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Soil-transmitted helminthiasis among mothers and their pre-school children on Unguja Island, Zanzibar with emphasis upon ascariasis

Published online by Cambridge University Press:  08 September 2008

J. R. STOTHARD ,
E. IMISON ,
M. D. FRENCH ,
J. C. SOUSA-FIGUEIREDO ,
I. S. KHAMIS  and
D. ROLLINSON
J. R. STOTHARD*
Affiliation:
Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK
E. IMISON
Affiliation:
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
M. D. FRENCH
Affiliation:
Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK
J. C. SOUSA-FIGUEIREDO
Affiliation:
Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK
I. S. KHAMIS
Affiliation:
Helminth Control Laboratory Unguja, Ministry of Health and Social Welfare, Zanzibar, Tanzania
D. ROLLINSON
Affiliation:
Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK
*
*Corresponding author: Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK. Tel: +44 2079425490. Fax: +44 2079425518. E-mail: [email protected]
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Summary

Soil-transmitted helminthiasis (STH) is a scourge to the health and well-being of infants and pre-schoolchildren throughout many parts of sub-Saharan Africa. To improve maternal and child health, regular de-worming is recommended and often delivered from mother and child health (MCH) clinics, yet there have been few studies monitoring the progress and impact of interventions on local levels of disease. A cross-sectional parasitological survey, supplemented with questionnaires, was therefore conducted across 10 Ungujan villages examining mothers (n=322) and their pre-school children (n=359). Within children, mean prevalence of ascariasis, trichuriasis and hookworm was 8·6% (95% CI 5·5–11·8), 18·9% (95% CI 14·5–23·4) and 1·7% (95% CI 0·2–3·5) while in mothers mean prevalence was 6·7% (95% CI 3·7–9·7), 11·9% (95% CI 8·0–15·8) and 1·9% (95% CI 0·2–3·5), respectively. There was, however, significant spatial heterogeneity of STH by village, 2 villages having much elevated levels of infection, although general access to anthelminthics and utilization of village MCH clinics was good. Levels of parasite aggregation (k) were determined and a multilevel logistic regression model identified access to a household latrine [OR=0·56 (95% CI 0·32–0·99)] and having an infected household member [OR=3·72 (95% CI 2·22–6·26)] as observed risk factors. To further investigate worm burdens of Ascaris lumbricoides, adult worms were expelled using Combantrin® and measured. A negative relationship between mean worm burden and mean worm mass was found. Villages in the north of Unguja represent locations where there is elevated prevalence of both ascariasis and trichuriasis and it appears that local factors are particularly favourable for transmission of these helminths. From a perspective of control, in such locations, intervention efforts should be stepped up and greater efforts placed upon improving household sanitation.

Keywords

maternal and child healthAscarisTrichurishookwormanthelminthicsSTH
Type
Original Articles
Information
Parasitology , Volume 135 , Issue 12 , October 2008 , pp. 1447 - 1455
Copyright
Copyright © 2008 Cambridge University Press

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References

REFERENCES

Akaike, H. (1973). Information criterion as an extension of the maximum likelihood principle. In Second Annual Symposium on Information Theory (ed. Petrov, B. N. and Csaki, F.), pp. 267–282. Akademi Kiado, Budapest, Hungary.Google Scholar
Albonico, M., Chwaya, H. M., Montresor, A., Stolfzus, R. J., Tielsch, J. W., Alawi, K. S. and Savioli, L. (1997). Parasitic infections in Pemba island schoolchildren. East African Medical Journal 75, 294–298.Google Scholar
Albonico, M., Montresor, A., Crompton, D. W. T. and Savioli, L. (2006). Intervention for the control of soil-transmitted helminthiasis in the community. Advances in Parasitology 61, 311–349.CrossRefGoogle ScholarPubMed
Albonico, M., Allen, H., Chitsulo, L., Engels, D., Gabrielli, A-F. and Savioli, L. (2008). Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy. PLoS Neglected Tropical Diseases 2, e126.CrossRefGoogle ScholarPubMed
Chan, L., Bundy, D. A. P. and Kan, S. P. (1994 a). Aggregation and predisposition to Ascaris lumbricoides and Trichuris trichiura at the familial level. Transactions of the Royal Society of Tropical Medicine and Hygiene 88, 46–48.CrossRefGoogle ScholarPubMed
Chan, L., Bundy, D. A. P. and Kan, S. P. (1994 b). Genetic relatedness as a determinant of predisposition to Ascaris lumbricoides and Trichuris trichiura infection. Parasitology 108, 77–80.CrossRefGoogle ScholarPubMed
Crompton, D. W. T. (1999). How much human helminthiasis is there in the world? Journal of Parasitology 85, 397–403.CrossRefGoogle ScholarPubMed
Crompton, D. W. T. (2001). Ascaris and ascariasis. Advances in Parasitology 48, 285–375.CrossRefGoogle ScholarPubMed
Crompton, D. W. T. and Savioli, L. (2007). Handbook of Helminthiasis for Public Health. CRC Taylor and Francis, London.Google Scholar
De Silva, N. R., Brooker, S., Hotez, P. J., Montresor, A., Engels, D. and Savioli, L. (2003). Soil-transmitted helminth infections: updating the global picture. Trends in Parasitology 19, 547–551.CrossRefGoogle ScholarPubMed
De Silva, N. R., Chan, M. S. and Bundy, D. A. P. (1997). Morbidity and mortality due to ascariasis: re-estimation and sensitivity analysis of global numbers at risk. Tropical Medicine and International Health 2, 519–528.CrossRefGoogle ScholarPubMed
Elkins, D. B. and Haswell-Elkins, M. (1989). The weight length profiles of Ascaris lumbricoides within a human community before mass treatment and following re-infection. Parasitology 99, 293–299.CrossRefGoogle Scholar
French, M. D. (2006). The epidemiology and control of helminth infections in Unguja, Zanzibar, M.Sc. thesis, Imperial College London, London, UK.Google Scholar
French, M. D., Rollinson, D., Basanez, M. G., Mgeni, A. F., Khamis, I. S. and Stothard, J. R. (2007). School-based control of urinary schistosomiasis on Zanzibar, Tanzania: monitoring micro-haematuria with reagent strips as a rapid urological assessment. Journal of Pediatric Urology 3, 364–368.CrossRefGoogle ScholarPubMed
Goodman, D., Haji, H. J., Bickle, Q. D., Stoltzfus, R. J., Tielsch, J. M., Ramsan, M., Savioli, L. and Albonico, M. (2007). A comparison of methods for detecting the eggs of Ascaris, Trichuris, and hookworm in infant stool, and the epidemiology of infection in Zanzibari infants. American Journal of Tropical Medicine and Hygiene 76, 725–731.CrossRefGoogle ScholarPubMed
Hall, A., Anwar, K. S., Tomkins, A. and Rahman, L. (1999). The distribution of Ascaris lumbricoides in human hosts: a study of 1765 people in Bangladesh. Transactions of the Royal Society of Tropical Medicine and Hygiene 93, 503–510.CrossRefGoogle ScholarPubMed
Hall, A. and Holland, C. (2000). Geographical variation in Ascaris lumbricoides fecundity and its implications for helminth control. Parasitology Today 16, 540–544.CrossRefGoogle ScholarPubMed
Luoba, A. I., Geissler, P. W., Estambale, B., Ouma, J. H., Magnussen, P., Alusala, D., Ayah, R., Mwaniki, D. and Friis, H. (2004). Geophagy among pregnant and lactating women in Bondo district, western Kenya. Transactions of the Royal Society of Tropical Medicine and Hygiene 98, 734–741.CrossRefGoogle ScholarPubMed
Luoba, A. I., Geissler, P. W., Estambale, B., Ouma, J. H., Alusala, D., Ayah, R., Mwaniki, D., Magnussen, P. and Friis, H. (2005). Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya. Tropical Medicine and International Health 10, 220–227.CrossRefGoogle ScholarPubMed
Martin, J., Keymer, A., Isherwood, R. J. and Wainwright, S. M. (1983). The prevalence and intensity of Ascaris lumbricoides infections in Moslem children from northern Bangladesh. Transactions of the Royal Society of Tropical Medicine and Hygiene 77, 702–706.CrossRefGoogle ScholarPubMed
Montresor, A., Crompton, D. W. T., Bundy, D. A. P., Hall, A. and Savioli, L. (1998). Guidelines for the Evaluation of Soil-Transmitted Helminthiasis and Schistosomiasis at Community Level. World Health Organization, Geneva.Google Scholar
Montresor, A., Crompton, D. W. T., Gyorkos, T. W. and Savioli, L. (2002). Helminth Control in School-Age Children. World Health Organization, Geneva.Google Scholar
Renganathan, E., Ercole, E., Albonico, M., de Gregorio, G., Alawi, K. S., Kisumku, U. M. and Savioli, L. (1995). Evolution of operational-research studies and development of a national control strategy against intestinal helminths in Pemba island, 1988–92. Bulletin of the World Health Organization 73, 183–190.Google ScholarPubMed
Savioli, L., Stansfield, S., Bundy, D. A. P., Mitchell, A., Bhatia, R., Engels, D., Montresor, A., Neira, M. and Shein, A. M. (2002). Schistosomiasis and soil-transmitted helminth infections: forging control efforts. Transactions of the Royal Society of Tropical Medicine and Hygiene 96, 577–579.CrossRefGoogle ScholarPubMed
Savioli, L., Engels, D. and Endo, H. (2005). Extending the benefits of deworming for development. Lancet 365, 1520–1521.CrossRefGoogle ScholarPubMed
Sousa-Figueiredo, J. C., Basanez, M.-G., Mgeni, A. F., Khamis, I. S., Rollinson, D. and Stothard, J. R. (2008). A parasitological survey of preschool children and their mothers for urinary schistosomiasis, soil-transmitted helminthiasis and malaria in rural Zanzibar, with observations on prevalence of anaemia. Annals of Tropical Medicine and Parasitology (in the Press).CrossRefGoogle ScholarPubMed
Southgate, V. R., Rollinson, D., Tchuente, L. A. T. and Hagan, P. (2005). Towards control of schistosomiasis in sub-Saharan Africa. Journal of Helminthology 79, 181–185.CrossRefGoogle ScholarPubMed
Stoltzfus, R. J., Chway, H. M., Montresor, A., Tielsch, J. M., Jape, J. K., Albonico, M. and Savioli, L. (2004). Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly anthelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children. Journal of Nutrition 134, 348–356.Google Scholar
Stothard, J. R. and Gabrielli, A. F. (2007). Schistosomiasis in African infants and preschool children: to treat or not to treat? Trends in Parasitology 23, 83–86.CrossRefGoogle ScholarPubMed
Stothard, J. R., Loxton, N., Rollinson, D., Mgeni, A. F., Khamis, S., Ameri, H., Ramsan, M. and Savioli, L. (2000). The transmission status of Bulinus on Zanzibar Island (Unguja), with implications for control of urinary schistosomiasis. Annals of Tropical Medicine and Parasitology 94, 87–94.CrossRefGoogle ScholarPubMed
Stothard, J. R., Mgeni, A. F., Khamis, S., Seto, E., Ramsan, M., Hubbard, S. J. and Kristensen, T. K. and Rollinson, D. (2002 a). Royal Society of Tropical Medicine and Hygiene meeting at Manson House, London, 21 February 2002 – fresh from the field – new insights into the transmission biology of urinary schistosomiasis in Zanzibar. Transactions of the Royal Society of Tropical Medicine and Hygiene 96, 470–475.CrossRefGoogle Scholar
Stothard, J. R., Mgeni, A. F., Khamis, S., Seto, E., Ramsan, M. and Rollinson, D. (2002 b). Urinary schistosomiasis in schoolchildren on Zanzibar Island (Unguja), Tanzania: a parasitological survey supplemented with questionnaires. Transactions of the Royal Society of Tropical Medicine and Hygiene 96, 507–514.CrossRefGoogle ScholarPubMed
Stothard, J R., Mook, P., Mgeni, A. F., Khamis, I. S., Khamis, A. N. and Rollinson, D. (2006). Control of urinary schistosomiasis on Zanzibar (unguja island): a pilot evaluation of the educational impact of the “Juma na Kichocho” health booklet within primary schools. Memorias do Instituto Oswaldo Cruz 101, 119–124.CrossRefGoogle ScholarPubMed
Williams, B. G. and Dye, C. (1994). Maximum-likelihood for parasitologists. Parasitology Today 10, 489–493.CrossRefGoogle ScholarPubMed
Young, S. L., Dave, G., Farag, T. H., Said, M. A., Khatib, M. R., Sabra, S. K., Tielsch, J. M. and Stoltzfus, R. J. (2007). Geophagia is not associated with trichuris or hookworm transmission in Zanzibar, Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene 101, 766–772.CrossRefGoogle ScholarPubMed