|Year : 2019 | Volume
| Issue : 4 | Page : 181-185
Soil-transmitted helminths and associated risk factors among elementary school pupils in Dadin Kowa, Jos
Abednego Samuel Dahal1, Esther Onyimowo Francis2, Joy Eguweye Francis3, Francis Istifanus Wamtas2
1 Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Jos, Jos, Plateau State, Nigeria
2 Department of Science, Plateau State Polytechnic Barkin Ladi, Bukuru, Nigeria
3 Department of Midwifery, School of Midwifery Makurdi, Makurdi, Benue State, Nigeria
|Date of Submission||04-May-2019|
|Date of Decision||14-Jul-2019|
|Date of Acceptance||14-Aug-2019|
|Date of Web Publication||25-Nov-2019|
Abednego Samuel Dahal
Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Jos, Jos, Plateau State
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Soil-transmitted helminths are intestinal parasites of humans transmitted through contaminated soil. They are considered neglected tropical diseases found mainly in areas with warm and moist climates where living condition and personal hygiene are poor. Aim: The aim of this study was to determine the prevalence of soil-transmitted helminths among primary school pupils in Kangang community of Dadin Kowa, Jos. Materials and Methods: This was a cross-sectional study of 136 elementary school pupils from three selected schools in Kangang community in Dadin Kowa of Jos South Local Government Area of Plateau State between April 2018 and June 2018. Stool samples were collected from all the consented participants in a sterile, universal sampling container prelabeled with the participant's identification number. The samples were analyzed within 2 h of collection using parasites concentration technique and microscopy. The results obtained were analyzed using SPSS version 21. Results: The prevalence of soil-transmitted helminthiasis among the study population was 42.6%. Ascaris lumbricoides (25.7%) was the most common parasites, followed by Trichuris trichiura (10.3%). Hookworm infection was observed in 5.1%, while strongyloidiasis caused 1.5% of STHs. The male participants had a prevalence of 55.2% compared to the females who had a prevalence rate of 44.8%. Based on the schools where the participants were recruited, STHs was more prevalence among participant from KS school with rate of 51.2% followed by EBI school (40.0%), while LP school had the least infection rate of 38.1%. Conclusion: This study revealed the prevalence of STHs among school pupils in Kangang community of Dadin kowa, Jos, as 42.6%. A. lumbricoides was the most common STHs in the area. Males were more infected than females. Age and type of toilet used by the participant were found to be significantly associated with STHs infection.
Keywords: Ascaris lumbricoides, hookworm, soil-transmitted helminths, Strongyloides stercoralis, Trichuris trichiura
|How to cite this article:|
Dahal AS, Francis EO, Francis JE, Wamtas FI. Soil-transmitted helminths and associated risk factors among elementary school pupils in Dadin Kowa, Jos. Niger Med J 2019;60:181-5
|How to cite this URL:|
Dahal AS, Francis EO, Francis JE, Wamtas FI. Soil-transmitted helminths and associated risk factors among elementary school pupils in Dadin Kowa, Jos. Niger Med J [serial online] 2019 [cited 2023 Sep 30];60:181-5. Available from: https://www.nigeriamedj.com/text.asp?2019/60/4/181/271543
| Introduction|| |
Soil-transmitted helminths are intestinal worms transmitted through contaminated soil, causing major health problems in tropical and subtropical regions of the world. The soil-transmitted helminths (STHs) of major concern to humans are Ascaris lumbricoides, Trichuris trichiura, and hookworms (Ancylostoma duodenale and Necator americanus), each parasitizing the gastrointestinal tracts of millions of infected individuals., These parasitic infections ultimately thrive and persist in human communities with high level of poverty, inadequate sanitation, and lack of basic health care.
The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 places the prevalence of infection with soil-transmitted helminths at 1.5 billion cases globally, with over 800 million cases of ascariasis and 400 million each of trichuriasis and hookworm infections., A number of features account for this high prevalence including a ubiquitous distribution, the high number of eggs produced per parasite, the durability of eggs under a variety of environmental conditions, and poor socioeconomic status that facilitate its spread. Although STH infection occurs at all ages, it is most common in children of 2–10 years, and the prevalence decreases over the age of 15 years making elementary school-age pupils the most vulnerable.
The prevalence of STHs may also be affected by climatic and seasonal changes which are important determinants of transmission of STHs infections. Adequate moisture and warm temperature are essential for egg/larval development in the soil.,, For example, eggs of A. lumbricoides and T. trichiura requires high humidity for embryonation and fast development of eggs., Previous studies had reported high STHs infections in rainy season than summer and comparatively lower incidence in winter season.,
The World Health Organization has recommended large-scale, periodic distribution of safe and efficacious antihelminthic drugs as preventive chemotherapy to at-risk populations in endemic areas for morbidity control of STH infections. The current control strategies have focused on mass drug administration (MDA), in which at-risk populations are treated once or twice per year with albendazole (usually given as a single oral dose of 400 mg) or mebendazole (500 mg). While preventive chemotherapy can greatly reduce morbidity from helminth infection, reinfection typically occurs rapidly after treatment. Long-term STHs control and eventual elimination require improvements to water, sanitation, and hygiene (WASH) access and practices.
The successful control of STHs in the United States of America, South Korea, and Japan where WASH improvements acted in concert with deworming to eliminate STHs as a public health problem supports the need for an integrated control programmed in other countries of high endemicity. WASH interventions are diverse, potentially including improvements in water access (e.g., water quality, water quantity, and distance to water), sanitation access such as access to improved latrines, latrine maintenance, and fecal wastes management, and hygiene practices – handwashing before eating and/or after defecation, water treatment, soap use, wearing shoes, and water storage practices. Interventions often include multiple components, for example, building ventilated-improved pit latrines while also providing hygiene education which are usually difficult to provide in developing countries because of high level of poverty., This underscores the need for this research to provide information on the prevalence of STHs among elementary school pupils in Kangang community of Dadin Kowa community, Jos.
| Materials and Methods|| |
The study was conducted among pupils of EBI, KS, and LP schools. The schools are in Kangang community of Dadin Kowa in Jos South Local Government Area of Plateau State. The study area was selected purposely, while the three schools were selected by balloting without replacement out of the total of six schools in the community. EBI and KS schools are privately owned day schools with population of 102 and 143 pupils, respectively. They both use conventional water system toilets and wells as sources of water supply. Most of the students still go to the nearby bushes to defecate as the toilets are inadequate to serve their needs. LP school is a government-owned day school with a total population of 214 pupils during the time of this study. The school lacks a functional toilet, no water supply, and students must use the bushes around to urinate and defecate.
Most of the children attending these schools live with their parents and guardians within the community. The people living in this community are mainly civil servants, farmers, traders, and artisans. The main sources of water supply for the community are from wells, streams, and a few others from borehole, as government pipe-borne water supply is almost none existence as the community is a new layout.
The study population comprised children between the ages of 4 and 14 years old attending primary school in the three selected schools.
Study design and sample size determination
The study was a cross-sectional school-based study of 136 pupils recruited using a multistage sampling technique from April 2018 to June 2018. The sample size was determined using the formula provided by Aeroye, 2003, at 95% confidence interval and a 5% expected error margin. A local prevalence of 9.0% obtained from a previous study by Mamman and Reuben, 2014, was used. By calculating and adding 10% attrition, sample size of 139 was arrived at but only 136 students participated because one student from EBL school and two from LP school did not return with sample. The sample size was distributed to the three selected schools proportionately taking into consideration the total number of students in each school. The students were finally recruited by using a simple paper balloting containing “YES” or “NO,” and those who picked YES were recruited into the study.
Sample collection and processing
Stool sample was collected from each participant using a sterile, leak-proof, and transparent wide-mouthed universal sampling container prelabeled with the participant's identification number. The collected samples were transported within 2 h of collection to laboratory for analysis. The stool samples were processed and examined using formol-ether concentration method. Microscopic examination was performed using ×100 and ×400 magnifications within 30 min of preparation.
The data obtained from the study were analyzed using Statistical Package for the Social Sciences version 21 (IBM SPSS Inc., Chicago, Illinois, USA). Proportions were compared using Chi-square with confidence limit, P < 0.05 considered statistically significant.
Approval for this study was obtained from the Ethics Committee of the Plateau State Specialist Hospital and Universal Basic Education Board. A written informed consent was obtained from the schools' authorities, the parents and guardians of the pupils recruited for this research. The pupils were also educated on the health implications of soil-transmitted helminths and their assent obtained before sampling.
| Results|| |
Out of the total number of 136 pupils screened for soil-transmitted helminths in three different schools Kangang community of Dadin Kowa, 58 (42.6%) were positive for soil-transmitted helminthiasis. Soil-transmitted helminths were more prevalent among participants from KS school with rate of 51.2% followed by EBI (40%), while LP school had the least infection rate of 38.1%. However, this was not statistically significant [Table 1] (χ2 = 1.89, P = 0.39). A. lumbricoides (25.7%) was the most common soil-transmitted helminthiasis among the study population followed by T. trichiura (10.3%). Hookworm infection was observed in 5.1%, while strongyloidiasis caused by Strongyloides stercoralis was responsible for 5.1% of the infection among the study population [Table 1].
|Table 1: Prevalence of soil-transmitted helminths among the study population|
Click here to view
STH infection was found to be more common among age group 7–9 years followed by the age group 4–6 years. Pupils between the age group 13 and 15 years were the least infected. The prevalence in term of age was statistically significant [Table 2] (χ2 = 12.65, P =0.01).
|Table 2: Prevalence of soil-transmitted helminths infections according to age groups|
Click here to view
The types of toilet used by the respondents were significantly associated with the prevalence of soil-transmitted helminthiasis. Those that used conventional water system toilet were infected in 54.3%, while open field/bush defecation was associated with 40.6% of infection with STHs [Table 3] (χ2 = 11.84, P = 0.01).
|Table 3: Prevalence of soil-transmitted helminths among the study population in relation to risk factors|
Click here to view
Another risk factor that was significantly associated with soil-transmitted helminthiasis among the study population was gender. Male participants were infected in 52.5%, while female who were infected with STHs accounted for 34.7%. This association was statistically significant [Table 3] (χ2 = 4.35, P = 0.04).
| Discussion|| |
The prevalence of soil-transmitted helminths among the study population was 42.6%. This was lower than the 58.2% reported in under five in a rural community in Mangu, central zone of the state. The lower prevalence in this research could be due to the fact that this research was conducted in the city where there are better living condition and proper sewage disposal than in the rural areas where sewage disposal is mainly in the bush/open field. In another study, a prevalence of 24.6% was reported among Fulani herders by Okolo and John. The lower prevalence in their study could be because the study was conducted in older age group who may be more conscious of their health and well-being than the younger age group.
Studies in other parts of the country reported different prevalent rates., This may probably be due to the timing of the research, the standard of living of the various communities where such researches were conducted and the periodic deworming and access to health facilities the study population, especially children in urban areas. Variable prevalence rates have been reported in other African countries such as 12.6%, 27.6%, and 43.8% were reported in Ethiopia, Kenya, and Cameroon, respectively, with the same reason as given above probably playing significant role.,
Comparatively, it has been reported that the prevalence of STHs is lower in developed countries because of effective implementation of MDA – albendazole and mebendazole and potable water supply, good sanitation, and hygiene (WASH).,
The most common cause of soil-transmitted helminthiasis in this study was A. lumbricoides responsible for 25.7% of the infection followed by T. trichiura (10.3%), while hookworm accounted for 5.1% and S. stercoralis the least (1.5%) [Table 4]. This is consistent with reports from other parts of the country.,, Similar findings have also been reported in other African countries as well as in Indonesia., However, this is contrary to a report in Kenya where hookworm was reported to be the most common caused of helminthiasis.
|Table 4: Species of soil-transmitted helminths among the study population|
Click here to view
The prevalence rate of STHs in this study based on age group was statistically significant [Table 2] (χ2 = 12.65, P = 0.01). The age group 7–9 years was responsible for the highest prevalence rate of 61.7%. This was possibly because the children in this age group are more adventurous and less concern about their personal hygiene. They commonly wandered into the bush/forest where people patronized for open defecation, either for hunting or looking for fruits such as mango making them prone to infection with STHs. The age group 13–15 years was the least infected possibly because they are more mature and becoming more conscious of their personal hygiene and increasing immunity. They tend to play less in unhygienic environment than the younger age group. Other studies have reported similar findings of high prevalence among this age group.,,
There was statistically significant difference of STHs infection between male and female [Table 3] (χ2 = 4.36, P = 0.04). The males' participants were responsible for 52.5% of the infection, while the female participants were infected in 34.5%. This may possibly be due to the fact that male children are known to be more adventurous, exploring their environment which may predispose them to getting STHs infection than the females who are usually more engaged in domestic activities.
Another risk factor that was significantly associated with STHs infection is the types of toilet used by the population. Those that have conventional water system toilet were more infected (54.3%) followed by those participants who used bush/open field defecation (40.6%) as a means of sewage disposal. Those who use pit latrine are the least infected [Table 3] (χ2 = 11.84, P = 0.01). The use of conventional water system toilet was associated with high risk of soil-transmitted helminthiasis possibly because they have inadequate water supply to adequately keep the toilet neat and therefore predispose to contamination with fecal matter and hence infection with STHs. Other risk factors such as sources of water, wearing of footwears, and washing of hands after defecation were not significantly associated with STHs infection in this study.
| Conclusion|| |
The prevalence rate of STHs was 42.6% with A. lumbricoides identified as the most prevalent parasite. Age group 7–9 years, the male gender, and types of toilet were identified as significant risk factors associated with soil-transmitted helminthiasis among the study population. These emphases the need for reintroduction of MDA and regular deworming to reduce the complications associated with the infections. Potable water supply, sanitation, and improved personal hygiene (WASH) should also be encouraged in our schools and communities to stem the tide of STHS infections.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Dhaka R, Verma R, Kumar R, Chayal V, Bhalla K, Singh R, et al.
Pattern and determinants of soil-transmitted helminthiasis in a rural area of Haryana: A school-based study. J Family Med Prim Care 2019;8:1971-5.
] [Full text]
Periago MV, García R, Astudillo OG, Cabrera M, Abril MC. Prevalence of intestinal parasites and the absence of soil-transmitted helminths in Añatuya, Santiago Del Estero, Argentina. Parasit Vectors 2018;11:638.
Moser W, Schindler C, Keiser J. Efficacy of recommended drugs against soil transmitted helminths: Systematic review and network meta-analysis. BMJ 2017;358:j4307.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the global burden of disease study 2016. Lancet 2017;390:1211-59.
Summary of global update on preventive chemotherapy implementation in 2015. Wkly Epidemiol Rec 2016;91:456-9.
Dunn JC, Turner HC, Tun A, Anderson RM. Epidemiological surveys of, and research on, soil-transmitted helminths in Southeast Asia: A systematic review. Parasit Vectors 2016;9:31.
Elkins DB, Haswell-Elkins M, Anderson RM. The importance of host age and sex to patterns of reinfection with Ascaris lumbricoides
following mass anthelmintic treatment in a South Indian fishing community. Parasitology 1988;96 (Pt 1):171-84.
Pullan RL, Brooker SJ. The global limits and population at risk of soil-transmitted helminth infections in 2010. Parasit Vectors 2012;5:81.
Abraham D, Kaliappan SP, Walson JL, Rao Ajjampur SS. Intervention strategies to reduce the burden of soil-transmitted helminths in India. Indian J Med Res 2018;147:533-44.
] [Full text]
Weaver HJ, Hawdon JM, Hoberg EP. Soil-transmitted helminthiases: Implications of climate change and human behavior. Trends Parasitol 2010;26:574-81.
Yawson DO, Kudu IB, Adu MO. Soil-transmitted helminths in top soils used for horticultural purposes in Cape Coast, Ghana. J Environ Public Health 2018;2018:5847439.
Schüle SA, Clowes P, Kroidl I, Kowuor DO, Nsojo A, Mangu C, et al. Ascaris lumbricoides
infection and its relation to environmental factors in the Mbeya region of Tanzania, a cross-sectional, population-based study. PLoS One 2014;9:e92032.
Choudhary L, Prabhawati, Sinha KP. Seasonal prevalence of soil transmitted helminths in the population of Kosi region of North Bihar. Flora Fauna 2015;21:9-14.
Avhad SB, Wahule VK, Hiware CJ. Effect of climate factors on the prevalence of intestinal helminths from Aurangabad district (MS), India. Int J Basic Appl Res 2012;2:49-55.
Utzinger J, Raso G, Brooker S, De Savigny D, Tanner M, Ornbjerg N, et al.
Schistosomiasis and neglected tropical diseases: Towards integrated and sustainable control and a word of caution. Parasitology 2009;136:1859-74.
Jia TW, Melville S, Utzinger J, King CH, Zhou XN. Soil-transmitted helminth reinfection after drug treatment: A systematic review and meta-analysis. PLoS Negl Trop Dis 2012;6:e1621.
Bartram J, Cairncross S. Hygiene, sanitation, and water: Forgotten foundations of health. PLoS Med 2010;7:e1000367.
Vaz Nery S, Pickering AJ, Abate E, Asmare A, Barrett L, Benjamin-Chung J, et al.
The role of water, sanitation and hygiene interventions in reducing soil-transmitted helminths: Interpreting the evidence and identifying next steps. Parasit Vectors 2019;12:273.
Gruber JS, Reygadas F, Arnold BF, Ray I, Nelson K, Colford JM. A stepped wedge, cluster-randomized trial of a household UV-disinfection and safe storage drinking water intervention in rural Baja California Sur, Mexico. Am J Trop Med Hyg 2013;89:238-45.
Luh J, Baum R, Bartram J. Equity in water and sanitation: Developing an index to measure progressive realization of the human right. Int J Hyg Environ Health 2013;216:662-71.
Pink R. Child rights, right to water and sanitation, and human security. Health Hum Rights 2012;14:E78-87.
Mamman AS, Reuben CR. Intestinal helminthiasis among immates of Jos prison, Plateau State, Nigeria. World Sc Res J 2014;2:67-71.
Afolaranmi TO, Zuwaira IH, Danjuma AB, Yetunde OT, Dakhin PA, Joro SM, et al
. Pattern of intestinal helminthiasis among under five in a rural community of Plateau state, Nigeria. J Trop Med Hyg 2015;2:34-45.
Okolo SN, John C. Nutritional status and intestinal parasitic infestation among rural Fulani children in Vom, Plateau state. Nig J Paediatr 2008;33:47-55.
Ugbomoiko US, Onajole AT, Edungbola LD. Prevalence and intensity of geohelminths infection in Oba-ile community of Osun state, Nigeria. Niger J Parasitol 2006;27:62-7.
Onyemaobi GA, Onimawo IA. Risk factors for Iron deficiency anaemia in under-five children in Imo state, Nigeria. J Appl Sci Res 2011;7:63-7.
Kepha S, Nuwaha F, Nikolay B, Gichuki P, Edwards T, Allen E, et al.
Epidemiology of coinfection with soil transmitted helminths and Plasmodium falciparum
among school children in Bumula district in western Kenya. Parasit Vectors 2015;8:314.
Kimbi H, Lum E, Wanji S, Mbuh J, Nyanga J. Co-infections of asymptomatic malaria and soil-transmitted helminths in school children in localities with different levels of urbanization in the Mount Cameroon region. J Bacteriol Parasitol 2012;3:2.
Adefioye OA, Efunshile AM, Ojurongbe O, Akindele AA, Adewuyi IK, Bolaji OS, et al
. Intestinal helminthiasis among school children in Ilie, Osun state, Southwest, Nigeria. Sierra Leone J Biomed Res 2011;3:36-42.
Samuel F, Demsew A, Alem Y, Hailesilassie Y. Soil transmitted helminthiasis and associated risk factors among elementary school children in Ambo town, Western Ethiopia. BMC Public Health 2017;17:791.
Novianty S, Dimyati Y, Pasaribu S, Pasaribu AP. Risk factors for soil-transmitted helminthiasis in preschool children living in Farmland, North Sumatera, Indonesia. J Trop Med 2018;2018:6706413.
Odinaka KK, Nwolisa EC, Mbanefo F, Iheakaram AC, Okolo S. Prevalence and pattern of soil-transmitted helminthic infection among primary school children in a rural community in Imo state, Nigeria. J Trop Med 2015;2015.
[Table 1], [Table 2], [Table 3], [Table 4]
|This article has been cited by|
||Prevalence and effect of Plasmodium spp. and hookworm co-infection on malaria parasite density and haemoglobin level: a meta-analysis
| ||Aongart Mahittikorn, Frederick Ramirez Masangkay, Giovanni De Jesus Milanez, Saruda Kuraeiad, Manas Kotepui |
| ||Scientific Reports. 2022; 12(1) |
|[Pubmed] | [DOI]|
||Personal Hygiene and Soil Transmitted Helminth Incidence in Elementary School Students Amanuban Barat District, South Central Timor
| ||Michael Bhadi Bia, Ni Made Susilawati, Agnes Rantesalu, Karol Octrisdey, Winioliski L.O. Rohi Bire |
| ||JURNAL INFO KESEHATAN. 2022; 20(2): 260 |
|[Pubmed] | [DOI]|
||Soil-transmitted helminths contamination of carrots and cucumbers, and molecular identification of Ascaris lumbricoides in Jos Plateau State, Nigeria
| ||FavourObioma Barnabas, AbednegoSamuel Dahal, JamesGarba Damen, WilliamsPeter Udo, EnoChongs Mantu, SuzanNduke Joseph, MartinaImeobong Ekpo, UjuUchenna Ashien |
| ||Nigerian Journal of Medicine. 2022; 31(6): 652 |
|[Pubmed] | [DOI]|
||Impact of Three to Five Rounds of Mass Drug Administration on Schistosomiasis and Soil-Transmitted Helminths in School-Aged Children in North-Central Nigeria
| ||Emily Griswold, Abel Eigege, Solomon Adelamo, Bulus Mancha, Nwodu Kenrick, Yohana Sambo, Joseph Ajiji, Gideon Zam, Jacob Solomon, Rita O. Urude, Jonathan Kadimbo, Jacob Danboyi, Emmanuel Miri, Andrew W. Nute, Lindsay Rakers, Obiageli Nebe, Chukwuma Anyaike, Paul Weiss, Gregory S. Noland, Frank Richards |
| ||The American Journal of Tropical Medicine and Hygiene. 2022; 107(1): 132 |
|[Pubmed] | [DOI]|
||Prevalence of intestinal parasitic infection and its associated factors among primary school students in Ethiopia: A systematic review and meta-analysis
| ||Moges Agazhe Assemie,Daniel Shitu,Yidersail Hune,Pammla Petrucka,Ayele Mamo Abebe,Animut Takele Telayneh,Mekdes Marew Ambaw,Daniel Bekele Ketema,Temesgen Getaneh,Belayneh Mengist,Muluneh Alene,Samuel Derbie Habtegiorgis,Zvi Bentwich |
| ||PLOS Neglected Tropical Diseases. 2021; 15(4): e0009379 |
|[Pubmed] | [DOI]|
||Prevalence and associated risk factors of intestinal helminthic infections in children from Lorestan province, Western Iran
| ||Hossein Mahmoudvand,Ebrahim Badparva,Amal Khudair Khalaf,Massumeh Niazi,Mehrdad Khatami,Mohammad Reza Nazer |
| ||Parasite Epidemiology and Control. 2020; : e00136 |
|[Pubmed] | [DOI]|