ABSTRACT
Background: Enterobiasis (pin worm infection) is caused by Enterobius vermicularis (E. vermicularis). According to World Health Organization, over a billion people are infected worldwide. A cross-sectional study was carried out to determine the prevalence and factors associated with the transmission of E. vermicularis infection in children from a poor urban community in Sri Lanka. Methods: This study was conducted in the Hantana Tea Estate (HTE) in Kandy district of Sri Lanka. A cross-sectional study was conducted from September to December 2013. After obtaining informed consent, data (socio economic data, educational level, deworming history, conditions and availability of the sanitary and housing facilities) were collected using an interviewer administered questionnaire. Clean rectangular (2x3 cm) transparent adhesive cellulose tapes (scotch tape) were distributed among all participants to collect samples. Results: Out of the 204 children 65 (31.9%) were positive for E. vermicularis eggs. Children aged 1-3 years showed the highest prevalence rate (37.5%). The risk factors significantly associated with E. vermicularis infection were, a lack of parental knowledge about pinworm infection (p<0.001), hand washing only with water before a meal (p< 0.001) and after defecation (p<0.029) and de-worming period more than three months (p<0.001). Age, sex, family clusters, sucking fingers, toilet facilities and socioeconomic status were not found to be significantly associated with the infection (p>0.05). Conclusion: This study showed a high prevalence of enterobiasis in children in Hantana Tea Estate indicating a high level of transmission. A lack of parental knowledge and poor personal hygiene were significantly associated with the transmission of E. vermicularis. Furthermore, the present study recommends mass medication of residents and their contacts to reduce the transmission of pin worm infection could be suggested. Further, it seems that singledose treatment may not be effective against enterobiasis. Therefore, treatment should be repeated 2 to 3 times at 3 weeks intervals.
ABSTRACT
A seroepidemiology study using TES-ELISA was carried out in 1,020 children aged 1-12 years in the Hindagala Community Health Project, Sri Lanka. Toxocariasis seroprevalence was 43% with 16.6% showing high antibody levels. Unconditional logistic regression analysis showed 7-9 year olds to be at the highest risk (OR 3.0820; CI = 1.95-4.87). Dog ownership, especially puppies (OR 29.28; CI = 7.40-116.0), and geophagia-pica (OR 6.3732; CI = 3.87-10.50), were significant risk factors. Family clustering of toxocariasis was significant (chi2 = 88.000; p = 0.0001). Abdominal pain (45%), cough (30%), limb pain (23%) and skin rashes (20%) were significantly associated with seropositivity indicating that toxocariasis causes covert morbidity. These findings are, overall, applicable to other areas in Sri Lanka. However, in the dry zone, survival of infective eggs in the soil could be affected by the climate while more importantly, in agricultural areas with a high buffalo population, Toxocara vitulorum could account for human toxocariasis. Using a species specific double sandwich ELISA based on 57 kDa protein of T. canis ES antigen, it is demonstrated that 91% of the seropositives were due to T. canis. Thus along with rabies and dirofilariasis, toxocariasis is an important zoonotic health hazard from dogs in Sri Lanka and prevention is indicated.