raw meat, strengthening sanitation and hygiene programs, and routine deworming of pregnant mothers to reduce the burden of IPIs among pregnant women.

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

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

Prevalence of Intestinal Parasitic Infections among Children in Europe over the Last Five Years

While the prevalence of intestinal parasitic infections (IPI) has been most commonly studied in African and Asian populations, less is known about the prevalence rates of IPI in European children, as well as the potential risk factors that favor the spread of parasites. We aimed to review published evidence on the prevalence rates of IPI in children residing in Europe, and to quantitatively synthesize the results of published studies. We searched Medline from 1 January 2015 to 1 April 2021 to address the most recently published prevalence patterns of IPI in European children. Random-effects meta-analyses were performed by type of IPI infection, age group and sex, depending on data availability. Of the 967 potentially relevant articles, eight eligible cross-sectional studies were included in this analysis, yielding a sample of 3376 children (0–19 years). The overall prevalence rate was 5.9% for any IPI in children residing in European countries. Blastocystis hominis was the most commonly detected parasite yielding a prevalence rate of 10.7%. Other parasites included Entamoeba coli, Endolimax nana, and Blastocystis hominis. Studies focusing on specific types of parasites showed prevalence rates ranging from 1.3% for Cryptosporidium to 68.3% for Dientamoeba fragilis. Despite the scarce literature, the present review showed relatively low prevalence rates of IPI in Europe. Future studies accounting for proper diagnostic methods used for the detection of parasites and including information on potential sociodemographic factors, such as travelling history and history of immigration, are needed to guide clinicians about which children to test, as well as when and how to test children for IPI.