Excreta disposal facilities and intestinal parasitism in urban Africa: preliminary studies in Botswana, Ghana and Zambia

Abstract

The relationships between intestinal parasitism and excreta disposal technologies in Gaborone (Botswana), Ndola (Zambia) and Kumasi (Ghana) were investigated. Parasitic prevalence and intensity rates amongst groups of urban residents having similar socio-economic status and housing, but different excreta disposal technologies, were compared. In Gaborone, there was no evidence of a difference in intestinal parasitism between those using aqua privies and having access to public taps and those in identical houses enjoying flush toilets, in-house water connections and showers. In Ndola, the group with sewered aqua privies had larger houses, cleaner toilets, better water supplies, longer residence and more people in paid employment than the groups using pit latrines or communal flush toilets. Despite this, the sewered aqua privy users were not found to be different from the other groups with regard to hookworm and protozoal infection but had significantly higher Ascaris infection rates. In Kumasi, despite the differences in toilet type--from squalid communal aqua privies, through often fouled bucket latrines to well-maintained flush toilet systems--and despite also the differences in water provision, no evidence was obtained of any differences in intestinal parasitism between the groups studied. These findings suggest that the provision of superior water and sanitation facilities to a small cluster of houses, or to houses scattered through an area, may not protect those families from infection if the over-all level of faecal contamination of the environment is high. The sample sizes and response rates achieved in this study were low and follow-up studies, employing the same methodology but with larger samples, are recommended.

Association Between HLA-DQ Genotypes and Haplotypes vs Helicobacter pylori Infection in an Indonesian Population

“…It seemed that sanitary/environmental conditions remain basic in Mataram, Lombok island, Indonesia. Some people still use the fingers when eating (Cairncross et al, 1997), consume well, pond or river water (Cairncross et al, 1997;Mckeown et al, 1999 ) and use privy/latrine type toilet (Feachem et al, 1983). Prevalence of hepatitis A, for instance, a typical waterborne infectious disease, is very high at no less than 90%, and the infection rates did not differ between the two areas (Brown et al, 1985;Hoang et al, 2008) Effects of pre-or co-infection of other organisms, including dengue, should be taken into account because the altered immune system may modify sensitivity or resistance to infection by H. pylori (Nurgalieva et al, 2005).…”

Intestinal helminth infections among children of district Shopian of Kashmir Valley, India

“…Even though, it is argued that in highly contaminated environments, faecal transmission in defecation ground may not be a single most important site for geohelminth infection (Feachem et al 1983), it was found to be a significant univariate risk factor for infection with intestinal helminthiasis, where in a high prevalence was seen in children defecating in open fields, compared to low prevalence among children who defecate in modern septic latrines. In Shopian district children are at particular risk with nearly 70 % of children less than the age of 15 years, defecating outdoors in either the open latrines or nearby fields.…”

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“…Ascariasis occurs through ingestion of food and or water contaminated with faeces containing Ascaris eggs. Its transmission and distribution is largely determined by inadequate sanitary practices and improper faeces disposal 8,25,59 . The absence could be due to the fact that adult worms of Ascaris are regularly found in stool of infected individuals who then self-medicate with antihelmentics 12 after seeing these worms in their stool, in addition to improvement in prevailing social environment and behaviours of people in the communities 60,61 .…”

“…There are about 20 major helminth infections of humans, affecting more than one third of the world's population 2 and the most common ones that account for most of the global helminth disease burden in many sub-Saharan African countries including Ghana are ascariasis, trichuriasis, strongyloidiasis, taeniasis, schistosomiasis and hookworm infections [3][4][5][6][7][8] .…”