Environmental Sanitation Factors and human Behaviour Associated with Intestinal Parasitic Infections in Rural Communities of Cameroon

Abstract

Introduction: Intestinal parasitic infections still constitute major public health threats in many areas in Cameroon. To improve control measures, epidemiological data from environmental and human aspects are necessary to draw concrete control strategies to better follow-up the population at risk.
 Aim of the Study: This study aimed to investigate environmental risk factors related to infections in the Lolodorf health district, a high risk area of south Cameroon.
 Methods: A total of 325 participants who gave their informed consent were recruited for the study. Stool samples were collected and examined microscopically in search of helminth eggs and protozoan cysts using the Kato Katz and concentration Formol-ether techniques. Questionnaires were filled by participants to evaluate the risk factors.
 Results: Overall, 117 (42.9%) among the 325 participants harbored at least one parasite species with 75 (27.5%) having single infections and 42 (15.4%) having multiple infections. Ascaris lumbricoides (11.0%), Trichuris trichiura (26.4%), Hookworms (12.5%), Entamoeba coli (10.6%) and Entamoeba histolytica / Entamoeba dispar (1,5%) were diagnosed. Females were more infected (48.7%; p=0.04) compared to males (35.2%). Infection rate varied significantly according to villages (p=0.001). Univariate analysis revealed the following: gender (48.7%; p= 0.04), agricultural activities (47.7%; p= 0.04) and absence of treatment (50.8%: p=0.02) to be risk factors correlated to infection. Other factors such as age (49.3%), family size (47.8%), absence of toilets (53.5%), irregular use of shoes (48.6%), not wearing shoes (60.0%), irregular hand washing before meals (48.4%) and eating raw food (45.5%) had high infestation rates though with no significance. Multivariate logistic regression analysis showed that people who had never received any treatment had high risks of being infected (p=0.01; OR =0.17; 95% CI = 0.06 to 0.5).
 Conclusion: Improved sanitation, water supply and regular and extended deworming in the entire communities are fundamental issues in controlling intestinal parasitic infections.