Prevalence, Molecular Characterization and Risk Factors Associated With Intestinal Parasites among School Going Children from Informal Settlements of Nakuru Town, Kenya

Abstract

Health and economic impact of intestinal parasitic diseases is huge. These diseases are prevalent in regions with poor or inadequate sanitation and sewerage facilities mainly in developing and underdeveloped countries. While most of rural areas have been the focus of national control strategies, urban informal centers have recently emerged as disease foci. However, transmission dynamics in these centers is different from rural foci, making deployment of standard control strategies of provision of clean water, sanitation, and hygiene (WASH) potentially inadequate. Consequently, understanding disease transmission dynamic in urban informal centers is important in deployment of appropriate control strategies. This was a cross-sectional study to determine prevalence of intestinal parasites IPs (soil transmitted helminths (STH) and intestinal protozoan parasites) and associated risk factors in school-going children between the ages of 8-13 years from informal centres in Nakuru town, Kenya conducted 2018. Children from Kaptembwa, Milimani and Prisons primary schools were studied. Socio-demographic variables were collected using a pre-tested structured questionnaire to inform on associated risk factors. A total of 248 stool samples from randomly selected pupils were screened for soil transmitted helminths (STH) using microscopy. A random subset of stool samples (n=96) were also screened for intestinal protozoan parasites using polymerase chain reaction (PCR). The overall prevalence of STH and intestinal protozoan parasites was 1.2%, (n=3) and 41.7% (n=40) respectively. Each school had one case of STH infection. Intestinal protozoan parasites infections prevalence by school was Kaptembwa 47.5% (n=19), Prisons 32.5% (n=13) and Milimani 20% (n=8). Multiple infections with STH and intestinal protozoan parasites were 0.4% (n=1) and 5.2% (n=5) respectively. Risk factors for STH and intestinal protozoan parasites included rearing of goat (p=0.046), earthen floor type (p=0.022), number of household rooms (p=0.035), and source of food (p=0.016). Additionally, sourcing of water from water vendors (p=0.003) and living > 1km from school (p=0.013) were important risk factors to infection in Prisons primary school children. The low prevalence of IPs could be attributed to improvements in sanitation, hygiene, and good health practices.