GULU UNIVERSITY MEDICAL JOURNAL

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Gulu University Medical Journal (GUMJ) 2009/2010 Vol 5. Abstract Helminth Infection in Gulu Municipality Sjoerd Redeker1; Peter Kizza2; Ambrose Katungi2; Julius Ocakacon2. 1 Leiden University Holland; 2 Gulu University Uganda Introduction: Knowledge of the presence, the distribution and the intensity of helminth infections, is needed at different levels. At the National level, it is a prerequisite for the planning of prevention and control strategies. At the hospital level or at the local level in general, it is of paramount importance to decide on diagnostic strategies at the Out patient Department (OPD) and in the Laboratory. Uganda is one of the few countries in Africa South of the Sahara with extensive control programs for schistosomiasis and soil transmitted helminthes. Nonetheless, and in spite of the availability of nation-wide data, the data are not always accessible for use at the hospital or local level. To create data that are suitable to complement data generated by the national control programs, it is essential to make use of a comparable methodology Polderman et al. 2010; Odongo-Aginya et al.1995. Study objectives Data from the period before the war in North Uganda suggest that Schistosoma mansoni could be highly prevalent in certain parts of Gulu towns itself and probably in villages around as well . The poor socioeconomic conditions in the area have undoubtedly resulted in high prevalence of at least some of the soil transmitted helminths in Gulu area. On the basis of these considerations the objectives of the research was formulated as follows. • To assess the prevalence and intensity of infection of the most important intestinal helminths and schistosomiasis in Gulu and adjacent townships. • To compare the efficacy and the sensitivity of some diagnostic procedures, • (1) the Kato-Katz-procedure as used by the National control programs, • (2) The Aginya staining-procedure as developed by Odongo-Aginya, • (3) The Polderman direct-smear examination as commonly used in hospital laboratories,in Holland. • (4) The stool culture procedure for Strongyloides stercoralis, hookworms and Oesophagostomum bifurcum, as extensively used by Polderman. • (5) And the molecular procedure PCR in the diagnostic of pathogenic intestinal Parasites Study areas. • Four schools in divisions of Gulu Municipality were selected • Kasubi Primary school, • Baptist primary school Layibi, • Pece pawel primary school • Laro day primary school Study design Cross-sectional study was designed to assess the prevalence and intensity of infection of the most important intestinal helminths and schistosomiasis in the adjacent of Gulu municipality. Methods All patients were registered using their name, age, residential location and the duration. No attempts were made to enquiries into complaints to avoid biasing the microscopic results. Twenty pupils were selected randomly using paper picking method • The stool samples were examined by each of these different procedures. • The Aginya adaptation of the Kato-Katzprocedure • Polderman adaptation of the Kato-Katz the classical direct smear method. • The Kato-Katz-procedure as used by the National Schistosomiasis control programme • The filter-paper Stool culture in Petri-dishes Gulu University Medical Students’ Association (GUMSA) Passion for life 50
Gulu University Medical Journal (GUMJ) 2009/2010 Vol 5. Results The results of the study showed that a total of 603 participants mainly school pupils from Kasubi, Pece Pawel, Baptist and Laro primary schools and a few of the staff of the schools were recruited in the study but only 582 of them gave stool specimens to be screened microscopically for Schistosoma mansoni and other helminthes infections. Out of 582 specimens screened 117 (20.1%) were infected with S.mansoni. The males 74 (12.7%) were more infected than the females 42(7.2%). Other intestinal helminthes were infrequent. Nevertheless Kasubi primary school showed the highest percentage of infection 47.2% (59/125); followed by Laro 25.6 %( 32/125); Pece Pawel 16.0% (20/125) and the Baptist school had the lowest percentage of infected participants 11.2% (14/125). The results obtained by all the diagnostic methods were comparable. Conclusion Schistosoma mansoni infection is a big problem in all the schools. Therefore treatment is necessary for all the children in the schools and those with the same age group in the villages within the study areas. Although other intestinal helminthes were infrequent, there is need to deworm the children against these parasites periodically. Because of the similarity in the sensitivity of the diagnostic methods used in this study any of them can be used in a similar study. This study was guided by Professors Odongo-Aginya Emmanuel Gulu University and Ton A.Polderman University of Leiden Holland. Gulu University Medical Students’ Association (GUMSA) Passion for life 51
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