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Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Prevalence and intensity of Ascaris lumbricoides infections in relation to undernutrition among children in a tea plantation community, Sri Lanka: a cross-sectional study

Authors: Lahiru Sandaruwan Galgamuwa, Devika Iddawela, Samath D. Dharmaratne

Published in: BMC Pediatrics | Issue 1/2018

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Abstract

Background

Ascaris lumbricoides infections are one of the commonnest intestinal nematode infections in the world, with a profound negative effect on nutritional status among underprivileged populations. In Sri Lanka, Ascaris infections and low nutritional status still persist in the plantation sector. However, research regarding the association between Ascaris infections and nutritional status is scarce. The main purpose of this study was to determine the association between Ascaris infections and physical growth among children in a plantation sector in Sri Lanka.

Methods

A cross sectional study was conducted among 489 children aged between 1 and 12 years ina plantation sector, Sri Lanka, from January to April 2013. Anthropometric measurements were collected to assess height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) to determine stunting, underweight and wasting respectively. Data on socio-demographic and antihelminthic treatment were ascertained using an interviewer administrated structured questionnaire. Stool samples were subjected to wet mount preparation followed byformaldehyde-ether sedimentation technique to diagnose Ascaris infection and a Kato Katz technique was performed to determine the eggs intensity. AnthroPlus, EpiInfo and SPSS software was used to analyze data.

Results

Of the study sample, 38.4% showed Ascaris lumbricoides infections. Light intensity infections (51%) were common in the infected children, followed by moderate (30%) and heavy (19%) infections. Prevalence of Ascaris infections was significantly associated with de-worming more than six months prior to the study. Prevalence of undernutrition among children was 61.7%. Forty-five per cent were underweight, while 24.1% and 21.5% of children were stunted and wasted respectively. However, no significant association was found between Ascaris infections status and undernutrition. Meanwhile, heavy intensity infections were associated with decreased values of WHZ (p = 0.020).

Conclusions

Ascaris infections and undernutrition are still highly prevalent and a major public health problem in the plantation sector in Sri Lanka. Health and nutrition intervention programs should be implemented to increase the nutritional status of children.
Literature
1.
go back to reference Elkins DB, Haswell-Elkins M, Anderson RM. The epidemiology and control of intestinal helminthes in the Pulicat region of southern India. Study design and pre- and post-treatment observations on Ascaris lumbricoides infection. Trans Roy Soc Trop Med Hyg. 1986;80(5):774–92.CrossRefPubMed Elkins DB, Haswell-Elkins M, Anderson RM. The epidemiology and control of intestinal helminthes in the Pulicat region of southern India. Study design and pre- and post-treatment observations on Ascaris lumbricoides infection. Trans Roy Soc Trop Med Hyg. 1986;80(5):774–92.CrossRefPubMed
2.
go back to reference Bethony JR, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367:1521–32.CrossRefPubMed Bethony JR, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367:1521–32.CrossRefPubMed
4.
go back to reference De Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2003;19(12):547–51.CrossRefPubMed De Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2003;19(12):547–51.CrossRefPubMed
5.
go back to reference Galvani AP. Age-dependent epidemiological patterns and strain diversity in helminth parasites. J Parasitol. 2005;91:24–30.CrossRefPubMed Galvani AP. Age-dependent epidemiological patterns and strain diversity in helminth parasites. J Parasitol. 2005;91:24–30.CrossRefPubMed
6.
go back to reference Khuroo MS, Zargar SA, Mahajan R. Hepatobiliary and pancreatic ascariasis in India. Lancet. 1990;335:1503–6.CrossRefPubMed Khuroo MS, Zargar SA, Mahajan R. Hepatobiliary and pancreatic ascariasis in India. Lancet. 1990;335:1503–6.CrossRefPubMed
7.
go back to reference Villamizar E, Mendez M, Bonilla E, Varon H. De onatra S. Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases. J Pediatr Surg. 1996;31(1):201–4.CrossRefPubMed Villamizar E, Mendez M, Bonilla E, Varon H. De onatra S. Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases. J Pediatr Surg. 1996;31(1):201–4.CrossRefPubMed
8.
go back to reference Taren DL, Nesheim MC, Crompton DW, Holland CV, Barbeau I, Rivera G, et al. Contributions of ascariasis to poor nutritional status in children from Chiriqui Province, Republic of Panama. Parasitology. 1987;95:603–13.CrossRefPubMed Taren DL, Nesheim MC, Crompton DW, Holland CV, Barbeau I, Rivera G, et al. Contributions of ascariasis to poor nutritional status in children from Chiriqui Province, Republic of Panama. Parasitology. 1987;95:603–13.CrossRefPubMed
9.
go back to reference Dickson R, Awasthi S, Williamson P, Demellweek C, Garner P. Effects of treatment for intestinal helminth infection on growth and cognitive performance in children: systematic review of randomised trials. BMJ. 2000;320(7251):1697–701.CrossRefPubMedPubMedCentral Dickson R, Awasthi S, Williamson P, Demellweek C, Garner P. Effects of treatment for intestinal helminth infection on growth and cognitive performance in children: systematic review of randomised trials. BMJ. 2000;320(7251):1697–701.CrossRefPubMedPubMedCentral
10.
go back to reference Drake LJ, Jukes MCH, Sternberg RJ, Bundy DAP. Geohelminth infections (Ascariasis, Trichuriasis, and hookworm): cognitive and developmental impacts. Semin Pediatr Infect Dis. 2000;11:245–51.CrossRef Drake LJ, Jukes MCH, Sternberg RJ, Bundy DAP. Geohelminth infections (Ascariasis, Trichuriasis, and hookworm): cognitive and developmental impacts. Semin Pediatr Infect Dis. 2000;11:245–51.CrossRef
11.
go back to reference Quihui-Cota L, Valencia ME, Crompton DWT, Phillips S, Hagan P, Diaz-Camacho SP, Tejas AT. Prevalence and intensity of intestinal parasitic infections in relation to nutritional status in Mexican schoolchildren. Trans R Soc Trop Med Hyg. 2004;98:653–9.CrossRefPubMed Quihui-Cota L, Valencia ME, Crompton DWT, Phillips S, Hagan P, Diaz-Camacho SP, Tejas AT. Prevalence and intensity of intestinal parasitic infections in relation to nutritional status in Mexican schoolchildren. Trans R Soc Trop Med Hyg. 2004;98:653–9.CrossRefPubMed
12.
go back to reference Schroeder DG, Brown KH. Nutritional status as a predictor of child survival: summarizing the association and quantifying its global impact. Bull WHO. 1994;72(4):569–79.PubMedPubMedCentral Schroeder DG, Brown KH. Nutritional status as a predictor of child survival: summarizing the association and quantifying its global impact. Bull WHO. 1994;72(4):569–79.PubMedPubMedCentral
13.
go back to reference Pelletier DL, Frongillo EA, Schroeder DG, Habicht JP. A methodology for estimating the contribution of malnutrition to child mortality in developing countries. J Nutr. 1994;124(suppl 10):2106S–22S.PubMed Pelletier DL, Frongillo EA, Schroeder DG, Habicht JP. A methodology for estimating the contribution of malnutrition to child mortality in developing countries. J Nutr. 1994;124(suppl 10):2106S–22S.PubMed
14.
go back to reference Del Rosso JM. In school feeding programs: improving effectiveness and increasing the benefit to education: The Partnership for Child Development Publication. Oxford University press; 1999. Del Rosso JM. In school feeding programs: improving effectiveness and increasing the benefit to education: The Partnership for Child Development Publication. Oxford University press; 1999.
16.
go back to reference Department of Census and Statistics. Sri Lanka demographic and health survey 2006/2007. Colombo: Department of Census and Statistics (Sri Lanka); 2009. Department of Census and Statistics. Sri Lanka demographic and health survey 2006/2007. Colombo: Department of Census and Statistics (Sri Lanka); 2009.
17.
go back to reference Galgamuwa GLS, Iddawela WMDR, Dharmaratne SD. Nutritional status and correlated socio-economic factors among preschool and school children in plantationcommunities, Sri Lanka. BMC Public Health. 2017;17:377.CrossRefPubMedPubMedCentral Galgamuwa GLS, Iddawela WMDR, Dharmaratne SD. Nutritional status and correlated socio-economic factors among preschool and school children in plantationcommunities, Sri Lanka. BMC Public Health. 2017;17:377.CrossRefPubMedPubMedCentral
18.
go back to reference Sorenson E, Ismail M, Amarasinghe DKC, Hettiarachchi I, Dassanayake TS. Prevalence and control of soil transmitted nematode infection among children and women in plantations in Sri Lanka. Ceylon Med J. 1996;41:37–41. Sorenson E, Ismail M, Amarasinghe DKC, Hettiarachchi I, Dassanayake TS. Prevalence and control of soil transmitted nematode infection among children and women in plantations in Sri Lanka. Ceylon Med J. 1996;41:37–41.
19.
go back to reference Gunawardena K, Kumarendran B, Ebenezer R, Gunasingha MS, Pathmeswaran A, de Silva NK. Soil-tranmittedhelminth infections among plantation sector school children in Sri Lanka prevalence after ten years of preventive chemotherapy. PLoS Negl Trop Dis. 2011;5(9):e1341.CrossRefPubMedPubMedCentral Gunawardena K, Kumarendran B, Ebenezer R, Gunasingha MS, Pathmeswaran A, de Silva NK. Soil-tranmittedhelminth infections among plantation sector school children in Sri Lanka prevalence after ten years of preventive chemotherapy. PLoS Negl Trop Dis. 2011;5(9):e1341.CrossRefPubMedPubMedCentral
20.
go back to reference Galgamuwa GLS, Iddawela WMDR, Dharmaratne SD. Development and piloting of Ascariasis surveillance system of children in Sri Lanka. Online J Public Health Informatics. 2015;7:e130. Galgamuwa GLS, Iddawela WMDR, Dharmaratne SD. Development and piloting of Ascariasis surveillance system of children in Sri Lanka. Online J Public Health Informatics. 2015;7:e130.
21.
go back to reference Gibson RS. Principle of nutrition assessment. Oxford: Oxford University Press; 2005. Gibson RS. Principle of nutrition assessment. Oxford: Oxford University Press; 2005.
22.
go back to reference Marti H, Escher E. SAF–an alternative fixation solution for parasitological stool specimens. Schweiz Med Wochenschr. 1990;120(40):1473–6.PubMed Marti H, Escher E. SAF–an alternative fixation solution for parasitological stool specimens. Schweiz Med Wochenschr. 1990;120(40):1473–6.PubMed
23.
go back to reference Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in schistosomiasismansoni. Rev Inst Med Trop São Paulo. 1972;14:397–400.PubMed Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in schistosomiasismansoni. Rev Inst Med Trop São Paulo. 1972;14:397–400.PubMed
24.
go back to reference Gunawardena GSA, Karunaweera ND, Ismail MM. Socio- economic behavioral factor affecting the prevalence of Ascaris infection in a low-country tea plantation in Sri Lanka. Ann Trop Med Parasit. 2004;98:615–21.CrossRefPubMed Gunawardena GSA, Karunaweera ND, Ismail MM. Socio- economic behavioral factor affecting the prevalence of Ascaris infection in a low-country tea plantation in Sri Lanka. Ann Trop Med Parasit. 2004;98:615–21.CrossRefPubMed
25.
go back to reference World Health Organization. Prevention and control of intestinal parasitic infections: prevention and control of schistosomiasis and soil-transmitted helminthiasis. Technical report series no. 912. Geneva: World Health Organisation; 2002. World Health Organization. Prevention and control of intestinal parasitic infections: prevention and control of schistosomiasis and soil-transmitted helminthiasis. Technical report series no. 912. Geneva: World Health Organisation; 2002.
26.
go back to reference Fernando SD, Goonethilleke H, Weerasena KH, Kuruppuarachchi ND, Tilakaratne D, De Silva D, et al. Geo-helminth infections in a rural area of Sri Lanka. Southeast Asian J Trop Med Public Health. 2001;32:23–6.PubMed Fernando SD, Goonethilleke H, Weerasena KH, Kuruppuarachchi ND, Tilakaratne D, De Silva D, et al. Geo-helminth infections in a rural area of Sri Lanka. Southeast Asian J Trop Med Public Health. 2001;32:23–6.PubMed
27.
go back to reference Karunaithas R, Murugananthan A, Kannathasan S. Prevalence and associated factors of soil transmitted helminthes infection among preschool children of Vadamarachi educational zone. Ving Journal of science. 2012;10:25–34.CrossRef Karunaithas R, Murugananthan A, Kannathasan S. Prevalence and associated factors of soil transmitted helminthes infection among preschool children of Vadamarachi educational zone. Ving Journal of science. 2012;10:25–34.CrossRef
28.
go back to reference De Siva NR, De Silva HJ, Jayapani VP. Intestinal parasitoses in the Kandy area Sri Lanka. Southeast Asian J Trop Med Public Health. 1993;25:469–73. De Siva NR, De Silva HJ, Jayapani VP. Intestinal parasitoses in the Kandy area Sri Lanka. Southeast Asian J Trop Med Public Health. 1993;25:469–73.
29.
go back to reference Traub RJ, Robertson ID, Irwin P, Mencke N, Andrew Thompson RC. The prevalence, intensities and risk factors associated with geohelminth infection in tea-growing communities of Assam, India. Trop Med Int Health. 2004;9(6):688–701.CrossRefPubMed Traub RJ, Robertson ID, Irwin P, Mencke N, Andrew Thompson RC. The prevalence, intensities and risk factors associated with geohelminth infection in tea-growing communities of Assam, India. Trop Med Int Health. 2004;9(6):688–701.CrossRefPubMed
30.
go back to reference Ngui R, Ishak S, Chuen CS, Mahmud R, Lim YAL. Prevalence and risk factors of intestinal parasitism in rural and remote West Malaysia. PLoS Negl Trop Dis. 2011;5(3):e974.CrossRefPubMedPubMedCentral Ngui R, Ishak S, Chuen CS, Mahmud R, Lim YAL. Prevalence and risk factors of intestinal parasitism in rural and remote West Malaysia. PLoS Negl Trop Dis. 2011;5(3):e974.CrossRefPubMedPubMedCentral
31.
go back to reference Escobedo AA, Cañete R, Núñez FA. Prevalence, risk factors and clinical features associated with intestinal parasitic infections in children from San Juan y Martínez, Pinar del Río, Cuba. West Indian Med J. 2008;57(4):377–82.PubMed Escobedo AA, Cañete R, Núñez FA. Prevalence, risk factors and clinical features associated with intestinal parasitic infections in children from San Juan y Martínez, Pinar del Río, Cuba. West Indian Med J. 2008;57(4):377–82.PubMed
32.
go back to reference Gilgen D, Mascie-Taylor CG. The effect of antihelmintic treatment of helminth infection and aneamia. Parastol 2000;122:105-22. Gilgen D, Mascie-Taylor CG. The effect of antihelmintic treatment of helminth infection and aneamia. Parastol 2000;122:105-22.
33.
go back to reference O’lorcain PHC, Holland CV. The public health importance of Ascaris lumbricoides. Parasitology. 2000;121:S51–71.CrossRefPubMed O’lorcain PHC, Holland CV. The public health importance of Ascaris lumbricoides. Parasitology. 2000;121:S51–71.CrossRefPubMed
34.
go back to reference Chukwuma MC, Ekejindu IM, Agbakoba NR, Ezeagwuna DA, Anaghalu IC, Nwosu DC. The prevalence and risk factors of Geohelminth infections among primary school children in Ebenebe town, Anambra state, Nigeria. Middle-East J Sci Res. 2009;4(3):211–5. Chukwuma MC, Ekejindu IM, Agbakoba NR, Ezeagwuna DA, Anaghalu IC, Nwosu DC. The prevalence and risk factors of Geohelminth infections among primary school children in Ebenebe town, Anambra state, Nigeria. Middle-East J Sci Res. 2009;4(3):211–5.
35.
go back to reference Nobre LN, Silva RV, Macedo MS, Teixeira RA, Lamounier JA, Franceschini SCC. Risk factors for intestinal parasitic infections in preschoolers in a low socio-economic area, Diamantina, Brazil. Pathog Glob Health. 2013;107(2):103–6.CrossRefPubMedPubMedCentral Nobre LN, Silva RV, Macedo MS, Teixeira RA, Lamounier JA, Franceschini SCC. Risk factors for intestinal parasitic infections in preschoolers in a low socio-economic area, Diamantina, Brazil. Pathog Glob Health. 2013;107(2):103–6.CrossRefPubMedPubMedCentral
36.
go back to reference Salam RA, Maredia H, Das JK, Lassi ZS. Bhutta ZA community based interventions for the prevention and control of helmintic neglected tropical diseases. Infect Dise of Pov. 2014;3:23.CrossRef Salam RA, Maredia H, Das JK, Lassi ZS. Bhutta ZA community based interventions for the prevention and control of helmintic neglected tropical diseases. Infect Dise of Pov. 2014;3:23.CrossRef
38.
go back to reference Shariff ZM, Bond JT, Johnson NE. Nutrition and educational achievement of urban primary school children in Malaysia. Asia Pasic J Clin Nutr. 2000;9(4):264–73.CrossRef Shariff ZM, Bond JT, Johnson NE. Nutrition and educational achievement of urban primary school children in Malaysia. Asia Pasic J Clin Nutr. 2000;9(4):264–73.CrossRef
39.
go back to reference World Food Programme (WFP). School children nutrition. London: WFP; 2004. World Food Programme (WFP). School children nutrition. London: WFP; 2004.
40.
go back to reference Mamabolo RL, Alberts M, Steyn NP, Waal HA, Levitt NS. Prevalence and determinants of stunting and overweight in 3-year-old black south African children residing in the central region of Limpopo Province, South Africa. Public Health Nutr. 2005;8(5):501–8.CrossRefPubMed Mamabolo RL, Alberts M, Steyn NP, Waal HA, Levitt NS. Prevalence and determinants of stunting and overweight in 3-year-old black south African children residing in the central region of Limpopo Province, South Africa. Public Health Nutr. 2005;8(5):501–8.CrossRefPubMed
41.
go back to reference Cristina R, Israel P, Sa Leal V, Oliveira JS, Cristina S, Augusta LA, et al. Determinants of stunting in children under five in Pernambuco, Northeastern Brazil. Rev Saude Publica. 2011;45(6):1079–87.CrossRef Cristina R, Israel P, Sa Leal V, Oliveira JS, Cristina S, Augusta LA, et al. Determinants of stunting in children under five in Pernambuco, Northeastern Brazil. Rev Saude Publica. 2011;45(6):1079–87.CrossRef
42.
go back to reference Ahmed A, Mekhlafi HM, Al-Adhroey AH, Ithoi I, Abdulsalam AM, Surin J. The nutritional impacts of soil-transmitted helminths infections among Orang Asli schoolchildren in rural Malaysia. Parasit Vectors. 2012;5:119.CrossRefPubMedPubMedCentral Ahmed A, Mekhlafi HM, Al-Adhroey AH, Ithoi I, Abdulsalam AM, Surin J. The nutritional impacts of soil-transmitted helminths infections among Orang Asli schoolchildren in rural Malaysia. Parasit Vectors. 2012;5:119.CrossRefPubMedPubMedCentral
43.
go back to reference Medhi GK, Barua A, Mahanta J. Growth and nutritional status of school-age children (6–14 years) of tea garden workers of Assam. J Hum Ecol. 2006;19:83–5.CrossRef Medhi GK, Barua A, Mahanta J. Growth and nutritional status of school-age children (6–14 years) of tea garden workers of Assam. J Hum Ecol. 2006;19:83–5.CrossRef
44.
go back to reference Osei A, Houser R, Bulusu S, Joshi T, Hamer D. Nutritional status of primary schoolchildren in Garhwali Himalayan villages of India. Food Nutr Bull. 2010;31:221–33.CrossRefPubMed Osei A, Houser R, Bulusu S, Joshi T, Hamer D. Nutritional status of primary schoolchildren in Garhwali Himalayan villages of India. Food Nutr Bull. 2010;31:221–33.CrossRefPubMed
45.
go back to reference Ramzan M, Ali I, Khan AS. Body mass status of school children of Dera Ismail Khan, Pakistan. J Ayub Med Coll Abbottabad. 2008;20:119–21.PubMed Ramzan M, Ali I, Khan AS. Body mass status of school children of Dera Ismail Khan, Pakistan. J Ayub Med Coll Abbottabad. 2008;20:119–21.PubMed
46.
go back to reference Armstrong H, Lhotska L, Engle P. The care initiative: assessment analysis and action toimprove care of nutrition. New York: UNICEF Nutrition section; 1997. Armstrong H, Lhotska L, Engle P. The care initiative: assessment analysis and action toimprove care of nutrition. New York: UNICEF Nutrition section; 1997.
47.
go back to reference Stratton R, Green C, Elias M. Disease-related malnutrition: an evidence-based approach to treatment. Wallingford: CABI Publishing; 2003.CrossRef Stratton R, Green C, Elias M. Disease-related malnutrition: an evidence-based approach to treatment. Wallingford: CABI Publishing; 2003.CrossRef
48.
go back to reference Ana Lourdes Sanchez AL, Jose Antonio Gabrie JG, Usuanlele MT, Rueda MM, Canales M, Gyorkos TW. Soil-transmitted Helminth infections and nutritional status in school-agechildren from rural communities in Honduras. PLoS Negl Trop Dis. 2013;7:e2378.CrossRefPubMedPubMedCentral Ana Lourdes Sanchez AL, Jose Antonio Gabrie JG, Usuanlele MT, Rueda MM, Canales M, Gyorkos TW. Soil-transmitted Helminth infections and nutritional status in school-agechildren from rural communities in Honduras. PLoS Negl Trop Dis. 2013;7:e2378.CrossRefPubMedPubMedCentral
Metadata
Title
Prevalence and intensity of Ascaris lumbricoides infections in relation to undernutrition among children in a tea plantation community, Sri Lanka: a cross-sectional study
Authors
Lahiru Sandaruwan Galgamuwa
Devika Iddawela
Samath D. Dharmaratne
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-0984-3

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