Health significance and risk factors for childhood intestinal parasitic infections in Guinea, Africa
Abstract
A cross-sectional study was conducted among children 1 to 18 years of age in Konindou, Guinea. The study investigated the risk factors for childhood intestinal parasitic infections and malnutrition, and the relationship between childhood intestinal parasitic infection and malnutrition. Households were stratified within districts and one child was randomly selected from each household. The study included a total of 293 children, 153 (52.2%) males and 140 (47.8%) females. All children underwent parasitological, anthropometric, laboratory, and clinical examinations and were interviewed regarding demographic factors, sanitation, personal hygiene, housing, socio-economic status and medical history. Five intestinal parasites were detected in children on fecal examination including hookworm (35.7%), Ascaris lumbricoides (18.5%), Trichuris trichiura (12.2%), Trichomonas intestinalis (7.7%), and Strongyloides stercoralis (10.1%). Moreover, Schistosoma mansoni (6.3%) was detected in children. Examination of thick blood films revealed that 52.9% of children were infected with malaria. Prevalence of intestinal parasitic infection did not differ by district and sex of children, but the prevalence of A. lumbricoides infection was significantly different between females and males 1 to 5 years of age ($\chi\sp2$ = 4.59; p = 0.03) and 11 to 18 years of age ($\chi\sp2$ = 5.57; p = 0.01). After controlling for age, males were found to be at higher risk for A. lumbricoides infection compared with females (odds ratio (OR) = 2.29; 95% confidence interval (CI) 1.12-4.71). The absence of a barrel latrine in the household was significantly associated with A. lumbricoides infection in children (OR = 2.81; CI 1.35-5.78). A strong association was found between A. lumbricoides infection and pica (OR = 3.36; CI 1.83-6.92). Fifty-six percent of A. lumbricoides infections that occurred in children were attributed to pica (attributable risk (AR) = 0.56; CI 0.31-0.75). Hookworm infection in children was significantly associated with the absence of a barrel latrine in the household (OR = 1.92; CI 1.12-3.25). Children living in homes with a soil floor had a higher risk (OR = 3.07; CI 1.54-6.08) of hookworm infection than children living in homes with a cement floor. Fifty-six percent of hookworm infections that occurred in children were attributed to living in a house with a soil floor (AR = 0.56; CI 0.32-0.72). Anemia was significantly associated (OR = 4.22; CI 2.34-7.62) with hookworm infection. Anemia and eosinophilia were not associated with A. lumbricoides infection. The risk of clinical signs including anemia, anorexia, diarrhea, elevated eosiphils count, nausea, and vomiting increased with an increase in the number of species of intestinal parasites harbored by children. The results of this study indicate that pica has a negative impact on the health of children in Guinea. Moreover, these results indicate that pica, poor sanitation, poor housing conditions, poor hygiene, and a large number of small children in a household are significantly associated with the likelihood of childhood intestinal parasitic infections and the growth of children in Guinea. The importance of these findings for the planning of parasite control measures is discussed.
Degree
Ph.D.
Advisors
Glickman, Purdue University.
Subject Area
Public health|Veterinary services
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