Socioeconomic and behavioral factors affecting the prevalence of geohelminths in preschool children.

The aim of this study was to examine the relationship between the prevalence of geohelminth infections in preschool children living in an urban slum area in Sri Lanka and parental education, socioeconomic status, the use of anthelmintics, and beliefs regarding these helminths. Between October 1992 and February 1993, stool samples were collected from preschool children (< or = 60 months of age) in the Mahaiyyawa area, Kandy, Sri Lanka, and examined using direct smears and a concentration technique. Stool samples which were found to be positive for helminth ova were also examined using the modified Kato-Katz technique. A pretested questionnaire was administered to the mothers or principal caretakers of the children from whom stool samples were obtained to assess parental education, socioeconomic status of the family and knowledge, attitudes and practices related to intestinal parasites, particularly geohelminths. Stool samples from 307 children were examined; 81 (26.4%) were positive for geohelminth ova. Roundworm infections predominated, and were seen in 73 of the 81 (90.1%), either alone or together with whipworm and/ or hookworm infections. All infections were of mild to moderate intensity. Questionnaires were administered to the mothers/principal caretakers of 208 children. Mothers/caretakers of 91 children (45%) claimed that the child was on regular anthelmintics. As the educational level of the mother/caretaker improved, the prevalence of geohelminth infections in the children declined (chi-square for linear trend = 8.19, p = 0.004). However, there was no significant correlation between prevalence of infections and paternal educational levels. Prevalence also tended to increase as the socioeconomic class declined (chi-square for linear trend = 4.899, p = 0.026). Another finding of note in this study was the widespread ignorance and misconceptions regarding geohelminth infections among carers.

Intestinal parasitoses in the Kandy area, Sri Lanka.

The prevalence of intestinal protozoa and geohelminths was assessed among two diverse populations in the Kandy area: adults attending medical outpatients clinics at the Teaching Hospital Peradeniya, and pre-school children in low-cost housing areas within the Kandy Municipality. In addition to a brief history and examination, a fresh stool sample was obtained and examined by direct smears in saline and iodine, and by formol-ether concentration. The children's stool samples were also examined for Cryptosporidium by cold Ziehl-Neelsen staining. A total of 192 stool samples from the adult outpatients (101 males, age range 15-82 years, mean 51.4 years) and 354 samples from the pre-school children (age range 1-72 months, mean 30 months) were examined. Entamoeba histolytica was not seen in any of the samples; Giardia cysts and Cryptosporidium oocysts were seen in three and one sample respectively from the pre-school children. The overall prevalence of geohelminth infections was 21.3% among the adults and 24.5% among the children. Ascaris lumbricoides was the predominant species in both populations. Comparison of the rate of intestinal parasite infection among 37 adult patients patients with non-specific abdominal complaints, with the rate among 37 matched controls with no abdominal complaints showed no significant difference (16% and 19% respectively). This suggests that the presence of abdominal pain or diarrhea was unrelated to the presence of intestinal parasites in the adult study population. Although the techniques used were not highly sensitive, the absence of E. histolytic probably reflects a true decline in the prevalence of this parasite in Sri Lanka.(ABSTRACT TRUNCATED AT 250 WORDS)