Prevalence and Factors Associated with Soil-Transmitted Helminths Infections among Preschool-age Children in Hoima District, Uganda

Abstract

Introduction: Soil transmitted helminths (STH) are still a major public health problem in Uganda, with an estimated prevalence in endemic areas being as high as 55%. With poor hygiene and sanitation, STH prevalence could be higher than the current estimate, leading to increased morbidity, which may result into long-term physical and mental growth retardations in children. Objectives: To determine the prevalence and factors associated with STH among the preschool children aged 1-5 years old in Hoima District. Methods: This was a cross-sectional study conducted among 562 preschool-age children (PSAC) randomly selected from 562 households in 6 counties of Hoima district-Uganda, using EPI. Stool samples from children were examined using the formol ether concentration technique for STH egg detection and quantitative egg count. Structured questionnaire was used to collect information on factors associated with STH infection. Data analysis was done using STATA version 12. Unadjusted and adjusted Generalized Linear models (GLM) were used to measure associations between factors associated with STH infection. Results: More than half 53.9%, (303/562) of participants were girls. Overall STH prevalence was 26.5%. Hookworm was most prevalent (18.5%), followed by A.lumbricoides (9.8%) and T.trichiura (0.5%). Hookworms were commonest among children aged 5 years. The geometric mean EPG counts for Hookworm infection among females was higher (789.82EPG; range (120 - 13200EPG) than among the males [639.00EPG; range (48 - 5280EPG)]. Hookworm infection was highly prevalent among children who defecated in the open and regularly walked barefooted. factors associated with STH were: not washing hands after defecation (adj.PR=2.6, 95%CI: 1.85-3.55; p<0.001); eating fruits (adj.PR=1.8, 95%CI: 1.11-2.78) and vegetables (adj.PR=1.9, 95%CI: 1.26-2.74) without first washing/cooking them, indiscriminate disposal of faeces of young children (adj.PR=1.5, 95%CI: 1.12-2.02) and not deworming children regularly (adj.PR=1.4, 95%CI: 1.04-1.82), after the effects of other significant factors in the model were controlled for. Conclusions: Poor personal and community hygiene and sanitation are associated with soil transmitted helminths infections among PSAC in this area. Hygiene promotion and improved sanitation as well as health education should be integrated into on-going prophylactic deworming programs in order to reduce the prevalence and burden of STH among PSAC. Key words: preschool-age children; Soil transmitted helminths and intensity.