International Journal of Advanced and Integrated Medical Sciences

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An epidemiological study of intestinal parasitic infestation amongchildren aged 6-12 years in rural area of Bareilly, Uttar Pradesh,India
  IJAIMS
ORIGINAL ARTICLE
An epidemiological study of intestinal parasitic infestation amongchildren aged 6-12 years in rural area of Bareilly, Uttar Pradesh,India
Ashish K Sharma, Swati Khan, Ajay Agarwal, Deepak Upadhyay, Arun Singh
Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
Corresponding Author:
Swati Khan, Department ofCommunity Medicine, RohilkhandMedical College and Hospital,Bareilly, Uttar Pradesh, India.
E-mail: swatiayub@gmail.com
Received: 14-03-2018
Accepted: 26-03-2018
Published: 16-06-2018
 
ABSTRACT
Background: According to a report of the World Health Organization, "the totalnumber of protozoa and helminthic infestations currently existing worldwide faroutnumber the total world population since multiple infestations are the rule ratherthan the exception." It is estimated that 3.5 billion people are affected and 450 millionare ill as a result of these infections, the majority being children. In India, the overallprevalence rate of intestinal parasitic infection ranges from 12.5% to 66% with varyingprevalence rate for individual parasite. About 50% of the urban population and 68% ofthe rural population in India are affected.
Materials and methods: A cross-sectionalstudy was conducted using multistage random sampling technique in rural area ofBareilly, Uttar Pradesh, India, from November 2016 to October 2017.
Results: Among248 children, the prevalence of intestinal parasitic infestation in 6-12 years of agedchildren was found to be 33.90%.
Conclusion: This study revealed high prevalence ofintestinal parasitic infection among 6-12 years of age children in rural area of Bareillydistrict and found association between washing hands before eating meal, eat washedfruits, wear footwear, wash hands after defecation, cut nail when grown, handwashbefore own food, information and training about personal and environmental hygieneand sanitation to study participants, and mode of defecation.
KEY WORDS: Bareilly, handwashing and cooking practices, intestinal parasitic infestation
How to cite this article: Sharma AK, Khan S,Agarwal A, Upadhyay D,Singh A. An epidemiological studyof intestinal parasitic infestationamong children aged 6-12 years inrural area of Bareilly, Uttar Pradesh,India. Int J Adv Integ Med Sci2018;3(2):17-21.
Source of Support: Nil,
Conflicts of Interest: None declared.
 
 

INTRODUCTION

Early childhood development is considered to be the mostimportant phase in life which determines the quality of health,well-being, learning, and behavior across the life span.[1]According to a report of the World Health Organization, "Thetotal number of protozoa and helminthic infestations currentlyexisting worldwide far outnumber the total world populationsince multiple infestations are the rule rather than theexception."[2,3] It is estimated that 3.5 billion people are affectedand 450 million are ill as a result of these infections, the majoritybeing children.[4,5] In India, overall prevalence rate of intestinalparasitic infection ranges from 12.5% to 66% with varyingprevalence rate for individual parasite. About 50% of the urbanpopulation and 68% of the rural population in India are affected.High rates of infestation are seen in rural areas due to poverty,poor sanitation, inadequate personal hygiene, lack of cleanwater supply, contaminated water supplies, and high populationdensities. Schoolchildren aged 5-10 years are at increased riskof helminthiasis.[6] There is a gap of knowledge about intestinalparasitic infestation which was seen in the last studies. Thus,the present study entitled, An epidemiological study of intestinalparasitic infestation among children aged 6-12 years in ruralarea of Bareilly, Uttar Pradesh, India, to evaluate the prevalencerate, knowledge transmission of intestinal parasitic infestation in6-12 years of age children.

 
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Sharma et al. Parasitic infestation in children

Aim

This study aims to find out the prevalence and associatedsociodemographic risk factors of intestinal parasitic infestationamong children aged 6-12 years in a rural community ofBareilly, Uttar Pradesh, India.

Objectives

The objectives of the study were as follows:
  • To estimate the prevalence of parasitic infestation amongthe children
  • To find out the association of the parasitic infestation withbehavioral factors.

MATERIALS AND METHODS

Study Setting

This study setting was children of 6-12 years of age fulfillingthe inclusion criteria of the study.

Study Duration

The study duration was from November 2016 to October 2017.

Type of Study

this was a cross-sectional observational community-based study.

Study Population

Population was the residence of rural area of Bareilly.

Inclusion Criteria

Children whose parents gave consent to allow their children toparticipate in the study and residing in the study area for the past6 months were included in the study.

Exclusion Criteria

Child's parents were not willing to provide stool sample afterthree consecutive house visits and counseling. Children whowere not on any therapy, for example, antibiotic/any other drugsdue to any disease during survey were excluded from the study.

Sample Size Estimation

Sample size estimated on the basis of prevalence. Initially, wecalculated the sample size on the basis of the prevalence ofparasitic infestation (37.6%).[2] P = 37%, Q = 100-P = 63, L(allowable error) = 15% of P (relative error) = 15% of 37, sosample size calculated by 4PQ/L2, sample size was 308. Wetook 10% of that sample size for pilot study, i.e. 30.8 = 30. Onthe basis of pilot study, we calculate prevalence which comes44%. On the basis of this prevalence, we calculated samplesize. P = 44%, Q = 100-P = 56, L (allowable error) = 15% of P(relative error) = 15% of 44, so final sample size calculated by4PQ/L2, sample size was 226. On taking 10% non-response rateof total sample size = 22. Hence, final sample size was roundedup to 248 (approximate).

 
Sampling Technique

We used multistage sampling technique for all the study unitsuntil the required sample size was attained.

Tool

We used semi-structured schedule contains both open and closeended with fulfilling the inclusion criteria.

RESULTS

The cross-sectional study was conducted from November 2016to October 2017. A total of 248 children of 6-12 years of ageof rural area were interviewed and inspected with stool routinemicroscopic examination. Graph 1 shows that the prevalenceof intestinal parasitic infestation in 6-12 years of aged childrenwas found to be 33.90%. In our study, Tables 1 and 2 showthat there was an association between parents education, typeof house, washing hands before eating meal, eat washed fruits,wear footwear, wash hands after defecation, cut nail whengrown, handwash before own food, information and trainingabout personal and environmental hygiene and sanitation tostudy participants, and mode of defecation (P < 0.05). This isbecause some study participants had no knowledge of personalhygiene, environmental hygiene, and also sanitation, some studyparticipants were using open field for defecation which leads tofeco-oral transmission of parasitic infestation.

DISCUSSION

In the present study, the overall prevalence of intestinal parasiticinfestation is 33.9% after screening the study participants(84/248) but on the other hand, in another study conducted inNorth Maharashtra by Mane et al.,[7] the overall prevalence ofintestinal parasitic infestation was estimated to be 37.66% whichis nearly similar to our study. Various studies have shown thatthe prevalence rate in India ranges from 12.5% to 66% withvarying prevalence for individual parasites. The wide variationin the prevalence of intestinal parasites may be due to variationsin factors such as quality of drinking water supply, sanitation,and other environmental conditions and also lack of knowledgeand personal hygiene.

An epidemiological study of intestinal parasitic infestation among children aged 6�12 years in rural area of Bareilly, Uttar Pradesh, India
Graph 1: Prevalence of intestinal parasitic infestation (n=248)

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Sharma et al. Parasitic infestation in children

An epidemiological study of intestinal parasitic infestation among children aged 6�12 years in rural area of Bareilly, Uttar Pradesh, India


In the present study, maximum study participants 44.8% (111)always wash hands before eating meal, but 55.3% (137) waswashing hands before eating meal, in which 44.8% (111) ofchildren sometimes wash their hands before eating meal followedby 10.5% (26) never wash their hands and habit of handwashingbefore eating meal, but another study was conducted in Nepalby Sah et al.[8] About 40% (80) never wash their hands beforeeating meal while 60% (120) were washing hands.

In the present study, maximum study participants 41.1% (102)were adequately eat washed and cooked vegetables, but 58.9%(146) of study participants were inadequately eating unwashedand uncooked vegetables, in which 45.2% (112) of childrensometime eat washed and cooked food.

 
In the present study, maximum study participants 51.6% (128)adequately wear footwear, but 48.3% (120) were inadequatelywear footwear, in which 32.3% (80) of children sometimeswear footwear followed by 16.1% of(40) children neverwear footwear but another study was conducted in Dakshina,Kannada by Champa and Sreeshma.[4] About 66.3% (345) ofstudy participants were wearing footwear while 29.80% (155) ofstudy participants were not using footwear in this comparison.In the present study, maximum study participants 91.9% (228)adequately wash hands after defecation/toilet followed by7.7% (19) never wash hands after defecation/toilet and least0.4% (1) sometimes wash hands after defecation/toilet andanother study was conducted in Ethiopia by Gebru et al.[9] Onehundred and seventy-nine (48.6%) had habit of handwashingafter defecation and 189 (51.3%) had not habit of handwashingafter defecation.

19International Journal of Advanced & Integrated Medical Sciences, April-June, Vol 3, 2018

Sharma et al. Parasitic infestation in children

An epidemiological study of intestinal parasitic infestation among children aged 6�12 years in rural area of Bareilly, Uttar Pradesh, India


In the present study, 76.6% (190) of study participants wereusing mud and water for handwashing while 23.4% (58) ofstudy participants were using soap and water for handwashingwhile another study was conducted in Bhopal by Kiran et al.[10]Maximum study participants 92% (276) were using soap andwater while 8% (24) of study participants were using mud andwater. There are different variations in washing after defecationdue to difference in the study participants, lack of knowledge andparent's education to child in different regions results in variationsin prevalence of intestinal parasitic infestation. In the presentstudy, maximum study participants 97.2% (241) of children hadtrim nails when grown followed by 2.8% (7) of children had dirtynails while in another study conducted in Bhopal by Kiran et al.[10]Maximum study participants 86.33% (259) had dirty nails while13.00% (41) of study participants had trimmed nails.

In the present study, maximum study participants 59.7% (148)were informed and trained about personal and environmentalhygiene and sanitation. About 40.3% (100) were not informedand trained.

In the present study, maximum 50.8% (126) had latrine insidehouse followed by 49.2% (122) had not latrine inside house inthese 25.8% (64) while in another study conducted in Ethiopiaby Wale et al.[11] showed that 61.4% (246) of study participantshad latrine inside house, but 38.6% (154) had not latrine insidehouse and in this study. In the present study, maximum studyparticipants were using simple pit latrines for defecation followedby 16.1% (40) were using public latrines for defecation, but33.0% (82) were using open field for defecation and least 25.0%(62) used excreta manually removed by service or bucket latrines.In some studies showed a variation in defecation practices,while some of them showed similarity in defecation practicesas a study conducted in Gujarat by Assudani et al.[12] Maximumstudy participants 58.33% (105) were having outside the house,but minimum 41.67% (75) were having inside the house andfurther 58.33% (105) of study participants were using open-fielddefecation while 41.67% (75) of study participants were usingsanitary latrine for defecation. This is due to insufficient watersupplies, poor hygienic practice, poor socioeconomic status ofthe study subjects, and contamination of vegetables with fecalmaterials in the farm.

 
All the aspects of health status, lifestyle, life satisfaction, mentalstate, or well-being together reflect the multidimensional natureof quality of life in an individual. Child health problems withrespect to the quality of life often remain neglected. Hence, thishealth study was conducted to explore the different variablessuch as sociodemographic, personal habits, and also the modeof defecation relationship with intestinal parasitic infestation.

CONCLUSION

This study revealed high prevalence of intestinal parasiticinfection among 6-12 years of age children in rural areaof Bareilly district and found association between washinghands before eating meal, eat washed fruits, wear footwear,wash hands after defecation, cut nail when grown, handwashbefore own food, information and training about personal andenvironmental hygiene and sanitation to study participants, andmode of defecation. These infected children can transmit theinfection to general population. There is a need for integratedcontrol programs for prevention including periodic deworming,regular epidemiological surveillance, raising awareness aboutpersonal hygiene, absence of handwashing habit after defecation,habit of walking on barefoot, and occupation which arenecessary steps for the prevention of infections. Early diagnosisby parasitological examination and complete treatment of thoseinfected are important for controlling infections.

REFERENCES

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  2. Lakhani SJ, Joshi S, RanaKhara R, Vasisht S Intestinal parasiticinfestations among school children in Piparia village, Vadodaradistrict. Int J Sci Res 2013;2:434-6.
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  1. Ragunathan L, Kalivardhan SK, Ramadass S, Nagaraj M,Ramesh K. Helminthic infection in school children inPuducherry, South India. J Microbiol Immunol Infect2010;43:228-32.
  2. Alwabr GM, Al-Moayed EE. Prevalence of intestinal parasiticinfections among school children of Al-Mahweet Governorate,Yemen. Eur J Biol Res 2016;6:64-73.
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  4. Sah RB, Paudel IS, Baral R, Poudel P, Jha N, Pokharel P.Prevalence of intestinal helminthic infections and associatedrisk factors. Indian J Community Health 2013;25:134-9.

 
  1. Gebru AA, Tamene BA, Bizuneh AD, Ayene YY, Semene ZM,Hailu AW, et al. Prevalence of intestinal parasites and associatedrisk factors at red cross clinic and chelaleki health center, EastWollega Zone, Ethiopia. Sci J Public Health 2015;3:445-52.
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