Abstract
BackgroundThe control of helminth infections and prevention of anemia in developing countries are of considerable public health importance. The purpose of this study was to determine patterns and risk factors of helminth infections and anemia in a rural and a peri-urban community of Zanzibar, Tanzania, in the context of national helminth control programs.Methodology/Principal FindingsWe carried out a community-based cross-sectional study in 454 individuals by examining at least two stool samples with different methods for soil-transmitted helminths (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, and Trichuris trichiura) and one urine sample for Schistosoma haematobium. Finger-prick blood was taken to estimate anemia levels and to detect antibody reactions against ascariasis, strongyloidiasis and schistosomiasis, using an enzyme-linked immunosorbent assay (ELISA) approach. Parasitological methods determined a helminth prevalence of 73.7% in the rural, and 48.9% in the peri-urban setting. Most helminth infections were of light intensity with school-aged children showing the highest intensities. Multiple helminth species infections were pervasive in rural dwellers regardless of age. More than half of the participants were anemic, with a particularly high prevalence in the peri-urban setting (64.7%). Risk factors for helminth infections were age, sex, consumption of raw vegetables or salad, recent travel history, and socio-economic status.Conclusion/SignificanceAfter several years of chemotherapy-based morbidity control efforts in Zanzibar, helminth prevalences are still high and anemia is common, but helminth infection intensities are low. Hence, chemotherapy should be continued, and complemented with improved access to clean water, adequate sanitation, and health education, along with poverty alleviation measures for a more enduring impact.
Highlights
Soil-transmitted helminthiasis and schistosomiasis affect hundreds of millions of people and the global burden due to these parasitic worms might exceed 40 million disability-adjusted life years (DALYs) lost annually [1,2,3]
In many parts of the developing world, parasitic worms and anemia are of considerable public health and economic importance
We studied the patterns and risk factors of parasitic worm infections in a rural and a periurban community on Zanzibar Island, Tanzania, in the context of national deworming programs
Summary
Soil-transmitted helminthiasis and schistosomiasis affect hundreds of millions of people and the global burden due to these parasitic worms might exceed 40 million disability-adjusted life years (DALYs) lost annually [1,2,3]. The global strategy for the control of soil-transmitted helminthiasis and schistosomiasis is morbidity control using single-dose orally-active anthelmintic drugs. In Zanzibar, infections with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) are highly endemic [10,11,12]. Due to excessively high helminth prevalences (.90%) in schoolaged children in Zanzibar, large-scale school-based administration of anthelmintic drugs (mebendazole or albendazole) was initiated in the mid-1990s [15], and contingent upon drug donations. The control of helminth infections and prevention of anemia in developing countries are of considerable public health importance. The purpose of this study was to determine patterns and risk factors of helminth infections and anemia in a rural and a peri-urban community of Zanzibar, Tanzania, in the context of national helminth control programs
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