Infections With Intestinal Protozoa And Geohelminths And The Risk Factors Among Secondary School Students In Maara Sub-County, Tharaka-Nithi County, Kenya

Intestinal parasitic infections caused mainly by protozoa and helminths are most prevalent in tropical and subtropical regions of the world where adequate water and proper sanitation are lacking. Helminthiasis has been listed among the three most prevalent diseases in Tharaka-Nithi County. The residents are mainly small scale nonmechanized farmers hence there is frequent contact with the soil. Chronic parasitic infection among students negatively affects their health, nutrition, cognitive development, and educational achievement. Research, treatment and control efforts have been focused largely in primary schools, while neglecting secondary schools. These interventions in primary schools have been shown to improve students’ health and academic achievements. Secondary school students potentially play a major role in transmission of intestinal parasites to entire populations since they originate from different regions of the country. The findings would enable the health sector establish programs to control intestinal parasitic infections among secondary school students and entire populations, hence improve their health.This study aimed at determining the occurrence of intestinal parasites among Form one, two and three students in four randomly selected public secondary schools both day and boarding in Maara SubCounty in Tharaka-Nithi County, Kenya. Faecal specimens were collected in May 2013, from 384 students, both male and female. The specimens were processed by direct wet mounts and concentration technique, and then examined microscopically to determine the presence and intensity of intestinal parasites. Chi square (χ2) test was used to predict association between infection rates with age, sex and school type. The difference was considered statistically significant at p-value ≤ 0.05. Structured questionnaires were used to collect data on transmission risk factors of intestinal parasites which were compared using adjusted odds ratio (aOR). The intestinal parasitic infection rate was 36.2%, of which 19.0% and 17.2% were due to protozoa and helminths respectively. The most commonly identified intestinal parasites were A. lumbricoides (10.4%), E. histolytica (16.9%), hookworms (3.9%), T. trichiura (2.9%), and G. lamblia (2.8%). More males (39.6%) than females (33.2%) were infected though the difference was not statistically significant (χ2=3.92 p=0.56, df=2). Kyeni Day school had the highest infection rate (42.2%) while Kajiunduthi had the least (32.8%). The parasitic infection rates were significantly higher in day schools (40.6%) compared to boarding schools at 34% (χ2=249 p=0.00, df=2). Majority of the students (96.4%) had single species infections while 3.6% had multiple protozoa and helminths infections. The co-infection rate of protozoa and helminths in day and boarding schools was statistically different (χ2=15.14, p=0.004, df=4). Most of the helminths infections among students (56.1%) were of light intensity while 25.8% were of heavy intensity. The infections were associated with involvement in farming activities (OR=3.07, CI=2.19-4.32) and water sources (OR=4.02, CI=2.57-6.92). The personal hygienic factors associated with intestinal parasitic infections were failure to boil drinking water (OR=3.3, CI=0.19-5.6), failure to wash hands with soap (OR=2.96, CI=2.07-4.21), failure to wash fruits before eating (OR=5.8, CI=3.82-8.94) and failure to wear shoes (OR=2.54, CI=1.87-3.45). This study concluded that there was high level of intestinal parasitic infections among the secondary school students with associated transmission risks. It is recommended that health education on personal hygiene and environmental sanitation be adopted in secondary schools in order to reduce intestinal parasitic infections among students. The County medical services should conduct deworming programs in secondary schools once every three months together with screening and treatment of protozoa infections.