Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study
Abstract Background Infections with soil-transmitted helminths and pathogenic intestinal protozoa pose a considerable public health burden, particularly in low- and middle-income countries, including Nepal. We assessed the extent of intestinal parasite infections among schoolchildren in two district...
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BMC
2018-09-01
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| Series: | Parasites & Vectors |
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| Online Access: | http://link.springer.com/article/10.1186/s13071-018-3105-0 |
| _version_ | 1818453621551923200 |
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| author | Akina Shrestha Christian Schindler Peter Odermatt Jana Gerold Séverine Erismann Subodh Sharma Rajendra Koju Jürg Utzinger Guéladio Cissé |
| author_facet | Akina Shrestha Christian Schindler Peter Odermatt Jana Gerold Séverine Erismann Subodh Sharma Rajendra Koju Jürg Utzinger Guéladio Cissé |
| author_sort | Akina Shrestha |
| collection | DOAJ |
| description | Abstract Background Infections with soil-transmitted helminths and pathogenic intestinal protozoa pose a considerable public health burden, particularly in low- and middle-income countries, including Nepal. We assessed the extent of intestinal parasite infections among schoolchildren in two districts of Nepal and determined underlying risk factors. Methods A cross-sectional survey was conducted between March and May 2015 in the districts of Dolakha and Ramechhap, Nepal. A total of 708 children, aged 8–16 years from 16 purposively selected schools, were enrolled. Each child provided a single stool sample that was subjected to a suite of copro-microscopic diagnoses for intestinal protozoa and helminths. Drinking water samples from different sources at schools (n = 29), community places (n = 43) and households (n = 562) were analysed for contamination with thermotolerant coliforms (TTC). A questionnaire was administered to determine individual- and household-level risk factors of intestinal parasite infections. Self-reported symptoms were assessed and a clinical examination was undertaken by a physician. Haemoglobin was measured and used as a proxy for anaemia. Mixed logistic regression models were applied to investigate associations. Results The overall prevalence of intestinal parasite infections was 39.7%. Trichuris trichiura (30.9%), Giardia intestinalis (30.5%) and hookworm (30.2%) were the predominant intestinal parasite infections. Children from households lacking soap for handwashing were at higher odds of intestinal parasite infections than children who had soap [adjusted odds ratio (aOR) 1.81; 95% confidence interval (CI): 1.13–2.89; P = 0.01]. Children from households without freely roaming domestic animals showed lower odds of G. intestinalis compared to children from households with freely roaming animals (aOR 0.52; 95% CI: 0.33–0.83; P = 0.01). One out of three (31.0%) children suffered from fever and 22.4% had watery diarrhoea within a two-week recall period. Anaemia was diagnosed in 23.6% of the children. Water contamination with TTC showed no clear association with intestinal parasite infection. Conclusions Intestinal parasites are common among schoolchildren in the two surveyed districts of Nepal. An important risk factor was lack of soap for handwashing. Our findings call for efforts to control intestinal parasite infection and emphasis should be placed on improvements in water, sanitation and hygiene interventions. Trial registration ISRCTN17968589 (date assigned: 17 July 2015). |
| first_indexed | 2024-12-14T21:41:54Z |
| format | Article |
| id | doaj.art-49a3704e8e8b49188fa4c4fb7ac0b32a |
| institution | Directory Open Access Journal |
| issn | 1756-3305 |
| language | English |
| last_indexed | 2024-12-14T21:41:54Z |
| publishDate | 2018-09-01 |
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| spelling | doaj.art-49a3704e8e8b49188fa4c4fb7ac0b32a2022-12-21T22:46:26ZengBMCParasites & Vectors1756-33052018-09-0111111510.1186/s13071-018-3105-0Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional studyAkina Shrestha0Christian Schindler1Peter Odermatt2Jana Gerold3Séverine Erismann4Subodh Sharma5Rajendra Koju6Jürg Utzinger7Guéladio Cissé8Swiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteKathmandu University, School of Science, Aquatic Ecology CentreKathmandu University, School of Medical SciencesSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteAbstract Background Infections with soil-transmitted helminths and pathogenic intestinal protozoa pose a considerable public health burden, particularly in low- and middle-income countries, including Nepal. We assessed the extent of intestinal parasite infections among schoolchildren in two districts of Nepal and determined underlying risk factors. Methods A cross-sectional survey was conducted between March and May 2015 in the districts of Dolakha and Ramechhap, Nepal. A total of 708 children, aged 8–16 years from 16 purposively selected schools, were enrolled. Each child provided a single stool sample that was subjected to a suite of copro-microscopic diagnoses for intestinal protozoa and helminths. Drinking water samples from different sources at schools (n = 29), community places (n = 43) and households (n = 562) were analysed for contamination with thermotolerant coliforms (TTC). A questionnaire was administered to determine individual- and household-level risk factors of intestinal parasite infections. Self-reported symptoms were assessed and a clinical examination was undertaken by a physician. Haemoglobin was measured and used as a proxy for anaemia. Mixed logistic regression models were applied to investigate associations. Results The overall prevalence of intestinal parasite infections was 39.7%. Trichuris trichiura (30.9%), Giardia intestinalis (30.5%) and hookworm (30.2%) were the predominant intestinal parasite infections. Children from households lacking soap for handwashing were at higher odds of intestinal parasite infections than children who had soap [adjusted odds ratio (aOR) 1.81; 95% confidence interval (CI): 1.13–2.89; P = 0.01]. Children from households without freely roaming domestic animals showed lower odds of G. intestinalis compared to children from households with freely roaming animals (aOR 0.52; 95% CI: 0.33–0.83; P = 0.01). One out of three (31.0%) children suffered from fever and 22.4% had watery diarrhoea within a two-week recall period. Anaemia was diagnosed in 23.6% of the children. Water contamination with TTC showed no clear association with intestinal parasite infection. Conclusions Intestinal parasites are common among schoolchildren in the two surveyed districts of Nepal. An important risk factor was lack of soap for handwashing. Our findings call for efforts to control intestinal parasite infection and emphasis should be placed on improvements in water, sanitation and hygiene interventions. Trial registration ISRCTN17968589 (date assigned: 17 July 2015).http://link.springer.com/article/10.1186/s13071-018-3105-0HelminthsHygieneIntestinal protozoaNepalSanitationWater |
| spellingShingle | Akina Shrestha Christian Schindler Peter Odermatt Jana Gerold Séverine Erismann Subodh Sharma Rajendra Koju Jürg Utzinger Guéladio Cissé Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study Parasites & Vectors Helminths Hygiene Intestinal protozoa Nepal Sanitation Water |
| title | Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study |
| title_full | Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study |
| title_fullStr | Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study |
| title_full_unstemmed | Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study |
| title_short | Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study |
| title_sort | intestinal parasite infections and associated risk factors among schoolchildren in dolakha and ramechhap districts nepal a cross sectional study |
| topic | Helminths Hygiene Intestinal protozoa Nepal Sanitation Water |
| url | http://link.springer.com/article/10.1186/s13071-018-3105-0 |
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