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

CHAPTER FIVE

DISCUSSION

Prevalence of intestinal parasites 5.1.1 Overall prevalence

The result of the investigation demonstrates very clearly a high prevalence of intestinal parasites among school pupils in UNICEF primary school, Isingwu, Oraifite, Ekwusigo L.G.A., Anambra State, Southeastern Nigeria. An overall prevalence of 47.6% recorded by this study appears high when compared with some reported results of previous studies in other parts of the country. For instance, Alakija (1986) reported a value of 25.6% in rural areas of Nigeria. Okeniyi et al. (2005) recorded a value of 33.1% among semi-urban Nigerian children. Opara et al. (2007) reported a value of 21.1% among primary school children in Owerri municipality, Imo State. Anosike et al. (2005) reported a value of 37.3% in a central Nigerian rural community. However the prevalence is almost similar with 48.7% prevalence rate reported by Mba and Amadi (2001). Several other reports from other parts of tropical Africa have shown very high (>70%) infection rates of intestinal helminthes (Dada et al., 1993).

Variations in prevalence rate of intestinal parasitosis from different rural communities could be related to several factors including people’s level of education, standard of personal/environmental hygiene and perhaps social habits (Anosike et al., 2006). More so, some ecological factors such as temperature, relative humidity, rainfall (Onwuliri et al., 1993), different diagnostic techniques employed by various workers could be responsible for observed differences in prevalence between schools. This calls for a uniform standard diagnostic technique for any National Control program on intestinal parasitiasis.

The high prevalence observed in this study could be due to the fact that a great number of pupils prefer to defaecate in the nearby bush and farm around their school, because their pit latrines were always soiled. It could also be as a result of infection from their homes, in line with the studies by Mba and Amadi (2001), as well as Okon and Oku (2001), who reported high prevalence of parasitic infections in the rural setting, pri-urban and urban- slum. Crompton (1999) reported that the high prevalence observed in his study was attributed to poor environment and personal hygiene, shortage of good water supply and indiscriminate defaecation.

Helminths

Ascaris lumbricoides was the most common intestinal parasite in this study, as in other studies, because the worm is remarkably infectious and usually versatile (WHO, 2002; Bello et al, 1992). The well-protected eggs of Ascaris can withstand drying and can survive for very lengthy periods (Mordi and Ngwodo, 2007). Ascaris lumbricoides had the highest prevalence of 12.8% in this study (figure 1). The prevalence appears low when compared with results obtained in other areas by different workers. For instance, Obiamiwe (1977) reported a prevalence value of 19.3%. Obiamiwe and Nmorsi (1992) reported a value of 46.7% in the defunct Bendel State of Nigeria. Eguwunyenga et al. (2004) reported a prevalence of 55%, in Eku, Delta State of Nigeria. Shitta and Akogun (2004) reported a prevalence of 48% among the nomadic Fulanis of Northen Nigeria. Odikamnoro and Ikeh (2004) reported a prevalence of 51.5% among the Kpirikpiri Community of Abakaliki of Ebonyi State. However, the prevalence is almost in line with 15.2% and 10.4% prevalence rate reported by Oyerinde (1978), and Elekwa and Ikeh (1996) respectively.

The presence of Trichuris trichiura infection is predictable, however low, since such unhealthy environmental conditions generally influence its endemicity (Ukoli, 1984). Trichuris trichiura had a prevalence value of 1.9% in this study. This value appears low when compared with the reports of both past and current studies in other parts of the country and in the world. For instance, Ramsay (1934) reported a value of 2.8%. Cowper and Woodward (1961) reported 18.5%. Alakija (1986) reported 1.7%. Anosike et al. (2002) reported 14.0%. Oyindo et al. (2002) reported 5.3% and Egwuyenga et al. (2004) reported 20.8%. Ogwurike and Rangna’an (2006) reported a value of 2.4% while Adeoye et al. (2007) reported 18.4% and Ngele (2008) reported 5.42%.

Hookworm was relatively the third most common parasite species identified in the study. The prevalence value was 7.6%. This value appears low when compared with the value from other studies in various part of the country. Egwuyenga et al. (2004) reported infection rate of 22.5%. Ogwurike and Rangna’an reported a value of 3.8%. Ijagbone and Olagunji (2006) recorded the value of 20.5% while Ngele (2008) recorded 58.33% and Obiukwu et al. (2008) recorded 31.1%. Nwosu (1981) had reported that hookworm transmission occurs more during the rainy season in Nigeria. This probably accounts for the low prevalence observed in this study as it was conducted during the dry season (from January to March). The higher prevalence of A. lumbricoides (12.8%) compared to that of Hookworm (7.6%) agreed with some previous reports (Opara et al., 2007), but different from others (Nwaorgu et al., 1998).

The low prevalence of Strongyloides stercoralis in faeces agreed with previous studies (Ijagbone and Olagunji, 2006; Adeboye et al., 2007). Reason for low prevalence observed in most studies may not be unconnected to its vulnerability to adverse environmental conditions hence its alternate mode of infection, autoinfection.

Protozoans

In this study, Entamoeba histolytica/dispar showed a prevalence of 11.0%. Studies done elsewhere in Nigeria had lower prevalence values. For instance, Obiamiwe and Nmorsi (1990), reported a value of 3.9 %, Ogunbi (1971) reported a value of 5.7%, while Cowper and Woodward (1961) reported a value of 4.2%. Anosike et al. (2002) reported a value 4.0%. The high prevalence of Entamoeba histolytica/dispar could be as a result person to person transfer through food or water among the school pupils, which the study observed.

Other protozoa that were observed in this study were Entamoeba coli (6.7%) and Giardia lamblia (2.8%). The prevalence of the two protozoa appear low, when compared with the findings of Oguoma et al. (2008) which recorded prevalence of 36.0 and 25.0%, for Entamoeba coli and Giardia lamblia respectively. Nzeako (1992) posited that the highest incidence of infection with intestinal protozoan parasites was peaked between July and August (peak of rainy season). This may probably account for the low prevalence observed in this study as it was conducted during the dry season (dry season).

Prevalence with respect to Sex

The prevalence of parasites by sex showed no significant difference (p > 0.05), implying that the difference in males and females only occurred by chance. This corroborates other reports (Obiukwu et al. 2008; Egwunyenga and Atakiru, 2005). They reported that both males and females have the same chances of being infected by these parasites.

Prevalence with respect to Age groups

Age group 10 - 14 years, recorded highest prevalence value of 61.4%. Pupils under this age-group play a lot in the sand. Besides, little or no care is given to them; they are allowed to do things on their own (Obiukwu et al., 2008) unlike their counterparts in age-group of 5 - 9 years in which the prevalence dropped to 24.1%.

Prevalence with respect to Occupation of Parents

In many tropical countries, geohelminth is an occupational disease of the farming community (Adams and Meaggraith, 1976; Onaedeko and Oladipo, 1989). It is therefore not surprising that in this study, pupils whose parents are farmers habour more parasites than those whose parents are traders and civil servants (Table 2).

Prevalence with respect to class of pupils

Nursery school pupils showed highest prevalence (54.9%) amongst the class of pupils examined. There was no statistically difference between the prevalence of intestinal parasites by class (p > 0.05). Therefore, it could be inferred that the observed differences in these classes occurred by chance. Also, the attitude of staying under the Mango tree in front of the school compound, by these nursery school pupils (as observed in this study) where they made contact with the soil might be the reason for the highest prevalence seen in them.

Generally, transmission of infection can be during outdoor play with no slippers or shoes on soil contaminated with faeces (Adeoye et al, 2007). Some of the children might have contacted infection through ingestion of helminth eggs and protozoan cysts in contaminated food, drinking infected water, eating with or licking unwashed contaminated hands and fingers, clothing or air, especially during outdoor play in the soil (Adeoye et al, 2007). Combination of defeacating in open spaces, playing in soil and the geophagus habit of the children could be a good source of high helminth infection (Etim and Akpan, 1999).

Conclusion and recommendation

The delibilitating effects of intestinal parasitic infections on school children are many and include among others, malnutrition, kwashiorkor, emaciation, abdominal pain, and mental backwardness (Ijagbone and Olagunji, 2006). Some of these features were observed physically among the children sampled. Some pupils complained of symptoms associated with intestinal parasitic diseases and absenteeism from school due to illness caused by these parasites. Also school teachers made similar observations on their pupils. In order to control the condition, local health officers should visit the school for routine deworming of the school children. Sanitary improvement such as regular washing of the toilets and effective use of water for hand washing after playing should be adopted. Adequate health education and provision of basic amenities should also help to provide some level of good living in the school.