Prevalence Of Entamoeba Histolytica Infections Among The Children Attending Primary Schools In Kyuso Zone, Kyuso District, Kitui County, Kenya

ABSTRACT

The occurrence of Entamoeba histolytica as a human intestinal parasite is a serious problem especially in developing countries. Entamoeba histolytica frequently infest as a commensal within the human large intestines with no overt clinical manifestations. However, trophozoites can invade the colonic epithelium and produce ulcers and dysentery, a condition known as Amoebiasis. Amoebic infections in Kyuso Zone, Kyuso District are common. The ecological aspects in the area and particularly water-related ones allow endemicity. There have been efforts to provide treatment and control of amoebic infections but the prevalence of the disease in this area has never been established. This study was aimed at determining the prevalence of E. histolytica in school children aged 6-12 years in Kyuso Zone and establish the relationship between the prevalence and ecological factors. A cross-sectional study design was used where 354 randomly selected pupils aged 6-12 years provided stool specimen which were taken to Kyuso District Hospital Laboratory for examination. They were examined microscopically for cysts/trophozoites of E. histolytica using direct wet smear and formal ether concentration technique. Questionnaires, focus group discussions and observational checklists were also used to determine risk factors. The overall prevalence of E. histolytica infections amongst the pupils was 42.1%. Chi-square (χ²) test was done to determine the relationship between prevalence and pupils’ age and gender. There was no significant association between prevalence and gender (χ²=0.9653, df=1, P>0.05) and no significant association between prevalence and age (χ²=3.5649, df=2, P>0.05). Logistic regression analysis was used to assess the significance of association between water sources and prevalence. A significant association was found between the use of dry riverbed wells and high prevalence (OR= 2.351, P=0.02) and the use of earth dam water and high prevalence (OR=2.828, P=0.0000). A significant association was found between high prevalence and use of latrines (χ²=4.7199, df=1, P=0.0298). Medical records in Kyuso District Hospital showed that 44.2% of the patients who were tested for gastro intestinal infections between April and September 2011 were found to be infected with E. histolytica. Of these patients, children aged between 6 and 12 years showed a morbidity rate of 46.9%. In this study there is clear indication that E. histolytica infections are a problem in schools in Kyuso Zone. It is therefore recommended to the ministry of education and the ministry of Public health that public health education programmes should be formulated and carried out in schools and within the community so as to inform people of good sanitation and hence reduce infections and morbidity. It is further suggested that school children be considered for chemotherapy treatment to reduce morbidity.