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PreprintCited by 36Parasites and Host InteractionsParasitic Infections and DiagnosticsChild Nutrition and Water Access

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Intestinal parasitosis, anaemia and risk factors among pre-school children in Tigray Region, Northern Ethiopia

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Wasihun, Araya Gebreyesus, Teferi, Mekonen, Negash, Letemichal, Marugán, Javier, Yemane, Dejen, McGuigan, Kevin G., Conroy, Ronan M., Abebe, Haftu Temesgen, Dejene, Tsehaye Asmelash·2019·BMC Infectious Diseases
DOI 10.1101/744938PMC PMC7251880

Preprint — published as 10.1186/s12879-020-05101-8 · Paper page

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Abstract

Background: Intestinal parasitic infections (IPIs) and anaemia are major health problems. This study assessed the prevalence of IPI, anaemia and associated factors among pre-school children in rural areas of the Tigray region, northern Ethiopia. Methodology/Principal Finding: A community based cross-sectional study was conducted among 610 pre-school children in rural communities of Northern Ethiopia from June 2017 to August 2017. Stool specimens were examined for the presence of trophozoites, cysts, oocysts, and ova using direct, formal-ethyl acetate concentration, Kato–Katz, and Ziehl-Neelsen techniques. Haemoglobin was measured using a HemoCue spectrometer. Among the 610 pre-school children participated in the study, prevalence of IPIs and anaemia were 58% (95% CI: 54.1–61.9%) and 21·6% (95% CI: 18·5% to 25·1%), respectively. Single, double, and triple parasitic infections were seen in 249 (41%, 95% CI: 37% to 45%), 83 (14%, 95% CI: 11% to 17%), and 22 (3.6%, 95% CI: 2.4% to 5.4%) children, respectively. Of the seven intestinal parasitic organisms recorded from the participants, Entamoeba histolytica/dispar was the most prevalent 220 (36.1%) followed by Giardia lamblia 128 (20.1%), and Hymenolepis nana 102 (16.7%). Mixed infections were common among G. lamblia, E. histolytica/dispar and Cryptosporidium spp. oocyst. Age 48-59 months prevalence ratio (PR = 1·078, P=0·009), child deworming (PR= 1.2; 95% CI=1.00-1.4, p= 0.045), and having two or more children aged under five (PR=0.76, 95% CI= 0.61-0.95, p=0.015) were independent predictors for IPIs. Anaemia was associated with proper disposal of solid waste (PR= 1.5, 95% CI=0.1.1-2.10, p=0.009). Eating raw meat (PR=0.49, 95% CI=0.45-0.54, p=0.000), any maternal education (PR=0.64 95% CI=0.52-0.79, p=0.000), and household water treatment (PR=0.75, 95% CI=0.56-1.0, p=0.044) were associated with lower prevalence of anaemia. Conclusions: More than half of the children were infected with intestinal parasites and one in five were anaemic. This study has identified a number of potentially modifiable risk factors to address the significant prevalence of IPIs and anaemia in these children. Improvements in sanitation, clean water, hand hygiene, maternal education could address both short and long-term consequences of these conditions in this vulnerable population. Author Summary: Intestinal parasitic infection and anaemia are public health problems in developing counties. Children due to their immature immune systems and frequent exposure to unhygienic environments are at high risk which in turn put them at an increased risk of malnutrition and growth deficits. Similarly, childhood anaemia impairs physical growth, impairs immune function and weakens motor development. The finding of this study reveals more than half of the children were infected. Entamoeba histolytica/dispar, Giardia lamblia and Hymenolepis nana were dominant parasites. Multiple infections was common among Giardia lamblia, Entamoeba histolytica/dispar and Cryptosporidium spp. Oocyst. Children aged 48-59 months were more infected with intestinal parasites. Soli transmitted helminths in this study was low. 21.5% of the children were anaemic and was associated with disposal of solid waste and presence of domestic animals. However, Eating raw meat, maternal education and household water treatment were found preventive of anaemia in the study. It seems worth understanding the prevalence and effects of parasitic infection and anaemia in this vulnerable group to design an appropriate interventions. Finally, if parasite transmission and anaemia is to be significantly prevented control programs such as improving sanitation, clean water, maternal education may be critical in this vulnerable age groups.

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Metadata

Authors
Wasihun, A. G., Teferi, M., Negash, L., Marugán, J., Yemane, D., McGuigan, K. G., Conroy, R. M., Abebe, H. T., & Dejene, T. A.
Affiliations
  • Mekelle University (ET)
  • Universidad Rey Juan Carlos (ES)
  • Royal College of Surgeons in Ireland (IE)
  • Aksum University (ET)
Corresponding author
Wasihun, Araya Gebreyesus
ORCID
Venue
BMC Infectious Diseases
Publisher
openRxiv
Published
2019-08-22
Volume
20
Issue
1
Pages
379-379
ISSN
1471-2334 (ISSN-L)
DOI
10.1101/744938
PMC
PMC7251880
OpenAlex
W3031274116
Cited by
36
References
1
Citations by year
2026: 3 · 2025: 5 · 2024: 6 · 2023: 14 · 2022: 4 · 2021: 3 · 2020: 1
FWCI
4.12
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Infectious Diseases (publishedVersion, cc-by)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • European Commission (H2020, 688928)
  • Horizon 2020 Framework Programme (GA 688928, 688928)
Topics
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasitic Infections and Diagnostics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Keywords
intestinal parasitic infections, anemia, preschool children, Entamoeba histolytica/dispar, Giardia lamblia, Hymenolepis nana, Cryptosporidium, mixed parasitic infection, anthelmintic treatment, risk factors, Tigray, rural children, hemoglobin, deworming efficacy
MeSH terms
Anemia, Animals, Child, Child, Preschool, Cross-Sectional Studies, Cryptosporidium, Entamoeba histolytica, Ethiopia, Feces, Female, Humans, Infant, Intestinal Diseases, Parasitic, Intestines, Male, Risk Factors, Rural Population, Sanitation, Prevalence, Giardia lamblia, Hymenolepis nana, Hand Hygiene

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Wasihun, A. G., Teferi, M., Negash, L., Marugán, J., Yemane, D., McGuigan, K. G., Conroy, R. M., Abebe, H. T., & Dejene, T. A. (2019). Intestinal parasitosis, anaemia and risk factors among pre-school children in Tigray Region, Northern Ethiopia. BMC Infectious Diseases. https://doi.org/10.1101/744938