Neglected Tropical Diseases (NTDs): Case Study on Gastrointestinal Parasites and Morbidity Indicators in Some Rural Villages of the South Region of Cameroon

Background: Parasitic diseases in tropical regions are important cause of morbidity and mortality. Some groups of infection that sufficient attention has not been attributed to by donors and planners worldwide still exist presently. These infections include schistosomiasis, soil transmited helminthes (STHs), amibiasis etc. Intestinal parasitic infections still constitute major public health threats in many parts of Cameroon. To improve on the different control measures and their effectiveness, continuous surveys are necessary to update epidemiological data.

Aim: This study aim to evaluate the transmission level of intestinal parasitosis and morbidity indicators link to infections in inhabitants of Lolodorf Health district in south Cameroon. Informations from such studies will permit to build concrete recommendations for the National control program for these infections.

Methodology: A total of 423 participants were recruited for the study. Stool samples were collected and examined microscopically for the search of helminthes eggs and protozoan cysts using Kato Katz and concentration formol-ether techniques respectively. Anemia was evaluated by measuring heamoglobin level using the spectrophotometic technic with a hemoglobinometer URIT-12 while malnutrition was determined by taking anthropometric parameters.

Results: Out of 423 participants examined, 321 (75.9%) were infected with Ascaris lumbricoides (30.3%), Trichuris trichiura (64.5%), Hookworms (12.5%), E. histolytica/ E. dispar (9.9%) and E. coli (34.0%). Among infected individuals, 117 (36.4%) had single infections, while 204 (63.6%) had multiple infections. Multiple infections were significantly high (P= 0.0001) compared to single infections.  E. histolytica/ E. dispar infection was significantly more prevalent in females than in males (P=0.01), same as in participants of 3-5 years for Hookworms (P= 0.02), 3-5 years and 11-15 years for E. coli (P= 0.04). T. trichura infections occurred more frequently as single infection (P= 0.0001). Interactions between T. trichiura+ E. coli led to a significant increase of E. coli prevalence (P= 0.001). Significant high egg load was observed for T. trichiura (P= 0.00001) and in people between 3-5 years infected by T. trichiura (P=0.0001) and hookworms (P=0.0001). Low infection intensity was significantly more observed compared to moderate and high infection intensities (P= 0.0001) for A. lumbricoides, T. trichiura, and Hookworm. T. trichiura density increases significantly when it interacts with A. lumbricoides + Hookworms, A. lumbricoides + E. coli, Hookworms + E. coli, E. histolytica/ E. dispar + E. coli, A. lumbricoides + Hookworms + E. coli and A. lumbricoides + E. histolytica/ E. dispar + E. coli (P< 0.05).Anemia and malnutrition were the morbidity indicators evaluated. Participants were severely anemic (46.2%) with probable chronic malnutrition (36.7%). Moderate anemia was significantly more observed in infected participants (49.7%: P<0.0001), same for participants of 11-15 years for the two indicators (P<0.0001).

Conclusion: This study has demonstrated that the Ngovayang health area in the health district of Lolodorf is highly endemic for intestinal parasites with high level of anemia and malnutrition observed in individuals, constitutes an area with high risk of transmission. This implies that, the protocol of mass drug administration recommended by MINSANTE might not be adequate to reduce the endemicity level and morbidity caused by these parasites.  Also, recommendations for control measures should be done while taking into consideration the impact of morbidity indicators in infected population.

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