Epidemiology of Soil-Transmitted Helminth and Intestinal Protozoan Infections in Preschool-Aged Children in the Amhara Region of Ethiopia

Kristen Aiemjoy Proctor Foundation, University of California San Francisco, San Francisco, California.

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Sintayehu Gebresillasie The Carter Center, Atlanta, Georgia.

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Nicole E. Stoller Proctor Foundation, University of California San Francisco, San Francisco, California.

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Ayalew Shiferaw The Carter Center, Atlanta, Georgia.

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Zerihun Tadesse The Carter Center, Atlanta, Georgia.

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Melsew Chanyalew Amhara Regional Health Bureau, Bahir-Dar, Ethiopia.

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Solomon Aragie The Carter Center, Atlanta, Georgia.

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Kelly Callahan The Carter Center, Atlanta, Georgia.

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Jeremy D. Keenan Proctor Foundation, University of California San Francisco, San Francisco, California.

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Intestinal parasites are important contributors to global morbidity and mortality and are the second most common cause of outpatient morbidity in Ethiopia. This cross-sectional survey describes the prevalence of soil-transmitted helminths and intestinal protozoa in preschool children 0–5 years of age in seven communities in the Amhara region of Ethiopia, and investigates associations between infection, household water and sanitation characteristics, and child growth. Stool samples were collected from children 0–5 years of age, 1 g of sample was preserved in sodium acetate–acetic acid–formalin, and examined for intestinal helminth eggs and protozoa cysts ether-concentration method. A total of 212 samples were collected from 255 randomly selected children. The prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm were 10.8% (95% confidence interval [CI] 6.6–15.1), 1.4% (95% CI = 0–3.0), and 0% (95% CI = 0–1.7), respectively. The prevalence of the pathogenic intestinal protozoa Giardia lamblia and Entamoeba histolytica/dispar were 10.4% (95% CI = 6.2–14.6) and 3.3% (95% CI = 0.09–5.7), respectively. Children with A. lumbricoides infections had lower height-for-age z-scores compared with those without, but were not more likely to have stunting. Compared with those without G. lamblia, children with G. lamblia infections had lower weight-for-age and weight-for-height z-scores and were more than five times as likely to meet the z-score definition for wasting (prevalence ratio = 5.42, 95% CI = 2.97–9.89). This article adds to a growing body of research on child growth and intestinal parasitic infections and has implications for their treatment and prevention in preschool-aged children.

Author Notes

* Address correspondence to Kristen Aiemjoy, Proctor Foundation, University of California San Francisco, 513 Parnassus Avenue, MedSci S309, Box 0412, San Francisco, CA 94143. E-mail: kristen.aiemjoy@ucsf.edu

Financial support: This study was supported by the National Institutes of Health—National Eye Institute (U10 EY016214), That Man May See, and the Sara and Evan Williams Foundation (San Francisco, CA).

Authors' addresses: Kristen Aiemjoy, Nicole E. Stoller, and Jeremy D. Keenan, Proctor Foundation, University of California San Francisco, San Francisco, CA, E-mails: kristen.aiemjoy@ucsf.edu, nicole.stoller@ucsf.edu, and jeremy.keenan@ucsf.edu. Sintayehu Gebresillasie, Ayalew Shiferaw, Zerihun Tadesse, Solomon Aragie, and Kelly Callahan, The Carter Center, Atlanta, GA, E-mails: sintayehugs@gmail.com, ayalewsisu2003@gmail.com, zerihun.tadesse@cartercenter.org, solomon.aragie@cartercenter.org, and kelly.callahan@cartercenter.org. Melsew Chanyalew, Amhara Regional Health Bureau, Bahir-Dar, Ethiopia, E-mail: yeshiwork97@yahoo.com.

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