| dc.description.abstract | Helminth infestations is one of the neglected tropical diseases that affects over 90 million
school aged children in Africa. It is a major public health problem especially in communities
with poor sanitation and hygiene practices. In Kenya, approximately 8,661,333 primary
school children are at risk of helminths. The degree of morbidity is related to the intensity
and the number of species harboured. Control is neccesary because children are at higher risk
of infection and may suffer from nutritional deficiencies, cognitive and physical
development impairement as well as other serious illnesses. To achieve this, updated
epidemiologic data is neccesary to guide policy makers and mass drug administrators. This
was a cross-sectional study that aimed to determine the prevalence, intensities of infestation,
pattern, relationships and geographical distribution of single and multiple species of
helminths in primary school children aged 5-12 years old in Kisumu Municipality. Three
stool samples were collected from 1300 pupils selected from 12 schools and analyzed for
parasites using Kato-Katz technique. Primary schools were mapped using geographical
information system data generated by hand-held geographical global positioning system
units. Prevalence and intensities maps were generated using ArcView geographical
information system software. Overall, 40.69% (529) of the pupils were infected by at least a
species of helminths. The prevalence of single helminths infections for, Ancylostoma
duodenale, Ascaris lumbricoides, Trichuris trichiura and Schistosoma mansoni was 2.15%
(28), 3% (39), 12.08% (157) and 32.77% (426) respectively. The prevalence of dual coinfections was 7.54% (98), triple helminths co-infestations 0.1% (10) and quadruple coinfestations 0.08% (1). Light intensity was common in all the helminths. Most helminths
were more prevalent in 9-12 years age group than in 5-8 years age group, Ascaris
lumbricoides P =0.0159 (95% CI = 1.391-24.285, ), Trichuris trichuria P = 0.0002 (95% CI
= 1.599-4.541) and S. mansoni P = 0.0001(95% CI = 2.461-4.888) and not significant in
Ancylostoma duodenale P = 0.0592 (95% CI = 0.947-17.059). Male pupils were more
infested than female pupils with Ancylostoma duodenale (OR 2.83, 95% CI = 1.07-5.04, P =
0.03), Ascaris lumbricoides (OR 2.57, 95% CI =1.28 - 5.13, P = 0.01), Trichuris trichiura
(1.43, 95% CI =1.02 - 5.31, P = 0.03) and Schistosoma mansoni (OR 1.40, 95 % CI = 1.40-
1.78, P = 0.01), Chi-square test was used. Mapping showed presence of Schistosoma mansoni
and Trichuris trichuria in all the school and the more proximate a school was to the Lake
Victoriathe more the number of helminths types present. In conclusion helminths are a public
health problem in Kisumu municipality. Schistosoma mansoni and Trichuris trichiura were
present in all the schools. The trend of Ancylostoma duodenale being the most prevalent soil
transmitted helminth as shown in earlier studies changed to Trichuris trichiura. This could
have been attributed by persistent use of albendazole which has less efficacy to Trichuris
trichiura, thus alternative use of albendazole and mebendazole should be embraced in mass
drug administration. The more proximate the school was to Lake Victoria the more the
number of helminths present and all the schools at the periphery had only two helminths
species of Schistosoma mansoni and Trichuris trichiura. These results provided current
epidemiologic information to the Ministry of Health and stakeholders that could be used in
targeted implementation of helminths control and eradication strategies. | en_US |
