Prevalence and associated risk factors of Entamoeba histolytica infection among school children from three primary schools in Arsi Town, West Zone, Ethiopia

Abstract

Entamoeba histolytica is one of the major pathogenic intestinal parasites and is amongst the leading causes of diarrheal illness in children. Around 500 million people are infected worldwide, while 75,000 die of the disease annually. E. histolytica is associated with moderate to severe diarrhoea and increased mortality among children in African countries and negatively affects child growth and development. Malnutrition is also an important contributor to the prevalence of E. histolytica in Ethiopia. It is mostly associated with poor hygiene, poverty, illiteracy, lack of access to potable water, and a hot, humid tropical climate. Thus, the present investigation was aimed to assess the prevalence rate and associated factors of E. histolytica among schoolchildren in Arsi Town, West Zone, Oromia Regional State, Ethiopia. A cross-sectional study was conducted from February 1st to May 1st, 2020. A total number of 334 students were selected from three governmental elementary schools in the west zone using a systematic sampling method. A structured questionnaire was adopted to identify environmental, socio-demographic, and behavioral factors. Microscopically positive samples for E. histolytica cysts were further characterised using an E. histolytica II antigen detection kit. The statistical analysis of the data was done using SPSS software. A univariate and multivariate logistic regression analysis was done. P value < 0.05 was considered statistically significant. The overall prevalence of E. histolytica was 19.8%. Hand washing habits before eating [AOR = 0.32; 95% CI (0.12, 0.84)], hand washing habits after defecation [AOR = 0.396; 95% CI (0.165, 0.946)], and ameba awareness [AOR = 0.35; 95% CI (0.142, 0.889)] were factors associated with parasite prevalence. The findings of this study could assist the government in targeting infected areas, improving sanitation to prevent E. histolytica transmission, and implementing effective control measures in these rural communities, particularly among youngsters, who represent the nation's future.

Keywords: Antigen detection test; Entameba histolytica; Ethiopia; Microscopy; School children.

Fig. 1

Morphology of the diagnostic stage of Entameba histolytica, cyst