Prevalence of Intestinal Helminthes among Children in Selected Communities in Monrovia, Liberia

The present study was carried out among children below 15 years in 10 communities in Monrovia. Out of the 646 children recruited in the study, 216 (33.4%) were positive for at least one intestinal helminth parasite. Children between 11 – 15 years had the highest prevalence of intestinal helminthes. Ascaris lumbricoides was the most common intestinal helminth parasite encountered (79.6%), followed by Trichuris trichura (19.0%). Strongyloides stercoralis and Enterobius vermicularis were the least prevalent helminth parasites encountered among the study population (1% each). The population in these communities depended largely on poorly built latrines and buckets for faecal disposal although some (49%) used flush toilets despite their being in poor conditions. Only 23.45 of the 646 children surveyed used pipe borne water for drinking and other domestic purposes. The high prevalence rates of helminth infection obtained could be due to persistent infection and re-infection of the study population as a result of the constant seeding of the soil with parasite eggs and larvae in these communities. Keywords: Prevalence, Intestinal helminth, Children, Liberi

Improved mapping strategy to better inform policy on the control of schistosomiasis and soil-transmitted helminthiasis in Sierra Leone

<p>Abstract</p> <p>Background</p> <p>Schistosomiasis and soil-transmitted helminthiasis (STH) are endemic in Sierra Leone confirmed by national mapping in 2008. To better inform planning of preventive chemotherapy strategy, another survey was conducted before mass drug administration (MDA) in seven districts according to the mapping results or local knowledge. Fifty-nine chiefdoms and one school in every chiefdom were selected. Thirty school children aged 9-14 years from each school (total: 1760) were examined by parasitological methods for infection with <it>Schistosoma mansoni </it>and STHs.</p> <p>Results</p> <p>The overall prevalence of <it>S. mansoni </it>was 40.2% (95% confidence interval (CI): 37.9-42.5%), particularly in Kailahun (63.3%), Kenema (46.7%), Koinadugu (41.9%) and Kono (71.7%). The results demonstrated the focal distribution of <it>S. mansoni </it>in Bo, Tonkolili and Bombali districts with prevalence ranging from 0.0-63.3%, 3.3-90.0% and 0.0-67.9% respectively. The arithmetic mean intensity of <it>S. mansoni </it>infection was 95.4 epg (95% CI: 61.4-129.5 epg), Heavy mean intensity of infection was found in Kailahun (120.2 epg), Kenema (104.5 epg), Koinadugu (112.3 epg) and Kono (250.3 epg). Heavy or moderate infection with <it>S. mansoni </it>occurred in 20.7% of children examined. Hookworm prevalence was moderate: 31.2% (95% CI: 29.1-33.4%), but high in Bo (50.0%) and Tonkolili (56.7%). Hookworm intensity of infection was light with a mean epg of 53.0 (95% CI: 38.4-67.7 epg). Prevalence and intensity of <it>Ascaris lumbricoides </it>(1.5%, 17.8 epg) and <it>Trichuris trichiura </it>(2.5%, 20.3 epg) was low.</p> <p>Conclusions</p> <p>The prediction by previous spatial analysis that <it>S. mansoni </it>was highly endemic across north-eastern Sierra Leone was confirmed with a significant proportion of children heavily or moderately infected. The distribution of <it>S. mansoni </it>in Bo, Tonkolili and Bombali districts ranged widely, highlighting the importance of considering the nature of focal transmission in national mapping exercises. These results were used to refine the MDA for schistosomiasis control to chiefdom implementation units rather than the entire district in these 3 districts. The survey demonstrated that sufficient number of survey sites for schistosomiasis mapping in each district should be used to provide a better national planning of MDA activities, and that it is affordable with the contributions from all parties involved and national resources mobilized.</p

Nutritional Status of Children in Displacement Camps in Sierra Leone

Civil wars have resulted in the displacement of millions of people worldwide and have forced many into temporary displacement camps. Sometimes, most are caught in prolonged and overcrowded refugee camps, which provide ideal grounds for the transmission of diseases, increased risk for acute respiratory infections, diarrhoeal diseases, and malnutrition. In this study, stunting, under nutrition, and wasting were measured among 454 children under the age of 10 years in four internally displaced persons (IDP) camps. Stunting was found to be the most common nutritional abnormality in all four IDP camps with the highest prevalence rate (29.3%) in the Trade Center Camp and lowest (14.2%) in the National Workshop Camp. This study indicates that forced internal displacement results in high prevalence of stunting, wasting and underweight among children.Key Words: Nutritional status, Children, Displacement, Sierra Leone

Prevalence and Intensity of Intestinal Helminth Parasites and Their Response to Treatment with Albendazole in a Rural Community in Sierra Leone

Helminth infections can be an important public health problem in most developing countries. Stool samples from five hundred and fourteen (514) participants in Gbondapi village were examined to determine the prevalence and intensity of intestinal helminths using the Kato-Katz method. The efficacy of a single dose of 200mg and 400mg albendazole in adults and subjects below and above 2 years respectively was also assessed. Seventy-nine (15.4%) of the 514 subjects were infected with at least one intestinal helminth. Data collected was analysed using Epi info statistical package. The most prevalent intestinal helminth was Hookworm (7.6%) followed by Ascaris lumbricoides (5.3%) and Strongyloides stercoralis (3.9%). The least prevalent helminth was Schistosoma mansoni (1.6%). The worm burden was generally light with mean egg counts ranging between 83 – 927eggs/gram of stool. Albendazole had an excellent safety record and found to be highly effective against Ascaris lumbricoides. In order to break the cycle of infection and re-infection in rural communities, programs embracing health education, mass treatment with albendazole, improved sanitation and the provision of protected water sources must be implemented

Combined Spatial Prediction of Schistosomiasis and Soil-Transmitted Helminthiasis in Sierra Leone: A Tool for Integrated Disease Control

Two forms of schistosomiasis or bilharzia (intestinal and urogenital) exist in Sierra Leone. The main control strategy for this disease currently is through mass drug administration (MDA) according to the World Health Organization recommended anthelminthic chemotherapy guidelines, and others include snail control, behavior change, and safe water, sanitation and hygiene. Survey on distribution and prevalence of the disease is vital to the planning of MDA in each district. The distribution of intestinal schistosomiasis in the country has been reported previously. The current national survey showed that urogenital schistosomiasis has a specific focal distribution particularly in the central and eastern regions of the country, most prevalent in Bo (24.6%), Koinadugu (20.4%) and Kono (25.3%) districts. Using a simple probabilistic model, this map was combined with the previously reported maps on intestinal schistosomiasis and the combined schistosomiasis prevalence was estimated. The combined schistosomiasis map highlights the presence of high-risk communities in an extensive area in the northeastern half of the country, which provides a tool for planning the national MDA activities

Geographical Distribution of Intestinal Schistosomiasis and Soil-Transmitted Helminthiasis and Preventive Chemotherapy Strategies in Sierra Leone

The common intestinal roundworm, whipworm and hookworm (together known as soil-transmitted helminthes - STHs) together with schistosomes or bilharzia are responsible for extensive ill health, reduced life expectancy and death in sub-Saharan Africa. These diseases are transmitted in areas of poor water supply and sanitation. In order to implement an appropriate national control program, knowledge of the prevalence and geographical distribution of these diseases is required. A national survey was performed in Sierra Leone in 2008. Overall prevalence of intestinal schistosomiasis was 18.4% and that of STHs was 39.1%. Intestinal schistosomiasis was mainly prevalent in the northern and eastern regions while STH is widespread in the country. The results justify routine de-worming for pre-school children, school age children, women of childbearing age, and adults at high risk twice a year. The results also justify using anti-schistosomiasis drug (praziquantel) in school age children, all women of childbearing age, and adults at high risk annually or biennially depending upon the prevalence in the areas