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JOINT MPH PROGRAM ADDIS CONTINENTAL INSTITUTE of PUBLIC HEALTH and UNIVERSITY of GONDAR View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by National Academic Repository of Ethiopia JOINT MPH PROGRAM ADDIS CONTINENTAL INSTITUTE OF PUBLIC HEALTH AND UNIVERSITY of GONDAR Prevalence and risk factors of intestinal parasites among Delgi elementary and junior secondary school students Delgi; North Gondar administrative zone By: Asrat Ayalew Advisor: Alemayehu Worku (PHD) A thesis submitted Addis continental institute of public health and University of Gondar in partial fulfillment of the requirements for the degree of master in public health. December, 2010 JOINT MPH PROGRAM ADDIS CONTINENTAL INSTITUTE OF PUBLIC HEALTH AND UNIVERSITY of GONDAR Prevalence and risk factors of intestinal parasites among Delgi elementary and junior secondary school students Delgi; North Gondar administrative zone By: Asrat Ayalew Addis continental institute of public health and University of Gondar Approved by the Examining Board ______________________________ ___________________________ Chair man, Dep. Graduate Committee ________________________________ ____________________________ Advisor ________________________________ ____________________________ Examiner ________________________________ ____________________________ Examiner ADDIS CONTINENTAL INSTITUTE OF PUBLIC HEALTH PREVALENCE AND RISK FACTORS OF INTESTINAL PARASITES AMONG DELGI ELEMENTARY AND JUNIOR SECONDARY SCHOOL STUDENTS DELGI; NORTH GONDAR ADMINISTRATIVE ZONE By: Asrat Ayalew Advisor: Alemayehu Worku (PHD) DEDICATION To my mother, the late Alem Worku Engida, who selflessly dedicated her whole life to the educational betterment of her children; Tayemye you are always in my hallucination. May God rest your soul in Heaven!! Acknowledgements I would like to extend my earnest gratitude to my advisor, Dr.Alemayehu Worku and Kidist Negash for their unreserved support and encouragement during development of proposal, data collection and finalizing the thesis. Amahra regional Health Bureau is duly acknowledged for Supporting Drugs for the treatment of intestinal parasite infected children. My sincere thanks go to Ato Belete Fentaye Takusa woreda Health office head, for his sincere collaboration in facilitating the field work. I would like to express my heartfelt gratitude to Delgi school community staffs and Delgi Health center staffs for their enthusiastic cooperation, Particularly to Ato Omer Yeshaw Delgi health center head for his technical and laboratory material support and Laboratory staffs Ato Fekade Assefa and W/t Tigist Alem for their Technical support during data collection. I would like to express my heartfelt gratitude to ACIPH and University of Gondar who gave a chance to conduct my research on this topic. I would like to extend thanks to all of my friends and family for their support in my academic life. Last but not least thanks go to Sr.Meseret Getahun for her support in my social and educational life. I Acronyms ACIPH: Addis Continental Institute of Public Health CI: Confidence Interval OR: Odds Ratio SOP: Standard Operating Procedure UoG: University of Gondar WHO: World Health Organization II CONTENT PAGE Acknowledgment…………………………………………………………………..........................I Acronyms ………………………………………………………………………………………...II Table of contents ………………………………………………………………………………...IV List of tables ………………………………………………………………….…………………..V List of figures…............................................................................................................................VI Abstract…………………………………………………………………………………………VII 1.0. Introduction……………………………………………………………….…………..............1 1.2. Significance of the study…………………………………………………………...................2 2.0. Literature review ……………………………………………………………………………..3 2.1. Global burden of intestinal parasites…………………………………….................................3 2.2. Prevalence of intestinal parasites in Ethiopia…………………………….………………...5 2.3. Factors associated with intestinal parasite infection……………………….…........................7 3.0. Objectives…………………………………………………………………….........................8 3. 1. General objective…………………………….........................................................................8 3.2. Specific objectives………………………………………………………………….…...........8 4.0. Methodology…………………………………. …………………………….…......................9 4.1. Study setting…………………………………………………….............................................9 4.2. Study design …………………………………………………….............................................9 4.3. Source and study population ........................................................................................…........9 4.3.1. Source of population ……………………………………………………….........................9 4.3.2 Study population…………………………………………………………….........................9 4.3.2.1. Inclusion criteria……………………………………………………………….................9 4.3.2.2. Exclusion criteria…………………………………………………………………………9 4.4. Sample size and sampling procedure…………………………..............................................10 4.4.1. Sample size………………………………………………………………………………..10 4.4.2. Sampling procedures ……………………………………………………………………...11 4.5. Study Variables…………………………………………………………….…......................12 4.5.1. In dependent variable …………………………………………………….……….............12 4.5.2. Dependent variable………………………………………………………………………..12 III 4.6. Data collection procedure and specimen analysis……………………………......................12 4.7. Quality control………………………………………………………………………………13 4.8.Operational definition………………………………………………………………………..14 4.9. Data management………………………………………………….………………………...15 4.10. Data analysis procedures…………………………………………….……………………..15 4.11. Ethical considerations……………………………………………….……………………..15 4.12. Dissemination of Findings…………………………………………………………………15 5.0. Results………………………………………………………………………………….........16 5.1. Socio-demographic description of the study subjects……………………………………….16 5.2. Prevalence of intestinal parasite……………………………………………………………..17 5.3. Factors associated with intestinal parasite infection…………………………………...........19 6.0. Discussion …………………….……………………………………………….……………22 7.0. Strengths and limitations of the study...................................………………………………..25 8.0. Conclusions and recommendations….………………………………………………………26 9.0. Reference…............................................................................................................................27 10.0. Annex…………………………………………………………………………....................30 Annex I Conceptual framework………………………………………………………………….30 Annex II Questionnaire English and Amharic version…………………………………………..31 Annex III Consent form English and Amharic version…………….……………........................36 Annex IV Standard Operating Procedure (SOP) for stool exam………………………...............37 IV LIST OF TABLES Table 1: Socio demographic characteristics among Delgi Elementary and junior secondary school children, Sept.2010 Table2: Prevalence of Single and mixed intestinal parasite infection among Delgi Elementary and junior secondary school children, Sept.2010 Table3: Prevalence and species of most frequent IPs in single and mixed infections among Delgi Elementary and junior secondary school children, Sept.2010 Table4: Bivariate logistic regression analysis for factors potentially associated with Intestinal parasite infection among Delgi Elementary and junior secondary school children Sep.2010 Table 5.Bivariate and multivariate logistic regression analysis for factors potentially associated with Intestinal parasite infection among Delgi Elementary and junior secondary school children Sep.2010 V LIST OF FIGURES Figure1. Graphical presentation of sampling procedures in Delgi Elementary and junior secondary school children, Sept.2010 Figur2: Prevalence of each intestinal parasite based on wet mount and formol -ether concentration technique among Delgi Elementary and junior secondary school children, Sept.2010 VI ABSTRACT Epidemiological information on the prevalence of various intestinal parasitic infections and identification of local risk factors in different regions/localities is a prerequisite to develop appropriate control strategies, particularly among high-risk groups. Objective: the aim of this study was to determine the prevalence of intestinal parasites and associated risk factors among school children in Delgi elementary and junior secondary school in North Gondar administrative zone. Methods: A cross sectional parasitological study involving 704 school children was conducted from Sept.27-oct.6, 2010. Structured questionnaire were used to identify the risk factors. Stool specimens were examined using direct smear and formal -ether concentration technique. Finally Data entry and analysis was done using Epi-info and SPSS statistical soft ware respectively. Results: Ten species of intestinal parasites were identified with an overall prevalence of 79.8% (562 of 704 children).The predominant parasites involved were A. lumbricoides 338 (48%), G.lambilia 295 (41.9%) and E.histolytica/dispar 192(27.3%). The prevalence of A. lumbricoides was the highest compared with other parasite species. Of the total positive individuals 96(13.6%) single infection and 466(66.2%) were mixed infection, from this mixed infection the majority of the students had double infection309 (43.9%).The highest prevalent parasitic species among single and mixed infections were G.lamblia (6.3%) and A.lumbricoids and G.lambilia (14.1%) respectively. In this study intestinal parasite infection was not statistically associated with Age, sex, residence, availability and usage of latrines (p>0.05). On the other hand ,a statistical
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