Volume 96, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



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 , , 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 and / were 10.4% (95% CI = 6.2–14.6) and 3.3% (95% CI = 0.09–5.7), respectively. Children with infections had lower height-for-age -scores compared with those without, but were not more likely to have stunting. Compared with those without , children with infections had lower weight-for-age and weight-for-height -scores and were more than five times as likely to meet the -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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. World Health Organization, 2016. Soil-Transmitted Helminth Infections Fact Sheet. Geneva, Switzerland: World Health Organization. [Google Scholar]
  2. Kelly P, Farrar J, , 2014. Intestinal protozoa. , ed. Manson's Tropical Diseases. Philadelphia, PA: Saunders. [Google Scholar]
  3. Fikresilasie S, , 2015. Status of soil-transmitted helminths infection in Ethiopia. Am Jf Health Res 3: 170176.[Crossref] [Google Scholar]
  4. Abera B, Alem G, Yimer M, Herrador Z, , 2013. Epidemiology of soil-transmitted helminths, Schistosoma mansoni, and haematocrit values among schoolchildren in Ethiopia. J Infect Dev Ctries 7: 253260.[Crossref] [Google Scholar]
  5. Tadesse Z, Hailemariam A, Kolaczinski JH, , 2008. Potential for integrated control of neglected tropical diseases in Ethiopia. Trans R Soc Trop Med Hyg 102: 213214.[Crossref] [Google Scholar]
  6. Zerdo Z, Yohanes T, Tariku B, , 2016. Soil-transmitted helminth reinfection and associated risk factors among school-age children in Chencha District, southern Ethiopia: a cross-sectional study. J Parasitol Res 2016: 4737891.[Crossref] [Google Scholar]
  7. King JD, Endeshaw T, Escher E, Alemtaye G, Melaku S, Gelaye W, Worku A, Adugna M, Melak B, Teferi T, , 2013. Intestinal parasite prevalence in an area of Ethiopia after implementing the SAFE strategy, enhanced outreach services, and health extension program. PLoS Negl Trop Dis 7: e2223.[Crossref] [Google Scholar]
  8. Victora CG, de Onis M, Hallal PC, Blössner M, Shrimpton R, , 2010. Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 125: e47380.[Crossref] [Google Scholar]
  9. Gebre T, Ayele B, Zerihun M, Genet A, Stoller NE, Zhou Z, House JI, Yu SN, Ray KJ, Emerson PM, Keenan JD, Porco TC, Lietman TM, Gaynor BD, , 2012. Comparison of annual versus twice-yearly mass azithromycin treatment for hyperendemic trachoma in Ethiopia: a cluster-randomised trial. Lancet 379: 143151.[Crossref] [Google Scholar]
  10. Aiemjoy K, Stoller NE, Gebresillasie S, Shiferaw A, Tadesse Z, Sewnet T, Ayele B, Chanyalew M, Callahan K, Stewart A, Emerson PM, Lietman TM, Keenan JD, Oldenburg CE, , 2016. ‘If an eye is washed properly, it means it would see clearly’: a mixed methods study of face washing knowledge, attitudes, and behaviors in rural Ethiopia. PLoS Negl Trop Dis 10: e0005099.[Crossref] [Google Scholar]
  11. Aiemjoy K, Stoller NE, Gebresillasie S, Shiferaw A, Tadesse Z, Sewent T, Ayele B, Chanyalew M, Aragie S, Callahan K, Stewart A, Emerson PM, Lietman TM, Keenan JD, Oldenburg CE, , 2016. Is using a latrine “a strange thing to do”? A mixed-methods study of sanitation preference and behaviors in rural Ethiopia. Am J Trop Med Hyg 96: 6573.[Crossref] [Google Scholar]
  12. Utzinger J, Botero-Kleiven S, Castelli F, Chiodini P, Edwards H, Köhler N, Gulletta M, Lebbad M, Manser M, Matthys B, N'Goran EK, Tannich E, Vounatsou P, Marti H, , 2010. Microscopic diagnosis of sodium acetate-acetic acid-formalin-fixed stool samples for helminths and intestinal protozoa: a comparison among European reference laboratories. Clin Microbiol Infect 16: 267273.[Crossref] [Google Scholar]
  13. WHO Expert Committee, 2002. Prevention and control of schistosomiasis and soil-transmitted helminthiasis. World Health Organ Tech Rep Ser 912: ivi, 1–57. [Google Scholar]
  14. Gonin P, Trudel L, , 2003. Detection and differentiation of Entamoeba histolytica and Entamoeba dispar isolates in clinical samples by PCR and enzyme-linked immunosorbent assay. J Clin Microbiol 41: 237241.[Crossref] [Google Scholar]
  15. de Onis M, Onyango AW, Van den Broeck J, Chumlea CW, Martorell R, , 2004. Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference. Food Nutr Bull 25: S27S36.[Crossref] [Google Scholar]
  16. World Health Organization, 1995. Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. Technical Report Series No. 854. Geneva, Switzerland: World Health Organization. [Google Scholar]
  17. Ayele B, Aemere A, Gebre T, Tadesse Z, Stoller NE, See CW, Sun NY, Gaynor BD, McCulloch CE, Porco TC, Emerson PM, Lietman TM, Keenan JD, , 2012. Reliability of measurements performed by community-drawn anthropometrists from rural Ethiopia. PLoS One 7: e30345.[Crossref] [Google Scholar]
  18. Leroy J, , 2011. ZSCORE06: Stata Module to Calculate Anthropometric Z-Scores Using the 2006 WHO Child Growth Standards. Chestnut Hill, MA: Boston College. [Google Scholar]
  19. Cummings P, , 2011. Estimating adjusted risk ratios for matched and unmatched data: an update. Stata J 11: 290298. [Google Scholar]
  20. Casapía MW, Joseph SA, Núnez C, Rahme E, Gyorkos TW, , 2007. Parasite and maternal risk factors for malnutrition in preschool-age children in Belen, Peru using the new WHO Child Growth Standards. Br J Nutr 98: 12591266.[Crossref] [Google Scholar]
  21. Heymann DL, , 2008. Control of Communicable Diseases Manual. Washington, DC: American Public Health Association. [Google Scholar]
  22. Prado M, Cairncross S, Strina A, Barreto ML, Oliveira-Assis A, Rego S, , 2005. Asymptomatic giardiasis and growth in young children; a longitudinal study in Salvador, Brazil. Parasitology 131: 5156.[Crossref] [Google Scholar]
  23. Nematian J, Gholamrezanezhad A, Nematian E, , 2008. Giardiasis and other intestinal parasitic infections in relation to anthropometric indicators of malnutrition: a large, population-based survey of schoolchildren in Tehran. Ann Trop Med Parasitol 102: 209214.[Crossref] [Google Scholar]
  24. Bartelt LA, Roche J, Kolling G, Bolick D, Noronha F, Naylor C, Hoffman P, Warren C, Singer S, Guerrant R, , 2013. Persistent G. lamblia impairs growth in a murine malnutrition model. J Clin Invest 123: 26722684.[Crossref] [Google Scholar]
  25. Hall A, Hewitt G, Tuffrey V, De Silva N, , 2008. A review and meta-analysis of the impact of intestinal worms on child growth and nutrition. Matern Child Nutr 4: 118236.[Crossref] [Google Scholar]
  26. Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, Wu Y, Sow SO, Sur D, Breiman RF, Faruque ASG, Zaidi AKM, Saha D, Alonso PL, Tamboura B, Sanogo D, Onwuchekwa U, Manna B, Ramamurthy T, Kanungo S, Ochieng JB, Omore R, Oundo JO, Hossain A, Das SK, Ahmed S, Qureshi S, Quadri F, Adegbola RA, Antonio M, Hossain MJ, Akinsola A, Mandomando I, Nhampossa T, Acácio S, Biswas K, O'Reilly CE, Mintz ED, Berkeley LY, Muhsen K, Sommerfelt H, Robins-Browne RM, Levine MM, , 2013. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet 382: 209222.[Crossref] [Google Scholar]
  27. McCormick B, , 2014. Frequent Symptomatic or Asymptomatic Infections May Have Long-Term Consequences on Growth and Cognitive Development. Old Herborn University Seminar Monographs. Herborn, Germany: Institute for Microbiology und Biochemistry, 2339. [Google Scholar]
  28. Petri WA, Miller M, Binder HJ, Levine MM, Dillingham R, Guerrant RL, , 2008. Enteric infections, diarrhea, and their impact on function and development. J Clin Invest 118: 12771290.[Crossref] [Google Scholar]
  29. De Vlas S, Gryseels B, , 1992. Underestimation of Schistosoma mansoni prevalences. Parasitol Today 8: 274277.[Crossref] [Google Scholar]
  30. Knopp S, Mgeni AF, Khamis IS, Steinmann P, Stothard JR, Rollinson D, Marti H, Utzinger J, , 2008. Diagnosis of soil-transmitted helminths in the era of preventive chemotherapy: effect of multiple stool sampling and use of different diagnostic techniques. PLoS Negl Trop Dis 2: e331.[Crossref] [Google Scholar]
  31. Glinz D, Silué KD, Knopp S, Lohourignon LK, Yao KP, Steinmann P, Rinaldi L, Cringoli G, N'Goran EK, Utzinger J, , 2010. Comparing diagnostic accuracy of Kato-Katz, Koga agar plate, ether-concentration, and FLOTAC for Schistosoma mansoni and soil-transmitted helminths. PLoS Negl Trop Dis 4: e754.[Crossref] [Google Scholar]
  32. Marti H, Escher E, , 1990. SAF: an alternative fixation solution for parasitological stool specimens [in German]. Schweiz Med Wochenschr 120: 14731476. [Google Scholar]

Data & Media loading...

  • Received : 11 Oct 2016
  • Accepted : 06 Jan 2017
  • Published online : 06 Feb 2017

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred