Risk factors for helminth infections and effects of participatory hygiene and sanitation transformation on intestinal helminths in children under five in Luweero district, Uganda

Abstract

Luweero district health records reveal high cases of intestinal worm infections that take third or fourth position among the top IO diseases in the out-patient diagnoses. Helminthiasis has caused morbidity ranging from 5.0% to 9% in recent years 1997 to 2004 in the under fives in the district. Despite this position, neither the cause of the high prevalence nor the impact of any intervention had been investigated. A three-phased study to assess the effect of Participatory Hygiene and Sanitation Transformation methodology (PHAST) on intestinal helminths in children less than five years was therefore carried out in 19 villages of Luweero district in Uganda, for 3 years ending April 2003. Phase l was a cross-sectional descriptive baseline survey that investigated the prevailing helminth status and risk factors that promote helminth transmission. Stools from 727 children were examined for presence of helminth ova using Kato/Katz technique and questionnaires administered to all respondents. Phase 2 investigated the viability of PHAST intervention in controlling helminthiasis: PHAST training was conducted thrice in the experimental villages while all the subjects in the study were dewormed with a single oral dose of 400-mg albendazole depending on age. Phase 3 was a follow up on the effect of the intervention. Overall, there was a prevalent rate of27.6% (201/727) of children in(ected with helminth ova; with an arithmetic mean of965.0 eggs per gram of faeces (epg). Out of201 children, 82.0% were infected with Ancylostoma duodenale and/or Necator americanus, 18.9% with Ascaris lumbricoides, 7.0% with Trichuris trichiura, 1.0% with Enterobius vermicularis, and 0.5% with Hymenolepis nana. Risk factors strongly associated with helminth infections included methods of anal cleaning, methods of hand washing after Latrine visits: maintenance of compounds and latrines, rearing of pigs as well as age of the subjects.