Prevalence of Intestinal Parasites among School Children in Deir El-Balah Town in Gaza Strip, Palestine
2002; King Faisal Specialist Hospital and Research Centre; Volume: 22; Issue: 3-4 Linguagem: Inglês
10.5144/0256-4947.2002.273
ISSN0975-4466
Autores Tópico(s)Parasites and Host Interactions
ResumoLetters to the EditorPrevalence of Intestinal Parasites among School Children in Deir El-Balah Town in Gaza Strip, Palestine Adnan Ibrahim Al-HindiMD Adnan Ibrahim Al-Hindi Department of Biology, Faculty of Science, The Islamic University of Gaza, P.O. Box 108, Gaza, Palestine Search for more papers by this author Published Online:1 May 2002https://doi.org/10.5144/0256-4947.2002.273SectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionTo the Editor. Intestinal parasites are prevalent in many countries all over the world. Low socioeconomic standards, poor sanitation, improper hygienic practices, lack of awareness and environmental factors contribute to this phenomenon. Gaza Strip in Palestine is an overpopulated area without any proper sewage disposal system in most of the localities. This, in addition to low standards of living, contribute to the high prevalence of parasitic diseases.1 Two studies on the prevalence of the intestinal parasites revealed that the most common parasites among school children in Gaza and camps were: Ascaris lumbricoides, Entamoeba histolytica, Enterobius vermicularis, Hymenolepis nana and Giardia lamblia.2,3 Higher prevalences of Ascaris lumbricoides, Entamoeba histolytica, and Giardia lamblia among children have been recorded by Al-Wahaidi in different areas of Gaza.1Deir El-Balah town is located on the Southeastern coast of the Mediterranean Sea and is bordered by Egypt on the South. The town is about 16 kilometers to the south of Gaza city and has a population of about 34,000.4 The aim of this study was to determine the prevalence of infection by some types of intestinal parasites including Ascaris lumbricoides, Entamoeba, histolytica, Giardia lamblia, Strongyloides stercoralis and Hymenolepis nana among 6-11-year-old school children in Deir El-Balah, and to determine the intensity of infection by the detected parasites.MATERIALS AND METHODSThis cross-sectional study included 650 stool samples collected from school children aged between 6 and 11 years old from Deir El-Balah town. The study population was divided into three age groups: 6-7, 8-9, and 10-11 years. Only one sample per child was investigated. All stool samples were examined microscopically on the same day of collection. Each sample was examined by direct smear microscopy, formal ether sedimentation technique and zinc sulphate flotation technique. Information such as sex, age, residence and type of sanitation system of the study population were consistently recorded. The intensity of intestinal parasites infection was estimated by microscopic counts of the parasites according to the Cheesebrough classification (1987). Data was statistically analyzed using the Epi-info version 6 program of (WHO/CDC). Simple distribution of the study variables, the cross-tabulation, chi-square test, were used to identify the significance of the relationships.RESULTSA total of 650 stool samples were examined for the common intestinal parasites including;Ascaris lumbricoides, Entamoeba histolytica, Giardia lamblia, Strongyloides stercoralis and Hymenolepis nana. Of the study population 236 subjects (36.3%) were positive for parasitosis. Table 1 shows the prevalence of the various types of the common parasites encounterd in the study and their prevalence in relation to sex. A significantly higher prevalence of infection was observed among males, 48% as compared to 27.8% in females (P<.05). Most of the positive cases were clustered in the 6-7 years age group (55%), followed by 28.4% in the older 8-9 years group. Throughout the study, no trophozoites were detected, while cysts and ova were prominent. Multiple parasitosis was observed in three samples collected from the 6-7 years age group: one child was infected with Giardia lamblia and Hymenolepis nana, one with Gardia lamblia and Entamoeba histolytica, and the third had Ascaris lumbricoides and Entamoeba histolytica.Table 1 also shows the variation in parasitic infection between males and females.Entamoeba histolytica was higher in males than in females (56 cases as compared to 30 cases).Ascaris lumbricoides was higher in females (19 as compared to 14). For Hymenolepis nana, Giardia lamblia and Strongyloides stercoralis, the variation in infection between females and males was not significant.Gardia lamblia was the most commonly isolated parasite and represented 38.1%.Table 1. Prevalence of parasites by age group and sex among 650 children.Table 1. Prevalence of parasites by age group and sex among 650 children.DISCUSSIONAscaris lumbricoides, Entamoeba histolytica, Giardia lamblia, Hymenolepis nana and Strongyloides stercoralis are common intestinal parasites constituting a public health problem and are prevalent in the communities of poor hygienic standards, lack of sanitation and low socioeconomic status. Our study revealed that Gardia lamblia was the highest parasitic infection among school children and represented 90 of the examined cases (38%), followed by Entamoeba histolytica with 86 cases (36.4%) and Ascaris lumbricoides 33 case (14%) and Hymenolepis nana with 23 cases (9.7%) while Strongyloides stercoralis infection was the lowest. Similar rates of prevalence of Ascaris lumbricoides (15.5% and 16%) have been reported among children in Abidjan City and Malaysia, respectively.5,6 Also, a prevalence of 33% for Giardia lamblia and 0.7% for Entamoeba histolytica among Saudi children,7 and 36% for Giardia lamblia among Jordanian school children8 have been reported.The present study showed higher rates of infection among males (48%) than females (28%). Deir El-Balah is a farming community, and most pupils walk across farmlands on their way to and from school. In contrast, females spend most of their time at or near their homes. Playing in sand exposes the children to higher risks of infection, as supported by Cheesebrough.9 A study done in Saudi Arabia by Kasim and El Hilue found an unexplainable higher prevalence of giardiasis among males.10Our results showed that the age group 6-7 years has the highest rate of infection (54.7%). There seems to be an influence of age on the presence of each type of parasites detected (P<0.05). Age-related prevalence variation has been reported by other investigators,9,10 who showed that more prevalence of intestinal parasites is evident in <5 year-old children. During the study, three stool samples which were negative on direct examination proved positive by the concentration technique. This indicates that direct smear microscopic examination of stool samples might not be sufficient for detecting parasites, and should be complemented by the concentration technique.The children included in this study live in poor areas with low sanitation standards.There is no closed sewage system in the refugee camps. Thus the possibility of infection tends to be very high. In the Gaza Strip, Giardia lamblia was estimated at 14.2%) among the infected Palestinian refugee school children.11 A different rate of infection was reported by Al-Wahaidi,1 who found that 48% of Palestinian refugee children were infected with Entamoeba histolytica (22.4%), Giardia lamblia (55%) and Ascaris lumbricoides (22.4%). Those children live in comparable environments as the school children in Deir El-Balah town.It was found that the prevalence of Ascaris lumbricoides in the 7-year-old refugee school children was 49%1 In the governmental records of Gaza Health Services Research Center,12 ascarisis prevalence in Gaza City constituted 44% of all infections. Poor or absent sanitation, and frequent fecal contamination of the environment with large numbers of Ascaris eggs lead to a high frequency of infection, especially among the children who are often infected with heavy loads of worms. In our study, the prevalence of ascariasis among male and female children was 14.4%. These eggs can survive in the warm moist soil protected by the outer coat, which can easily stick to the children's fingers when they play in the sand.13 Reduction of infection with increasing age may be explained by the fact that older children have more awareness regarding personal hygiene and cleanliness. During the study, it was noticed that all children in the three selected schools drink tap water. Regular water sample analyses, however, excluded the possibility of the water being a source of parasitic infections. This was contradictory to the study by Lechevallier14 who reported that Giardia cysts have been detected in 81% of raw water samples and 17% of filtered water samples in the United States. Another common source of infection in our study population is the inappropriate washing of vegetables and fruits, which may be contaminated with cysts, and ova of parasites. This study must create awareness among the local community and health authorities, which should take appropriate measures to overcome or at least minimize the exposure of our children to environmental hazards.ARTICLE REFERENCES:1. Al-Wahaidi A. "Effect of different sanitation conditions on the prevalence of infection with three types of intestinal parasites among the children in two localities in the Gaza Strip, Palestine (thesis)" . University College London, 1977 (not published). Google Scholar2. Annual Report. Health research and planning directorate statistics and information department, Palestine, 1996;. Google Scholar3. Abed YA. An epidemiological study of the prevalence of intestinal parasites and their effect of HB and growth and development in children of Jabalia village. MSc. Dissertation, Hadassah Medical School, Jerusalem, 1979. Google Scholar4. "Palestinian Central Bureau of Statistics" ., Gaza Governorate, 1997. Google Scholar5. Menan EI, Nebri NG, Adjetey TA. "Profile of intestinal helminthiasis in school aged children in the city of Abidjan" . Bull Soc Pathol Expt. 1997; 90:51–4. Google Scholar6. Mahendra Raj S, Sein KT. "Intestinal helminthiasis in relation to height and weight of early primary school children in northeast Peninsular Malaysia" . Southeast Asian J Trop Med Public Health. 1997; 28:320–4. Google Scholar7. Mazloum MA. "Haematological values and parasitic infections in school children in Riyadh, Saudi Arabia" ., J Egyptian Soc Parasitol. 1991;2831–838. Google Scholar8. Nimri LF. "Prevalence of giardiasis among primary school children of Jordan" . Child Care Health and Development. 1994; 20:231–7. Google Scholar9. Cheesebrough M. Medical laboratory, Manual of countries. Second edition. Cambridge: Butterworth Co., 1987. Google Scholar10. Kasim AA, El-Hilue MA. "Giardiasis in Saudi Arabia" . Acta Trop. 1983; 40:155–8. Google Scholar11. United Nations Relief and Work Agency Fact Sheet. UNRWA Gaza Publication Office. Gaza: November, 1996. Google Scholar12. Gaza Health Services Research Center (NPAMOH). "The status of health in Palestine. Annual Report, 1995" . Statistics and Information Division. Gaza, March1996. Google Scholar13. Zinkman WH. "Visceral larva migrants: a review and assessment indicating two forms of clinical expression, visceral and ocular" . Am J Dis Child. 1978; 132;627. Google Scholar14. LeChevallier MW, Norton WD, Lee RG. "Occurrence of Giardia and Cryptosporidium spp. in surface water supplies" . Appl Environ Microbiol. 1991; 57:2610–6. Google Scholar Previous article FiguresReferencesRelatedDetails Volume 22, Issue 3-4May-July 2002 Metrics History Published online1 May 2002 InformationCopyright © 2002, Annals of Saudi MedicinePDF download
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