Risk of Soil-Transmitted Helminthiasis among Agrarian Communities of Kogi State, Nigeria.

BACKGROUND: Soil-transmitted helminths (STH) have remained a major threat to humans, especially children in developing countries, including Nigeria. Interventions have always been geared towards school-aged children, neglecting preschool-aged children and occupational risk adults. The Soil-Transmitted Helminthiasis Advisory Committee (STHAC) recently suggested incorporating other at-risk groups. OBJECTIVE: This study assessed the associated risk of STH infection among agrarian communities of Kogi State, Nigeria. METHODS: A total of 310 individuals of all ages participated in the cross-sectional survey. Stool samples were analyzed using standard Kato-Katz method. RESULTS: A total of 106 (34.2%) individuals were infected with at least one STH. Hookworm was the most prevalent (18.1%); followed by Ascaris lumbricoides (16.8%). Worm intensity was generally light. Prevalence of infection was similar between four age groups considered (preschool, school, 'women of reproductive age' and older at-risk group). Poor socio-economic status (SES) was a major risk for STH infection. Using a 20-asset based criteria, 68 (23.1%) and 73 (24.7%) of 295 questionnaire respondents were classified into first (poorest) and fifth (richest) wealth quintiles respectively. Risk of infection with STH was 60% significantly lower in the richest wealth quintile compared to the poorest (Prevalence Ratio [PR] = 0.4843, 95% CI = 0.2704-0.8678, p = 0.015). Open defecators were more likely to harbour STH than those who did not (PR = 1.7878, 95% CI = 1.236-2.5846, p = 0.00201). Pit latrine and water closet toilets each approximately reduced STH infection by 50% (p < 0.05). CONCLUSION: Preventive chemotherapy for all age groups, health education and provision of basic amenities especially toilets are needed in order to achieve the goal toward the 2020 target of STH control.

Antenatal Practices Ineffective at Prevention of Plasmodium falciparum Malaria during Pregnancy in a Sub-Saharan Africa Region, Nigeria.

Pregnancy-associated malaria (PAM) is a major public health concern constituting a serious risk to the pregnant woman, her foetus, and newborn. Management of cases and prevention rely partly on effective and efficient antenatal services. This study examined the effectiveness of antenatal service provision in a major district hospital in sub-Saharan Africa at preventing PAM. A cross-sectional hospital based study design aided by questionnaire was used. Malaria diagnosis was by microscopy. Overall prevalence of PAM was 50.7% (38/75). Mean Plasmodium falciparum density was (112.89 ± standard error of mean, 22.90) × 10³/µL red blood cell (RBC). P. falciparum prevalence was not significantly dependent on gravidity, parity, trimester, age, and BMI status of the women (p > 0.05). Difference in P. falciparum density per µL RBC in primigravidae (268.13 ± 58.23) × 10³ vs. secundi- (92.14 ± 4.72) × 10³ vs. multigravidae (65.22 ± 20.17) × 10³; and in nulliparous (225.00 ± 48.25) × 103 vs. primiparous (26.25 ± 8.26) × 10³ vs. multiparous (67.50 ± 20.97) × 10³ was significant (p < 0.05). Majority of attendees were at 3rd trimester at time of first antenatal visit. Prevalence of malaria parasitaemia in the first-time (48.6%), and multiple-time (52.6%) antenatal attendees was not significantly different (χ² = 0.119, p = 0.730). The higher prevalence of malaria among bed net owners (69.6% vs. 42.9%, χ² = 2.575, p = 0.109, OR = 3.048 (95% CI 0.765⁻12.135)) and users (66.7% vs. 33.3%, χ² = 2.517, p = 0.113, OR = 4.000 (95% CI 0.693⁻23.089)) at multiple antenatal visits vs. first timers was not significant. None of the pregnant women examined used malaria preventive chemotherapy. Antenatal services at the hospital were not effective at preventing PAM. Holistic reviews reflecting recommendations made here can be adopted for effective service delivery.

Gastrointestinal helminth infection in pregnancy: disease incidence and hematological alterations.

BACKGROUND: The incidence and hematological effects of helminth infection during pregnancy were investigated among pregnant women in Isiala, Mbano, Southeast Nigeria. METHODS: Totally 282 pregnant women were enlisted for the study between October 2011 and September 2012. Stool samples were examined for intestinal helminths using formalin-ether sedimentation technique. Hemoglobin (Hb) and Packed Cell Volume (PCV) levels were evaluated in venous blood samples using Sahli's and microhaematocrit methods respectively. RESULTS: Forty six (16.3%) subjects were infected with at least one helminth parasite; 24 (8.5%) hookworm, 14(5.0%) and 2(0.7%) A. lumbricoides and Trichuris trichiura infections respectively. Intestinal helminthiases in pregnant women was significantly associated with age (P<0.05). The prevalence of intestinal helminthiases by parity was also significantly different (P<0.05) with primigravidae having the highest infection rate (27.5%). Hematological assessment showed that the prevalence of anemia among the women was 58.9% (mean±SD = 9.3±1.0). The differences in hemoglobin levels by age groups was statistically significant (P <0.05). The contributory effect of gastrointestinal helminths in anemia showed that infected pregnant women had lower mean hemoglobin (8.60±0.22g/dl) than the uninfected (9.72±0.07g/dl). Significant difference (t-value = 5.660, P<0.05) was observed between the Hb of the infected and uninfected pregnant women. In addition, infected pregnant women had mean PCV of 26.09±0.65% while the uninfected had 34.54±2.96%. The mean PCV of infected pregnant women was significantly different (t-value= 0.013, P<0.05) from that of the uninfected. CONCLUSION: Anti-helminthic therapy after the first trimester should be part of the antenatal programme. Intestinal helminth infection showed significant negative correlation with Hb and PCV and contributed moderately to anemia.