Intestinal parasitism is a priority health
problem. Since worm infestation is seldom the direct cause of
death, they tend to be regarded as relatively unimportant. Worm
infestation is probably more significant than specific vitamin and
mineral deficiences in developing countries. In India, the problem
is likely to be more common because of bad hygiene, poor
awareness, illiteracy, misbeliefs, poverty and variety of allied
factors(1). Studies carried out in various parts of India have
reported a prevalence of intestinal parasitism upto 30-50% and
anemia from 40-73% among school going girls(2-4). Our objective
was to evaluate the prevalence of anemia and worm infestation in
716 school going girls of age 6-10 at Gulbarga, a semiarid region
located in the Deccan plateau of North Karnataka.
Grading of anemia was done according to WHO
guidelines(5). Prevalence of anemia and mean hemoglobin values are
depicted in Table I. The percent prevalence of worm
infestation was 71.73%. The maximum infestation was of Ascaris
lumbricoides (23.73%) followed by Hymenolepsis nana
(16.36%), Entamoeba histolytica (10.34%), Ankylostoma
duodenale (8.46%) and Trichuris trichura (6.34%). In
severely anemic children, Ankylostoma duodenale infestation
was 4.76%, and multiple infestation was seen in 5.56% girls. Enterobius
vermicularis, Giardia lamblia, and Diphylobothrium latum
were demonstrated in 2.76%, 2.16% and 1.1% cases respectively. Out
of 281 non-anemic girls, 177 (62.98%) had worm infestation, while
of the 435 anemic girls, 334 (76.8%) demonstrated evidence of
worms in their stool. Prevalence of worm infestation was 86.66%,
68.16% and 82.97% in mild, moderate and severely anemic groups
respectively.
Table I__Prevalence of Anemia in School Girls at Gulbarga
Category (Hb g/dL)
|
n(%)
|
Hemoglobin
(g/dL) Mean±SD
|
Non-anemic(>11)
|
281 (39.2)
|
12.6 ± 1.6
|
Mild anemia (9 to <11)
|
165 (23.0)
|
9.9 ± 0.7
|
Moderate anemia
|
223 (31.1)
|
8.2 ± 0.6
|
(7 to <9)
|
Severe anemia(<7)
|
47 (6.56)
|
6.5 ± 1.2
|
The high prevalence of worm infestation is
stressed here as worms are so closely correlated with nutrition.
The continuous presence of worms in marginally nourished children
can cause severe anemia and subsequently affect the growth and
development of these children. In the present study, stool
parasite positivity was 71.3% among school children age 6-10,
which is comparatively high as compared to the study carried in
the tribal areas of Madhya Pradesh, which reported 50% prevalence,
in school going children(2). Anderson et al.(6) reported
41% of population in a rural village of Guatemala in Central
America to be infected with Ascaris lumbricoides and 60%
with Trichuris trichura.
The high prevalence of parasitic infestation
seems directly related to the unhygienic living conditions
associated with lack of knowledge about the communicable disease
and variety of allied factors, which need to be studied. Amongst
the intervention measures, it is important to take up sustained
health education, provision of safe drinking water and improvement
in environmental sanitation. It would be also useful to teach them
about personal hygiene and conduct health education at schools
through ‘School Health Projects’. During the school health
checkups, periodic screening for intestinal parasites and blood
indices can be evaluated.
Acknowledgement
We would like to thank the Hon’ble President, Khaja Education
Society, Gulbarga and Principals of Bibi Raza Primary School,
Khaja Primary School and Akbar Hussaini Primary School for their
kind co-operation.
Vinod Kumar CS, Anand Kumar H., Sunita
V., Indu Kapur
Neonatal of microbiology,
K.B.N. Instititue of Medical Sciences,
Gulbarga 585 104,
Karnataka, India.
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Prevention of parasitic infections in immuno-compromised
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Nutrition intake amongst adolescent girls belonging to poor
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Nutritional Anemias. Report of a WHO Scientific Group. World
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in Guatemala. Mem Inst Oswaldo Cruz 1993; 88: 53-65.
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