Prevalence of and factors associated with intestinal parasites among children from 1 to 5 years of age in an urban slum of Karachi
Date of Award
Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)
Community Health Sciences
Intestinal parasitic infections (IPIs), the leading cause of morbidity, are globally prevalent and considered a major public health problem in developing countries. Young children living in abject poverty are the most vulnerable population to IPIs and require additional care. The current literature is not clear regarding the impact of various socio demo graphic factors with IPIs and there is a need of studies with reference to Pakistan for evidence based policy formulation. A cross sectional survey was conducted to estimate the prevalence and to identify the factors associated with IPIs among children aged 1 to 5 years in an urban slum of Karachi. The study used simple random sampling strategy in which the sampling frame was generated through a preliminary census type survey of the study area. A structured pre-tested questionnaire, anthropometry measuring tools and stool test were used to obtain data for the study. Data were analyzed using appropriate descriptive analysis and univariate and multivariable logistic regression analysis methods. The study included information on 350 children and stool sample examination on 218 children constituting a response rate of 62.3%. The respondent and non-respondent populations were comparable. The mean age of the children was 33.9 months and about 53% of the children were male. The proportions of wasted, stunted and underweight children were 10.4%, 58.9% and 32.7%. This study estimated that every second child is infected with intestinal parasites (IPs) (Prevalence = 52.8%; 95% CI: 49.5; 56.1). Giardia lamblia was the most common IP followed by Ascaris lumbricoides, Blastocystis hominis, Hymenolepis nana, Endolimax nana, Entamoeba colt and lodoamoeba butschlii. About 42% children were infected with single IP and 10% with multiple IPs. With each year increase in age the adjusted odds ratio of IPIs increased by 1.5 times (95% CI: 1.1; 1.9). Children living in rented households were more likely to be infected with IPs as compared to children living in their own households (AOR = 2.0; 95% CI: 1.0; 3.9). Children with a history of excessive crying were also more likely to be infected with IPs (AOR = 1.9; 95% CI: 1.0; 3.4). Past month history of diarrhea and latrine care of the child were confounders and were therefore adjusted in the multivariable analysis. Poverty was highlighted as an important factor associated with IPIs. Prospective and intervention studies are required for evidence based policy formulation. There is a need for mass scale campaigns to create awareness about health and hygiene. Effective poverty reduction programmes and promotion of mass scale deworming campaigns could change the situation. Deworrning should also be focused on pre-school children due to the huge burden of disease.
Mehraj, V. (2006). Prevalence of and factors associated with intestinal parasites among children from 1 to 5 years of age in an urban slum of Karachi (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.