Nutritional Status, Intestinal Parasite Infection and their Associated Factors among Schoolchildren in Arba Minch Town, Southern Ethiopia

Abstract

Background: Malnutrition and intestinal parasitic infections are major public health problems for children in developing countries, with negative implications for child survival, growth and development. However, little is known about the health and nutritional status of Ethiopian schoolchildren. Moreover, to the best of our knowledge until now no separate prior studies have been conducted to elucidate nutritional status, intestinal parasite infection and their predictors in schoolchildren in the study area. Objectives: To determine the prevalence and associated factors of undernutrition and intestinal parasitic infections among schoolchildren in Arba Minch town. Methods: Cross-sectional study was employed to assess nutritional status and IPIs among 532 students in primary schools of Arba Minch town in March and April 2014. A two-stage sampling procedure was applied, where in the first-stage, PPS sampling to select study schools, followed by SRS to select study subjects. Background characteristics were collected using a structured questionnaire by interviewing parents. Household food insecurity and child dietary diversity were measured as FAO/FANTA guidelines. Anthropometric measurements were made according to WHO standardized procedure. Parasitological examinations were performed according to the WHO Bench aids. Multivariable logistic regression analysis was employed for determining the relative contribution of each independent variable to a single outcome. Results: The prevalence rates of stunting, thinness and underweight were 26.0 % (95%CI: 22.2, 29.8%), 19.9% (95%CI: 14.1, 25.7%) and 11.7% (95%CI: 8.9, 14.5%), respectively. Low level of maternal education [AOR (95%CI): 4.4(1.7, 11.3)], polyparasitism [AOR (95%CI): 5.1(1.6, 15.7)], and intensity of STH infection [AOR (95%CI): 0.01(0.001, 0.09)] were independent factors associated with stunting, whereas polyparasitism[AOR(95%CI):3.6(1.21,10.8)], Amoebiasis[AOR(95%CI):7.3(1.8,30.8)], Giardiasis[AOR(95%CI):4.3(1.2,15.1)],and reported illness in the last two weeks[AOR(95%CI):2.9(1.04,7.9)] were significantly associated with thinness. Polyparasitism [AOR (95%CI):8.8(2.6, 29.6)], reported illness in the last two weeks [AOR (95%CI):7.6(2.2, 26.1)], household food insecurity [AOR (95%CI):3.5(1.03, 11.6)] and maternal unemployment [AOR (95%CI):5.6(1.4, 22.1)] were associated with being underweight. While the prevalence of intestinal parasite infection was 55.8% (95%CI: 51.5, 60.1%). The prevalence of any STH (Path) was 62.96%, and 47% were moderate-to-heavy intensity. Low household wealth [AOR (95%CI):2.4(1.2,4.7)], maternal unemployment [AOR (95%CI): 2.4(1.2,4.7)], low child dietary diversity [AOR (95%CI):10.1(5.5,18.5)], never hand washing with soap after defecation [AOR (95%CI): 17.6 (7.2, 43.2)],less frequent use of footwear[AOR(95%CI): 4.2 (1.8, 9.5)] and open field garbage disposal [AOR (95%CI):3.7(1.4,9.5)]were significantly associated with intestinal parasites. Conclusions and Recommendations: According to the findings of this study, undernutrition was highly prevalent in the in the study area where intestinal parasites are highly prevalent. Low child dietary diversity, low household wealth, household food insecurity, intestinal parasites, illness in the last two weeks, open field garbage disposal, low level maternal education and maternal unemployment were independent factors associated with undernutrition. While low child dietary diversity, poor hand washing after defecation, less frequent use of footwear, low household wealth and maternal unemployment were independent factors associated with intestinal parasite infections. Due to the interrelation between many of these health and nutrition problems, effective health and nutrition interventions that require a multi- disciplinary approach such as periodic de-worming, improving sanitation and hygiene, women empowerment, addressing household food insecurity and improving dietary diversity at both the school and community based should be scaled-up to curb undernutrition.