Intestinal Parasites Among Unity Primary School Pupils, In Oraifite, Ekwusigo L.g.a., Anambra State, Southeastern Nigeria

More than one billion of the world’s populations, including at least 400 million school children, are chronically infected with Ascaris lumbricoides, Trichuris trichiura, Hookworms, Enterobius vermicularis and Taenia sp. (Adeyeba and Akinlabi, 2002; Braide, 2004). Parasitic diseases of blood and gastro-intestine of human are rampant in the tropics because there are favourable climatic, environmental and socio­cultural factors which permit transmission of these parasitic diseases, whether water-borne, vector-borne, soil transmitted or those that result from some poor sanitary or social habits provide some of the many public health problems in the tropics (Woodrouff, 1965; Oduntan, 1974). Few studies had also indicated a direct correlation between the intensity of infection with hookworms and with Ascaris lumbricoides and non­deficiency anaemia and intestinal obstruction (Salimon, 1980).Since hookworm larval stages have limited motility, their rate of development and survival are dependent on the surrounding environmental humidity, temperature and ultra-violet light, such that geographical differences in transmission will be influenced by these factors and related factors such as rainfall, soil type and altitude. The influence of climate on hookworm transmission was reviewed by Chandler (1929). Chandler concluded that 20-30OC was optimal for transmission with larvae reaching maturity in five days, with the lower limit lying between 8-10OC and the upper limit 40-45OC. available experimental data indicate that above temperatures of 35-40OC development of eggs arrests and death occurs (Nwosu, 1978; Udonsi and Atata, 1987) showed that at temperature of 35OC larvae of Necator amerianus were all dead, with the highest cumulative hatching rates obtained at 30OC. The apparent difference between these experimental findings and Chandler’s observation can be explained by the ability of hookworm larvae to migrate downwards in the soil and to areas of shade. Thus, although the ambient temperature may exceed 35OC hookworm larvae can still find refuge in cooler microhabitats.In the developing world, amoebiasis causes some 450 million infections per annum, about 50 million incidents and about 100,000 deaths (Mirelman, 1987). Invasive amoebiasis is prevalent in certain areas of the world including West and South East Africa, China, the whole of S.E. Asia, Mexico, and the West portion of South America, and the Indian subcontinents (Mirelman, 1987). Giardia lamblia infection is endemic throughout the world and epidemics of it occur sporadically. It has been estimated that about 200 million infections occur per year in Africa, Asia, and Latin America (WHO, 1987).In Nigeria, high prevalence of intestinal parasites ranging between 14 and 42%, especially in the communities without toilets, has been reported (Nwosu and Anya, 1980). Intestinal nematodes, amoebae and few other protozoa have not been identified as opportunistic in Acquired Immune Deficiency Syndrome (AIDS) patients.Etim et al, (2002) obtained prevalence values of 53.2, 31.0, 27.0 and 5.5% for Ascaris sp., Ancylostoma sp., Trichuris sp., and Schistosoma mansoni respectively, from primary school children aged 5­13 years in Calabar, Nigeria. The prevalence of these helminthes varies with respect to sex, age-groups, standard of sanitation as well as socio­economic status of patients. For instance, children of parents in the low income group, showed the highest prevalence of infection, just as males showed more infection than females.Of the 1,177 randomly surveyed children in Lagos, Nigeria, 46.8% had parasitic infections with four types of helminthes, Ascaris lumbricoides (29.7), Trichuris trichiura (18.4), hookworm (0.7), and Strongloides stercoralis (0.3%) as well as malarial trophozoites (43.3) and gametocytes (2.0%) (Adeoye et al, 2007). Parasitic diseases in association with nutritional imbalance were known to cause about 20.7% mortality in Lagos (Ejezie, 1983).The prevalence of intestinal protozoan parasites in Owerri Metropolis, in the studied health facilities and resident homes, respectively was: E. histolytica/dispar (36.5% and 31.4%), E. coli (33.6% and 45.7%), G. lamblia (25.5% and 22.9%) and C. parvum (4.4% and 0.0%) (Oguoma et al., 2008).They also showed that the Month of July had the highest prevalence rate (31.4%).

The morbidity associated with intestinal parasitic infections is varied and ranges from mild, transient clinical signs and symptoms to severe clinical disease, as well as chronic and insidious effects on the growth, learning and productivity of individuals. In areas of high transmission, repeated waves of N. americanus and A. duodenale L3 larvae entry through the skin can result in a cutaneous syndrome known as ground itch. This comprises a puritic erythematous papulovesicular rash. Ground itch appears most commonly on the hands and feet. In contrast to infection by the anthropophilic hookworm, zoonotic infection with A. braziliensis L3 results in cutaenous larva migrans (CLM) (Blackwell and Vega-Lopez, 2001). This is characterized by serpiginous burrows appearing most frequently on the feet, buttocks, and abdomen (Blackwell and Vega-Lopez, 2001). CLM has been reported with increased frequency among travelers returning from the Caribbean resorts and among residents along the Atlantic and Gulf Coasts of the United States (Yosipovitch et al, 2002).Intestinal blood loss is the major clinical manifestation of human hookworm infection (Crompton and Stephenson, 1990). Heavy hookworm infections or moderate infections in patiences wioth underlying iron and protein nutritional deficiencies results in hookworm disease, the clinical entity that specifically refers to the resulting iron deficiency and microcytic, hypochromic anaemia (Beaver et al., 1984).Guyatt (2000) highlights the way in which intestinal parasitic infection can affect productivity and wage-earning capacity in adults, either directly or indirectly through an effect of early ill-health in childhood. Nevertheless, she noted that there is little or no direct evidence that helminth infections lower the productivity of adults, in part due to the lack of well-designed studies. However, some of the health consequences of hookworm, especially anaemia and under-nutrition, are known to affect productivity. Several field studies show a strong impact of iron deficiency anaemia (IDA) on decreased aerobic work capacity and to a lesser extent on economic productivity (Haas and Brownlie, 2001). A recent study among Bangladesh tea pluckers found a negative association between intensity of major nematode species (A. lumbricoides, T. trichiura, and hookworm) and both haemoglobin and measures of labor productivity (Gilgen et al., 2001). They however observe that haemoglobin and productivity were positively associated. In a four-way trial design both anthelminthic treatment and iron supplementation increased haemoglobin but did not have a measurable effect on labour productivity, although this was suggested to reflect seasonal nutritional stress which occurred in the latter part of the trial (Gilgen and Mascie-Taylor, 2001). Even where IDA does not result in reduced productivity, the higher energetic cost of undertaking work may reduce non-economic activities such as childcare and leisure.

Pathogenesis of Enterobius species have two aspects: damage caused by worms within the intestine and damage resulting from egg deposition around the anus. Minute ulcerations of adults may lead to mild inflammation and secondary bacterial infection (Shubenko- Gabuzova, 1965). Very rarely, pinworms will penetrate into the submucosa with fatal results. Movements of females out of the anus to deposit eggs, especially when the patient is asleep, lead to a tickling sensation of the perianus, causing the patient to scratch. The subsequent vicious circle of bleeding, bacterial infection, and intensified itching can lead to a nightmare of discomfort.