Intestinal Parasitic Infections and Hemoglobin Levels among Schoolchildren participating in a Deworming Program in Jakarta, Indonesia: A Cross-sectional Study

Rizal Subahar; Lisawati Susanto; Hendri Astuty; Rawina Winita; Ika Puspa Sari

doi:10.3889/oamjms.2020.5153

Authors

Rizal Subahar Department of Parasitology, Faculty of Medicine, University of Indonesia, Depok, Indonesia
Lisawati Susanto Department of Parasitology, Faculty of Medicine, University of Indonesia, Depok, Indonesia
Hendri Astuty Department of Parasitology, Faculty of Medicine, University of Indonesia, Depok, Indonesia
Rawina Department of Parasitology, Faculty of Medicine, University of Indonesia, Depok, Indonesia
Ika Puspa Sari Department of Parasitology, Faculty of Medicine, University of Indonesia, Depok, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.5153

Keywords:

Ascaris lumbricoides, Trichuris trichiura, Blastocystis hominis, Giardia lamblia, Anemia

Abstract

BACKGROUND: Deworming programs have had positive impacts on the incidence of intestinal parasitic infections (IPIs) and hemoglobin (Hb) levels among schoolchildren.

AIM: This study aimed to evaluate effects of a deworming program on IPIs and Hb levels among schoolchildren in Jakarta, Indonesia.

METHODS: A cross-sectional study was performed in one school in Jakarta, Indonesia. Stool samples from schoolchildren were examined using the direct smear and Kato-Katz methods. The Hb concentrations of the schoolchildren were measured using the Easy Touch GCHb tool kit.

RESULTS: A total of 219 stool samples were obtained, and 18.7% (41/219) were positive for IPIs; specifically 8.2% (18/219) were positive for helminth and 10.5% (23/219) were positive for protozoan infections. The prevalences of Ascaris lumbricoides and Trichuris trichiura were 6.4% and 1.8%, respectively. The prevalences of Blastocystis hominis, Giardia lamblia, Entamoeba histolytica, and Entamoeba coli were 6.8%, 2.7%, 0.5%, and 0.5%, respectively. The prevalence of anemia (Hb < 11.5 g/dL) among the schoolchildren was 19.6% (43/219). The IPIs were significantly associated with Hb concentrations among the schoolchildren (p < 0.05).

CONCLUSION: The results of this study support the use of integrated programs involving deworming, nutrient supplementation, development of good living conditions, use of sanitary facilities, and active participation in the community to reduce IPIs and to improve the nutritional status among schoolchildren.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Bethony J, Brooker S, Alabonica M, Geiger SM, Laukas A, Diemert D, et al. Soil-transmitted helminth infections: Ascariasis, trichuriasis, and hookworm. Lancet. 2006;367(9521):1521-32. https://doi.org/10.1016/s0140-6736(06)68653-4 PMid:16679166

Stanley SL Jr., Reed SL. Microbes and microbial toxins: Paradigms for microbial-mucosal interactions. VI. Entamoeba histolytica: Parasite-host interactions. Am J Physiol Gastrointest Liver Physiol. 2001;280(6):G1049-54. https://doi.org/10.1152/ajpgi.2001.280.6.g1049 PMid:11352795

Ayele BH, Geleto A, Ayana DA, Redi M. Prevalence of fecooral transmitted protozoan infections and associated factors among university students in Ethiopia: A cross-sectional study. BMC Infect Dis. 2019;19(1):499. https://doi.org/10.1186/s12879-019-4095-z PMid:31174474

Jourdan PM, Lamberton PH, Fenwick A, Addiss DG. Soiltransmitted helminth infections. Lancet. 2018;391(10117):252-65. https://doi.org/10.1016/s0140-6736(17)31930-x PMid:28882382

Centers for Disease Control and Prevention (CDC). Trichuriasis (Alos Known as Whipworm Infections); 2013. Available from: https://www.cdc.gov/parasites/whipworm. [Last Accessed 2020 Jun 22].

Gardner TB, Hill DR. Treatment of giardiasis. Clin Microbiol Rev. 2001;14(1):114-28. PMid:11148005

Wawarzyniak I, Poirier P, Viscogliosi E. Dionigia M, Texier C, Delbac F. Blastocystis, an unrecognized parasite: An overview of pathogenesis and diagnosis. Ther Adv Infect Dis. 2013;1(5):167-78. PMid:25165551

El-Dib NA. Entamoeba histolytica: An overview. Curr Trop Med Rep. 2017;4:11-20. https://doi.org/10.1007/s40475-017-0100-z

Ashtiani MT, Monajemzadeh M, Saghi B, Shams S, Mortazavi SH, Khaki S, et al. Prevalence of intestinal parasites among children referred to children’s medical center during 18 years (1991-2008), Tehran, Iran. Ann Trop Med Parasitol. 2011;105(7):507-13. https://doi.org/10.1179/1364859411y.0000000040 PMid:22185945

World Health Organization. Deworming to Combat the Health and Nutritional Impact of Soil-Transmitted Helminthes; 2012. Available from: https://www.who.int/elena/titles/bbc/deworming/en. [Last Accessed 2020 Jun 22].

Schmidlin T, Hurlimann E, Silue KD, Yapi RB, Houngbedji C, Kouadio BA, et al. Effects of hygiene and defecation behavior on helminths and intestinal protozoa infections in Taabo, Cote d’lvoire. PLoS One. 2013;8(6):e65722. https://doi.org/10.1371/journal.pone.0065722 PMid:23840358

Quihui-Cota L, Morales-Figueroa GG. Persistence of intestinal parasitic infections during the national de-worming campaign in schoolchildren of northwestern Mexico: A cross-sectional study. Ann Gastroenterol. 2012;25(1):57-60. PMid:24714136

Koukounari A, Estambale BB, Njagi JK, Cundill B, Ajanga A, Crudder C, et al. Relationships between anaemia and parasitic infections in Kenyan schoolchildren: a Bayesian hierarchical modelling approach. Int J Parasitol. 2008;38(14):1663-71. PMid:18621051

World Health Organization. Bench Aids for the Diagnosis of Intestinal Parasites. 2nd ed. Geneva: World Health Organization; 2019. p. 1-32. Available from: https://www.who.int/intestinal_worms/resources/9789241515344/en. [Last Accessed 2020 Jul 01].

User Manual, Easy Touch GCHb. Available from: https://www.5.imimg.com/data5/dd/vs/cj/seller-28906720/easy-touchmeter.pdf. [Last Accessed 2020 Jun 26].

Ugoni A, Walker BF. The chi square test: An introduction. COMSIG Rev. 1995;4(3):61-4. PMid:17989754

Sullivan KM, Mei Z, Grummer-Strawn L, Parvanta I. Haemoglobin adjustments to define anaemia. Trop Med Int Health. 2008;13(10):1267-71. https://doi.org/10.1111/j.1365-3156.2008.02143.x PMid:18721184

Silver ZA, Kaliappan SP, Samuel P, Venugopal S, Kang G, Sarkar R, et al. Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia-a systematic review. PLoS Negl Trop Dis. 2018;12(1):e0006153. https://doi.org/10.1371/journal.pntd.0006153 PMid:29346440

Gelaw A, Anagaw B, Nigussie B, Silesh B, Yirga A, Alem M, et al. Prevalence of intestinal parasitic infections and risk factors among schoolchildren at the University of Gondar Community School, Northwest Ethiopia: A cross-sectional study. BMC Public Health. 2013;13:304. https://doi.org/10.1186/1471-2458-13-304 PMid:23560704

Dahal AS, Francis EO, Francis JE, Wamtas FI. Soiltransmitted Helminths and Associated Risk Factors among Elementary School Pupils in Dadin Kowa, Jos. Niger Med J. 2019;60(4):181-5. https://doi.org/10.4103/nmj.nmj_62_19 PMid:31831936

Ranjan S, Passi SJ, Singh SN. Prevalence and risk factors associated with the presence of soil-transmitted helminths in children studying in municipal corporation of Delhi schools of Delhi, India. J Parasit Dis. 2015;39:377-84. https://doi.org/10.1007/s12639-013-0378-2 PMid:26345038

Yang D, Yang Y, Wang Y, Yang Y, Dong S, Chen Y, et al. Prevalence and risk factors of ascaris lumbricoides, trichuris trichiura and cryptosporidium infections in elementary school children in Southwestern China: A school-based cross-sectional study. Int J Environ Res Public Health. 2018;15(9):1809. https://doi.org/10.3390/ijerph15091809 PMid:30135364

Speich B, Moser W, Ali SM, Ame SM, Albonico M, Hattndorf J, et al. Efficacy and reinfection with soil-transmitted helminthes 18 weeks post-treatment with albendazole-ivermectin, albendazole-mebendazole, albendazole-oxantel pamoate and mebendazole. Parasit Vectors. 2016;9:123-33. https://doi.org/10.1186/s13071-016-1406-8 PMid:26935065

Gopalakhrisnan S, Eashwar VM, Muthulaksmi M, Geetha A. Intestinal parasitic infestations and anemia among urban female school children in Kancheepuram district, Tamil Nadu. J Family Med Prim Care. 2018;7(6):1396-400. https://doi.org/10.4103/jfmpc.jfmpc_89_18 PMid:30613531

Tandukar S, Ansari S, Adhikari N, Shrestha A, Gautam J, Sharma B, et al. Intestinal parasitosis in school children of Lalitpur district of Nepal. BMC Res Notes. 2013;6:449. https://doi.org/10.1186/1756-0500-6-449 PMid:24207086

Osman M, El Safadi D, Cian A, Benamrouz S, Nourrisson C, Poirier P, et al. Prevalence and risk factors for intestinal protozoan infections with cryptosporidium, Giardia, Blastocystis and Dientamoeba among schoolchildren in Tripoli, Lebanon.PLoS Negl Trop Dis. 2016;10(3):e0004496. https://doi.org/10.1371/journal.pntd.0004496 PMid:26974335

Leung AK, Leung AA, Wong AH, Sergi CM, Kam JK. Giardiasis: An overview. Recent Pat Inflamm Allergy Drug Discov. 2019;13(2):134-43. https://doi.org/10.2174/1872213x13666190618124901 PMid:31210116

Hernández PC, Morales L, Chaparro-Olaya J, Sarmiento D, Jaramillo JF, Ordoñez GA, et al. Intestinal parasitic infections and associated factors in children of three rural schools in Colombia. A cross-sectional study. PLoS One. 2019;14(7):e0218681. https://doi.org/10.1371/journal.pone.0218681 PMid:31291262

Gyang VP, Chuang TW, Liao CW, Lee YL, Akinwale OP, Orok A, et al. Intestinal parasitic infections: Current status and associated risk factors among school aged children in an archetypal African urban Slum in Nigeria. J Microbiol Immunol Infect. 2017;52(1):106-13. https://doi.org/10.1016/j.jmii.2016.09.005 PMid:28711437

Bakarman MA, Hegazi MA, Butt NS. Prevalence, characteristics, risk factors, and impact of intestinal parasitic infections on school children in Jeddah, Western Saudi Arabia. J Epidemiol Glob Health. 2019;9(1):81-7. https://doi.org/10.2991/jegh.k.190219.001 PMid:30932395

Hailegebriel T. Prevalence of intestinal parasitic infections and associated risk factors among students at Dona Berber primary school, Bahir Dar, Ethiopia. BMC Infect Dis. 2017;17(1):362. https://doi.org/10.1186/s12879-017-2466-x PMid:28535750

Sitotaw B, Mekuriaw H, Damtie D. Prevalence of intestinal parasitic infections and associated risk factors among Jawi primary school children, Jawi town, North-West Ethiopia. BMC Infect Dis. 2019;19(1):341. https://doi.org/10.1186/s12879-019-3971-x PMid:31023271

Tezera R, Sahile Z, Yilma D, Misganaw E, Mulu E. Prevalence of anemia among school-age children in Ethiopia: A systematic review and meta-analysis. Syst Rev. 2018;7(1):80. https://doi.org/10.1186/s13643-018-0741-6 PMid:29793528

Birhanu M, Gedefaw L, Asres Y. Anemia among school-age children: Magnitude, severity and associated factors in Pawe town, Benishangul-Gumuz region, Northwest Ethiopia. Ethiop J Health Sci. 2018;28(3):259-66. https://doi.org/10.4314/ejhs. v28i3.3 PMid:29983525

Khatiwada S, Gelal B, Gautam S, Tamang MK, Shakya PR, Lamsal M, et al. Anemia among school children in eastern Nepal. J Trop Pediatr. 2015;61(3):231-3. https://doi.org/10.1093/tropej/fmv016 PMid:25828831