Survey on the Prevalence of Helminths Neglected Tropical Diseases in Jos South L.G.A Plateau State
Chapter One
Objective of the study
The objectives of the study are;
- To assess the current prevalence and distribution of helminth infections in the target population in Jos south L.G, plateau state
- To identify the risk factors and determinants contributing to the prevalence of helminth infections in Jos south L.G, plateau state
- To evaluate the effectiveness of existing preventive and control interventions for helminth NTDs in Jos south L.G, plateau state
CHAPTER TWO
REVIEWED OF RELATED LITERATURE
Epidemiology of helminth infections
With the exception of Strongyloides stercoralis, helminths do not replicate within the human host. This fundamental aspect of helminth biology establishes a set of transmission dynamics quite different than those for viruses, bacteria, fungi, and protozoa. For example, prevalence, which is the proportion of persons in a defined population at a given time point infected with the helminth, isseldom used asthe only measure to assessthe epidemiological situation for that helminth infection, because morbidity is associated with the number of worms infecting the host (i.e., the worm burden) rather than the absence or presence of infection. Prevalence is commonly combined with worm burden (also referred to as the “intensity of infection”), which is commonly measured by the number of eggs per gram (EPGs) of feces for intestinal helminths and schistosomes. Based on EPGs and their association with morbidity, individuals are classified into categories of light, moderate, and heavy infection by the WHO). Furthermore, in the case of soil-transmitted helminths, the WHO recommends use of both prevalence and intensity of infection to classify communities into transmission categories category I (high), category II (medium), and category III (low). These transmission categories are assigned according to both the number of heavily infected people in the community (greater or less than 10%) and the prevalence of infection (greater or less than 50%). For example, a community with greater than 50% prevalence but less than 10% heavy infection would be considered a category II transmission community. The WHO uses this information in algorithms to determine the type of mass treatment a community should receive. For filarial helminths, the transmission status in a community is determined by assessing the number of people with blood-circulating microfilariae or microfilarial antigen; in the case of onchocerciasis, it is determined by counting the number of microfilariae in a skin biopsy or even counting the number of palpable nodules It important to note that the quantitative assessment of worms provides no information on whether the infection represents either a recent or long-term infection nor doesit indicate either the length or extent of exposure to infection (i.e., an individual residing near a source of transmission for many years may not necessarily have high egg count despite extensive exposure). There are several key determinants underlying the epidemiology of helminth infections. Environment. Climate and topography are crucial determinants of the distribution of helminth infections. Helminths transmitted by vectors are limited to landscapes in which host and vector come together in the same habitat, resulting highly focal distribution. For example, the distribution of schistosomiasis reflects the biotic and abiotic features(i.e., climatic, physical, and chemical factors) that affect the survival and development of the snail vector. In the case of onchocerciasis, the distribution and incidence of the disease are limited by biogeographic variations favorable to exposure to the blackfly vectors. Soil-transmitted helminths are highly affected by surface temperature, altitude, soil type, and rainfall. Heterogeneity. Heterogeneity in the worm burden among different individuals infected with the same helminth is a hallmark feature of helminth epidemiology. A consequence ofsuch heterogeneity is the aggregated distribution of helminth infection in endemic communities, such that a small proportion of hosts are rapidly, frequently, and/or heavily infected. For example, 70% of the worm burden occurs in 15% of the infected individuals at a given time point. The aggregated distribution of helminth infection hasled some to hypothesize that certain “wormy” people are “predisposed” to heavy infection from as yet undefined genetic, immunogenetic, ecological, behavioral, and social factors. Predisposition refers to studies in which intensity of infection prior to anthelminthic treatment positively correlates with intensity of reinfection 12–24 months after treatment . The bases of both heterogeneity and predisposition to helminth infection have yet to be fully elucidated. However, among the major factors under consideration are age, household clustering, and genetics. Age dependency. Much epidemiologic research has focused on heterogeneity in the intensity of helminth infection by age . Changes with age in the average intensity of infection tend to be convex, rising in childhood and declining in adulthood. For Ascaris lumbricoides and Trichuris trichiura, the heaviest and most frequent infections are in children aged 5–15 years, with a decline in intensity and frequency in adulthood. Similarly, for all the majorschistosomes, the heaviest and most frequent infections are in older children aged 10–15 years. In contrast, hookworm frequently exhibits a steady rise in intensity of infection with age, peaking in adulthood. Similarly, the pathologic events that occur with filarial infections also predominate in adulthood. Some ofthe strongest evidence for protective immunity to human helminth infection has come from epidemiological observations of a “peak shift” in prevalence and intensity of infection with age. Briefly, if age-infection data are compared across host populations, the peak level of infection intensity (e.g., EPGs for intestinal helminths) is higher and occurs in younger individuals when transmission is also higher, but the peak intensity of infection is lower and occurs in older individuals when transmission is lower. This shift in the peak level of infection intensity and the age at which this peak occurs is consistent with mathematical models that assume a gradually acquired protective immunity, an interpretation supported by experimental studies in animals. Household clustering. Evidence for household clustering of infected individuals exists for most diseases caused by infection with a helminth, including ascariasis, trichuriasis, and strongyloidiasis. This clustering can persist through time, as shown by familial predisposition to heavy infection with Ascaris lumbricoides and Trichuris trichiura in Mexico. Household aggregation of lymphatic filarial infection (individuals with LF and/or microfilaraemia) has been described in India and Polynesia. In one study of schistosomiasis, shared household accounted for 22% of the variance in S. mansoni egg counts. There is also some evidence for a similarity in antibody isotype level among family members for crude schistosome antigen extracts, reflecting the degree to which this phenotype might be influenced by genetic factors. Genetics. For a number of species of parasitic worms, it has been established that the intensity of infection is a heritable phenotype. The most advanced research program investigating the identity of host genes that influence helminth infection involves schistosomiasis. The first genome scan for a helminth infection identified linkage of intensity of infection with S. mansoni in a Brazilian population to the chromosomal region 5q31–q33 (56), and subsequent confirmation of this link was established in a Senegalese population (57). The 5q31–q33 region includes loci for numerous immune response genes, including those encoding the Th2 cytokines IL-3, IL-4, IL-5, IL-9, and IL-13, interferon regulatory factor 1, colony-stimulating factor 2, colony-stimulating factor 1 receptor, and the IL-12/IL-23 p40 subunit. Genes controlling IgE production, asthma, malaria parasitaemia, and inflammatory bowel disease, among others, have also been mapped to this region of chromosome 5, although the causative polymorphisms have not yet been identified. Polyparasitism. Finally, an increasing number of studies of helminth epidemiology have shown that it is common for individuals to be infected with more than one species of helminth. There is also evidence suggesting synergism and antagonism in concurrent intestinal nematode and schistosome infections as well as filarial nematode infection and soil-transmitted helminth infections. A number of epidemiological studies have indicated that individuals infected with multiple species of helminth often harbor heavier infections than individuals infected with a single helminth species. An important consequence of simultaneous infection with the parasites that cause hookworm, schistosomiasis, and malaria is severe anemia. It has also been speculated that helminth infections may adversely influence host immune responses to the malaria-causing parasite and other pathogens.
CHAPTER THREE
RESEARCH METHODOLOGY
INTRODUCTION
In this chapter, we described the research procedure for this study. A research methodology is a research process adopted or employed to systematically and scientifically present the results of a study to the research audience viz. a vis, the study beneficiaries.
RESEARCH DESIGN
Research designs are perceived to be an overall strategy adopted by the researcher whereby different components of the study are integrated in a logical manner to effectively address a research problem. In this study, the researcher employed the survey research design. This is due to the nature of the study whereby the opinion and views of people are sampled. According to Singleton & Straits, (2009), Survey research can use quantitative research strategies (e.g., using questionnaires with numerically rated items), qualitative research strategies (e.g., using open-ended questions), or both strategies (i.e., mixed methods). As it is often used to describe and explore human behaviour, surveys are therefore frequently used in social and psychological research.
POPULATION OF THE STUDY
According to Udoyen (2019), a study population is a group of elements or individuals as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The emphasis on study population is that it constitutes of individuals or elements that are homogeneous in description.
This study was carried to examine Survey on the prevalence of Helminths Neglected tropical diseases . Jos south L.G, plateau state form the population of the study.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
INTRODUCTION
This chapter presents the analysis of data derived through the questionnaire and key informant interview administered on the respondents in the study area. The analysis and interpretation were derived from the findings of the study. The data analysis depicts the simple frequency and percentage of the respondents as well as interpretation of the information gathered. A total of eighty (80) questionnaires were administered to respondents of which only seventy-seven (77) were returned and validated. This was due to irregular, incomplete and inappropriate responses to some questionnaire. For this study a total of 77 was validated for the analysis.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
Introduction
It is important to ascertain that the objective of this study was to Survey on the prevalence of Helminths Neglected tropical diseases in Jos south L.G, plateau state. In the preceding chapter, the relevant data collected for this study were presented, critically analyzed and appropriate interpretation given. In this chapter, certain recommendations made which in the opinion of the researcher will be of benefits in addressing Survey on the prevalence of Helminths Neglected tropical diseases in Jos south L.G, plateau state
Summary
This study was on Survey on the prevalence of Helminths Neglected tropical diseases in Jos south L.G, plateau state. Three objectives were raised which included: To assess the current prevalence and distribution of helminth infections in the target population in Jos south L.G, plateau state, to identify the risk factors and determinants contributing to the prevalence of helminth infections in Jos south L.G, plateau state and to evaluate the effectiveness of existing preventive and control interventions for helminth NTDs in Jos south L.G, plateau state. A total of 77 responses were received and validated from the enrolled participants where all respondents were drawn from Jos south L.G, plateau state. Hypothesis was tested using Chi-Square statistical tool (SPSS).
Conclusion
In conclusion, the survey on the prevalence of helminths in neglected tropical diseases has shed light on the significant burden these parasitic infections continue to impose on affected communities. Through the analysis of various data sources and epidemiological studies, key findings have emerged, revealing the widespread distribution of helminths and their association with a range of health consequences.
The survey has highlighted the alarming prevalence of helminthic infections in regions with limited access to basic sanitation, clean water, and adequate healthcare infrastructure. These factors contribute to the persistence and transmission of helminths, perpetuating the cycle of disease and poverty in affected communities.
Furthermore, the survey has emphasized the disproportionate impact of helminthic infections on vulnerable populations, particularly children, who are most susceptible to the detrimental effects of these parasitic worms. The long-term consequences of helminthiasis on child development, nutritional status, and cognitive abilities underscore the urgency for targeted interventions and preventive measures.
The findings of the survey underscore the need for a comprehensive approach to combat neglected tropical diseases caused by helminths. This approach should encompass preventive measures such as improved sanitation, access to clean water, and health education to promote personal hygiene practices. Additionally, it is imperative to enhance the availability of safe and effective treatment options for helminthic infections, including the provision of deworming medications and regular mass drug administration campaigns.
Collaboration between governments, international organizations, researchers, and local communities is essential to tackle the prevalence of helminths and neglected tropical diseases effectively. By combining efforts in surveillance, research, and implementation of control strategies, it is possible to reduce the burden of helminthic infections and improve the overall well-being of affected populations.
Ultimately, the survey serves as a call to action to prioritize the control and prevention of helminths within the broader framework of neglected tropical diseases. By addressing the underlying social, economic, and environmental determinants, we can make significant progress towards achieving sustainable development goals and ensuring the health and dignity of all individuals affected by these debilitating infections
Recommendation
Based on the survey findings on the prevalence of helminths in neglected tropical diseases, several key recommendations can be made to address and mitigate the impact of these infections:
- Strengthen healthcare infrastructure: Governments and organizations should prioritize the improvement of healthcare infrastructure, particularly in regions with a high burden of neglected tropical diseases. This includes the establishment of well-equipped clinics and hospitals, training healthcare workers, and ensuring the availability of essential diagnostic tools and treatment options.
- Enhance access to clean water and sanitation: Efforts should be made to provide communities with access to clean water sources and promote proper sanitation practices. This can help break the transmission cycle of helminths and reduce the risk of infection. Investment in water and sanitation infrastructure, along with community education on hygiene practices, is crucial.
- Implement regular deworming programs: Mass drug administration campaigns targeting at-risk populations, especially children, should be implemented regularly. This approach can effectively reduce the prevalence of helminthic infections and alleviate the associated health burdens. Collaboration between governments, healthcare providers, and international organizations is necessary to ensure the availability and distribution of safe and effective deworming medications.
- Conduct targeted health education and awareness programs: Community-based health education initiatives should be developed to raise awareness about the causes, symptoms, and prevention of helminthic infections. These programs should emphasize the importance of hygiene practices, proper sanitation, and regular deworming. Additionally, targeted educational campaigns can help dispel misconceptions and reduce stigmatization associated with neglected tropical diseases.
- Support research and innovation: Continued investment in research and innovation is essential for developing new diagnostic tools, treatment options, and preventive measures for helminthic infections. Collaboration between scientists, researchers, and healthcare providers can lead to the development of more efficient and cost-effective interventions.
- Foster multi-sectoral collaboration: Addressing the complex challenges posed by neglected tropical diseases requires collaboration among various sectors, including health, education, water and sanitation, and agriculture. Governments, international organizations, and local communities should work together to develop integrated approaches that tackle the underlying determinants of helminthic infections.
- Monitor and evaluate progress: Regular monitoring and evaluation of interventions and programs are crucial to assess their effectiveness and make necessary adjustments. Collecting accurate data on the prevalence of helminths and the impact of control measures can inform evidence-based decision-making and resource allocation.
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