Environment related intestinal parasitic infections in selected areas in Kumasi

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One thousand (1,000) human stools from residents between 1½ to 90 years in selected areas of Kumasi were examined prospectively for infection with environment-related parasites viz. mo.ba hjioltica, Giardia lamblia, Trichomonas hominis, hookworm, Ascaris lumbricoides,, Trichuris trichiura, Strongyloides stercoralis, Hymenolepis Hymenolepis jjuta, TrichostWflgylUS orientalis and Enterobius vermicularis. The specimens were first checked macroscopically for consistency (degree of moisture) and for presence of adult worms. Conventional methods were then used, examining each faecal preparation by direct wet mount in physiological saline followed by microscopy of each faecal specimen using formol-ether concentration method for the presence of amoeba, trophozoites, cysts and helminth larvae or eggs. Ten (10) different species of intestinal parasites were detected in 15.9% of the specimens. The following parasites, Giardia lamblia (4.1 %), Trichuris trichit,ga (3.2%), Trichomonas hominis (3.1%), hookworm (2.4%), Ascaris lumbricoides (1%), Hymenolepis (1.1 %), Hymenolepis diminuta (0.1 %), Trichostrongylus orientalis (0.1 %), Enterobius vermicularis (0.1%) and Strongyloides stercoralis (0.7%) were detected in this study. No Entamoeba histolytica and Taenia species were detected in the study. Eleven (11) participants in this study (i.e., 6.9% of all positive individuals) had multiple infestations with concurrence of T. trichiura and other parasites. The prevalence rates in different age groups were highest in children between 5 - 14 years of age and lowest in adults. Data on many potential risk factors for parasitic infections and infestations were collected from participants by using a questionnaire and by visual observation of each household and the neighbourhood in the selected areas for the study. Using Friedman two-way analysis of variance by ranking the data and laboratory investigations of positive stools and comparing with several factors there were significant associations between intestinal parasitic infection and subjects use of community latrine and private latrine (P <0.001), as well as living in a house with an earthen floor as against cement floor (P< 0.02). The habit of indiscriminate defaecation among children had significant correlation with the presence of intestinal parasites in the stool specimens in children between 5 and 14 years of age. The proportion of positive stool specimen from individuals living in an area with poor environmental sanitation viz, living close to refuse disposal sites, along drainage system and with low basic, basic or no formal education compared with those with low basic, basic or no formal education but living in clean environment and with basic standard of living was highly significant (P<0.001). No significant difference in overall infection rates was detected between males and females. It is recommended that while the District Assemblies are employed to build more public toilets in the study areas, house owners should be encouraged to improve on the conditions of their houses, by providing private toilets, cementing the floors of the compounds and providing piped water supply. These among others when done will reduce the incidence of intestinal parasitic infection.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirements for the award of the Master of Science degree in Clinical Microbiology, 1998