. 245.12 -aphical Medicine 129 QC pp ———————•"-——" " " - ~~~- -• ——————- — — ————~— —— .- -.—— _,--.————.——_————————•—————————————————— MCE OF INTESTINAL PARASITES IN TWO INSHASA (ZAIRE THEID AN ) R RELATIOO NT TER SUPPLIES B. GRYSEEl.S d P.L*an . GIGASE" •Mission d'Assainisscmcnl dc la Plainc dc la Ru/.i/i (MAPR). B.P. 337. Bujumbura. Burundi. (Formerly Laboratory of Parasiiolog\. UNAZA. Kinshasa. Zaire): "Laboratory of Hisiopaihology and Experimen- tal Schistosomiasis. Institute of Tropical Medicine. Nationalesiraai 155. Antwerp. Belgium. Received Augus . 198I t 3 Accepte r publicatiofo d n Ociobc . 19810 r 4 Abstract. The prevalence of common intestinal nematodes (Ascaris, Trichuris and hookworms protozod an ) a (Entamoeba coli, . hisiolytica,E Giardia, Trichomonas) was compared in two suburbs of Kinshasa, one provided with piped water and the othe e witon r h wells t latrinePi . s were use botn di h places significano N . t differences were observed for the worms, but the prevalence of the four common protozoa was approximately twic e communits higth a e n i h y without piped water supply. s i It concluded that providing piped wate s somha r e impactransmissioe th n o t f potenno - tially pathogenic intestinal protozoa o influencen t bu ,shore t th leasa , tn o trun n o . intestinal worms. Infections with Giardiaand Trichonionas were significantly associa- ted. Key \\-ords: intestinal parasite; domestic water supply; Zaire Introduction ^ At the Laboratory for Parasitology of the University of Kinshasa we had observed a high numbe f caseo r f intestinao s l amoebiasi d giardiasian s n peoplesi , e livinth n gi nearby district of Makala. Piped water not beingavailablein this area, we thought that the use of well water might play a role in the local transmission of intestinal protozoa. We compared the prevalence of intestinal parasites in Makala with those in Ngaba, an adjacent and comparable district where piped water was available. Though more profound studie c requirear s o providt d ewater-borne prooth f o f e characte f parasiteso r resulte th , f thiso s small-scale survey seemed interesting enough o reportt . Population and methods Makal d Ngab an aurbac ar a n district southere th n si n outskirt f Kinshasao s , separate tarmaa y db c road. Bot e inhabitear h immigranty db s from nearby rural provinces e socio-economiTh . c statu d hygienisan c standards of both populations are comparable low. Families of 5 to 20 live in small houses surrounded by a yard whicn i , generan hi t latrinpi a l presents ei . Sewage system e nosar t available. Piped wate availabls i r en i Ngaba since several yearsMakaln i t bu , a this provisio t exis no t th a td estudye ndi tim th e inhabitant f eo Th . s draw water fro m5 deem± p wells, presen mosn i t tyards e ofth . This wate generalls i r ybecomn clearca t bu , e turbid after heavy rains. The survey was carried out in August- September 198 I at the end of the dry season. The two suburbs were surveye immediatn i d e succession. Three avenues were selecte boin di h suburbs; the study areas situatee ar d • : <V Trap, geogr. Med., 3 . GryseelB d P.Lan s . Gigase 130 t lesa s than ondistancem ek l residenAl . t families e agreebuon t participato dt thn ei e study Makaln I . 0 22 a people were examined against 14 n Ngaba6i . Abou 0 fres3 t h stool samples were collected each mornin d ai gan onc e transporte o tht d e nearby laboratory. Duplicata direct smears were immediaiely performe n eaco d h sample e stoolTh . s were then concentrate d examinean d d followin e formol-etheth g r method. People examined were subdivide dpreschoon i accordin e ag d l an childre gx tose n (0-6). school children (7-18) and adults (over 18 years) (Table I). Results e resultTh f tho s e surve presentee yar thre e th r e commodfo n nematode foue th rd san most common protozoa (Table /). For Giardialamblia, Entamoebahisfolyticaand E. coli, infections with trophozoi'tes and/or cyst consideree sar d together. Egg f hookso - t specificallwormno e sar y designate bots da h Ankylostomaand Necatorare presenn i t Kinshasa [1]. Among other parasites observed, Sirongylo'idesstercoraliswas present in six people (3%) examined in Makala and five (3%) in Ngaba. Schisiosomamansoni was found in e examineon d perso n Makali n d fou an n Ngabaai r l bee. al The nd stayinha y n i g known endemic area a recen n i s t past. Endollmax nana s foun wa sever n i d , persons (3% n Makali ) d fifteean a n (7% n Ngabai ) . Chilomastix mesnili s founwa d twicn i e Ngab d lodamoebaan a buetschlii s foun wa thren i d e sample eacn i s h suburbo N . Entamoeba hartmani were identified. s observewa It n Makali d f Trichomonaso a tha% 55 t hominis infections were associated with Giardia lamblia tota(21e th %ln i population) . Converselye th f o % 54 , Giardia carriers were associated with Trichomonas e tota(21th %n li population). In Makala 22 people produced liquid stool samples. Seven of them were positive for both Trichomonas and Giardia. No other correlation was found between the aspect of th e presenc stoolth d f an sparasites o e . Discussion Day to day variability in the excretion of intestinal parasites is admittedly great. Furthermore, important monthly fluctuations have been observed [2]. In the present survey onle sampl on ys examine o attempwa en s d madan wa dt longitudinaa e l follow-up. Conclusions should therefore be careful and limited to the most salient points. e generaTh l prevalenc f intestinaeo l nematode abous si same th t botn ei h districts with the exception of Trichuris which is 50% more common in Ngaba. Our figures for nematode e mucar s h lower than those recorde othen di r suburb f Kinshasaso , e.gn i . N'Djili [3] and in Bandalungwa [4]. The prevalence of the four most common species of intestinal protozoa is, contrary to that of nematodes, about twice as high in Makala as in Ngaba in all cases. There is a close correlatio e presencth n i nd prevalenc an e f Trichomonaseo d Giardia.an r Fo both specie e differenceth s prevalencn i s e betwee districte nth s essentialli s o t e ydu lower figure children i s d womean n n Ngabai n , suggestin a gdomesti c sourcf o e infection. This feature is less obvious for both Eniamoeba species. In Lagos (Nigeria), Oyerinde [5] found figures for E. histolytica and G. intestinalis which are near to those observed in Ngaba, but the prevalence of lodamoeba buets- chlii, uncommon a n parasit Kinshasan ei mucs wa , h highe Lago n ri 9,6%= = M s( F ; 14,7%). Another study by Oyerinde [2] reports observations on Entamoeba histolytica n V: 5' OJ Table 1. Prevalence (% )f selecteo d intestinal parasites in districts Makaba [ Ma] and Ngaba [Ngn i ] Kinshasha -o ————————— — i Siuti\ A scar is Trichiiris Hook H'nrni Trichunwnus (jianlia A;. (•<»// L'. Hismlviica •£. l'<>l>ulatiun o c/i Age group Ma Ng Ma Ng Ma A* Ma Ng Ma NX Ma NX Ma Ng Ma NK =_ (in years) a. o B Men < 7 29 29 35 45 43 72 17 14 17 0 24 7 24 21 7 14 r. r> 7-18 27 18 70 61 41 72 49 22 II II 22 17 44 II 15 6 > 18 35 15 54 40 49 33 20 7 14 20 11 20 37 27 7 17 w Total 91 62 53 48 46 63 27 15 14 8 19 13 35 19 13 10 g 73 Women "H. < 7 37 28 43 50 31 71 14 18 30 14 38 18 24 0 16 7 S!' 7-18 41 30 56 77 54 60 15 20 39 0 34 1 3 46 23 39 7 ^ > 18 51 26 55 46 39 58 12 15 14 4 6 0 47 38 14 19 5" Total 129 84 52 58 42 63 13 18 26 6 24 II | 40 2 0 I I 22 N Population CO 24 7 24 11 < 7 66 57 39 47 39 72 15 16 32 12 I I 12 =!' n 7-18 68 48 62 71 49 65 28 21 28 4 29 15 46 19 28 6 > 18 86 41 55 44 43 49 15 12 14 10 8 7 43 34 15 15 Total 220 146 52 54 44 63 19 16 21 7 21 12 38 20 19 10 . GryseelB d P.Lan s . Gigasej 132 only in Lagos. The prevalence of the infection in people who had water from wells at their disposa s 23.4wa l % whil t amountei e o 10.dt 6- 12.4 %peopln i e obtaining their water from taps. Prevalence figures were highest in the wet season, givingcrcdit to the hypothesis thae higheth t r prevalenc contaminatioo t well-usern i ee du s e wa s th f no water throug t e latrinesproximitpi th h e th .f o y The results of our study also suggest that the well water used in Makala can play an important role in the transmission of intestinal protozoa as Trictwnionax hominis. Giardia lamblia, Eniamoeba iiistolyiica and E. coli. The availability of piped water in Ngaba is the only apparent factor which might explain the lower prevalence of intestinal proto/oa in this district as compared to Makala.