GASTRO INTESTINAL PROTOZOANS AND HELMINTHS INFECTING CHILDREN IN DAYCARE CENTRES AND NURSERY SCHOOLS IN SABON GARI LOCAL GOVERNMENT AREA OF ZARIA, KADUNA STATE

Intestinal infections caused by protozoans and helminths are globally endemic and have been described as constituting the greatest worldwide cause of illness and disease, with more severe cases in children. The prevalence and risk factors of gastro-intestinal parasitic infections of protozoans and helminths in children in seventeen (17) schools (daycare and nursery sections), in Sabon-Gari Local Government Area of Zaria, Kaduna State, were investigated. The study was carried out between January and March, 2015 (dry season), and between May and July, 2015 (wet season). Questionnaires were administered and a total of 772 stool samples were collected from the children and examined for parasite cysts and eggs. The stool samples were examined using formol- ether concentration technique and data obtained were analysed using Microsoft Excel and Epi-info software packages. The overall prevalence of the protozoa plus helminths was 9.33%. The cysts of two intestinal protozoans, Balantidium coli Malmsten, 1857 (0.26%) and Entamoeba histolytica Lesh, 1873 (0.26%), and eggs of six intestinal helminths: Hookworm (4.92%); Ascaris lumbricoides Linnaeus, 1758 (3.50%); Dipylidium caninum Linnaeus, 1758 (0.52%); Diphyllobothrium latum Linnaeus, 1758 (0.39%); Strongyloides stercoralis Normand, 1876 (1.04%) and Hymenolepis nana Grassi, 1887 (0.26%) were identified. The protozoan cysts were only observed in the stool samples of nursery school children. There was a higher and statistically significant difference in prevalence of intestinal protozoans and helminths in girls (12.04%) than in boys (6.67%) (P = 0.007). Increase in age was found to be positively and significantly associated with the intestinal protozoan and helminth infections (P = 0.000695), with the lowest prevalence in children aged between 0 and 2 years (5.00% and 4.76%) and highest prevalence in the 6year-olds (12.26%). The prevalence of intestinal parasitic protozoan and helminth infections among children in the day care and nursery schools was associated with risk factors such as improper hand-washing, drinking of tap water, possession of domestic animals, use of pit latrines and sharing of toilets between staff and children, and the dry season (OR≥1). This study has identified that intestinal parasites are prevalent among children in day care centres and nursery schools in Sabon-Gari Local Government Area of Zaria, there is therefore the need for an intervention programme for sustainable elimination of these intestinal parasitic infections.

 

 

 

 

 

 

Intestinal parasitic infections caused by protozoans and helminths are globally endemic and have been described as constituting the greatest worldwide cause of illness and disease (Chan, 1997; Pillai and Kain, 2003). It has been estimated that 3.5 billion people worldwide are infected with intestinal parasites and the most affected population with highest morbidity are children (Lawn et al., 2005; Chirdan et al., 2010). Also, over 270 million preschool children and over 600 million school-age children live in areas where these parasites are intensively transmitted (WHO, 2015). Intestinal parasitic infections in children have been attributed to their exposure to contaminated meals at onset of weaning when the child’s immune system and personal hygiene are still poor, and when the child is beginning to explore the environment through crawling and other activities (Yilgwan and Okolo, 2012).

Although infections with intestinal protozoans and helminths are said to cause problems to their hosts, parasites are seen to live for long periods in the bowel without causing symptoms or requiring treatment (Haque, 2007). Certain risk factors have been associated with the proliferation of these intestinal parasitic infections among which are low socio- economic status and poor living conditions as well as people in over-crowded areas with poor environmental sanitation, poor garbage disposal, unsafe water supply and unhygienic personal habits (Adamu et al., 2006).

Most intestinal protozoans and helminths are easily transmitted from person to person by direct contact or through contaminated food, water and environments. Over 70 species of parasitic protozoans and helminths infect humans (Odu et al., 2013); this leads to dysenteric and diarrhoeic conditions, intestinal obstruction, malnutrition, iron deficiency, anaemia, malabsorption and other such conditions (Buchini et al., 2007). Most common protozoan parasites infecting humans include Giardia duodenalis Leeuwenhoek, 1681; Cryptosporidium spp. Tyzzer , 1912; Entamoeba histolytica and Balantidium coli, while Trichuris trichiura Morgani, 1740; Strongyloides stercoralis, Ascaris lumbricoides, Necator americanus Stiles, 1898 and Ancylostoma duodenale Dubini, 1834 are some common helminths that affect children (Cox, 2002; Cheesebrough, 2009; Okpala et al., 2014; Abera et al., 2014).

Day care centres and nursery schools are environments where children are more likely to acquire intestinal parasites and pre-school children have been reported to harbour the greatest number of intestinal parasites, especially worms (Crompton and Nesheim, 2002; Gonçalves et al., 2011). Childcare-acquired infections within these institutions may occur due to contact among children, poor toilet facilities, poor sanitary conditions and contaminated playgrounds in the nursery schools (Odoba et al., 2012). Transmission of intestinal parasites among the children can be attributed to the children’s ignorance on the occurrence and mode of transmission of such parasites as well as poor hygienic and sanitary habits. Children have been reported to be at the greatest risk of helminthiasis and other intestinal parasitic infections which are often associated with poor growth, reduced physical activity and impaired learning ability. Also, due to the global endemicity of these intestinal parasites, they greatly affect the health, growth and development of children worldwide (Wakelin, 1996; Matthys et al., 2011; Okpala et al., 2014).

It is an established fact that diarrhoea is an important cause of morbidity and death among children, especially children under 5years in developing countries. This leads to about 9% of all deaths among children under age 5 worldwide in 2015 (UNICEF, 2016). The prevalence of parasitic protozoa and helminths among children, especially those in the day care centres and nursery schools is poorly reported and therefore not known to permit formulation of intervention strategies by relevant authorities, especially in Sabon-Gari Local Government Area.

Over 270 million pre-school children and over 600 million school-age children live in areas where intestinal protozoans and helminths are intensely transmitted, and are in need of treatment and preventive interventions (WHO, 2015). Studies around the globe and some parts of Nigeria reported various protozoans and helminths to be prevalent among day care, pre-school (mostly under 5years) and school-age children (Chirdan et al., 2010; Obadiah et al., 2011; Okpala et al., 2014; Umeh et al., 2015); some of the studies have associated these parasitic infections to diarrhoeic and dysenteric conditions, anaemia, retarded growth among other illnesses. In most of these studies, the prevalence of these intestinal parasites was associated to parent’s occupations, family background, housing conditions and feeding habits. Hence, there is a need to assess the health risk associated with attendance of day care centres and nursery school within Sabon Gari Local Government Area towards proffering an intervention programme by relevant authorities.

The aim of this study is to evaluate the occurrence of gastro-intestinal helminths and parasitic protozoans in children attending day care centres and nursery schools within Sabon-Gari Local Government Area of Zaria, Kaduna State, Nigeria.

 

The objectives of this study are: