Epidemiology of human intestinal parasites in Qwa-Qwa, South Africa.

Abstract

This study investigated the prevalences and intensity of intestinal parasites and aspects of their epidemiology among children in the Qwa-Qwa region of the eastern Free St~te. Faecal samples of 1180 children differing socio-economic status from nine schools at altitudes varying from 1660m to 2200m were examined quantitatively by means of the formol-ether sedimentation technique. Socio-economic, and demographic characteristics for the communities served by the schools were obtained from the literature and from a questionnaire. The study showed that, the area supports a markedly low diversity of parasite infections, and at lower intensities, than low altitude areas such as the coastal plain of KwaZulu-Natal and Eastern Cape, the Northern Province, Mpumalanga and the Western Cape. The intestinal parasite fauna affecting children in Qwa-Qwa is dominated by protozoans with only few helminths and no hookworm or bilharzia. The results indicated that factors which influence the transmission of intestinal parasites in Qwa-Qwa appear to be related primarily to social, economic and cultural aspects of the peoples' lifestyles. Climatic factors were not found important. There was a significant seasonal effect on the intensities of all parasite infection, except two protozoans, Entamoeba coli and Endolimax nana. Water source, electricity, house-type and quality of meat were found to be the important socio-economic factors that influenced parasite transmission. These relationships were investigated by fitting logistic regression and generalized linear mixed models. By documenting human parasitism (above 1700m) this study provided an endpoint to the altitudinal transect conducted in 1993 in KwaZulu-Natal by Appleton and Gouws (in press). Public health authorities and Primary Health Care personnel should find this study useful when designing and implementing nutrition and parasite control. Severe ascariasis has been reported from the study area. It will help focus PHC activities in Qwa-Qwa and in the wider context of Free State Province by demonstrating the value of proper personal and environmental hygiene in the home, thereby forming the basis for intestinal parasite control at the community level.