Prevalence and risk factors of intestinal parasitism among two indigenous sub-ethnic groups in Peninsular Malaysia

Abstract

BackgroundIntestinal parasitic infections (IPIs) among indigenous people have been widely documented in Malaysia, however, the prevalence of these infections remains high. In the past, most studies have focused on specific species of parasites but polyparasitism has received limited attention. In addition, epidemiology studies on indigenous people tend to consider them as a homogenous group, whereas in reality different sub-ethnic groups have different cultural and living practices. Variations in living habits such as personal hygiene practices may predispose different groups to different parasitic infections. To better understand prevalence and risk factors of intestinal parasitism among different sub-ethnic groups, the present study was conducted among two sub-ethnic groups of indigenous people (Temuan and Mah Meri) residing in Selangor state, Malaysia.MethodsA cross-sectional study that focused on two distinct sub-ethnic groups was carried out from February to September 2014. Faecal samples were collected from 186 participants and examined using the formalin-ether sedimentation technique. A molecular approach was adopted to conduct a genetic characterisation of the parasites. Additionally, questionnaires were administered to obtain information on the demographics, socio-economic backgrounds and behavioural risks relating to the participants, as well as information about their environments. Statistical analyses (i.e. binary and multivariate logistic regression analyses) were performed to measure risk factors.ResultsFor Temuan communities, trichuriasis (64.2 %) was the most common infection found, preceding hookworm infection (34 %), ascariasis (7.5 %), giardiasis (14.2 %) and amoebiasis (7.5 %). As for the Mah Meri communities, trichuriasis (77.5 %) prevailed over ascariasis (21.3 %), hookworm (15 %), giardiasis (7.5 %) and amoebiasis (3.8 %). Significant differences in proportions of trichuriasis, ascariasis and hookworm infections were observed between the Temuan and Mah Meri sub-ethnic groups. Polyparasitism was more common among the Temuan sub-ethnic group (41.5 %) compared to the Mah Meri sub-ethnic group (32.5 %), with the majority of participants harbouring two parasites concurrently (Temuan: 33 %, Mah Meri: 20 %). Trichuris trichiura and Ascaris lumbricoides co-infections were most prevalent (10 %) among the Mah Meri communities, while a co-infection of T. trichiura with hookworm (19.8 %) was most common among the Temuan communities. Multivariate analyses showed that being unemployed, having a large family and drinking unboiled water were found to be significantly associated with intestinal parasitism.ConclusionThe present study highlights substantial polyparasitism and risk factors for infections in the Temuan and Mah Meri sub-ethnic groups. The high prevalence of IPIs among these two sub-ethnic groups indicates that parasitic infections are important health issues in these communities. Hence, it is imperative to implement sound intervention strategies such as periodic preventive chemotherapy coupled w...

Spatio-temporal analysis of small-area intestinal parasites infections in Ghana

“…One would, on the contrary, expect the hot-spots to occur mainly within the northern parts of Ghana where the socioeconomically less privilege are mostly found. This finding is an unexpected departure from other previous studies 20 , 45 – 47 , and suggests that interaction effects of environmental and socioeconomic risk factors that combine best to enhance infection could play a role. Although the study did not build a formal causal explanation model for the clustering patterns, a visual comparison of the patterns with the ecological zones of Ghana generates a working hypothesis that is worth testing in future research efforts.…”

Risk Factors and Spatial Clusters of Cryptosporidium Infection among School-Age Children in a Rural Region of Eastern China

“…In addition, we did not observe any association between “supplied with piped water” and Cryptosporidium infection. Previous studies revealed that tap water was a risk factor for Cryptosporidium infection in other regions [ 25 , 30 ]. In our study, supplied drinking water covered most of the households.…”

Intestinal parasitic infections and risk factors: a cross-sectional survey of some school children in a suburb in Accra, Ghana

“…This study found only four students (three males and one female) with mixed parasitic infections. The varying differences in mixed infections may be due differences in concentrations of parasites and sanitation conditions of the communities [ 20 ].…”