Molecular Detection of Soil-Transmitted Helminths and Enteric Protozoa Infection in Children and Its Association with Household Water and Sanitation in Manhiça District, Southern Mozambique.

Berta Grau-Pujol,Charfudin Sacoor,Augusto Nhabomba,Anelsio Cossa,Juliana Da Silva,Rojelio Mejia,Jose Muñoz,Chenjerai Jairoce,Carlota Dobaño,Inocencia Cuamba

doi:10.3390/pathogens10070838

Abstract

Intestinal parasite infections can have detrimental health consequences in children. In Mozambique, soil-transmitted helminth (STH) infections are controlled through mass drug administration since 2011, but no specific control program exists for enteric protozoa. This study evaluates STH and protozoan infections in children attending healthcare in Manhiça district, Southern Mozambique, and its association with water and sanitation conditions. We conducted a cross-sectional study in children between 2 and 10 years old in two health centers (n = 405). A stool sample and metadata were collected from each child. Samples were analyzed by multi-parallel real-time quantitative PCR (qPCR). We fitted logistic regression-adjusted models to assess the association between STH or protozoan infection with household water and sanitation use. Nineteen percent were infected with at least one STH and 77.5% with at least one enteric protozoon. qPCR detected 18.8% of participants with intestinal polyparasitism. Protected or unprotected water well use showed a higher risk for at least one protozoan infection in children (OR: 2.59, CI: 1.01–6.65, p-value = 0.010; OR: 5.21, CI: 1.56–17.46, p-value = 0.010, respectively) compared to household piped water. A high proportion of children had enteric protozoan infections. Well consumable water displayed high risk for that.

Highlights

Intestinal parasites are transmitted by the fecal-oral route or by skin penetration
We aim to describe Soil-transmitted helminths (STH) and enteric protozoa infection prevalence in children between 2 and 10 years old attending healthcare in Manhiça District, Southern
The proportion of participants belonging to a poor socioeconomical status was 24.2%, 12.1% in Manhiçasede, and 40.5% in Ilha Josina

Summary

Introduction

Intestinal parasites are transmitted by the fecal-oral route or by skin penetration. They mostly affect deprived populations, and children, with lack of hygiene, safe water, and improved sanitation access. Their infections can be asymptomatic or cause abdominal pain, diarrhea, malnutrition, anemia, and impaired development and growth [1,2,3]. MDA-continued campaigns have substantially reduced STH infections in many countries [5,6,7]. The WHO recommends improving water, sanitation, and hygiene (WASH) strategies to reduce STH reinfection, but it has been poorly accomplished [8]

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