Elsevier

Acta Tropica

Volume 92, Issue 3, November–December 2004, Pages 179-186
Acta Tropica

Prevalence of intestinal parasitic infections and their relation with socio-economic factors and hygienic habits in Tehran primary school students

https://doi.org/10.1016/j.actatropica.2004.06.010Get rights and content

Abstract

School age children carry the heaviest burden of morbidity due to intestinal parasitic infections. Our objective was to determine the prevalence of these infections in primary school children living in Tehran and their association with socio-economic factors and hygienic habits. In September 1998, a total of 19 213 subjects were invited to participate. Data on health and socio-economic status and health-related behaviours, collected via questionnaires, physical examinations and stool sample analyses, were available for 19 209 persons, with a participation rate greater than 99.99%. All participants were subjected to three methods of microscopic examinations on the stool sample and an adhesive cellophane tape slide evaluation. The prevalence rate of intestinal parasitic infection among the students was 18.4%. Coinfection with two or three parasites was seen in 2%. With increase in educational level of parents (especially mothers), the infection rate of children was decreased. Girls showed a significantly higher positive rate than boys. Using piped water, correct method of washing vegetables and increase in the economic score of the family, resulted in a decrease in the infection rate. According to the results, low level of education and consequently poor socio-economic and hygienic condition of families appear to be powerful determinants of infection.

Introduction

Available data show that parasitic diseases constitute great medical, social and economic problems all over the world. There are two important epidemiological factors that make parasitic infections unique. First, parasitic infections have a high prevalence and it is estimated that more than three billion people are infected by intestinal parasites in the world today (Markell et al., 1999). Second, these dangerous infections are most common among the poorest and disadvantaged communities and are most intense and frequent in school age children. These infections pose a serious threat to the health and development of children in low-income countries and are associated with poor growth, reduced physical activity and impaired learning ability (Stephenson et al., 1990, Nokes et al., 1992, Stoltzfus et al., 1996).

As mentioned above, when compared to other age groups, school children carry the heaviest burden of morbidity due to intestinal nematodes. Using a mathematical model, it is estimated that approximately 70% of the disease burden on whole population can be prevented in high prevalence communities by treating school children alone (Chan, 1997). Although many studies regarding intestinal parasites focus on establishing the prevalence and intensity of these infections in different populations, fewer studies have examined the socio-cultural factors that affect transmission of intestinal helminths. Some studies have shown that the lack of education, lack of latrines, occurrence of diarrhea, lower socio-economic status, inadequate disposal of human excreta and the level of sanitation in households are related to parasitoses (Holland et al., 1996, Tshikuka et al., 1995, Gamboa et al., 1998, Gamboa et al., 2003).

The objective of this investigation was to study intestinal parasitic infections (with stool examination and Graham's technique) in primary school children living in Tehran to estimate their prevalence, their association with socio-economic characteristics and the influence of simple and primary hygienic measures in reducing their frequency.

Section snippets

Materials and methods

In September 1998, a large population-based survey was performed at the medical faculty of Azad University of Tehran, by 40 trained medical school seniors of the university and under the supervision of four parasitologists.

Results

Out of 19 213 invited subjects, 19 209 students took part in the survey and were included in the present analysis. Of these, 50.5% were male and 49.5% female. The mean age of the children was 8.5 ± 1.5 years.

The overall prevalence of intestinal parasitic infection among Tehran primary school students was 18.4%, of which 11.5% was Giardia lamblia, 3.8% Enterobius vermicularis, 3.1% Blastocystis hominis, 1.7% Entamoeba coli, 0.3% Hymenolepis nana, 0.1% Entamoeba histolytica/dispar, and less than

Discussion

Many studies on the prevalence of intestinal parasitic infections have been performed in Africa and Asia, due to their wide diffusion in these continents. However, no data are available from the urban settings of Tehran. Most of the studies have reported a considerably higher prevalence of infections in similar situations (Kyu-Jae et al., 2002, Chan, 1997). Our study may actually have underestimated the true prevalence of parasitic infections because only one stool sample was collected from

Acknowledgements

This study was carried out with the sponsorship of Azad University of Tehran and support of Ministry of Education of Iran and its regional officials and schools. We are indebted to Mr. Javaheripoor for his support and to Dr. Mohsen Malekinezhad, Dr. Banafsheh Sadeghi and Dr. Nasibeh Khaleghnezhad for data analysis of this study. Our research team is grateful to Dr. Mohammadbagher Shayvard who provided support for this research. Thanks are extended to Dr. Jafar Masoud, Dr. Iraj Moubedi and Dr.

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