Prevalence of Intestinal Parasitic Infections and Associated Water, Sanitation, and Hygiene Risk Factors among School Children in Mwea Irrigation Scheme, Kirinyaga County, Kenya.

Elizabeth Njambi,Janet Masaku,Sammy M Njenga,Collins Okoyo,Dennis Magu

doi:10.1155/2020/3974156

Abstract

School children bear a significant burden of intestinal parasitic infections. Because they spend most of their time at home and school, it is necessary to identify the key water, sanitation, and hygiene (WASH) factors associated with these infections in both environments. This was a cross-sectional survey conducted in Mwea West, Kirinyaga County. 180 primary school children aged 8–14 years were randomly selected from three schools (Mianya, Mbui Njeru, and Mukou primary schools). Questionnaires and checklists were administered and single stool samples were collected. Stool samples were microscopically examined for Schistosoma mansoni, soil-transmitted helminths, and protozoan infections. Data on WASH were obtained at home and school. The factors significantly associated with S. mansoni and intestinal protozoa infections in the school children were determined using univariable and multivariable logistic regression models reporting the odds ratio at 95% confidence intervals. The overall prevalence of S. mansoni and intestinal protozoa infections was 70.5% (95% CI: 59.1–84.3) and 32.7% (95% CI: 26.8–40.1), respectively. Only one case of STH (A. lumbricoides) was identified. The prevalence of coinfections of S. mansoni and intestinal protozoa infections was 22.8% (95% CI: 19.2–27.1). An increased prevalence of S. mansoni infection was associated with children above 12 years (aOR = 3.19, p=0.015), those in Mianya primary (aOR = 1.23, p=0.001), those in Mukou primary (aOR = 3.19, p=0.001), and reported behavior of wearing shoes at home (aOR = 1.67, p=0.010). However, handwashing behavior after defecation at home (aOR = 0.39, p=0.001) was protective against S. mansoni infection. For any protozoan infection, male children had increased odds of infection (aOR = 2.41, p=0.001) while use of wiping material (aOR = 0.55, p=0.019) and water contact (aOR = 0.32, p=0.001) was protective against intestinal protozoa infections. Infections with S. mansoni and any protozoa and their coinfection were present. Findings revealed that several hygiene factors were protective against infections while other were risk factors. Therefore, deworming should be complemented with behavior education on hygienic habits.

Highlights

Intestinal parasitic infections are a major public health concern in developing countries and the risk factors for infection include living in rural areas, poor communities, poor sanitation, lack of clean water, and poor personal hygiene [1]
Sociodemographic, Household, and School Characteristics. e overall data were collected from 180 children in three primary schools in Mwea West. e mean age of children was 10.0 years (range: 7–15 years, standard deviation (SD) 1.6 years). ere was an equal representation of study participants in terms of gender (50.0%/50.0%) females/ males
In Kenya, schistosomiasis caused by S. mansoni occurs mostly in the central and western parts of the country [29, 30], and in cases where S. mansoni infections are a public health concern, the World Health Organization (WHO) recommends for mass drug administration (MDA) [22]

Summary

Introduction

Intestinal parasitic infections are a major public health concern in developing countries and the risk factors for infection include living in rural areas, poor communities, poor sanitation, lack of clean water, and poor personal hygiene [1]. Studies have shown that Giardia intestinalis and Entamoeba histolytica are the most common pathogenic intestinal protozoa in temperate and tropical countries, especially among children and the elderly, causing severe diarrhea. Transmission of these pathogenic protozoa is by consumption of contaminated water and food [7, 8]. In Sub-Saharan Africa, an estimated 89.9 million school age children are infected, and studies have shown that factors associated with transmission of infections include fecal contamination of water sources, especially the unimproved sources, lack of environmental sanitation, poor socioeconomic conditions, and poor hygiene practices [9,10,11,12,13,14]

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