Intestinal parasitic infections in children presenting with diarrhoea in outpatient and inpatient settings in an informal settlement of Nairobi, Kenya

Abstract

BackgroundThe distribution of and factors associated with intestinal parasitic infections are poorly defined in high risk vulnerable populations such as urban slums in tropical sub-Saharan Africa.MethodsIn a cross sectional study, children aged 5 years and below who presented with diarrhoea were recruited from selected outpatient clinics in Mukuru informal settlement, and from Mbagathi District hospital, Nairobi, over a period of two years (2010–2011). Stool samples were examined for the presence of parasites using direct, formal-ether concentration method and the Modified Ziehl Neelsen staining technique.ResultsOverall, 541/2112 (25.6%) were positive for at least one intestinal parasite, with the common parasites being; Entamoeba histolytica, 225 (36.7%),Cryptosporidium spp. 187, (30.5%), Giardia lamblia, 98 (16%).The prevalence of intestinal parasites infection was higher among children from outpatient clinics 432/1577(27.4%) than among those admitted in hospital 109/535 (20.1%) p < 0.001. Infections with E. histolytica, and G. lamblia were higher among outpatients than inpatients (13.8% vs 1.3% p < 0.001 and 5.8% vs 1.3% p < 0.049) respectively, while infection with Cryptosporidium spp. was higher among inpatients than outpatients (15.3% vs 6.7%) respectively p < 0.001. Other parasites isolated among outpatients included Isospora belli, 19 (1.2%), Ascaris lumbricoides, 26 (1.6%), and Hymenolepis nana 12 (0.8%), with the remainder detected in less than ten samples each. HIV-infected participants were more likely to be infected with any parasite than uninfected participants, Adjusted Odds Ratio (AOR), 2.04, 95% CI, 1.55-2.67, p < 0.001), and with Cryptosporidium spp. (AOR, 2.96, 95% CI 2.07-4.21, p < 0.001).The inpatients were less likely to be infected with E. histolytica than outpatients (AOR, 0.11, 95% CI, 0.51- 0.24, p < 0.001), but more likely for inpatients to be infected with Cryptosporidium spp. than outpatients (AOR, 1.91, 95% CI, 1.33-2.73, p < 0.001). Mixed parasitic infections were seen in 65 (12.0%) of the 541 infected stool samples.ConclusionIntestinal parasitic infections are common in urban informal settlements’ environment. Routine examinations of stool samples and treatment could benefit both the HIV infected and uninfected children in outpatient and inpatient settings.

Prevalence and Associated Risk Factors of Intestinal Parasitic Infection among Under five Children in University of Gondar Hospital, Gondar, Northwest Ethiopia

“…Similarly to this study, in Kenya statistical association between age (P<0.001) and IP infection was observed. In contrast to this study finding the study in Kenya showed association between sex (P=0.045) and IP infection (Mbae, 2013). …”

“…The prevalence was less than in previous studies conducted in different parts of Ethiopia namely, Wondo Genet, 85.1% (C, 2010), wonji, 24.3% (G/hiwot, 2014), Yergalem Hospital, 49.5 (Firdu, 2014) and Addis Ababa, 24.3%) (Adamu, 2006). This study also showed low prevalence as compared with studies conducted in different parts of the world like Cuba, 58.2% (Cañete, 2012), Pakistan, (52.8%) (Adeoye, 2007) and Kenya (25.6%) (Mbae, 2013). This difference could be due to the difference in geographical location, time of survey, diagnostic method difference and socioeconomic status.…”

“…In Portugal, prevalence of Intestinal Parasitic infection among children aged 0-5 years was 7.8%, and was similar among genders (6.9% in boys and 6.5% in girls (Julio et al, 2012). In Nairobi, Kenya, 25.6% were positive for at least one intestinal parasite, with the common parasites, Entamoeba histolytica, 36.7%, and Giardia lamblia, 16% (Mbae et al, 2013).…”

Intestinal Parasitoses in HIV Infected Children in a Nigerian Tertiary Hospital

“…A higher polyparasitism rate of 12% was however obtained among HIV infected Kenyan children and cryptosporidium spp was the most common parasite implicated in intestinal parasitoses [13]. Cryptosporidium was also the most common parasite identified in Nkenfou et al, study accounting for 19% of the population studied, which is also the exact percentage of children infected with cryptosporidium in the present study.…”

Giardia intestinalis infection associated with malnutrition in children living in northeastern Brazil

“…Intestinal parasitoses are neglected conditions linked to poverty and poor sanitation, being more prevalent in developing countries [1,2]. Among the protozoan parasites, Giardia intestinalis is present in distinct sociodemographic settings, being a potentially zoonotic pathogen [3][4][5][6].…”