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Letters to the Editor Indian Pediatrics 2002; 39:403-404 |
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Determining Geohelminth Prevalence in a Semiurban Conglomerate in Pondicherry–Questionnaire versus Stool Examination |
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Chemotherapeutic intervention is a quick and effective method of geohelminth control. The type of chemotherapeutic intervention depends on the prevalence and intensity of infection(1). Although WHO has suggested a rapid survey technique for delimiting areas according to the prevalence and intensity, it involves stool collection and examination both of which are time consuming and laborious. It is, therefore, desirable to find an alternate screening tool such as a simple structured questionnaire as is being used for schisto-somiasis. Attempts are already being made to evolve similar methods for intestinal parasites(2,3). With this background, a study was undertaken with the objective of validating a simple structured questionnaire for geohelminth screening so as to ascertain its utility as a rapid screening tool. A total of 402 children studying in standards IV and V (9-10 years of age) in the 3 government primary schools at Villianur town of the Union Territory of Pondicherry were screened for geohelminths by a single stool examination by Kato-Katz method(1). At the time of stool collection, each student was also interviewed with a simple, structured pre-tested questionnaire that included the following three questions: (i) History of passing worms during the previous 2 weeks; (ii) History of abdominal pain during the previous 2 weeks; and (iii) History of diarrhea/dysentery during the previous 2 weeks.
The overall prevalence of geohelminths as estimated by stool examination, history of passing worms in the stool, history of abdominal pain, and by history of diarrhea/dysentery, was 60.7%, 58.5%, 59.5% and 35.5%, respectively. There was no statistically significant difference between the prevalence of geohelminths as estimated by stool examination and as estimated by history of passing worms in the stool or history of abdominal pain (p >0.05). Besides, the sensitivity of these two symptoms was moderate (77%). On the other hand, the prevalence estimated by history of diarrhea/dysentery was significantly lower than that estimated by stool examination (p <0.05). The sensitivity and specificity of the question-naire is shown in Table I. In the light of these results, a structured questionnaire including a history of passing worms in the stool or abdominal pain in the previous two weeks may be a useful tool for preliminary geohelminth screening especially when large scale community surveys have to be conducted in a short time. However, the low specificity and predictive values of the questionnaire in this study limit its use in individuals.
S. Ananthakrishnan, | |||||||||||||||||||||||||||||||||||
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