Gastroenteritis in Primary School Children in Enugu Metropolis (6 – 12 Yrs)
Chapter One
AIMS AND OBJECTIVES
– to determine the prevalently of gastroenteritis in primary school children
– also to implicate in gastroenteritis .
– to relate the environment of the pupil to the types of diseases which they acquire from it.
CHAPTER TWO
LITERATURE REVIEW
Parasite
A parasite is an organism that is entirely dependent on another organism, referred to as its host for all or part of its life cycle and metabolic requirements (Jordan and Verma, 2010, Arora and Arora, 2011). Gerald and Larry (2010) considered a parasite as an organism that resides on or within another living organism. i.e the host, in order to find the environment and nutrients required for its own growth and development. The term parasite can be applied to any infectious agent but, this includes protozoa and helminths excluding the viruses, bacteria and fungi (Arora and Arora, 2011). Parasites can be classified according to sizes into 2 types: micro parasite e.g. Protozoans and macro parasites e.g. Helminths.
Ectoparasites are parasites which live on the surface of the body e.g. the human louse (pediculus humanu). The infection by these parasites is known as infestation. Some ectoparasites serve as vectors transmitting pathogenic microorganisms.
Endoparasites are parasites that live within the body of the host. All protozoan and helminth parasites of man are endoparasites. The invasion by endoparasites is known as infection (Kathleen and Arthur, 2002, Arora and Arora, 2011); a condition in which pathogenic microorganisms penetrate the host defense, enter the tissues and multiply. When the cumulative effects of the infection damage or disrupt tissues and organs, disease result. A disease is defined as any deviation from health.
Types of Intestinal Parasites
Intestinal parasites can be classified into two, the protozoans and helminths. The protozoa intestinal parasites can be grouped into Amoebae, Sarcodina, Flagellates, Ciliates and Sporozoa (Arora and Arora, 2011).
Amoebae include Entamoeba histolytica/dispar, E.hartmani, E.coli, Iodamoeba butschii and Endolima nana. Flagellates of intestinal, oral and genital flagellates are Giardia lamblia, Trichomonas vaginalis, T. tenax homini, and Dientamoeba fragilis. Sporozoan consists of Cryptosporidium parvum and Isospora belli while Balantidium coli is the only ciliate that infects man.
The major intestinal helminths of humans can be grouped into intestinal nematodes, trematodes and cestodes (Kathleen and Arthur, 2002). Intestinal nematodes include Trichuris trichiura (whip worm), Ascaris lumbricoides, Enterobius vermicularis (pin worm), Necator americanus and Ancylostoma duodenale (hookworm) Strongyloides stercoralis (thread worm), Trichinella spiralis (trachina worm). Trematodes include Schistosoma mansoni, S. haematobium and S. Japonicum. Cestodes include Taenia Saginata (Beef tapeworm), T. solium (Pork tapeworm), Diphyllobotrium latum (fish tapeworm) and Hymenolepis nana (Dwarfworm).
Transmission of Intestinal Parasitic Infections
A parasite enters the human host through a proper route so that it can reach an appropriate site where it can continue its life cycle. Three (3) main routes of transmission through which the parasite enters the human body are explained by (Ochei and Kolhatkar, 2007).
Faecal-oral route
The commonest method of transmission of parasites is by ingestion of food or water contaminated with faeces containing the infective stage of the parasite as is the case in nematodes such as Trichuris trichiura and Enterobius vermicularis; and protozoans such as Entamoeba histolytica and Giardia lamblia. Ingestion of improperly cooked meat, fish or vegetables can expose an individual to the infective stage of the parasite (Ochei and Kolhatkar, 2007).
The larvae undergo encystment and lie in the muscles or tissues of the intermediate host. If not killed during cooking, they continue their life cycle when ingested by man e.g. Taenia saginata in beef, Taenia solium in pork and Trichinella spiralis in pork. Ingestion of the intermediate host harbouring the parasite e.g. infection can be transmitted by drinking water containing Cyclops, an intermediate host for Dracunculus medinensis (Ochei and Kolhatkar, 2007).
Penetration through the skin
The infective larvae of various parasites can enter the human body by penetration through the skin, reach the blood stream and then migrate to the site where they can mature and reproduce. The free swimming cercariae of schistosomes in water enter through the skin of a person coming in contact with that body of water. Infective (e.g. filariform) larvae of Strongyloides or hookworm can enter through the skin if in contact with soil polluted by faeces containing these larvae (Cheesbrough, 2005, Ochei and Kolhatkar, 2007).
By sexual contact
Parasites such as Trichomonas vaginalis can be transmitted from one person to another by sexual contact. Others are transmitted by oral- anal sex.
Geographic Distribution of Intestinal Parasites
The prevalence and profile of intestinal parasitic infections vary widely among continents and within countries or sub-regions. There are about 50 species of helminthes that parasitize humans (Valdenir et al., 2011). They are distributed in all areas of the world. Some worms are restricted to a given geographic region and many have a higher incidence in tropical areas. This knowledge must be tempered with the realization that jet-age travel, along with human migration are gradually changing the patterns of worm infections, especially of those species that do not require alternate hosts or special climatic conditions for development (Kathleen and Arthur, 2002). The yearly estimate of worldwide cases numbers in billions and these are not confined to developing countries. A conservative estimate places 50,000,000 helminth infections in North America. The primary targets are malnourished children (Kathleen and Arthur, 2002).
CHAPTER THREE
MATERIALS AND METHODS
Study Design
It is a term used to describe a number of decisions which need to be taken regarding the collection of data before they are collected. (Nwana, 1981). It provides guidelines which direct the researcher towards solving the research problem and may vary depending on the nature of the problem being studied. According to Okaja ( 2003, p. 2),” research design means the structuring of investigation aimed at identifying variables and their relationship, it is used for the purpose of obtaining data to enable the investigator test hypothesis or answer research question by providing procedural outline for conducting research”. It is therefore, an outline or scheme that serves as a useful guide to the researcher in his efforts to generate data for his study.
Sources of Data
The data for this study were generated from two main sources; Primary sources and secondary sources. The primary sources include questionnaire, interviews and observation. The secondary sources include journals, bulletins, textbooks and the internet.
Study Population
The study population comprised of 600 primary school pupils. 60 pupils were selected at random from 10 primary schools in 10 wards. The enrolled pupils were within the ages of 5-13 years. A simple ballot system was used for the selection of the schools and the pupils.
CHAPTER FOUR
PRESENTATION OF DATA AND ANALYSIS
Prevalence of Intestinal Parasites in Relation to Age of Pupils
Age-specific prevalence of parasites showed that class 1 and 2 pupils who are in the 5-7 age group had the highest prevalence of 105(52.5%), Class 3 and 4 (age group 8-10 years) had 90 pupils infected out of 200 with 45.0% prevalence and 5 and 6 (age group 11-13 years) had the least with 76 pupils infected out of 200 and prevalence rate of 38.0%. There was statistically significant association between prevalence of infection and age groups. P= 0.014. Odds ratio value of 1.56 for 5-7years showed associations between the age group and the infection (Table 4.1). Regression of age on prevalence showed that prevalence of infection reduced with increase in age (r = -0.9998).
CHAPTER FIVE
CONCLUSIONS AND RECOMMENDATIONS
wnload Conclusions
- This study on prevalence of gastrointestinal parasites among primary school children recorded a prevalence of 45.2% in Emene Area of Enugu State.
- The prevalence was highest in age group of 5-7 years with 105(52.5%) and lowest in age group of 10-13 years with 76(38.0%). Odds ratio of 1.56 showed association between age and the infection. The prevalence was also higher in male pupils 49.7% compared to female pupils 40.7%. Odds ratio of 1.44 also showed association between sex and the infection.
- Poor sanitation, inadequate potable water supply, low level of personal hygiene education and lack of de-worming were observed as the major risk factors that enhances the transmission of the disease.
Recommendations
- The Health Services Unit of the Local Government should embark on mass public health education to improve the level of hygiene in the area.
- There should be large-scale de-worming campaigns in all the primary school children in the area to be extended to the host communities.
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