Epidemiological study of the EnterobiusVermicularis & AscarisLumbricoides Elementary school students inKhalis
Lamiaa Saoud Abbod
Assistant lecturer
Analysis Technical Institute/ Baquba department
Abstract The main objective of the study to study the distribution of parasite nematode in primary school children in khalis , during the period from the 11th of September 2015 until of 19th November 2015 which included (60) samples , (26) males and (34) females . The study showed higher significated difference between the Enterobius vermicularis and Ascaris lumbricoid .The study showed a lack s significant differences between males and female P- Value = 0302 .It was clear from our study , current that infected with parasite nematode was injury highest in females than in males and repeat (56.7 %),and the highest rate of injury in residency was in rural (55 %) and the study recorded a significant more difference between the infected by one worm (61.7%) than the infected by both worms (38.3%)
Key words :- Enterobius vermicularis – Ascaris lumbricoid ' infected- nematode
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Introduction
Worm infestation is a major public health problem in children of developing countries because of poor socioeconomic conditions and lack of good hygienic living. It causes not only nutritional deficiencies and anaemia but can lead to intestinal obstruction in the infested children. The purpose of this study was to determine the frequency of intestinal worms' infestation in children of rural Peshawar area. Enterobius vermicularis (pinworm) is one of the most prevalent worms found in children worldwide. Pinworms, also called threadworms, typically infect the bowel of children in tropical areas (4,5). Enterobius vermicularis is the causative agent of human enterobiasis. The disease is more prevalent in temperate regions and is facilitated by factors such as overcrowding in schools and family groupings, as well as inadequate personal and community hygiene. (5). Intestinal parasitic infections are endemic and have been described as the greatest single worldwide cause of illness and disease. Worm infestation is a major problem in children from developing countries. Intestinal parasitic infections are most common among school age children and tend to be of high intensity in school-age children (Sharma et al., 2004 and Ekpenyong, 2008). The highest infection rate and worm burden were found among school children aged 4-16 years and were attributed to poor sanitation and hygiene. These infections can affect child development, educational achievement, reproductive health, a Nowadays, despite biomedical advances; parasite infections remain and continue to be an example of the parasite-host interaction complex. Ascaris lumbricoides is intestinal nematodes (Round worm) which belong to a super family Ascaridodea. It is the etiological agent of ascariasis which infects man. A person become infected by ingesting infective eggs in contaminated food, water or from hands that have become faecally contaminated following ingestion, the larvae hatch in the circulation where they are carried to the heart and lungs(Andrade e tal,2001). They remain in the alveoli for several days, ascends the respiratory tree to the epiglottis where they descends, esophagus to mature on the intestine after mating the female large numbers of eggs are layed which are passed in the faeces (ukoli,1991,cheesbrough 1987). it is particularly common in areas of inadequate sanitation where untreated humans faces are used as fertilization (cheesbrough 1987). Ascaris worms are large heavy infection, especially in children; worm masses can cause obstruction or perforation of the intestine and occasionally obstruction of the bile ducts and pancreatic ducts (Braids 1986). Though infection with a few worms may be symptomaless,heavy infections are serious, as will be known to anybody who has seen marasmic children with distended bellies starved 80-100 worms(Denhams et al,1985),
Patient & Methods
A prospective study was conducted in Al-KALaIs school during period from the 11th of September 2015 until of 19th November 2015 which included ( 60) samples (26) males and ( 34) females. The Data were collected by simple questionnaire contain some of question about the gender , Residency. All the statistical analysis were done by using SPSS ( Version 14 ) to analysis data .The statistical data analysis was done by using Chi-square ( '' 2- test).Each student was given in collaboration with the primary school departments in his area private collecting stool clean containers (clean containers of plastics airtight non-leaking), attached to the instructions appropriate for people of all manner and timing of the collection of the stool, he was sent to the laboratory to conduct parasite examination after her visually examined .Macroscopic examination of a stool sample: a stool sample was examined eye Naked with flipping sample a glass or wooden rod to reveal the contents. And note the following : Stool color, the smell of feces, feces cohesion and texture, and the presence of parts or components parasitic strange materials, parts of worms or complete worms you see within the sample can be observed as well as the presence of purulent secretions or blood or mucous Microscopic examination of a stool sample: It was examined stool samples for direct way by using physiological solution and a drop of iodine solution Physiologist – glass slide – cover slip glass – a glass rod or wooden or plastic – an ordinary optical microscope. I took the amount of stool sample and mix with two drops of physiological solution on the glass slide, during mixing exclude large-sized impurities and emulsifying it continues until the shape becomes suspended semi-transparent. Placed on a microscope slide after concealed Bsatrh scan and zoom x10 – x40 and considering all the squares to watch carefully microscopic parasitic phases natural colors and physiological movements .(6,7)
Results and discussion This study found that the prevalence of E. vermicularis infection in children was (70 % ), It is higher than the average level of Ascaris Lumbricoides infection observed (30%) ( Table 1). The type of worms was significantly between EnterobiusVermicularis and AcarisLumbricoides ( p-value= 0.002 ).This was shown in study of Azazy and Al-Tiar ( 1999)and in Guangdong in( 2004 ).That the high risk was in Enterobius vermicularise ( 12). coworkers in 2011 showed that Enterobius vermicularis was the most frequently reported helminth among outpatients with gastrointestinal symptoms in Catalonia, Spain [22]. K''ksal et al in 2010 in a retrospective evaluation of the prevalence of intestinal parasites in Istanbul, Turkey, reported that Enterobius vermicularis was detected in 129 (9%) out of 1423 cellophane tape samples (23). The higher incidence of these nematodes to direct their life cycle where their eggs transferred to the mouth by the hands and fingers and contaminated nails ,when Knit infected director after lay female eggs at night, they stick fingernails and fingers as you can get injury from breathing polluted air the eggs of the worm during cleaning or arrangement contaminated clothing. An analysis of the difference between males and females in the study indicated that females exhibited a slightly higher rate of infection. However, these results were not significantly different statistically. The females was ( 56.7%) than males ( 43.3 %) .The study showed that the infection with nematode in rural was ( 55 %) than the infected in urban ( 45 %) .The infected in one worm was the highest (61.7 % ) than the both worms ( 38.3 %) .
Table (1): Distribution of study sample according to number and percentage
Groups
Type of worm No. % Statistics
EnterobiusVermicularis 42 70 Chi-Square= 9.600
df= 1
p-value= 0.002 (HS)
AscarisLumbricoides 18 30
Total 60 100
Child Gender No. % Statistics
Males 26 43.3 Chi-Square= 1.067
df= 1
p-value= 0.302 (NS)
Females 34 56.7
Total 60 100
Residency No. % Statistics
rural 33 55 Chi-Suare= 0.600
df= 1
p-value= 0.439 (NS)
urban 27 45
Total 60 100
Worm Infestation No. % Statistics
One worm 37 61.7 Chi-Square= 3.267
df= 1
p-value=0.071 (S)
Both worms 23 38.3
Total 60 100
HS= Highly Sig.; S= Sig.; NS= Non Sig; df= degree of freedom
Table (2) showed that the males was the high infected with Ascarise ( 61.1%) than the infected with Enterobius.v ( 35.7 %) , this is not in agreement with Elekwa and Ikeh 1996 which show a slightly higher prevalence among girls compare to boys and it is similar with that recorded by Cort 1992, Stoll 1993, Sawyer 1995, Hill 1996 and Chandler et al, 1995 whose result shows higher prevalence among males in relation to their female counter part. The injured female reverse injury in males, where the highest rate of infection was in Enterobius.v ( 64.3 % ) in female than the Ascaris ( 38.9 %) . This may be attributed to female exposure levels to play groups on sand, hawking, sharing of food with unwashed hands and other domestic chores. [7]. This study was statistically significantly between males and females in the infected with nematode p-value=0 .063
Table (2) Relationship between child gender and type of worm
Gender Type of Worm Statistics
Enterobius Ascaris
No. % No. %
Males 15 35.7 11 61.1 Chi-Square= 3.310
df= 1
p-value=0 .063 (S)
Females 27 64.3 7 38.9
Total 42 100 18 100
S= Sig.; df= degree of freedom
( Table 3) showed the highest rate of infection with Ascaris nematode was in urban ( 61.1%) than in rural ( 38.9 %) , is very common in the world. It increased in poor sanitation regions, particularly where human feces is used as a fertilizer and where children defecate directly on the ground , and the infected with Enterobius.v was the highest in rural ( 61.9%) than in urban (38.1%), These were in accordance with El-Masry et al., (2010) who reported that parasitic infection was more common in rural areas and among lower socioeconomic(24) . because There are many people in rural areas who suffering from parasitic infections, poor public health practices, increasing of vectors and malnutrition states in addition to using of river water directly for drinking and washing. In addition to the affect of the economic blockage in Iraq for long period leading to decreasing of drugs and sanitation. ( 16)
Table (3) Relationship between child residency and type of worm
Residency Type of Worm Statistics
Enterobius Ascaris
No. % No. %
Rural 26 61.9 7 38.9 Chi-Square= 2.697
df= 1
p-value= 0.087 (S)
Urban 42 38.1 11 61.1
Total 42 100 18 100
S= Sig.; df= degree of freedom
( Table 4 ) In this study, single, double infection , the higher infected was in signal infestation in Ascaris 94 % than in Enterobius.v (47.6%) This is probably due to environmental conditions that was favorable for the two parasites live together or the occurrence of high prevalence of the two parasites in the study area . The observed prevalence of nematode parasites of 60 (94.4%) was higher compared with reports of other similar studies, (Aschalew Gelaw 2013) ( 1)
Table (4) Relationship between infestation and type of worm
Infestation Type of Worm Statistics
Enterobius Ascaris
No. % No. %
One worm 20 47.6 17 94.4 Chi-Square= 11.687
df= 1
p-value=0.000(HS)
Both 22 52.4 1 5.6
Total 42 100 18 100
HS= Highly Sig.; df= degree of freedom
In order to avert the harmful effects and complications of the this ignored problem prompt preventive measures should be taken for the eradication of high infestation rate, which should include public health education, clean water supply, sanitation facilities, promoting personal hygiene and periodic deworming of the children. In view of the WHO recommendations, 'In areas where prevalence of mild to moderate underweight children is greater than 25% and where parasites are known to be widespread, high priority should be given to deworming programme, data on prevalence of worms and trials of anthelminthic drugs are vital. (9)Some studies show that the prevalence of worms infestation as 25% to 91%21 in some communities of the world. In a study done in Nigeria shows 49.7% intestinal helminthes with Ascaris lumbricoides 64.4%, hookworms 10.9% and Trichuris trichuria in1.1% cases studied.(5)
Conclusion
1- A significant relationship was found between the A.lumbercoids and E. vermecualtse
2- A significant relationship was found between the infestation and type of worms infected
Recommendation
Based on the findings and observations, infected persons should be treated and adequate attention should be given to awareness, and children should be educated on the mode of infection and epidemiology of the parasite. Give a health education programs about pin worm and roundworms to preparatory school student, teachers and school workers.
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