Abstract

BackgroundThis cross-sectional study aimed to investigate the current prevalence and risk factors associated with intestinal polyparasitism (the concurrent infection with multiple intestinal parasite species) among Orang Asli school children in the Lipis district of Pahang state, Malaysia.Methods/Principal findingsFecal samples were collected from 498 school children (50.6% boys and 49.4% girls), and examined by using direct smear, formalin-ether sedimentation, trichrome stain, modified Ziehl Neelsen stain, Kato-Katz, and Harada Mori techniques. Demographic, socioeconomic, environmental, and personal hygiene information were collected by using a pre-tested questionnaire. Overall, 98.4% of the children were found to be infected by at least one parasite species. Of these, 71.4% had polyparasitism. The overall prevalence of Trichuris trichiura, Ascaris lumbricoides, hookworm, Giardia duodenalis, Entamoeba spp., and Cryptosporidium spp. infections were 95.6%, 47.8%, 28.3%, 28.3%, 14.1% and 5.2%, respectively. Univariate and multivariate analyses showed that using an unsafe water supply as a source for drinking water, presence of other family members infected with intestinal parasitic infections (IPI), not washing vegetables before consumption, absence of a toilet in the house, not wearing shoes when outside, not cutting nails periodically, and not washing hands before eating were significant risk factors associated with intestinal polyparasitism among these children.Conclusions/SignificanceIntestinal polyparasitism is highly prevalent among children in the peninsular Malaysian Aboriginal communities. Hence, effective and sustainable control measures, including school-based periodic chemotherapy, providing adequate health education focused on good personal hygiene practices and proper sanitation, as well as safe drinking water supply should be implemented to reduce the prevalence and consequences of these infections in this population.

Highlights

  • Intestinal parasitic infections (IPI) are still public health problems in many communities, among children in rural areas of developing countries

  • Almost half of the houses are without toilets and it was found that Orang Asli people preferred to defecate at the site of the streams

  • The results showed that T. trichiura was the predominant species with a prevalence rate of 95.6% (476/498), followed by A. lumbricoides (47.8%), G. duodenalis (28.3%), and hookworm (27.9%)

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Summary

Introduction

Intestinal parasitic infections (IPI) are still public health problems in many communities, among children in rural areas of developing countries. Opportunistic IPI such as Cryptosporidium, Isospora belli, Microsporidia, and Strongyloides infections are commonly reported among immunocompromised individuals with significant morbidity and mortality [8,9]. This cross-sectional study aimed to investigate the current prevalence and risk factors associated with intestinal polyparasitism (the concurrent infection with multiple intestinal parasite species) among Orang Asli school children in the Lipis district of Pahang state, Malaysia

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