Patterns and Risk Factors of Helminthiasis and Anemia in a Rural and a Peri-urban Community in Zanzibar, in the Context of Helminth Control Programs

Abstract

BackgroundThe control of helminth infections and prevention of anemia in developing countries are of considerable public health importance. The purpose of this study was to determine patterns and risk factors of helminth infections and anemia in a rural and a peri-urban community of Zanzibar, Tanzania, in the context of national helminth control programs.Methodology/Principal FindingsWe carried out a community-based cross-sectional study in 454 individuals by examining at least two stool samples with different methods for soil-transmitted helminths (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, and Trichuris trichiura) and one urine sample for Schistosoma haematobium. Finger-prick blood was taken to estimate anemia levels and to detect antibody reactions against ascariasis, strongyloidiasis and schistosomiasis, using an enzyme-linked immunosorbent assay (ELISA) approach. Parasitological methods determined a helminth prevalence of 73.7% in the rural, and 48.9% in the peri-urban setting. Most helminth infections were of light intensity with school-aged children showing the highest intensities. Multiple helminth species infections were pervasive in rural dwellers regardless of age. More than half of the participants were anemic, with a particularly high prevalence in the peri-urban setting (64.7%). Risk factors for helminth infections were age, sex, consumption of raw vegetables or salad, recent travel history, and socio-economic status.Conclusion/SignificanceAfter several years of chemotherapy-based morbidity control efforts in Zanzibar, helminth prevalences are still high and anemia is common, but helminth infection intensities are low. Hence, chemotherapy should be continued, and complemented with improved access to clean water, adequate sanitation, and health education, along with poverty alleviation measures for a more enduring impact.

The Impact of a School-Based Hygiene, Water Quality and Sanitation Intervention on Soil-Transmitted Helminth Reinfection: A Cluster-Randomized Trial

“…17,24,[35][36][37] The current study found WASH impacts on the prevalence of A. lumbricoides to other intervention trials of household-and school-based hygiene promotion programs that have shown a reduction in A. lumbricoides reinfection on primary school-age children. 38,39 In Brazil, Moraes and colleagues 40 found great reductions in the prevalence of infection because of community sanitation improvement.…”

Prevalence of intestinal parasites in the elderly enrolled in the Family Health Strategy in Porto Alegre, Brazil

“…Anemia was not associated with significant intestinal parasites, in contrast to many studies. 27,28 However, it should be noted that parasites that cause anemia, especially helminthes, were less prevalent in this study.…”

Prevalence and risk factors associated with the presence of Soil-Transmitted Helminths in children studying in Municipal Corporation of Delhi Schools of Delhi, India

“…However, studies show that men are more prone to and also harbour more hookworm infection than women while females have higher levels of Ascaris infection owing to gender differences in exposure to contaminated soil (Holland et al 1989;Kightlinger et al 1998;Knopp et al 2010). Growth deficits in children have been attributed to Ascaris while deficit in height to intense T. trichiura infections (Bundy and Cooper 1989;Hlaing et al 1991).…”