Gastrointestinal parasites in Africa: A review

Data on human gastrointestinal parasites (GIP) infections in the african sub-regions and countries are mainly lacking in terms of prevalence and population stratification by afflicted age group, symptomatology, multi-parasitism, and diagnostic methods. This study aims to describe the GIP reported in african countries and discuss the extent of the burden in the african context. Only 68.42% (39/57) of african countries reported human cases of GIP with helminths (45%, CI: 40-50%, I²: 99.79%) as the predominant parasitic group infecting the african population. On a regional scale, Central Africa had the highest pooled prevalence for GIP (43%, CI: 32-54%, I²: 99.74%), while the Central African Republic led all countries with a pooled prevalence of 90% (CI: 89-92%, I²: 99.96%). The vulnerable population (patients who are minorities, children, old, poor, underfunded, or have particular medical conditions) was the most affected (50%, CI: 37-62%, I²: 99.33%), with the predominance of GIP in the 6 to <20 years age group (48%, CI: 43-54%, I²: 99.68%). Reports on multi-parasitism (44%, CI: 40-48%, I²: 99.73%) were almost double the reports of single infections (43%, CI: 27-59%, I²: 99.77%) with combined molecular and non-molecular techniques demonstrating the best performance for GIP identification. The current review spans more than 40 years of GIP reports from the african continent. Geographical characteristics, environmental factors, habits of its inhabitants, and their health status play a crucial role in GIP modulation and behaviour in its captive hosts. Strategies for regular and enhanced surveillance, policy formation, and high-level community awareness are necessary to identify the true incidence in Africa and the transmission of the pathogens via water and food.

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

BACKGROUND

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

METHOD

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

RESULT

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

CONCLUSION

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

Prevalence and associated factors of soil transmitted helminthes among pregnant women attending antenatal care in Maytsebri primary hospital, North Ethiopia

OBJECTIVES

Soil-transmitted helminthes are among the most common infections worldwide and affect the poorest and most deprived communities. A health facility based cross-sectional study was conducted among pregnant women attending at Maytsebri primary hospital. Data was entered and analysed using SPSS version 20 software. Multivariate analyses were used to identify determinant factors associated with soil transmitted helminthiasis. A total of 448 pregnant women were examined microscopically with a Katokatz technique for parasitological study to each women.

RESULTS

Out of the total 448 pregnant women examined in the primary hospital, 229 (51.5%) women were infected by at least one of the soil transmitted helminthiasis. Hookworm was the most prevalent 179 (78.16%) soil transmitted helminthes infection. Women who had a habit of eating soil were 2.6 times more likely to be infected by soil transmitted helminthes compared to who do not eat soil. Participants who wear shoe always were 95% less likely to be infected by soil transmitted helminthes. Efforts should be done to advance the awareness of women how to prevent soil transmitted helminthes.

Prevalence, infection intensity and associated factors of soil transmitted helminths among primary school children in Gurage zone, South Central Ethiopia: a cross-sectional study design

Objective

The aim of this study was to determine the prevalence of soil transmitted helminthes among primary school children. School based cross-sectional study design was employed. A total of six hundred study subjects were selected by a multistage sampling method. Fresh stool specimens were collected using clean, dry and wide mouthed labeled stool cups. It was processed by Kato-Katz technique. The data were analyzed using SPSS version 20 and p-value < 0.05 was considered statistically significant.

Result

The overall prevalence of soil transmitted helminthes was 57 (9.5%). Hookworm was the most prevalent helminthes species isolated (4.2%) followed by A. lumbricoide (3%). The prevalence of Taenia species, T. trichiura, H. nana and E. vermicularis were; 1.2%, 0.5%, 0.7% and 0.8% respectively. The prevalence of the Soil transmitted helminthes infection was low and all cases of Soil transmitted infections in this study were with low infection intensity. This might be due to the preventive chemotherapy given to the school children.

Electronic supplementary material

The online version of this article (10.1186/s13104-019-4254-8) contains supplementary material, which is available to authorized users.

Lessons from implementing mass drug administration for soil transmitted helminths among pre-school aged children during school based deworming program at the Kenyan coast

Background

The 2012 London declaration which committed to “sustaining, expanding and extending drug access programmes to ensure the necessary supply of drugs and other interventions to help control soil-transmitted helminths (STH) by 2020” has seen many countries in Africa roll out mass drug administration (MDA) especially among school age children. In Kenya, however, during the National school-based deworming exercise, pre-school aged children (PSAC) have to access treatment at primary schools as the pre-school teachers are not trained to carry out deworming. With studies being conducted on the effectiveness of MDAs, the experiences of key education stakeholders which could improve the programme by giving best practices, and challenges experienced have not been documented.

Methods

This was a cross-sectional qualitative study using Focus group discussions (FGDs) and Key informant interviews (KIIs). It was conducted in 4 sub-counties with high STH prevalence at the Kenyan coast (Matuga, Malindi, Lunga Lunga and Msambweni) to understand best practices for implementing MDA among PSAC.FGDs categorized by gender were conducted among local community members, whereas KIIs involved pre-school teachers, primary school teachers, community health extension workers (CHEWs) and opinion leaders. Participants were purposefully selected with the saturation model determining the number of interviews and focus groups. Voice data collected was transcribed verbatim then coded and analyzed using ATLAS.Ti version 6.

Results

Majority of the primary school teachers and CHEWs reported that they were satisfied with the method of mobilization used and the training tools. This was however not echoed by the pre-school teachers, parents and chiefs who complained of being left out of the process. Best practices mentioned included timely drug delivery, support from pre-school teachers, and management of side effects. Overcrowding during the drug administration day, complexity of the forms (for instance the ‘S form’) and long distance between schools were mentioned as challenges.

Conclusion

There is need to utilize better sensitization methods to include the local administration as well as the parents for better uptake of the drugs. Extending deworming training to pre-school teachers will enhance the national deworming programme.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4481-7) contains supplementary material, which is available to authorized users.