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PubMed2001

Some aspects in the control of schistosomosis and soil-transmitted helminthosis in Yemeni children.

OBJECTIVE: Prevalence, intensity and incidence of schistosomosis and soil-transmitted helminthosis among school children in an ignored area in Yemen were determined. The study aimed to investigate the impact of single doses of Praziquantel or Albenedazole or both, relating to sanitary, socioeconomic and behavioral practices on the prevalence and intensity of infections. METHODS: Out of a total number of 897 pupils, 453 were randomly selected from AlMahweet town and 444 from rural surrounding areas. Millipore filtration, modified Kato and precipitation techniques were applied for urine and stool analysis. RESULTS: Prevalence rates were 27% for schistosomosis, 61% for ascariosis, 21% for trichuriosis, 2% for fascilosis, 0.3% for entrobiosis, 0.7% for hook worm infection and 0.2% for strongloydiosis. Factors found confounding the relationship between schistosomosis and residence, under logistic regression analysis, were sex and frequency of water contact. Probability of infection by Bilharzia for boys who reside in rural AlMahweet and visit the water source is 0.52, compared to 0.30 for their mates who reside in AlMahweet town. Odds ratio estimates accounted for via residence was 2.5, via water contact 1.7 and via boys 3.2. With regards to other helminthic infections, availability of latrines remained the only significant factor under ANOVA. CONCLUSION: In conclusion, annual campaigns for treatment as a single control measure can reduce the infection rate of S. mansoni by 62.5%, T. trichura by 48% and A. lumbricoides by 24%. Whereas for S. hematobium the appropriate time interval for intervention should be shortened according to the findings of a properly designed intervention study before used as a single control measure. Since 77% of the children were infected by other helminthes, therefore mass treatment should be extended to cover all children. For those boys in rural AlMahweet who visited the water source during the week before the interview, mass treatment for schistosomosis is recommended since the prediction of infection rate reached 52%.

Adolescent↗
PubMed2001

Evidence of behaviour change following a hygiene promotion programme in Burkina Faso.

OBJECTIVES: To determine whether a large, 3-year hygiene promotion programme in Bobo-Dioulasso, Burkina Faso, was effective in changing behaviours associated with the spread of diarrhoeal diseases. The programme was tailored to local customs, targeted specific types of behaviour, built on existing motivation for hygiene, and used locally appropriate channels of communication. METHODS: Two population surveys recorded the coverage of the programme among target audiences (mothers of children aged 0-35 months). Four surveys were carried out: three prior to the programme and one in 1998 (after the programme had been running for 3 years), using structured observation of hygiene behaviours in the participants' homes to document changes in target behaviours. FINDINGS: After the programme had run for 3 years, three-quarters of the mothers targeted had had contact with programme activities. Half could cite the two main messages of the programme correctly. Although the safe disposal of children's stools changed little between 1995 and 1998 (80% pre-intervention, 84% post-intervention), hand-washing with soap after cleaning a child's bottom rose from 13% to 31%. The proportion of mothers who washed their hands with soap after using the latrine increased from 1% to 17%. CONCLUSION: Hygiene promotion programmes can change behaviour and are more likely to be effective if they are built on local research and use locally appropriate channels of communication repeatedly and for an extended time.

Burkina Faso↗
PubMed2000

Schistosomes infection rate in relation to environmental factors in school children.

OBJECTIVE: An epidemiological comparative survey aimed at determination of prevalence and focal distribution of Schistosomes infection and intestinal parasites to provide a reference for evaluating the need for community intervention. METHODS: All children of 14th October Primary School were involved. The children were from 7 villages that lie on the Assahul valley of lbb governorates in Yemen. The total number was 230 with (82%) boys and (18%) girls. Their age was between 5-18 years with a mean of 10.24 +/- 2.6 years. Millipore and modified Kato techniques were adopted to quantify urinary and intestinal Schistosomes eggs. Other ova, larvae, cysts were recorded whenever seen. RESULTS: It was revealed that there was a Schistosomes infection rate of 37%. The mansoni prevalence was 35%, hematobia was 5% and mixed infections were 3%. Light infection was classified among 17% of all children; moderate infection among 18% and no intense mansoni infection was determined. Whereas in the case of hematobia species, 2% were intense and 3% were light. Intensity in all children was 5% eggs/g feces in case of intestinal bilharzia and 1% egg/10 ml urine in case of urinary. With regard to the prevalence of any soil-transmitted parasites, it was found to be 69% (Ascariosis 68%, Trichuriosis 10%). Double infection was found in 10%. Hookworm eggs were not seen. Infection rates with other parasites were as follows: Giardiosis 18%, Amoebiosis 14%, ova of Hymenolepes nana were seen in 13%, Taeniosis affected 13% and E. Vermicularis 1%. CONCLUSION: Bivariate analysis revealed significant associations between Schistosomes infection with residence near the valley, male sex and frequent water contact activities. No significant association was found with the age of the child, parents' education, availability of latrine or household standpipe water. In conclusion, schistosomosis was moderate, whereas soil transmitted helminthosis were intense.

Adolescent↗
PubMed2001

Improvement of environmental health and hygiene practices--case study in the Northern Province.

The primary purpose of an improved water supply and sanitation is the achievement of acceptable health and hygiene standards as well as the sustainable improvement of the environment. Many governments recognize this and so they budget for large sums of money to improve these services to the communities. The purpose of this study was to investigate the different gaps in environmental health and hygiene practices with the aim of suggesting a strategy of improving this in the Northern Province of South Africa. To do this, 231 households and 30 schools were surveyed. Workshops and visits to different government departments were also used. This paper reports the results from this study which indicate that the situation in schools was not any better than that in households, with more than 90% of the villages still dependent on the unimproved pit latrines and 56,6% relying on standpipes which were (70% of the time) non-operational. The main problems identified seem to those associated with implementation and maintenance. The study concludes that with proper training of the water committees and their active involvement with the government and NGOs, environmental health and hygiene problems can be minimized or eliminated.

Environmental Health↗
PubMed2001

Sociodemographic, environmental and clinical risk factors for developing persistent diarrhoea among infants in a rural community of Egypt.

The study documents the incidence of persistent diarrhoea and its sociodemographic, household, environmental and clinical risk factors. One hundred and fifty-two newborns were followed for the first 12 months of life in Bilbeis, Egypt. The household of each participant was surveyed at baseline and was visited twice a week. The study infants experienced persistent diarrhoea at a rate of 0.51 episode/case per year. Development of persistent diarrhoea was associated with water storage in mud-containers (Odds ratio [OR] = 4.36, confidence interval [CI] 1.4-14.8), pump-water supply (OR = 3.5, CI 1.2-10.2), and absence of a latrine in the household (OR = 2.74, CI 1.01-7.38). Detection of faecal IgE (OR = 3.32, CI 1.0-10.9) and high stool frequency (OR = 2.95, CI 1.1-7.8) appeared as important clinical predictors for the onset of persistent diarrhoea. The incidence of persistent diarrhoea among young infants in Bilbeis, Egypt, was high. Sociodemographic, environmental and clinical parameters were important risk factors for the development of persistent diarrhoea.

Chronic Disease↗
PubMed2002

A model for government-community partnership in building sewage systems for urban areas: the experiences of the Orangi Pilot Project--Research and Training Institute (OPP-RTI), Karachi.

Over 20 years the Orangi Pilot Project has been working to understand the problems of Orangi, a district of Karachi largely characterised by high-density informal settlement, and enable its residents to develop and implement solutions. Sanitation was identified as the major problem and a sewerage system was built. From this work was developed the "internal-external" concept for sanitation, which has 4 levels: sanitary latrines in houses; underground sewer in lane; neighbourhood collector sewer; and trunk sewer and treatment plant. The first three components are "internal" and can be undertaken by low-income communities; the "external" fourth component has to be funded and carried out by government or similar agency. Successful and unsuccessful attempts elsewhere to replicate this model have both confirmed the effectiveness and practicality of such community-based action and shown the - largely organisational pitfalls that must be avoided.

Cities↗
PubMed1988

The impacts of health, education, family planning and electrification programs on fertility, mortality and child schooling in East Java, Indonesia.

This paper examines the effects of public health, family planning, education, electrification, and water supply programs on fertility, child mortality, and school enrollment decisions of rural households in East Java, Indonesia. The theoretical model assumes that parents maximize a utility function, subject to 1) a budget constraint that equates income with expenditures on children (including schooling and health inputs), and 2) a production function that relates health inputs to child survival possibilities. Public programs affect prices of contraceptives, schooling and health inputs, and environmental conditions that in turn affect child survival. Data are taken from the 1980 East Java Population Survey, the Socio-economic Survey, and the Detailed Village Census. The final sample consists of 3170 rural households with married women of childbearing age. Ordinary least squares and logit regressions of recent fertility, child mortality, and school enrollment on program and household variables yielded the following findings. 1) The presence of maternal and child health clinics reduced fertility but not mortality. 2) The presence of public health centers strongly reduced mortality but not fertility. 3) The presence of contraceptive distribution centers had no effect on fertility. 4) School attendance rates were influenced positively by the availability of primary and secondary schools. 5) Health and family planning programs had no effects on schooling. 6) The availability of public latrines reduced fertility and mortality. 7) The water supply variable did not affect the dependent variables when ordinary least squares techniques were applied but had statistically significant impact when logit methods were used. 8) Electricity supply had little effect on the dependent variables. 9) The mother's schooling had a strong positive correlation with children's schooling but no effect on fertility or mortality. 10) Household expenditures were related positively to school attendance and negatively to mortality. 11) There was little or no interaction between household variables and presence of government programs. 12) Subprovincial area measures of service availability appeared more appropriate for public health and family planning services, while village-level measures appeared more appropriate for schooling.

Asia↗
PubMed2002

[Epidemiological study on taeniasis and cysticercosis in Shandong Province].

OBJECTIVE: To investigate current epidemiological status of Taenia solium infection and cysticercosis in Shandong Province. METHODS: By house to house interview in the field, fecal examination and serological tests, the prevalence data of taeniasis and cysticercosis in human and pig population, and epidemiological factors in relation to the diseases were carried out. RESULTS: The prevalence of Taenia infection and cysticercosis in human population were 0.048% and 0.057% respectively. The sero-positive rate of the specific IgG4 of anti-Cysticercus was 1.91%. The prevalence differed among occupations and from region to region, but there was no significant difference between men and women, city and suburb. Unhealthy eating and unhygienic habits commonly practised among residents, 92.3% of the families have "latrines connected to pigsties". The surrounding sanitation and the disposal of fecal material were poor. The detection rate of porcine cysticercosis was 0.06%, and the positive rate of anti-Cysticercus antibody in pigs was 1.99%. CONCLUSION: The prevalence of taeniasis and cysticercosis is decreasing. However, the endemic area is expanding and the epidemiological factors are still existing. Continued effort is therefore needed for sustain the control programme.

Adolescent↗
PubMed2003

Chlamydia trachomatis infections among Yemeni school pupils in relation to environmental conditions.

OBJECTIVE: This study is aimed at establishing the prevalence of Chlamydia trachomatis infections among school pupils in Sana'a, Republic of Yemen, and to explore the association of infection with environmental and social factors. METHODS: A total of 787 school children, 529 boys and 258 girls, were randomly selected for enrollment in this study. Four hundred and twenty-nine were from 4 schools in Sana'a city, and 358 from 3 rural schools around Sana'a, Republic of Yemen. Questionnaire forms were filled in for each child to investigate environmental and social factors. Sera were tested for anti Chlamydia trachomatis IgG antibodies using enzyme-linked immunosorbent assay CTM-IgG . RESULTS: An overall rate of infection of 45.9% was determined. The rate of infection among rural pupils (73.2%) was higher (P<0.0001) than that among urbanones (23.1%). The rate of infection was found significantly (P<0.001) inversely correlated with age of the pupils. Environmental factors which were found to influence the infection rate were; rural residence, unplastered walls, mud floor, lack of stand pipe water, lack of latrine and presence of animals within dwelling with odds ratio of 9.1, 6.3, 6.1, 5.2, 3.7, 3.5 and 1.7. Also, the male sex and illiteracy of the parents has been found to be risk factors for infection. CONCLUSION: Prevalence of Chlamydia trachomatis infection was found to be high. The prevalence correlates inversely with age. Rural residence, environmental conditions and social factors were risk factors for infections. Yemen could be identified as a trachoma endemic area, which should be targeted by the control programs.

Adolescent↗
PubMed1958

Bilharziasis in Swaziland.

Although no full-scale survey of the prevalence of bilharziasis in Swaziland has been carried out, examinations of schoolchildren have revealed S. mansoni infection rates of up to 49% in some areas, and S. haematobium infection rates ranging from 3% to 75%. The highest prevalence occurs in areas where there are thickly populated African reserves, or irrigation schemes. The spread of infection is encouraged by the use of rivers, dams and canals for bathing and washing purposes. Preventive measures are recommended, including the provision of more suitable bathing, washing and latrine facilities for the population, the control of waste waters, and the use of molluscicides.

Environment↗
PubMed1960

Health and morbidity survey, Seychelles, 1956-57.

Adequate knowledge of existing health and morbidity conditions is the basis for all planning of future health services. For this reason, a health and morbidity survey of the population of the Seychelles was carried out in 1956-57 under the joint auspices of the Seychelles Government and the World Health Organization. Statistical sampling methods were used and the information was obtained by the household interview method. Health, morbidity and relevant demographic data were thus disclosed for the first time for Seychelles. Basic information was obtained on: general morbidity of the population, including dental and nutritional status, malnutrition, incidence of intestinal diseases and other easily diagnosable conditions; growth and weight curves of children up to the age of 16; haemoglobin levels; erythrocyte sedimentation rates; general living conditions such as housing and overcrowding, social status and latrine arrangements; the connexion of soil pollution with the incidence of amoebiasis and helminthiasis; and lastly, the incidence of the sickle cell trait, eosinophilia and positive serological reactions to the Chediak test (for manifest or latent syphilis). The findings are presented with a minimum of remarks and interpretation.

Child↗
PubMed2004

[Schistosomiasis Control in Sub-Saharan Africa. Proceedings of a round table, Lisbon, Portugal, September 9, 2002].

The Round Table organized by the Société de pathologie exotique during the 3rd European Congress on Tropical medicine and International Health held in Lisbon on September 9, 2002 has been attended by a hundred participants. Five communications were presented and followed by a debate concerning the main aspects of the epidemiology and the control of schistosomiasis in sub-Saharan Africa. The necessity of studying intermediate hosts to identify vectors, some of which being able to colonize new areas or to modify their susceptibility to parasites, has been emphasized. The population is infected during water contacts and Poda et al. showed the importance of water projects, necessary for the development of poor countries, but facilitating the transmission of schistosomiasis. Most current activities force the population to use stagnant water However, it is well known that children are more infected, with severe clinical and functional consequences. The contamination of the environment is linked to hygienic practices. Sow et al. demonstrated that usually recommended solutions are inappropriate. Latrines, for example, are notably sub-used by some at risk groups because culturally unsuitable and considered as avoiding discretion or comfort. Besides the technical improvement which can be proposed, education by the parents and the teachers must begin from the youngest age. Ernould et al. showed the strong heterogeneity of schistosomiasis transmission in water projects due notably to the distance between habitations and transmission sites as well as modalities of use and maintenance of the irrigation system. In this respect, the communication of Poda et al. showed that schistosomiasis was underestimated by the health system due to the lack of training of health staff, poor equipment of health centers and low awareness of both populations and political authorities. Garba et al. confirmed the efficiency of mass treatments with praziquantel, even with a low therapeutic coverage. The renewal of the treatment can be adapted to the intensity of the transmission. The modeling of the performances of the hematuria test described by Etard allows to adjust the sample of population participating to a survey. Other indicators must be proposed to estimate the efficiency of the strategy of control and, possibly, to adapt it to local constraints. Ultrasonographic scores have been proved as faithful and specific indicators for clinical surveillance of complications. Several participants evoked the promising experimental results of candidate vaccines against schistosomiasis and noticed delay taken by clinical trials. The weakness of the financial support postponed considerably the development of the vaccines which interests a numerous population but unable to pay for them. Participants insisted on health education, hygiene, construction or modernization of infrastructures and sanitation which, together, will guarantee durability. Mass treatment with praziquantel appears as a method, certainly indispensable at this stage, but which must be transient. A wide consensus emerged in favor of a community based and integrated control strategies organized at peripheral level in association with technical services (health, hydraulics, agriculture, education) and local governments. Although schistosomiasis seems not to drain any more financial supports, restricting human and scientific resources mobilization of industrial countries, this Round Table underlined the dynamism of researches performed by sub-Saharan African scientists.

Africa South of the Sahara↗
PubMed2003

Evaluation of pilot control trial of intestinal schistosomiasis in the Finchaa Sugar Estate, Ethiopia.

Intestinal schistosomiasis is undergoing a rapid increase in magnitude in Finchaa Sugar Estate in Ethiopia. A pilot control trial of intestinal schistosomiasis was instituted in 1995 to reduce the magnitude of the disease and introduce sustainable schistosomiasis control approaches in the Sugar Estate. Following initial parasitological survey of all the camps in the Sugar Project area in 1995 using Kato method, mass chemotherapy of the heavily infected residents of Camp 7 and selective treatment of lightly infected residents of other camps were made using praziquantel. Endod (type 44) was applied to transmission sites along Fekerie stream in Camp 7 on quarterly basis whenever Biomphalaria pfeifferi was detected. Other inputs to the project as parts of capacity building included transplantation of Endod cuttings (type 44), training and health education. Cross sectional parasitological surveys were made in 1998 to assess the impact of the pilot control trial. The results of stool examination showed that the prevalence of schistosomiasis was reduced from 30% in 1995 to 26% in 1998 among residents of Camp 7 and the intensity of infection from 198 eggs per gram of feces (EPG) in 1995 to 85 EPG in 1998. Similarly, the prevalence of infection among children in Finchaa Valley Elementary School was reduced from 78% in 1994 to 56% in 1998 and the reduction in respective intensity of infection was from 283 EPG to 114 EPG. Although significant reduction in the magnitude of the disease was not achieved, the control activities were taken over by the Sugar Project Polyclinic to ensure sustainability. In addition to chemotherapy and snail control using Endod, other disease non-specific methods such as health education should be used to get maximum benefit from such facilities as latrines, and ensure participation of the community in order to sustain the control activities.

Adolescent↗
PubMed1992

Soil contamination with Ascaris lumbricoides eggs as an indicator of environmental hygiene in urban areas of north-east Brazil.

The objective of this study was to detect the pathways of transmission of Ascaris lumbricoides eggs in low-income households of two Brazilian cities. An inexpensive flotation technique for egg isolation was applied for the determination of soil contamination in 227 households. The median contamination levels were 0.8 (indoor), 0.3 (backyard) and 0.6 (defaecation site) eggs per gram soil. The contamination levels showed no significant correlation with the presence or quality of latrines or flush toilets. Houses with flush toilets were found to be sources of faecal contamination of the neighbourhood due to the absence of an adequate sewage system. Households with small children were more often contaminated than those without. The keeping of pigs was correlated with an increased yard contamination. The faecal egg excretion showed a significant correlation with the soil contamination in the backyard. Embryonated eggs, which represent the 'older' eggs, constituted 37% of all eggs. In the dry season significantly fewer Ascaris eggs were found in the soil than during the rainy season. The usefulness of the soil contamination with Ascaris lumbricoides eggs as an indicator of the efficacy of hygiene programmes is discussed.

Animals↗
PubMed2005

The quality of water from protected springs in Katwe and Kisenyi parishes, Kampala city, Uganda.

BACKGROUND: In the sub-urban areas of Kampala city, springs are a major source of water for domestic use. Though spring water is considered to be aesthetically acceptable for domestic use, presence of poorly designed pit latrines, poor solid waste management as well as poor and inadequate spring protection, may lead to contamination of spring water with pathogenic bacteria. OBJECTIVES: The objectives of the study were to examine the bacteriological quality of water from ten springs in Katwe and Kisenyi parishes of Kampala, and to identify and quantify risks for spring water contamination with faecal bacteria. METHODS: A cross-sectional sanitary risk assessment using a standardised format was carried out in ten randomly selected springs in the parishes of Katwe and Kisenyi parishes in Kampala. A total of 80 samples of water from these springs were collected from December 2001 to March 2002. The samples were analysed for indicators of faecal contamination: total coliforms, faecal coliforms and faecal streptococci. Physico-chemical parameters were measured. RESULTS: Aggregate qualitative sanitary risk scores ranged from medium to high. The total coliform counts in 90% of the samples exceeded the WHO guideline for drinking water. All the samples had faecal coliform counts above the WHO guideline. A strong correlation (r2= 887) was observed between the median faecal coliform counts and the sanitary risk score. Sixty percent of the samples had nitrate levels above the WHO recommended limit. There was no correlation between the levels of chlorides and nitrates and levels of indicators of faecal bacterial contamination. CONCLUSIONS: The sanitary risk assessment score is a reliable tool for predicting the likely levels of bacterial contamination of spring water. Water from the ten protected springs studied is unsuitable for drinking without treatment.

Cross-Sectional Studies↗
PubMedDate not supplied

[Intestinal parasitosis in children admitted to the Pediatric Teaching Hospital of Cerro, Havana City, Cuba].

A study on intestinal parasitism was conducted among 401 children admitted in the Pediatric Teaching Hospital of Cerro, from May to June, 1999. To this end, a representative, randomized and stratified sample by service was taken. 3 samples of feces per child were collected, preserved in formaldehyde, and processed by 3 parasitological methods. There was an intestinal parasitism prevalence of 15% at the hospital and there were no differences between the stratum of children admitted in Gastroenterology and the rest of the services as regards commensals and parasites in general (p > 0.05); however, commensals predominated in the second group (p < 0.01) The intestinal coccidia, Cryptosporidium parvum and Cyclospora cayetanensis prevailed in the Gastroenterology service over the rest of the services (p < 0.01). The age group over 4 (school children) was the most affected, both by protozoa and commensals (p < 0.01), excepting Cryptosporidium parvum that affected the infants more (p < 0.05). The analysis of some epidemiological antecedents showed that those children eating fruit without peeling and washing them, having vegetables withouth washing them first and walking barefooted were more prone to infection (RR > 1). A higher frequency of infection due to intestinal parasites was found among those living in rural areas, drinking well or river water, and defecating in latrines or in the open air (RR > 1). These results suggested that in spite of the existing knowledge of the epidemiological and risk factors, the intestinal parasites continue affecting the child population

Child, Preschool↗
PubMed1992

[The cholera epidemic in Panama 1991].

The authors studied the epidemiology of the outbreak of cholera (due to Vibrio cholerae 01, Inabe serotype) which occurred in Panama in 1991, during which 1179 probable cases were reported, with 292 hospitalizations, 29 deaths and 51 confirmed cases. There was an average of 24.7% hospitalizations and a 2.5% mortality. The epidemic involved 21 of 24 "corregimientos' in Darién, 2 of 4 in San Blas, 5 of 15 in Panama East, 3 of 40 in Colón and one of 19 in the metropolitan area of Panama City. The incidence of infected patients was seen in infants less than 1 year old and in children 1 to 4 years of age. Taking into account the population in each 'corregimiento', it can be said that less than 1% of the population was infected, but that in San Blas, where few communities have aqueduct and latrines, 10% of the population was infected.

Age Factors↗
PubMed2005

Factors associated with intestinal parasitic infection among school children in a rural area of Kathmandu Valley, Nepal.

We studied predisposing factors of enteric parasitic infections in school children [n=340 (Boys: 177 and Girls: 163)] in a rural area in Kathmandu Valley, Nepal. Fecal samples were examined by formal-ether concentration technique. A total of 71.2% children had parasite. Altogether nine types of parasites were recovered; Trichuris trichiura was the commonest one followed by hookworm and others. A structured questionnaire regarding various predisposing factors was used. No significant differences in the infection rate between the sexes, age groups (< or = 10 years, 11-14 years and > or = 15 years) and family sizes (< or = 5 and > or = 6) were observed (P>0.05). The positive rates were significantly low in children with the history of taking antihelminthic drugs in the past six months (P<0.05). A marginally higher positive rate was found among Dalits children compared to Tibeto-Burmans and Indo-Aryans (P>0.05) and children from farming family (P>0.05). No difference in the infection rate was found in children having different types of toilet facility: open-field defecation, pit latrine and modern toilet at their houses (P>0.05). Slightly higher positive rate was associated with drinking water from Kuwa (shallow well) compared to natural spout, piped water and Khola (river) (P>0.05). Children were infected despite of their awareness regarding the safe water and geophagy.

Adolescent↗