Soil-transmitted helminths infections, malnutrition and anaemia among primary school children in Same district

Abstract

Introduction: Soil-transmitted helminths (STHs) are major public health problems in several tropical and subtropical developing countries with poor socio-economic status. In Tanzania published data suggest that all regions have some level of infection with some areas having prevalence of up to 100%. Children are found to have the highest prevalence and infection intensities and are also very vulnerable to the effects of worm infection which includes nutritional deficiencies which aggravate malnutrition and worsening the rates of anaemia. Prior to the implementation of any control programme, WHO recommends a baseline survey in school children to determine the prevalence and intensity of infections as governments need to target treatment appropriately, based on reliable and up-to-date information on the geographical distribution of infection . Currently there are no data on the extent of these problems in Same district. Therefore this study was designed to determine the prevalence and intensity of STH infections, malnutrition and anaemia among priamary school children in Same district Objective: This study aimed at determining the prevalence and intensity of STH infections, malnutrition and anaemia among primary school children in Same district. Materials and Methods: A descriptive cross-sectional study was carried out in Same district. A stratified multistage cluster sampling was applied to obtain 10 schools for the study. A minimum of 61 children were sampled from each school. A total of 579 school children were recruited. Stool specimens were obtained from 549 children. Kato-katz technique was used to determine status and intensity of STH infection. Body weight and height were determined by using a weighing scale and height pole respectively. Anthropometric measurements were analyzed using z- scores of height-for-age and BMI-for-age (BMIA) indices. Hemoglobin levels were determined using HemoCue photometer. Data analysis was done using SPSS software version13. Ethical clearance was obtained from the MUHAS Ethical Review Board and permission to conduct the research was obtained from the district authorities. Results: The overall prevalence of STH was found to be 0.9% (5/549). The prevalence of light and moderate intensity infections were 0.5% (3/549) and 0.4% (2/549) respectively. Theprevalence of stunting was 42.3% with 11.1% being severely stunted. Prevalence of stunting was more in male (48.6%) than in female (37.8%) (P=0.015). Pupils in the upland plateau zone were more stunted than children in the middle plateau zone and lowlands zone with prevalence of 48.4%, 38.6% and 38.5% respectively (P=0.029). The overall prevalence of thinness was 11.7%. The prevalence of thinness was highest in the lowlands zone (15.8%) compared to the middle and upland plateau zone 14.6% and 5.9% respectively (P=0.013). The mean Hb level was 13.4g/dl [95%CI (13.2g/dl, 13.5g/dl)]. The overall prevalence of anaemia was 3.1%. There was no difference in the prevalence of anaemia by age-group, sex and topographical zone. Conclusion: This study revealed that STHs is not a problem in Same district. The mass chemotherapy conducted by NSSCP in 2008, and the ongoing provision of antihelminthic drugs to children under the age of five has achieved to maintain the prevalence of STH in the district at low levels. However malnutrition has been observed to be a problem in the district with nearly half of the children being stunted. Recommendations: With the observed low prevalence of STH in Same district, selective treatment is recommended as a chemotherapeutic method of controlling STH in the district. Studies that are going to establish the cause of the observed prevalence of malnutrition are also recommended.