Abstract

Background
Intestinal helminthes infestations are prevalent in most developing communities. Children both preschool and school-age children (including adolescents) for reasons not well understood compared with any other age group harbor some of the most intense infestations. It is one of the major Neglected Tropical Diseases. Deworming and Health Education is pivotal in control of scourging effects of Helminthes infestation in our society
Objective
The study was to determine the prevalence of worm infestation and factors that influence worm infestation among the school children in Enugu State. Also to compare the effect of health education alone and deworming plus health education on worm infestation.
Methodology
It was an interventional study with one group received only anti-helminthic (control group) and the other group received both anti-helminthic and health education (study group). It was a multistage sampling study involving deworming both groups and health educating the study group. Baseline and post-intervention data were collected from their parents using questionnaires. The stool sample of the pupil were collected and analyzed at baseline and three months post-intervention using brine flotation method. Data was analyzed using Statistical Packages for Social Sciences (SPSS) version 15 at p=0.05
Results
The result was based on 859 pupils, 428 from study and 431 control groups; 400 parents, 212 from study group and 198 from control group who are all parents to the pupil; 66 teachers, 30 from study and 36 control schools. The findings of knowledge, attitude and practice of parents were graded as: Good = 70% to 100%; Fair = 50% to 69%; and Poor = less than 50%,. Findings: Age distributions of the children showed that > half were 5 to 9 years with mean 9.54 ± 2.06 for study group and 9.44 ± 2.14 for control group, Males > females in both group, About 2/3 of parents 25 to 34 years. More than 80% of parents in study group and over 75% of control group had primary education, about 27.3% of pupil in study and 23% of control group were infested with the predominant worm being Ascaris species (roundworm) followed by Ancylostoma duodenale and Necatar americanus (hookworm) at 14.3% and 9.6% against 11.6% and 9.7% in the study and control groups respectively, 2.6% and 2.1% had protozoa in their stool, four(3.4%) pupil had mixed infection in study and five(4.9%) in control group. There were no statistically differences in infestation at baseline. There was marginal reduction in worm infestation in both study and control group (27.3% to 2.6% and 23.9% to 3.0% respectively) following intervention. There was statistically significant difference in worm infestation at pre and post intervention in both groups
vi
(p <0.001). The cure rate for study group and control group were 90.6% and 87.4% respectively with ratio of 1.03. There were statistically significant increases in knowledge of features, mode of transmission, ways to prevent, attitude and practice in the study group three months post-interventions, compared with the pre-interventions levels (p <0.001) but not the case in control There were no significant association between socio-demographic variables of parents, teachers and pupil, parents’ source of knowledge, knowledge of worm infestation, features of worm infestation, mode of transmission, age affected most, mode of prevention and practice as well as parents’ knowledge of deworming and reasons for practice or non-practice of deworming with worm infestation in pupil.
Conclusion
Deworming alone reduced the worm infestation. Addition of health education is needed for effective and sustained control of worm infestation in our society as it significantly increased their knowledge attitude and practice on worm infestation and deworming.