The relationship between perception and prevalence of faecal-orally transmitted parasitic infections among school children’s in a rural community in Cameroon

Background: Faecal-orally transmitted parasites are those which are spread through faecal contamination of food and drinks. Infections with these parasites are responsible for high morbidity and mortality, especially in children in developing countries.Objective: This study was carried out to determine school children’s perception of faecal-orally transmitted parasitic infections and the relationship between that perception and the prevalence of the infections.Methods: Data were collected through questionnaires and laboratory analysis of stool samples. The study was conducted in two phases. In phase 1 questionnaires were administered to determine children’s knowledge on the cause, risk behaviours and prevention of the faecal-orally parasite infections. Stool specimens were analyzed using the formol-ether concentration technique. Health education was utilized in the experimental village, but not the control. Phase 2 was conducted six months later during which questionnaires were distributed and stool samples analyzed from both villages.Results: A total of 370 children were enrolled in this intervention study, out of which 208 were from Kake II (experimental arm) and 162 from Barombi-kang (control arm). At Kake II there was a significant increase in awareness in relation to the source of infection (9.5% vs. 62.5%, P< 0.001), risk behaviour (12.4% vs. 83.7, P<0.001) and prevention (17.9% vs. 84.8%, P<0.001) between the first and second phase of the study, followed by a significant change in the prevalence of Ascaris lumbricoides (24.9% vs. 3.4%, P<0.001), Entamoeba coli (12.9% vs. 6.5%, P<0.001), Trichuris trichiura (22.4% vs. 12.5%, P=0.004) and Entamoeba histolytica (6.0% vs. 1.9%, P=0.035). In Barombi-kang the change in the awareness was not significant (P>0.1) and there was no significant change in the prevalence of any of the faecal-orally transmitted parasites detected. The relationship between the perception and the prevalence of feacal orally transmitted parasitic infections showed a strong negative correlation (r dispersed between -0.97 and -99)Conclusion: Health education applied in the experimental village was responsible for the changed perception of infection by children and consequently for the reduction of infestation rate. Good perception of the infection was inversely proportional to its prevalence. Therefore, health education through the framework of school proved to be an effective control method for faecalorally parasite infections. We recommend this inexpensive method to be adopted as a national policy in developing countries, especially in rural communities.Key Words: Perception and prevalence, Faecal-orally transmitted parasitic infections, School children, Cameroo

Malaria and HIV coinfection in sub-Saharan Africa: prevalence, impact, and treatment strategies

Tebit E Kwenti1,2 1Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, 2Regional Hospital Buea, Buea, Cameroon Abstract: Malaria and HIV, two of the world’s most deadly diseases, are widespread, but their distribution overlaps greatly in sub-Saharan Africa. Consequently, malaria and HIV coinfection (MHC) is common in the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategies of MHC obtained by searching major electronic databases (PubMed, PubMed Central, Google Scholar, ScienceDirect, and Scopus) were reviewed, and it was found that the prevalence of MHC in SSA was 0.7%–47.5% overall. Prevalence was 0.7%–47.5% in nonpregnant adults, 1.2%–27.8% in children, and 0.94%–37% in pregnant women. MHC was associated with an increased frequency of clinical parasitemia and severe malaria, increased parasite and viral load, and impaired immunity to malaria in nonpregnant adults, children, and pregnant women, increased in placental malaria and related outcomes in pregnant women, and impaired antimalarial drug efficacy in nonpregnant adults and pregnant women. Although a few cases of adverse events have been reported in coinfected patients receiving antimalarial and antiretroviral drugs concurrently, available data are very limited and have not prompted major revision in treatment guidelines for both diseases. Artemisinin-based combination therapy and cotrimoxazole are currently the recommended drugs for treatment and prevention of malaria in HIV-infected children and adults. However, concurrent administration of cotrimoxazole and sulfadoxine–pyrimethamine in HIV-infected pregnant women is not recommended, because of high risk of sulfonamide toxicity. Further research is needed to enhance our understanding of the impact of malaria on HIV, drug–drug interactions in patients receiving antimalarials and antiretroviral drugs concomitantly, and the development of newer, safer, and more cost-effective drugs and vaccines to prevent malaria in HIV-infected pregnant women. Keywords: malaria, HIV, coinfection, prevalence, treatment, sub-Saharan Afric