Amoebiasis levels in relation to sanitation and personal hygiene among patients attending Kauwi and Muthale hospitals in Kitui county, Kenya

ABSTRACT

Entamoeba histolytica, an intestinal protozoan parasite, is the causative agent for amoebiasis which is the third leading parasitic disease causing deaths in humans after malaria and schistosomiasis. Globally, it is responsible for 40,000 to 100,000 deaths annually. Amoebiasis is on the rise in Kitui County and is responsible for diarrheal illnesses and early deaths in children under 5 years. There is no surveillance system in Kenya to combat the disease and its real level of occurrence remains unknown in Kitui west district. It occurs particularly in the tropics largely due to conducive temperatures for the parasite to complete its life cycle and is more common in areas with poor sanitation where barriers between human feces, food and water are inadequate. How this infection associated with age remains unclear. As a result, this study was aimed at determining the occurrence levels of E. histolytica infection among persons of various age groups attending Muthale mission and Kauwi sub-district hospitals in Kitui west district. The study involved observation of clinical signs and symptoms as well as microscopic examination of E. histolytica trophozoites and cysts in feces. The patients were sampled using simple random method. Fecal samples were collected from a total of 277 subjects attending the Kauwi sub-district and Muthale mission hospitals. To increase the chance of detecting the parasite in the stool, three direct smears were prepared from each sample and examined. Any observation of cyst or trophozoite was recorded. Formal-ether concentration technique was done for each sample that tested negative under direct smear and examined microscopically at low (20x) and high (40x) magnifications. The study collected data on personal hygiene and sanitation level in the study area by use of questionnaires. Laboratory data was obtained based on presence of cysts and / or trophozoites in the stool. Data on level of sanitation and infection by E. histolytica in different sexes and age groups were analyzed using Mean square contingency coefficient, Cramer’s V and Chi-square. The study revealed that 81 (29.2%) of the sampled individuals tested positive for amoebiasis of which 10.8% were males while females were nearly double at 18.4%. The most affected age group was the under five years at 58.8% and the least infected was 26 to 35 years at 20.6%. Source of water for domestic use played a key role in acquiring the parasite. Washing of hands, fruits and vegetables had no significance since the water used was from unsafe sources highly likely to have been contaminated with Entamoeba histolytica. This rendered fruitless the effort shown by the residents in maintaining good sanitation and personal hygiene. The current study findings are critical in preventing amoebiasis in the study area. This would have a long lasting impact in reducing the high child mortality rate in Kitui west district and other regions of the world with similar epidemiological factors. Thus, would put Kenya in an advantage position to achieve Millennium Development Goal number four and her Vision 2030.