SOIL TRAANSMITTED HELMINTHIASES,NUTRITIONAL STATUS AND ANAEMIA IN PUBLIC PRIMARY SCHOL PUPILS OF URBAN AND RURAL AREA OF LAGOS STATE :A COMPARATIVE STUDY

SOIL TRAANSMITTED HELMINTHIASES,NUTRITIONAL STATUS AND ANAEMIA IN PUBLIC PRIMARY SCHOL PUPILS OF URBAN AND RURAL AREA OF LAGOS STATE :A COMPARATIVE STUDY

Abstract

Introduction: Nigeria has been confirmed to have the highest number of people with soil-transmitted helminthiasis (STHs) among all African nations and school – aged children especially those in the rural areas are an important high risk group for these infections. The consequences of STH burden are varied including nutritional disturbance and anaemia, thus increasing morbidity in these children. This study was, therefore, carried out to compare the prevalence of STHs, nutritional status and anaemia prevalence in public primary school pupils of urban and rural local government areas of Lagos State.
Methodology: This study was a comparative cross sectional study of rural (Badagry) and urban (Lagos Mainland) Local Government Areas in Lagos State. Multistage sampling technique was used to select 264 pupils each from two schools in the two locations. A pre-tested interviewer administered questionnaire was used for data collection. The following procedures were carried out on the pupils using different tools; anthropometric measurement (height and weight measurement), stool testing for STH and haemoglobin estimation. Hygienic characteristics of the schools were also ascertained. Data analysis included bivariate and multivariate analysis using multiple logistic regressions to identify significant predicting risk factors of STH, undernutrition and anaemia.
Results: The prevalence of STH was higher in the rural area (41.5%) than in the urban area (25.2%) with the prevalence rates of Ascaris lumbricoides, Trichuris trichiura and Hookworm higher in the rural area (27.4%, 17.8% and 10.4% respectively) compared with 21.9%, 5.8% and 1.7% respectively in the urban area and the differences observed in the prevalence of Trichuris and Hookworm infection were statistically significant (P<0.05). Majority of the
9
infection (89.0% in the rural and 85.2% in the urban) were light intensity infections and there were statistically significant differences in the mean egg per gram of Trichuris trichiura and hookworms (P<0.05). The prevalent rates of stunting, thinness and underweight were 18.2%, 13. 6% and 20.4% respectively in the rural area and these were higher than the rates in the urban area; 4.5%, 6.4% and 3.5% respectively. There was a statistically significant difference in the nutritional status of respondents in the two locations (P<0.05). The prevalence of anaemia was slightly higher (21.3%) in rural area pupils than in the urban (16.7%), though this difference was not statistically significant. STH and undernutrition co-prevalence was also statistically higher in the rural area (6.4%) than in the urban area (1.5%).
After controlling for the effects of other factors, multiple logistic regression analysis revealed the use of pit latrine as a predictor of ascariasis (OR=1.861,CI=1.090 – 3.179,P-value= 0.023) and indiscriminate defecation like open defecation as predictor of trichuriasis (OR=2.374,CI= 1.057-5.333,P-value=0.03). Younger age group (6-9 years) and the use of pit latrine were significant predictors of moderate intensity of STH (OR=3.165, CI=1.150-8.714,P-value=0.026) and (OR=2.903,CI=1.023-8.237,P-value=0.045) respectively. Younger pupils (6-9 years) were less likely to be stunted (OR= 0.230, CI=0.113-0.469, P-value < 0.001) and middle class occupation of pupils’ fathers was also protective of anaemia (OR=0.473,CI=0.285-0.786,P-value=0.004) when compared with low class occupation.
Conclusion: STH, undernutrition and anaemia are still problems among school children in Lagos State, Nigeria, especially in the rural area. Socio-demographic and environmental conditions such as age group, sex, father’s occupation and toilet type were significant determinants of these health problems.
Recommendation: There is need for health education on hygienic practices for the prevention of STH especially for the rural pupils. This should be supported with provision of sufficient and adequate toilet facilities by the government. In addition, targeted health education for the
10Introduction: Nigeria has been confirmed to have the highest number of people with soil-transmitted helminthiasis (STHs) among all African nations and school – aged children especially those in the rural areas are an important high risk group for these infections. The consequences of STH burden are varied including nutritional disturbance and anaemia, thus increasing morbidity in these children. This study was, therefore, carried out to compare the prevalence of STHs, nutritional status and anaemia prevalence in public primary school pupils of urban and rural local government areas of Lagos State.
Methodology: This study was a comparative cross sectional study of rural (Badagry) and urban (Lagos Mainland) Local Government Areas in Lagos State. Multistage sampling technique was used to select 264 pupils each from two schools in the two locations. A pre-tested interviewer administered questionnaire was used for data collection. The following procedures were carried out on the pupils using different tools; anthropometric measurement (height and weight measurement), stool testing for STH and haemoglobin estimation. Hygienic characteristics of the schools were also ascertained. Data analysis included bivariate and multivariate analysis using multiple logistic regressions to identify significant predicting risk factors of STH, undernutrition and anaemia.
Results: The prevalence of STH was higher in the rural area (41.5%) than in the urban area (25.2%) with the prevalence rates of Ascaris lumbricoides, Trichuris trichiura and Hookworm higher in the rural area (27.4%, 17.8% and 10.4% respectively) compared with 21.9%, 5.8% and 1.7% respectively in the urban area and the differences observed in the prevalence of Trichuris and Hookworm infection were statistically significant (P<0.05). Majority of the
9
infection (89.0% in the rural and 85.2% in the urban) were light intensity infections and there were statistically significant differences in the mean egg per gram of Trichuris trichiura and hookworms (P<0.05). The prevalent rates of stunting, thinness and underweight were 18.2%, 13. 6% and 20.4% respectively in the rural area and these were higher than the rates in the urban area; 4.5%, 6.4% and 3.5% respectively. There was a statistically significant difference in the nutritional status of respondents in the two locations (P<0.05). The prevalence of anaemia was slightly higher (21.3%) in rural area pupils than in the urban (16.7%), though this difference was not statistically significant. STH and undernutrition co-prevalence was also statistically higher in the rural area (6.4%) than in the urban area (1.5%).
After controlling for the effects of other factors, multiple logistic regression analysis revealed the use of pit latrine as a predictor of ascariasis (OR=1.861,CI=1.090 – 3.179,P-value= 0.023) and indiscriminate defecation like open defecation as predictor of trichuriasis (OR=2.374,CI= 1.057-5.333,P-value=0.03). Younger age group (6-9 years) and the use of pit latrine were significant predictors of moderate intensity of STH (OR=3.165, CI=1.150-8.714,P-value=0.026) and (OR=2.903,CI=1.023-8.237,P-value=0.045) respectively. Younger pupils (6-9 years) were less likely to be stunted (OR= 0.230, CI=0.113-0.469, P-value < 0.001) and middle class occupation of pupils’ fathers was also protective of anaemia (OR=0.473,CI=0.285-0.786,P-value=0.004) when compared with low class occupation.
Conclusion: STH, undernutrition and anaemia are still problems among school children in Lagos State, Nigeria, especially in the rural area. Socio-demographic and environmental conditions such as age group, sex, father’s occupation and toilet type were significant determinants of these health problems.
Recommendation: There is need for health education on hygienic practices for the prevention of STH especially for the rural pupils. This should be supported with provision of sufficient and adequate toilet facilities by the government. In addition, targeted health education for the
10
caregivers especially mothers and teachers on proper nutrition is advocated while parents, philanthropists, drug companies and NGOs are encouraged to support deworming.
caregivers especially mothers and teachers on proper nutrition is advocated while parents, philanthropists, drug companies and NGOs are encouraged to support deworming.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

SOIL TRAANSMITTED HELMINTHIASES,NUTRITIONAL STATUS AND ANAEMIA IN PUBLIC PRIMARY SCHOL PUPILS OF URBAN AND RURAL AREA OF LAGOS STATE :A COMPARATIVE STUDY

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