Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study

Abstract

BackgroundInfections with soil-transmitted helminths and pathogenic intestinal protozoa pose a considerable public health burden, particularly in low- and middle-income countries, including Nepal. We assessed the extent of intestinal parasite infections among schoolchildren in two districts of Nepal and determined underlying risk factors.MethodsA cross-sectional survey was conducted between March and May 2015 in the districts of Dolakha and Ramechhap, Nepal. A total of 708 children, aged 8–16 years from 16 purposively selected schools, were enrolled. Each child provided a single stool sample that was subjected to a suite of copro-microscopic diagnoses for intestinal protozoa and helminths. Drinking water samples from different sources at schools (n = 29), community places (n = 43) and households (n = 562) were analysed for contamination with thermotolerant coliforms (TTC). A questionnaire was administered to determine individual- and household-level risk factors of intestinal parasite infections. Self-reported symptoms were assessed and a clinical examination was undertaken by a physician. Haemoglobin was measured and used as a proxy for anaemia. Mixed logistic regression models were applied to investigate associations.ResultsThe overall prevalence of intestinal parasite infections was 39.7%. Trichuris trichiura (30.9%), Giardia intestinalis (30.5%) and hookworm (30.2%) were the predominant intestinal parasite infections. Children from households lacking soap for handwashing were at higher odds of intestinal parasite infections than children who had soap [adjusted odds ratio (aOR) 1.81; 95% confidence interval (CI): 1.13–2.89; P = 0.01]. Children from households without freely roaming domestic animals showed lower odds of G. intestinalis compared to children from households with freely roaming animals (aOR 0.52; 95% CI: 0.33–0.83; P = 0.01). One out of three (31.0%) children suffered from fever and 22.4% had watery diarrhoea within a two-week recall period. Anaemia was diagnosed in 23.6% of the children. Water contamination with TTC showed no clear association with intestinal parasite infection.ConclusionsIntestinal parasites are common among schoolchildren in the two surveyed districts of Nepal. An important risk factor was lack of soap for handwashing. Our findings call for efforts to control intestinal parasite infection and emphasis should be placed on improvements in water, sanitation and hygiene interventions.Trial registrationISRCTN17968589 (date assigned: 17 July 2015).Electronic supplementary materialThe online version of this article (10.1186/s13071-018-3105-0) contains supplementary material, which is available to authorized users.

A Retrospective Study of Intestinal Parasite among Patients in the Ho Teaching Hospital, Ghana

“…Intestinal protozoa infections (B. hominis, E. histolytica, E. coli and intestinal flagellates were prevalent than soil-transmitted helminth infection (A. lumbricoides, S. stercoralis, hookworm and S. mansoni). This finding is in contrast with the findings of a study conducted in Nepal [16] and Saudi Arabia [17] which revealed soil-transmitted helminth as the most predominant intestinal parasite. The low prevalence of soil-transmitted helminth infection in this study could be due to the periodic deworming exercise initiated by the regional School Health and Education Programme (SHEP) of Ghana Education Service / Ministry of Education and the Neglected Tropical Disease Control Programme (NTDCP) of the Ghana Health Service [18].…”

Prevalence of intestinal parasitosis and associated risk factors among school children of Saptari district, Nepal: a cross-sectional study

“…This study attempted to determine some potential risk factors associated with the prevalence of parasitosis among school going children of two schools based in Saptari district. In this study, one third of enrolled school children (33%, 94/285) was found to be infected with intestinal parasites and a similar rate of prevalence was reported by Shah et al [17] while some other studies have reported a low rate of intestinal parasites in school going children from different parts of the country [6,18,19]. Higher prevalence of IPIs in the study might be due to the contamination of the drinking water supply by the parasites and poor sanitation practice in the study sites [20].…”

“…Higher prevalence of IPIs in the study might be due to the contamination of the drinking water supply by the parasites and poor sanitation practice in the study sites [ 20 ]. On the other hand, Shreshtha et al have reported 39.7% of IPIs among school children of two schools from central Nepal [ 18 ]. Similarly, very high rates of IPIs were reported in school children from different countries [ 21 – 24 ].…”

Desnutrição associada à giardíase em escolares: Análise de parâmetros antropométricos e socioeconômicos / Malnutrition associated with giardiasis in school children: Analysis of anthropometric and socioeconomic parameters

“…A prevalência de Giardia em populações infantis estimadas na faixa de 3-35% em diferentes ambientes e regiões da comunidade 8,9,10 . No entanto, esses achados são limitados devido ao pequeno tamanho das amostras.…”