Prevalence and Risk Factors of Intestinal Helminth and Protozoa Infections in an Urban Setting of Cameroon: the Case of Douala

Abstract

Intestinal parasitic infections remains a public health problem in rural areas of low-income and middle-income settings of tropical and subtropical zones however epidemiological evidence is scarce in urban areas. This study aimed to assess the extent of intestinal helminths and protozoa infections among residents of Douala city in Cameroon, and to identify risk factors of their transmission. A community-based cross-sectional study was carried out in 2013 on 428 residents from two quarters of Douala city by microscopic examination of a stool sample from each participant simultaneously as fresh wet mounts, Kato-Katz thick smear and smear from formol-ether concentration technique. All participants from the selected quarters were invited to provide a stool sample, and interviewed about demographic and socioeconomic characteristics, sanitary situation, hygiene behaviors, antihelminthic chemotherapy. The overall prevalence of intestinal helminths and protozoa infection was 15,2%. The infection rate was significantly different between quarters (p=0.003). Dwellers harbored helminths, protozoa or both infections. The prevalence of pathogenic intestinal protozoa, namely E.histolytica/E.dispar and G.intestinalis was 8.9% and 0.7% respectively. The prevalence of the non pathogenic protozoa E.coli was 1,6%. Prevalences of helminth namely A.lumbricoides, T.trichiura, S.stercoralis, H.nana and S.mansoni were below 5%. Polyparasitic infections occurred in 2.1% of the participants. The prevalence of intestinal parasites carriage were influenced by age, educational level, dwelling area, household clustering for all parasitic infections taken together, poor sanitation and hygiene behaviors. Intestinal helminth and protozoa infections were hypoendemic in Douala urban area. Amoebiasis, giardiasis, ascaridiasis, trichuriasis, strongyloidiasis hymenolepiasis, and mansoni schistosomiasis were the main infections identified mostly at low prevalent rates. All helminth infections recorded were of low intensity. Provision of health education, improving personal hygiene, potable drinking water supply as well as school based deworming should be the major focus area of all institutions in Douala.