Prevalence Of Geohelminthiases And Its Effects On Growth And Cognitive Functions In Pupils In Kibera And Korogocho Slums, Nairobi County, Kenya

ABSTRACT

Geohelminthiases are infections caused by Ascaris lumbricoides, Ancylostoma

duodenale, Necator americanus, Strongyloides stercoralis and Trichuris trichiura

leading to oedema, iron-deficiency, protein-energy malnutrition, electrolyte derangement,

endocrine upsets and cardio-vascular failure. Resulting sequelae lead to poor health,

physical fitness and anaemia. Geohelminthiases is widespread in areas with poor

sanitation but empirical data on prevalence and its effects on growth, academic

performance and cognitive functions is scanty. The current study aimed at determining

effects of geohelminthiases on growth, Cognitive functions and academic performance of

children in Kibera and Korogocho slums, Nairobi County. Kasarani (Korogocho slum),

Lang’ata (Kibera slum) and Dagoretti (Kibera slum) sub-Counties were purposefully

selected. Four schools were selected purposefully using cluster random sampling method:

2 from Kasarani, 1 from Dagoretti and 1 from Lang’ata sub-Counties. Sample size of 470

children in class 2-7 were selected by systematic random sampling method. Kato-Katz

technique was used to estimate infection intensity. Point prevalence was determined by

comparing total number of infected children against total number of sampled children,

expressed as percentage. Information on Cognitive functions was obtained using Word

Generation Semantic (WGS), Word Generation Initial (WGI), List Memory (LM),

Standard Progressive Matrices (SPM), Coding-B (Cod-B), Symbol Search-B (SS-B) and

Digit Span (DSP) tests. Anthropometric measurements were used for computing BMI.

Data on absenteeism and academic performance was deduced from class records for 3

terms pre-treatment (400 mgs albendazole) and immediate 2 terms, post-treatment. Stool

examination was repeated 3 months after treatment. Questionnaire was administered to

collect information on family background to cater for confounders influencing cognitive

functions. Pearson’s Product moment correlation was used to determine associations. ttest

was used to determine differences between means of infected and non-infected

children. ANOVA was used to determine relationships. Linear Regression was used to

identify the confounders influencing Cognitive functions. Highest prevalence of

geohelminths (51.9%) occurred in Dagoretti sub-County (Kibera slum). Highest

prevalence occurred with A. lumbricoides (37.4%) and T. trichiura (33.2%). Highest light

and moderate infections (16.5%) and (10.4%), respectively, occurred in 11-14 years-old

children. Heavy infections (1.1%) occurred in 6-10 and 11-14 year-old children. Highest

absenteeism (44.3%) was in Mbagathi school (Kibera slums) and highest prevalence

(51.7%) in Olympic school (Kibera slum). Significant differences in infection intensities

occurred between males and females (p < 0.05), with females having higher infections

than males. Geohelminthiases negatively affected Growth (r = - 0.809; p < 0.05).

Children with low BMI had high infection rates (p < 0.05). Geohelminthiases inversely

correlated with Cognitive performance as measured in WGS, WGI, LM, SPM, Cod-B

and DSP tests (p < 0.05). Infections positively correlated with Absenteeism (r = 0.971; p

< 0.05) and adversely affected Academic performance (r = - 0.879; p < 0.05).

Interestingly, chemotherapy with albendazole improved BMI, Cognitive functions and

Academic performance. Data generated will support policy on control of

geohelminthiases. It is recommend that regular mass-chemotherapy programmes be

applied in schools and slum communities to improve children’s general health, growth,

school attendance and academic performance.