NTESTINAL PARASITE INFECTIONS IN PRESCHOOL-AGED CHILDREN IN KIBERA INFORMAL SETTLEMENTS IN NAIROBI COUNTY AND ASSOCIATED RISK FACTORS

Abstract

Infections with intestinal parasites are a major public health problem in children in developing countries like Kenya. School-going children are considered more vulnerable to intestinal parasitic infections and thus are included in school-based deworming programmes. Less focus is given to preschool-aged children, and information available on intestinal parasitosis in this age group is both limited and inconsistent. The main objective of this study was to determine the prevalence and intensity of helminth and protozoa infections in preschool-aged children (2 to 5 years old) in Kibera informal settlements in Nairobi County, Kenya, and identify associated risk factors. It was a community-based cross-sectional study conducted between October 2016 and January 2017 among 406 children selected from 7 of 14 villages that comprise the Kibera informal settlements. A structured, interviewer-administered questionnaire was used to collect sociodemographic information and data on risk factors associated with intestinal parasite infections. Stool samples were examined microscopically using formal ether concentration, iodine wet-mounting, modified Ziehl-Neelsen staining, and the Kato-Katz method. Multivariable logistic regression analysis was used to identify factors associated with intestinal parasites. The overall prevalence of any helminth and protozoan infections was 13.1% (53/406) and 22.4% (91/406), respectively. The predominant parasites were Giardia lamblia (13.8%), Ascaris lumbricoides (11.3%), Entamoeba histolytica/dispar (9.4%), Trichuris trichiura (3.9%), Entamoeba coli (1.5%), and hookworm (0.2%). The prevalence of coinfection with any helminths or protozoan was 2.7%. About 10.8% (44/406) and 20.7% (84/406) of children were infected with a single species of helminth and protozoan parasites. All helminth infections were light, with a mean intensity of 592 eggs per gram. The intensity of any protozoan infections was heavy, 62.6% (57/406). Dirt floors in the household (aOR = 2.22, p = 0.046), dirty toilets (aOR = 2.33, p = 0.014), water from communal taps (aOR = 0.27, p = 0.019), parent’s education level (aOR =0.27, p = 0.032) and parent’s earning (aOR =3.34, p = 0.007) were factors found to be significantly associated with intestinal parasites. The study found both helminth and protozoan parasites to be prevalent among preschool-aged children in Kibera. Intervention measures, including education on the improvement of hygiene and health, socio-economic conditions, sanitation, and provision of safe drinking water, could reduce the prevalence of these infections.