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American Journal of Health Research2015; 3(2): 57-62Published online February 28, 2015 (htt:!!"""#s$ien$eublishin%%rou#$o&!'!a'hr)doi: 10#1168!'#a'hr#20150302#12
**+: 2330-8788 (Print); **+: 2330-876 (nline)
A Survey of Soil-Transmitted Helminths Infections and
Schistosomiasis mansoni among School Children inLibo-Kemem !istrict" #orth$est %thio&ia' Cross SectionalStudy
Tesfahun Addisu1, Achenef Asmamaw
2
1.eart&ent o/ edi$al aboratory *$ien$e, olle%e o/ ealth *$ien$e, 4ahir .ar ealth *$ien$e olle%e, 4ahir .ar, thioia2.eart&ent o/ bstetri$s and ynae$olo%y, P+ /ri$an ni9ersity, ni9ersity o/ badan, badan, +i%eria
Email address:tes/ahunhi&i%&ail#$o& (# es/ahun), ashua201%&ail#$o& (# s&a&a")
To cite this article:es/ahun ddisu, $hene/ s&a&a"# *ur9ey o/ *oil-rans&itted el&inths n/e$tions and Schistosomiasis mansoni a&on% *$hool
hildren in ibo-<e&=e& .istri$t, +orth"est thioia: ross *e$tional *tudy# American Journal of Health Research.
>ol# 3, +o# 2, 2015, # 57-62# doi: 10#1168!'#a'hr#20150302#12
Abstract: he burden o/ disease $aused by in/e$tion "ith s$histoso&iasis and soil-trans&itted hel&inthes re&ains enor&ous#
t is "idely re$o%ni?ed that s$hool $hildren $arry the hea9iest burden o/ &orbidity# art /ro& the &orbidity asso$iated "ith
a$ute in/e$tions, those "ho are $hroni$ally in/e$ted are o/ten hysi$ally and intelle$tually $o&ro&ised by anae&ia, leadin% to
attention de/i$its, learnin% disabilities, s$hool absenteeis& and hi%her droout rates# a=in% this into $onsideration, the ai& o/
this study "as to in9esti%ate the re9alen$e, the intensity and the relati9e /re@uen$y o/ &ulti-arasitis& o/ the &a'or soil-
trans&itted hel&inthes ( Ascaris lumbricoides, Trichuris trichiura, and the hoo="or&s) and Schistosoma mansoni# $ross
se$tional sur9ey "as $ondu$ted /ro& February 10, 2011 u to ay 10, 2011, in three ri&ary s$hools in ibo-<e&=e&
.istri$t, north"est thioia# 365(173 &ales and 12 /e&ales) uils, sele$ted usin% syste&ati$ sa&lin% usin% a rando& start,
had their /e$al se$i&ens been eAa&ined usin% <ato-<at? $ellohane /e$al thi$= s&ear te$hni@ue (1#7 &% te&late)# *#
&ansoni "as the &ost re9alent (15#B) /ollo"ed by A. lumbricoides (11#0B), the hoo="or&s (8#2B) and T. trichiura (1#6B)
and the $orresondin% %eo&etri$ &ean e%% $ounts er %ra& "ere 122, 17, 582 and 13 rese$ti9ely# *in%le, double and trile
in/e$tions en$ountered "ere 21#1B, #B and 1#B rese$ti9ely# ost o/ the double in/e$tions "ere a $o&bination o/ A.
lumbricoides and the hoo="or&s (3#6B)# ll s$hools $o&bined, the a9era%e re9alen$e and e%% $ount /or ea$h hel&inthes
"ere neither a%e nor seA related but intensity o/ S. mansoni by a%e %rou "hi$h "as statisti$ally si%ni/i$ant (C0#05)# he
distribution o/ hel&inthes a&on% uils "as o9er disersed: that is, "hile &ost uils harbored /e" or no and a /e" harbored
&any o/ the&# lthou%h, as $o&ared to the re9ious studies, the resent study sho"ed a lo"ered in/e$tion rates, the relati9e
in$rease in S. mansoni re9alen$e si%ni/ies a need /or ro&otin% inter9ention &easures#
Keywords: *oil-trans&itted hel&inthes in/e$tion, Schistosma mansoni, thioia
1. Background
he burden o/ disease $aused by in/e$tion "ith
s$histoso&iasis and soil-trans&itted hel&inths (*)
re&ains enor&ous D1E# bout 2 billion eole are a//e$ted
"orld"ide, o/ "ho& 300 &illion su//er asso$iated se9ere
&orbidity# orld ealth r%ani?ation () esti&ated that
these in/e$tions reresented &ore than 0B o/ the disease
burden due to all troi$al diseases, eA$ludin% &alaria D1E#
&on% arasiti$ diseases in the troi$s and subtroi$s,s$histoso&iasis ran=s se$ond to &alaria in ter&s o/ so$io-
e$ono&i$ and ubli$ health i&ortan$e, "ith an esti&ated
77 &illion eole are at ris= and 200 &illion in/e$ted D2, 3E#
n esti&ated 85B o/ all $ases, and the &a'ority o/ se9ere
&orbidity, are no" $on$entrated in sub-*aharan /ri$a D3E#
he yearly death rate in the re%ion is esti&ated to be &ore
than 200,000 DE# *$histoso&iasis has also lon% been
re$o%ni?ed as a &a'or ubli$ health roble& in ast /ri$a
D5E# thioia is one o/ the oorest and least de9eloed$ountries in the "orld, ende&i$ /or &any ne%le$ted troi$al
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&eri$an Gournal o/ ealth Hesear$h 2015; 3(2): 57-62 58
diseases (+.s) in$ludin% s$histoso&iasis D6E#
he soil-trans&itted hel&inths (*): hoo="or&s, A.
lumbricoides and T. trichiura are also "idely distributed in
troi$al $ountries D7E, in/e$tin% 1300, 150 and 1050 &illion
eole, rese$ti9ely D8E
t is "idely re$o%ni?ed that s$hool $hildren $arry the
hea9iest burden o/ &orbidity due to intestinal hel&inths and
s$histoso&iasis in/e$tion D10E#
hroni$ in/la&&atory ro$ess asso$iated "ith lon%-ter&
s$histoso&iasis $ontributes to ane&ia and under-nutrition,
"hi$h, in turn, $an lead to %ro"th stuntin%, oor s$hool
er/or&an$e, oor "or= rodu$ti9ity, and $ontinued o9erty
DE# oo="or& in/e$tion is a ubli$ health roble& o/ %reat
&a%nitude and rodu$es &orbidity by blood loss, "ith
$onse@uent iron de/i$ien$y ane&ia and hyo-roteinae&ia
D10E# s$ariasis has an ad9erse e//e$t on nutrition and also
results in serious atholo%y due to &i%rations o/ the "or&s
in the body# Trichuriasis is i&li$ated in re$tal rolase and
$hroni$ dysentery D10E# *i&ultaneous and se@uentialtrans&ission o/ &ultile arasites, and their resultant
o9erlain% $hroni$ in/e$tions, are /a$ts o/ li/e in &any
underde9eloed rural areas# hese reresent si%ni/i$ant but
o/ten oorly &easured health and e$ono&i$ burdens /or
a//e$ted oulations DE#
*ur9eys $arried out on *$histoso&es and the %eo-
hel&inths on s$hool $hildren in thioia ha9e sho"n that the
hel&inthi$ in/e$tions "ere &a'or ubli$ health roble&s in
&any areas D10E# lthou%h /e" studies ha9e tried to address
the roble&s en$ountered by hel&inthes in $ertain
$o&&unities in north"est thioia, no study, to our
=no"led%e, "as $ondu$ted in the distri$t o/ ibo-<e&=ee$ause o/ this, the resent study "as $ondu$ted to
deter&ine the re9alen$e and the intensity o/ the &a'or
intestinal hel&inthes arasites and the relati9e /re@uen$y o/
&ulti-arasitis& on s$hool $hildren#
2. ethods and aterials
2.1. Study Design, Period and Area
$ross-se$tional sur9ey usin% @uantitati9e ðod "as
$ondu$ted# he study "as $arried out in ibo-=e&=e&
distri$t, *outh ondar Ione; +orth"est thioia /ro&
February10, 2011 to ay-10, 2011# he study area is lo$ated bet"een 4ahir .ar and ondar on the &a'or road $onne$tin%
ddis baba to the *udan#
2.2. Study Population
ll s$hool$hildren in ri&ary s$hools o/ the ibo-
<e&=e& distri$t
2.3. Variables
*oil-trans&itted hel&inths in/e$tions and Schistosomiasis
mansoni "as deendent 9ariable# %e, seA, s$hools "ere
indeendent 9ariables#
2.4. Sample Size and Sampling Procedures
*a&le si?e "as $al$ulated usin% sin%le oulation
roortion /or&ula by ta=in% the roortion o/ one or
&ultile arasiti$ in/e$tions /ro& re9ious studies $ondu$ted
in other art o/ the $ountry i#e# 68#B (10)# 4y settin%
$on/iden$e inter9al at 5B and alha at 5B and addin%$ontin%en$y o/ 10B a total o/ 365 sa&le si?e "as $al$ulated#
he study "as underta=en in three ri&ary s$hools (labo,
ddis Ie&en and bebaye ri&ary *$hool) out o/ those
/ound in the .istri$t# $$essibility by /our "heel dri9e and
roAi&ity /or health $enters "as a /a$tor in the sele$tion o/
the s$hools to be in9ol9ed in the study# Fi9e se$tions "ere
sele$ted /ro& ea$h s$hool by lottery ðod and the nu&ber
o/ students to be in$luded in the study /ro& the sele$ted
se$tions o/ ea$h s$hool "as deter&ined based on roortion#
he $al$ulated roortion o/ students /ro& se$tions o/ ea$h
s$hool "as sele$ted by a syste&ati$ sa&lin% te$hni@ue
usin% a rando& start /ro& a $o&lete re%ister o/ /i9e se$tions#heir a%es and seAes "ere re%istered to a reared /or&at#
2.5. Stool ollection and !"amination
*tudents "ere sulied "ith labeled lasti$ $ontainers and
ali$ator sti$=s to brin% about 3%&s o/ /ae$es# *a&les
$olle$ted /ro& 365 students "ere ro$essed "ith the <ato-
<at? $ellohane thi$= s&ear te$hni@ue usin% 1#7 &%
te&lates# hree slides "ere reared /or ea$h sa&le and
eAa&ined by "ell trained eAertise# he e%%s o/ all intestinal
hel&inths en$ountered under the &i$ros$oe (usin% the 10 A
eyeie$e &a%ni/i$ation) "ere $ounted and the a9era%e "as
ta=en "hen e%%s /ound on the three slides# For ea$h arasitese$ies the a9era%e nu&ber o/ e%%s $ounted "as $on9erted to
e%%s er %ra& o/ /ae$es by &ultilyin% by a /a$tor o/ 2#
2.#. Data Analysis
.ata "as analy?ed usin% *P** 9ersion 16#0 and *tata *
10 $o&uter so/t"are and resented in tables and %rahs#
he hi-s@uare test and indeendent -test "ere utili?ed to
assess si%ni/i$ant di//eren$es obtained in in/e$tion rates and
e%% $ounts a&on% the a%e %rou and seA o/ s$hool$hildren
under $onsideration# di//eren$e "as ta=en as si%ni/i$ant at
a -9alue less than 0#05#
2.$. %uality Assurance
he @uality o/ the se$i&ens "as =et by %i9in%
orientation to the students ho" to $olle$t be/ore $olle$tion#
he stool s&ear that "as eAa&ined and said either ositi9e or
ne%ati9e /or any o9a o/ hel&inthes "as re-$he$=ed by other
eAerien$ed erson to de$ide its ositi9ity or ne%ati9ity#
2.&. !t'ical learance
thi$al $learan$e "as obtained /ro& nstitutional He9ie"
4oard o/ =lilu e&&a nstitute o/ Pathobiolo%y (P4),
ddis baba ni9ersity and letter "ritten by P4 to the
oreda ealth and du$ation //i$e "as ta=en to %et er&ission to in9ol9e students in the study and %et suort
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5 es/ahun ddisu and $hene/ s&a&a": *ur9ey o/ *oil-rans&itted el&inths n/e$tions and Schistosomiasis mansoni
a&on% *$hool hildren in ibo-<e&=e& .istri$t, +orth"est thioia: ross *e$tional *tudy
"ith &aterials rese$ti9ely# he bene/it o/ the study "as
eAlained to the dire$tors o/ ea$h s$hool and students# hose
students "ho "ere ositi9e /or any o/ the hel&inths "ere
o//ered /ree treat&ent# hildren ositi9e for S. mansoni "ere
treated on the sot "ith a sin%le dose o/ ra?i@uantel at
0&%!=% stat body "ei%ht# o"e9er, those "hi$h "ere
ositi9e /or the other hel&inthes "ere treated "ith sin%le
dose o/ albenda?ole 00&% stat body "ei%ht#
!. "esults
total o/ 365 $hildren "ere eAa&ined# / these 173 and
12 "ere &ales and /e&ales rese$ti9ely (able 1)# he
o9erall re9alen$e rate /or one or &ultile arasiti$ in/e$tions
in the s$hool $hildren "as 27#B (table 3)# / the sa&led
s$hool $hildren, 15#B, 11#0B, 8#2B, and 1#6B had S.
mansoni, A. lumbricoides, the hoo="or&s and T. trichiura
and the $orresondin% %eo&etri$ &ean e%% $ounts er %ra&
o/ /ae$es "ere 122, 17, 582 and 13 rese$ti9ely (table 1)#
he o/ the /our hel&inthi$ in/e$tions "as hi%h in labo# S.
mansoni "as hi%hest in re9alen$e in labo (20#3B)
/ollo"ed by bebaye (15#5B) "hile the intensity o/ in/e$tion
"as hi%hest in labo (1 e%) /ollo"ed by ddis Ie&en
(112 e%)# o"e9er, the intensity o/ A. Lumbricoides
in/e$tion "as hi%hest (206 e%) in ddis Ie&en#
oo="or& in/e$tion "as &ost re9alent in labo (#0B)
/ollo"ed by ddis Ie&en (8#6B)# he intensity o/
hoo="or& in/e$tion "as hi%hest (65 e%) in bebaye "here
the re9alen$e "as lo"est (6#B) indi$atin% that the /e"
in/e$ted $hildren $ould ha9e hi%h "or& burdens# +o T.
trichuria in/e$tion "as re%istered in bebaye "hereas the
intensity o/ in/e$tion "as $o&arable in labo and ddis
Ie&en (able 1)#
(able 1. Prevalence (%) of intestinal helminthes infections and averae e counts !er ram of faeces ("P#) includin anal$sis b$ ae rou! and se in
children attendin three !rimar$ schools in Libo&'emem istrict, *orth+est "thio!ia, ebruar$, -//
#o.
E$am
%ositi&e for
S. mansoni A. lumbricoides 'ookworms (. tric'iura
( ) *+ E%* ( ) * E%* ( ) * E%* ( ) * E%*
chools
labo P#* 133 27 20#3 1 1 1#3 1611 12 #0 613 3#0 13
ddis Ie&en P#* 116 13 11#2 112 11 #5 206 10 8#6 6 2 1#7 1
bebaye P#* 116 18 15#5 100 10 8#6 1702 8 6# 65 0 0#0 0
otal ositi9e 365 58 15# 122 0 11#0 17 30 8#2 582 6 1#6 13
e$
ale 173 33 1#1 101 22 12#7 238 1 8#1 1013 2 1#2 8
Fe&ale 12 25 13#0 156 18 # 118 16 8#3 35 2#1 16
Age *rou-s
5- years 12 36 18#8 17 21 10# 1838 18 # 713 3 1#6 12
10-1 years 173 22 12#7 8 1 11#0 1656 12 6# 30 3 1#7 15
J PKeo&etri$ ean %% er ra&
e&g for (-) years
e&g for *+-*, years
6 8 10 12 14
Age in years
50
10 0
15 0
20 0
25 0
g e o m e t r i c
m e a n e & g
)igure 1. 0ntensit$ of infection of S. mansoni b$ ae rou! in children attendin three !rimar$ schools in Libo&'emem istrict, *orth+est "thio!ia, ebruar$,
-//
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&eri$an Gournal o/ ealth Hesear$h 2015; 3(2): 57-62 60
+o statisti$ally si%ni/i$ant di//eren$e "as obtained in
intensity o/ in/e$tion a&on% the a%e %rous and seAes o/
s$hool $hildren /or A. lumbricoides, the hoo="or&s and T.
trichuria in/e$tions under $onsideration (L0#05)# his
denotes a si&ilar eAosure ris= to in/e$tion by these
hel&inthes (table-1)
nalysis o/ a%e-se$i/i$ intensities o/ S. mansoni in/e$tion
sho"ed that s$hool$hildren o/ the a%e %rou 5- years $arried
the hea9iest load "hi$h "as statisti$ally si%ni/i$ant (C0#05)
(Fi%# 2) "hile no statisti$ally si%ni/i$an$e di//eren$e "as
obser9ed in re9alen$e (PL0#05) (table-1)# 4oth re9alen$e
and intensity o/ S. mansoni in/e$tion due to seA sho"ed no
statisti$ally si%ni/i$ant di//eren$es (PL0#05) (able1)#
he /re@uen$y distribution o/ e%% $ounts o/ the hel&inthes
a&on% s$hool$hildren "as o9er disersed: i#e#, "hile &ost
$hildren harbored /e" or no e%%s, a /e" harbored &any o/
the&# his distribution has $lini$al $onse@uen$es /or the
$hildren, as it is &ainly the intensity o/ in/e$tion thatdeter&ines the se9erity o/ &orbidity# 4ut /or T. trichuria, the
re9alen$e o/ both &oderate and hea9y in/e$tions "as ?ero
(table 2)#
(able 2. 1lassification of intensit$ of infection of S. mansoni, A.
lumbricoides, T. trichiura, and the hoo+orms in children attendin three
elementar$ schools in Libo 'emem istrict, *orth+est "thio!ia, ebruar$,
-//
Egg range All school
#o. e$am. *
S. mansoni
+e%ati9e (0 e%) 307 8#1
i%ht in/e$tion (1- e%) 26 7#1
oderate in/e$tion (100-3 e%) 26 7#1
ea9y in/e$tion (L00 e%) 6 1#6
otal 365 100#0
A. lumbricoides
ne%ati9e (0 e%) 325 8#0
li%ht in/e$tion (1- e%) 30 8#2
&oderate in/e$tion (5000- e%) 8 2#2
hea9y in/e$tion (L50000 e%) 2 0#6
otal 365 100#0
oo="or&s
ne%ati9e (0 e%) 335 1#8
li%ht in/e$tion( 1-1 e%) 27 7#
&oderate in/e$tion (2000-3 e%) 1 0#3
hea9y in/e$tion ( L000 e%) 2 0#5
otal 365 100#0T. trichuria
+e%ati9e (0 e%) 35 8#
i%ht in/e$tion (1- e%) 6 1#6
0tal 365 100#0
rile, double and sin%le in/e$tions "ere /ound in 7(1#B),
18 (#B) and 77 (21#1B) o/ stool se$i&ens, rese$ti9ely#
ost o/ the double in/e$tions "ere a $o&bination o/ A.
lumbricoides and the hoo="or&s 13(3#6B)# nly S. mansoni,
A. lumbricoides, and the hoo="or&s o$$urred as trile
in/e$tion "hile no @uadrule in/e$tion "as re$orded# his
&ay be due to a de$rease in re9alen$e o/ in/e$tions# he
hi%hest re9alen$e /or a sin%le in/e$tion "as re$orded /or S.
mansoni 6(12#6B) /ollo"ed by A. Lumbricoides 18 (#B)
(able 3)#
(able 3. 2ulti!le intestinal helminthic infections in children attendin three
elementar$ schools in Libo 'emem istrict, north+est "thio!ia, -//
ulti-licity of
infections
ales emales Both se$es
( ) ( ) ( )
*e$i&ens "ith 3
hel&inth arasites
*# , and 5 2# 2 1#0 7 1#
*e$i&ens "ith 2
hel&inth arasites
* and 0 0#0 2 1#0 2 0#5
and 6 3#5 7 3#6 13 3#6
* and 1 0#6 0 0#0 1 0#3
* and 1 0#6 1 0#5 2 0#5
*e$i&ens "ith 1
hel&inth arasite
* 26 15#0 20 10# 6 12#6
11 6# 7 3#6 18 #
2 1#2 7 3#6 2#5
1 0#6 3 1#6 1#1
otal Positi9e 53 30#6 25#5 102 27#
otal +e%ati9e 120 6# 13 7#5 263 72#1
otal 173 100#0 12 100#0 365 100#0
* K *# &ansoni, K oo="or&, K # lu&bri$oides, K#tri$hiura
/. 0iscussion and onclusion
he &ain interests o/ this study "ere re9alen$e, intensity
and &ultili$ity o/ &a'or intestinal hel&inthes in/e$tion#
$$ordin% to the result o/ this ro'e$t the re9alen$e o/ S.
mansoni, A. lumbricoides, the hoo="or&s and T. trichiura
in/e$tions a&on% s$hool $hildren "ere 15#B, 11#0B, 8#2B
and 1#6B rese$ti9ely# his result is lar%er as $o&ared to
the study $ondu$ted in the se&i-astoralist tribes in lo"er
&o >alley D11E# his di//eren$e &ay be attributed to the
di//eren$e in en9iron&ental $onditions; hen$e arid $ondition
is not /a9orable /or lar9al de9elo&ent in re9ious study#
*ur9eys $ondu$ted by Ge&aneh on intestinal hel&inths
a&on% s$hool $hildren in hil%a .istri$t, +orth ondar Ione
reorted o9erall re9alen$eMs o/ 1#B, 2#B, 37#7B, and
1#8B /or *. mansoni, # lumbricoides, hoo="or& and T.
trichira in/e$tions rese$ti9ely "hi$h are hi%her than our
reort D10E# n9iron&ental sanitation, "ater suly and
so$ioe$ono&i$ status o/ households &ay be $ontributin%/a$tors /or the di//eren$e, althou%h this needs to be 9eri/ied in
&ore eAtensi9e /ollo" u studies# ther /a$tors related to
&a$ro-and &i$ro-en9iron&ent, ti&e o/ study, ðod o/
eAa&ination, et$#, do also lay a role#
i%her results "ere re$orded as $o&ared to the resent
study on resear$hes $ondu$ted on intestinal arasites a&on%
$o&&unities in di//erent arts o/ thioia D12E; &ay be
resultin% /ro& di//eren$e in ðodolo%ies used; be$ause less
sensiti9e te$hni@ue "as used in this study than the re9ious#
n the other hand, a reort /ro& a study on intestinal
hel&inthes a&on% residents o/ the Fin$hia *u%ar Plantation
rea sho"ed a hi%her re9alen$e than the $urrent study D13E#
he re9ious ro'e$t area $an be &ore /a9orable /or
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61 es/ahun ddisu and $hene/ s&a&a": *ur9ey o/ *oil-rans&itted el&inths n/e$tions and Schistosomiasis mansoni
a&on% *$hool hildren in ibo-<e&=e& .istri$t, +orth"est thioia: ross *e$tional *tudy
de9elo&ent, sur9i9al and trans&ission o/ hel&inths# &on%
s$hool $hildren, S. mansoni (21#2B), A. lumbricoides (6#2B) ,
the hoo="or&s (60#2B) and T. trichuria (1#7B) in/e$tions
"ere reorted D1E# Hesults "ere hi%her but /or A.
lumbricoides than this ro'e$t; i&li$ation o/ the sa&lin%
di//eren$es#
n eneral, $o&ared to the re9ious reorts, the resent
study sho"ed lo"er re9alen$e o/ the hel&inthes in/e$tion#
his &ay be due to an in$rease in eoleMs a"areness on
ersonal hy%iene, en9iron&ental sanitation, use o/ latrines
$reated by health eAtension "or=ers in a rural area and
"ee=ly health a$=a%e ro%ra&s "ith other health "or=ers in
rban# o"e9er, the re9alen$e obtained still indi$ates as
&ore e//ort has been anti$iated /ro& health eAtension
"or=ers and other health ro/essionals to $reate a"areness on
the eide&iolo%y and $ontrollin% ðods o/ intestinal
hel&inthes in the $o&&unity, s$hool$hildren in arti$ular#
n s$hool $hildren o/ 4abile to"n, a re9alen$e o/ #3B
/or S. mansoni and 6#7B /or the hoo="or&s "as re%isteredD15E# he re9alen$e o/ the hoo="or& is $o&arable "ith
the resent ro'e$t but that o/ S. mansoni is &u$h lo"er
"hi$h is an i&li$ation o/ a /re@uent eAosure o/ $hildren to
s$histo-in/ested "ater in the $urrent ro'e$t rea# reort
/ro& +i%eria, $uador and ala"i sho"ed a hi%her
re9alen$e a&on% s$hool $hildren than this study D16, 17, 18E#
he di//eren$e &ay arise due the di//eren$e in the study
$o&&unities; i#e# i&&unity, /eedin% habit, li9in% $ondition
and a"areness on health#
+o si%ni/i$ant di//eren$e "as obtained in in/e$tion rates
and e%% $ounts a&on% the a%e %rou and seA o/ s$hool
$hildren under $onsideration but S. mansoni intensity o/in/e$tion by a%e %rou# his denotes &ore or less a si&ilar
eAosure ris= to in/e$tion by these hel&inths#
he intensity o/ hel&inthi$ in/e$tion in this study has been
assessed indire$tly by e%% $ounts in /ae$es# his ðod,
althou%h sus$etible to errors o/ sa&lin% due to eriodi$ity
o/ e%% rodu$tion by /e&ale "or&s "hi$h &ay lead to
une9en distribution o/ e%%s in /ae$es, is still "idely used as a
&easure o/ intensity o/ intestinal hel&inthi$ in/e$tions D1)#
sin% this ðod, study on the intensity o/ in/e$tion has
been $arried out a&on% s$hool $hildren o/ .e&bia lains in
+orth ondar area# he intensity o/ in/e$tion "as /ound to be
$o&arable "ith the resent study D20E# *i&ilar atterns o/
intensity o/ in/e$tion ha9e been obser9ed else"here D13E# 4ut
&u$h hi%her Ps /or the hel&inths "as obser9ed in a study
$ondu$ted in dar=ay .istri$t than that o/ the resent ro'e$t
D21E# he di//eren$e &ay be due to di//erent /a$tors; i#e#
en9iron&ental sanitation, "ater suly, so$io-e$ono&i$
status, i&&unity, and di//eren$es in eAosure to in/e$tion#
he $ate%ori?ation o/ the intensity o/ in/e$tion due to S.
mansoni, A. lumbricoides, T. trichiura, and the hoo="or&s
sho"ed that &a'ority o/ the sa&led $hildren "ere ne%ati9e
or /e" e%% eA$reters# 4ut, a /e" rodu$ed &oderate and
hea9y e%%s# *i&ilar /indin%s ha9e been reorted /ro& a study
$ondu$ted in the Fin$ha *u%ar Plantation area D13E# He9erse
/indin%s "ere /ound in hil%a .istri$ts and .e&bia lains inthioia and in +i%eria also hea9y in/e$tion "as hi%her D21,
20, 16E# his &ay be attributed to the ran%e o/ 9alues used /or
$lassi/i$ation; that &eans in the resent study the
standard is used# he hi%h de%ree o/ a%%re%ation o/ e%%s in
the in/e$ted oulation has an i&li$ation in the
$onta&ination o/ the en9iron&ent#
ultile hel&inthes in/e$tion is a $o&&on heno&enon in
areas "here di//erent tyes o/ arasites are en$ountered# n
double in/e$tion, S. mansoni and A. lumbricoides
$o&binations "ere &ost $o&&on in the study $ondu$ted in
hil%a .istri$t si&ilar to the resent study "hile di//erent in
trile in/e$tion $o&bination D21E# n trile in/e$tion,
$o&bination o/ S. mansoni, A. lumbricoides and the
hoo="or&s "ere &ost $o&&on in this study, si&ilar to the
re9ious reorts in .e&bia Plains and dar=ay but di//erent
in double in/e$tion o&bination D20E#
his is robably due to the hi%her re9alen$e o/ the three
hel&inths in the study $o&&unities# n $on$lusion,
in9esti%atin% the re9alen$e, the intensity and &ulti-
arasitis& o/ intestinal hel&inthes, S. mansoni and &a'or* in arti$ular, in s$hool $hildren is o/ ara&ount
i&ortan$e in illustratin% their health status and the roble&s
that need to be addressed to i&ro9e their health and "ell-
bein%# 9en thou%h, the o9erall re9alen$e, in this study, "as
lo"er as $o&ared to &ost o/ the re9ious reorts in
di//erent areas; still the redo&inant re9alen$e o/ S.
mansoni, /ollo"ed by A. lumbricoides and the hoo="or&s
alon% "ith the hea9iest burdens raises a serious $on$ern# s
hel&inthes in/e$tion and disease ad9ersely a//e$t $hild
%ro"th and de9elo&ent, nutritional status and $o%niti9e
$aa$ity "hi$h ha9e been roortionally asso$iated "ith
"or& burden, inter9ention &easures i#e# health edu$ation on ersonal hy%iene, $ontrollin% &e$hanis&s and "ays o/
trans&issions o/ hel&inths in/e$tions, roer use o/ latrines,
$onse@uen$es o/ oen /ield de/e$ation and other health-
ro&otin% beha9ior should tar%et s$hool $hildren, "ith lon%
ter& i&ro9e&ents o/ sanitation and ro9ision o/ $lean "ater
to the $o&&unity#
. trength and 3eakness
5.1. Strengt'
he results o/ stool eAa&ination "as re-$he$=ed by &ore
eAerien$ed laboratory ersonnel and as &u$h as ossiblearoriate stool eAa&ination ðod is used /or its
&aAi&u& @uality
5.2. +eaness
i=e &ost other health studies, data /ro& $ross-se$tional
studies, by its nature has a de/e$t to dete$t $ause and e//e$t
relationshi; there $ould be so$ial desirability and re$all bias
by resondents to address all rele9ant 9ariables and sin$e the
study did not in$lude asso$iated /a$tors, the relationshi "ith
$ontributin% /a$tors $ould not be eAlained# he sa&lin%
ðod used &ay a//e$t the 9alidity o/ the result but "e use it
due to resour$e $onstraint
7/23/2019 10.11648.j.ajhr.20150302.12
http://slidepdf.com/reader/full/1011648jajhr2015030212 6/6
&eri$an Gournal o/ ealth Hesear$h 2015; 3(2): 57-62 62
Authors4 ontribution
: on$etuali?ed the resear$h roble&, desi%ned the
study, reared the roosal, $ondu$ted /ield "or=, and
analy?ed the data, &anus$rit "ritin%#
: Parti$iated durin% analysis o/ data, rearin% the
&anus$rit /or ubli$ation
Acknowledgements
e "ould li=e to eAress our %rate/ul heart/elt
are$iation to ibo-=e&=e& distri$t du$ation //i$e and
*$hool d&inistrators, data $olle$tors and suer9isors o/ the
study /or their $ooeration and suort, %i9in% unreser9ed
ti&e and /ollo" u /ro& the be%innin% till $o&letion o/ this
resear$h# ur a$=no"led%e&ent also eAtends to study
arti$iants "ho "ere in9ol9ed in this study#
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D11E
ilahun # ntestinal arasitosis a&on% <ara and <"e%oe&iastoralist tribes in lo"er &o >alley, *outh"esternthioia# thio G ealth .e9 , 200, 23: 57-62
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D17E
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