Environmental contamination, prevalence and other risk factors for geohelminth infection in three informal settlements in Durban, South Africa.

Abstract

The effect of different types of sanitation facilities on soil contamination with geohelminth eggs and the associated risk factors were assessed in three informal settlements in Durban, South Africa. Adult members of 30 households in each settlement were interviewed to determine their knowledge, attitudes and perceptions on risk factors associated with geohelminth transmission. Two hundred soil samples were collected in each study settlement from areas considered potential sources of infection such as houses, pathways, sanitation facilities and washing areas. Of the total 600 soil samples collected, 190 (32%) were positive for geohelminth eggs with the eggs of Ascaris lumbricoides, Trichuris trichiura and Taenia spp. being recovered. Quarry Road West, where open defaecation was the most common (80%), sanitation coverage the lowest (11%) and lack of knowledge on geohelminth transmission high (97%), showed the highest levels of soil contamination (mean = 102.55eggs/100g). Stool samples were also collected from 135 children aged 1-16 years living in the three study areas. Children were found to be infected with A. lumbricoides and T. trichiura with prevalences of 33.4 and 6.5%, respectively and corresponding geometric mean intensities of 5.6 and 0.87eggs/g faeces. Some children (9.6%) also harboured dual infections. No hookworm or tapeworm infections were recorded. The results show a direct link between high levels of soil contamination and increased prevalence and infection rates. Indiscriminate defaecation by community members is recognised as the main contributing factor of geohelminth eggs in soil. The type and the number of toilets provided to a community greatly influence the success of a sanitation facility. In order to effectively control geohelminth transmission, health education and antihelminthic treatment need to accompany sanitation programmes in these areas.