Intestinal parasites prevalence and related factors in hospitalized children age upto 12 years with diarrhea in Surat, India

Year 2013, Volume: 5 , - , 18.06.2013

Panna Patel Upendra Chaudhary Rajesh Chudasama

Abstract

Background: Intestinal parasitic infection is important public health problem in developing countries. Present study was conducted to identify the prevalence of intestinal parasites and risk factors among children upto age of 12 years hospitalized with diarrhea in tertiary care hospital. Methods: Total 298 children upto the age of 12 years except neonates, admitted in ward of pediatric department with complaints of diarrhea during one year period from May 2011 to April 2012 were included in this study. Various demographic and clinical characteristics were collected on a pretested proforma. Stool smears were examined under light microscope with direct saline smear and lugol`s iodine solution. Parasitic detection was confirmed by formalin ethyl acetate concentration method. Results: Prevalence of intestinal parasites was 8.7% reported among admitted children. Most common parasite isolated was Giardia Intestinalis (5.4%) followed by ascaris lumbricoids (1.3%). Half of study participants were male and belongs to lower socio-economic class. Toilet facility was not available for 26.8% children; 81.2% children received piped water supply of municipality. Duration of diarrhea for more than seven days (p=0.004, OR=4.50, CI=1.59-12.67), more than ten passage of stool per day (p=0.016, OR=2.76, CI=1.20-6.34), non availability of toilet facility (p=0.007, OR=3.05, CI=1.35-6.92) reported as risk factor for intestinal parasitic infection. Such children are more likely to present with vomiting (p=0.038, OR=2.89, CI=1.06-7.90) and abdominal pain (p=0.013, OR=0.35, CI=0.15-0.80). Conclusion: Low socio-economic status, longer duration and frequency of diarrhea, non availability of toilet facility and presence of dehydration were leading risk factors for parasitic infection in present study.

Keywords

Intestinal parasites, children, diarrhea, social status, toilet facility, dehydration

References

• Guerrant RL, Hughes JM, Lima NL, Crane J. Diarrhea in developed and developing countries: magnitude, special settings and etiologies. Rev Infect Dis 1990: 12: 541-550.
• Gracey M. Diarrhea and malnutrition: a challenge for pediatricians. J Pediatr Gastroenterol Nutr 1996; 22: 6-16.
• Ogunlesi T, Okeniyi J, Oseni S, Oyelami O, Njokanma F, Dedeke O. Parasitic etiology of childhood diarrhea. Ind J Paediatr 2006; 73: 1081-1084.
• Quihui L, Valencia ME, Crompton DWT, Phillips S, Hagen P, Morales G, et al. Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural school children. BMC Public Health 2006; 6: 225-232.
• Mumtaz S, Siddiqui H, Ashfaq T. Frequency and risk factors for intestinal parasitic infection in children under five years age at a tertiary care hospital in Karachi. J Pak Med Assoc 2009; 59: 216-2
• Okyay P, Ertug S, Gultekin B, Onen O, Beser F. Intestinal parasites prevalence and related factors in school children, a western city sample-Turkey. BMC Public Health 2004; 4: 64-69.
• Ostan I, Kilimcioğlu AA, Girginkardeşler N, Ozyurt BC, Limoncu ME, Ok UZ. Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites. BMC Public Health 2007; 7: 342.
• World Health Organization (WHO). Deworming for health and development: WHO Report of third PCC meeting. Available from: http://whqlibdoc.who.int/hq/2005/who_cds_cpe_ pvc_2005.14.pdf. (accessed on February 21, 2013).
• Wani SA, Ahmed F, Zargar SA, Dar PA, Dar ZA, Jan TR. Intestinal helminthes in a population of children from Kashmir Valley. Ind J Helminthology 2008; 2: 1-5.
• Wani SA, Ahmed F, Zargar SA, Ahmed Z, Ahmed P, Tak H. Prevalence of intestinal parasites and associated risk factors among school children in Srinagar city, Kashmir, India. J Parasitol 2007; 93: 1541-1543.
• Saha DR, Gupta DN, Sengupta PG, Mondal SK, Ghosh S, Saha NC, et al. Intestinal parasitism: a childhood problem in rural Bengal. J Commun Dis 1995; 27: 170-174.
• World Health Organization (WHO). Ministry of Health & Family Welfare, Government of India: Integrated Management of Neonatal & Childhood Illness, Module Available from http://mohfw.nic.in/NRHM/Documents/CH/IMN CI_Training_Modules/Module_5.pdf. (accessed on February 19, 2013).
• Nutrition Sub-Committee of the Indian Academy of Pediatrics. Report of Convener. Indian Pediatr, 1972; 7: 360.
• Kumar P. Social classification – need for constant updating. Indian J Community Med 1993: 18: 2.
• Centers for Disease Control and Prevention. Epi Info version 3.5.1, August 18, 2008. Available from http://cdc.gov/epinfo/. (accessed on January 10, 2010).
• Kaur R, Rawat D, Kakkar M, Uppal B, Sharma VK. Intestinal parasites in children with diarrhea in Delhi, India. Southeast Asian J Trop Med public Health 2002; 33: 725-729.
• Ganga N, Ravichandran R. Intestinal parasites in children from middle income families. Indian pediatrics 1995; 32: 828.
• Sethi S, Sehgal R, Malla N, Dubey ML, Mahajan RC. Changing trade of intestinal parasitic infections in Chandigarh (Northern India): hospital based study. Ind J Med Microbiol 2000; 18: 106-109.
• Mehraj V, Hatcher J, Akhtar S, Rafique G, Beg MA. Prevalence and factors associated with intestinal parasitic infection among children in an urban slum of Karachi. PLoS One 2008; 3: e3680. doi: 1371/journal.pone.0003680.
• Nduka FO, Nwaugo VO, Nwachukwu NC. Human intestinal parasite infections in Ishiagu, a leading mining area of Abia state. Animal Research International 2006; 3: 505-507.
• Kia EB, Hossein M, Nilforoushan MR, Meamar AR, Rezaeian M. Study of intestinal protozoan parasites in rural inhabitants of Mazandaran Province, Northern Iran. Iranian J Parasitol 2008; 3: 22-25.
• Mbanugo JI, Onyebuchi CJ. Prevalence of intestinal parasites in Ezinifite community, Aguata Local Government Area of Anambra state. Nigerian J Parasitol 2002; 23: 27-34.
• Nasiri V, Esmailnia K, Karimi G, Nasiri M, Akhavan O. Intestinal parasitic infections among inhabitants of Karaj city, Tehran province, Iran in 2006-2008. Korean J Parasitol 2009; 47: 265-268. Reither K, Ignatius R, Weitzel T, Seidu-Korkar A, Anyidoho L, Saad E, et al. Acute childhood diarrhea in northern Ghana: epidemiological, clinical and microbiological characteristics. BMC Infectious Diseases 2007: 7: doi:1186/1471-2334/7/104.
• Moyo SJ, Gro N, Matee MI, Kitundu J, Myrmel H, Mylvaganam H et al. Age specific aetiological agents of diarrhea in hospitalized children aged less than five years in Dar es Salaam, Tanzania. BMC Pediatrics 2011; 11: 19. doi: 10.1186/14712431-11-19.
• Marothi Y, Singh B. Prevalence of intestinal parasites in Ujjain, Madhya Pradesh India: five year study. Afr J Microbiol Res 2011; 5: 271127
• Jacobsen KH, Ribeiro PS, Quist BK, Rybeck BV. Prevalence of intestinal parasites in young Quichua children in the Highlands of rural Ecuador. J Health Popul Nutr 2007; 25: 399-405. Akinbo FO, Omoregie R, Eromwon R, Igbenimah IO, Airueghiomon UE. Prevalence of intestinal parasites among patients of a tertiary hospital in Benin city, Nigeria. N Am J Med Sci 2011; 3: 462-4
• Ostan I, Kilimcioğlu AA, Girginkardeşler N, Ozyurt BC, Limoncu ME, Ok UZ. Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites. BMC Public Health 2007; 7: 342. doi:10.1186/14712458-7-342.
• Balcioglu IC, Kurt O, Limoncu ME, Dinç G, Gümüş M, Kilimcioglu AA, et al. Rural life, lower socioeconomic status and parasitic infections. Parasitol Int 2007; 56: 129-133.
• National Family Health Survey (NFHS-3), 200506, India: Key Findings. Mumbai: IIPS. International Institute for Population Sciences (IIPS) and Macro International 2007. Available from: http://www.rchiips.org/NFHS/factsheet.shtml.
• (accessed on February 26, 2013).
• Asfaw ST, Goitom L .Malnutrition and enteric parasitoses among under-five children in Aynalem Village, Tigray. Ethiop J Health Dev 2000; 14:67-75.
• Haque R, Mondal D, Kirkpatrick BD, Akther S, Farr BM, Sack RB, et al. Epidemiologic and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in an urban slum of Dhaka, Bangladesh. Am J Trop Med Hyg 2003; 69: 39840
• Haque R, Mondal D, Karim A, Molla IH, Rahim A, Faruque AS, et al. Prospective case-control study of the association between common enteric protozoal parasites and diarrhea in Bangladesh. Clin Infect Dis 2009; 48: 1191-97. doi: 1086/597580.