Gastro-intestinal parasites are micro-organisms that live in the intestine, where they may cause problems or can live for long periods in the bowel without causing any symptoms that may require treatment [1]. Intestinal parasitic infections have been reported to have high prevalence among children in Nigeria because of their vulnerability [2-4]. The high prevalence in children is attributed to many factors, especially the social and economic condition of the individuals, which is the important cause of the prevalence of intestinal parasites, in addition to environmental, poor sanitary and personal hygiene [5]. Gastro-intestinal parasites cause a lot of problem all over the world; but it is more pronounced in areas where these infections are endemic [6]. Intestinal parasitic infections have continued to pose serious medical and public health problems in developing countries [7]. Intestinal parasitic infections can cause ill effects mostly in children some of which include trauma, nutrition robbing and poisoning [8], change in resistance and immune impotence [9]. Estimates show that about 3.5 billion people are affected with intestinal parasites, 450 million are ill, majority of which are children. Also, estimates report that Ascaris lumbricoides can infect over a billion, Trichuris trichuria 795 million, and hookworms 740 million people [10]. The World Health Organization (WHO) estimates that approximately 50 million people worldwide suffer from invasive amoebic infection each year, resulting in 40 – 100 thousand deaths annually [11]. The aim of this study was to find out the current status of gastro-intestinal parasites in some selected schools in Delta State; and also, to find out the correlation between gastro-intestinal parasitic infections and some associated local risk factors among the school children in the study area.

Study Area

This study was conducted in Amai, Ukwuani Local Government Area in Delta State, Nigeria from October 2017 to February 2018. The inhabitants of Amai like most other rural communities in Delta State engage in farming activities. The produce is consumed by the farmers while the excess are sold to traders who come from nearby towns such as Warri.

Study Population

Five schools were selected for the study. These schools include Ododo Primary School, Igwete Primary School, Nge Primary School, Ekum Primary School and Umubu Primary School. Approval was obtained from the head teacher of each of the schools and the parents / legal guardians of the pupils were informed. A total of 244 pupils took part in the study.

Sample Collection

Permission for the study was obtained from heads of the primary schools as well as the parent/ legal guardians of the pupils who enrolled for the study. The class teachers assisted in the distribution of sample bottles with identification tags to the pupils. The pupils were instructed on how to collect the samples (that is, put a small portion of early morning stool sample in the bottle using a spatula attached to the sample bottle and bring it to the school) [12]. Stool samples were preserved in 10% formalin solution and transported to the laboratory for parasitological examination. A structured questionnaire was used to collect socio-demographic and socio-economic data of the study subjects.

Parasitological Examination

In the laboratory, the fecal samples collected were examined for ova, cysts and/ or larvae of gastro-intestinal parasites. The direct wet mount microscopic examination and the formol-ether concentration technique were carried out as described by [13]. 

Overall prevalence of gastro-intestinal parasites recovered was 22.13% (Table 1). Parasites identified in the study were Ascaris lumbricoides 58.12%, hookworm 20.27%, Strongyloides stercoralis 1.35%, Taenia species 5.41%, Schistosoma mansoni 2.70%, Entamoeba histolytica/ dispir 6.76% and Giardia lamblia 5.41% (Table 2). The overall distribution of gastro-intestinal parasites among primary schools showed that pupils from Ododo Primary School had the highest infection rate (33.61%) while those from Igwete Primary School had the least infection rate (4.00%). The differences in the schools were statistically significant (p < 0.05). The males were slightly more infected (22.90%) than the females (21.24%). The age specific infection rate of gastro-intestinal parasites showed that pupils within the age group 5 - 7 years (25.93%) experienced more infections. Pupils who had body weight of 19kg and below were more infected (24.59%).  The occupation of the parents showed that pupils whose parents were farmers were the most infected (23.02%).  Family type specific infection rate showed that pupils from polygamous homes were more infected (25.00%) (Table 111). No infection was observed in pupils who drank water from the stream and sachet water while the highest infection rate (32.63%) was observed in pupils who drank water from the well. The difference in the source of drinking water at home was statistically significant (p < 0.05). Pupils who drank unboiled water had the highest infection rate (23.16%) while pupils who drank boiled water had the least infection rate (16.00%). Those who lacked a toilet facility at home had more infection (30.08%) than those who had toilet facility at home (12.61%). The differences in the availability of toilet facility at home were statistically significant (p<0.05) (Table 3).

The highest infection (25.87%) was observed in pupils who bought food from vendors once in a while whereas the least infection (15.38%) was observed in pupils who do not buy food from vendors. The specific infection rate showed that those who go to farm had the highest infection rate (24.66%) while those who do not go to farm had the least infection rate (18.37%). Sanitation specific infection rate showed that the highest infection (33.33%) was observed in pupils who do not keep their homes clean and pupils who sometimes keep their homes clean while the least infection (20.19%) was observed in pupils who keep their homes clean. Pupils who play on barefoot had the highest infection rate (24.00%) while those who sometimes play on barefoot had the least infection rate (20.69%). Results showed that more infection (23.15%) was observed in pupils who had previous vomiting than (14.29%) infection rate observed in pupils who had no previous vomiting. The highest infection rate (22.51%) was recorded in pupils who had previous deworming while the least infection rate (15.38%) was observed in pupils who had no previous deworming. Pupils whose homes were not visited by government sanitary inspectors had the highest infection rate (22.38%) while those whose homes were visited by government sanitary inspectors had the least infection rate (21.78%) (Table 3).

Table 1: Characteristics of study population.

Table 2: Type of Gastro – intestinal parasite obtained.

Table 3: Prevalence of gastro-intestinal parasites and bivariate analysis of socio-demographic and behavioural factors associated with infestation.

The overall prevalence of gastro-intestinal parasites in the area was 22.13%. This is similar with the work of [12] who observed 27.66% among primary school children in Rivers State Nigeria. However, it disagreed with the work done by some researchers in other areas. For instance, [14] reported 30.70% among school children in Port-Harcourt, Rivers State Nigeria; [15] reported 15.70% among primary school children in Rivers State Nigeria; [16] reported 66.00% among primary school children in Kagarko Local Government Area, Kaduna State, Nigeria; while [17] reported a very high prevalence of 83.00% among school children in Etulo Benue State, Nigeria. The prevalence of gastro-intestinal parasitic infections varies from place to place in relation to the pattern of transmission of the disease [18]. The distribution of parasites according to gender showed that more males (53.69%) were infected than females (46.31%). This is in line with the work of [19] during an epidemiological study of gastro-intestinal helminthes among pupils in urban and sub-urban communities in Nigeria. This high prevalence associated with males may be because they are more often engaged in predisposing activities such as football, barefoot and playing in streams and ponds. The differences of the results between sexes were not statistically significant. The study also agreed with [20] who also reported that difference in prevalence values of intestinal helminthes parasites between sexes in Uga, Anambra State, Nigeria were not statistically significant. The study observed that Ododo primary school had the highest infection (33.61%) while Igwete primary school had the least infection (4.00%). Results showed that differences in prevalence of gastro–intestinal parasites according to the schools were statistically significant (p<0.05). These differences could be attributed to different predisposing factors in the schools and geographical locations where most of the studies were carried out. Toilets are inadequate in schools, and this is of epidemiological significance considering the number of hours pupils spend in school [21-24], reported fecal contamination of soil samples collected from school premises in Makurdi, India, Calabar and Zaria respectively. This indiscriminate contamination of the school compound encourages the transmission of diseases. Results of the study showed that Ascaris lumbricoides had the highest prevalence (58.12%) while Strongyloides stercoralis had the least prevalence (1.35%). The possible reason for the high prevalence of Ascaris could be their embryonated eggs that have a high capacity to withstand environmental extremes. Also, the eggs are coated with mucopolysaccharide that makes them adhesive to a variety of surfaces like vegetables, fruits, door handles and money [25]. Results showed that pupils whose source of water at home was well had the highest infection (32.63%) while those who drank stream water and sachet water had no infection. Difference in prevalence of gastro-intestinal parasites according to source of drinking water at home was statistically significant. High prevalence of intestinal parasitic infection is likely to occur in low socio–economic condition with inadequate water supply [26-28].

Results showed that pupils who lacked a toilet facility at home had more infection (30.08%) than those that had a toilet facility at home (12.61%). The difference in the availability of a toilet facility at home was statistically significant (p<0.05). It has been reported that poor sanitary disposal of feces is one of the conditions associated with high prevalence of intestinal parasitic infection [26, 27]. Epidemiology studies have shown that poor sanitary conditions such as defecation and fecal contamination of water bodies are the most important factors leading to intestinal worm infection [29]. Difference in prevalence of gastro intestinal parasites according to source of drinking water at home was statistically significant. The result of the study indicates that there is need for collaboration of school management, health officers and community leaders in gastro-intestinal parasite control.

The study has shown that gastro-intestinal parasites were present in stool samples of some pupils in some schools around Delta State. Therefore, there is need for collaboration of the school management, health officers and community leaders on gastro-intestinal parasite control to curb it present and future prevalence.

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