Prevalence of soil-transmitted helminth infections and malnutrition among 9-10 year old children attending estate sector schools

Abstract

Introduction: The health status of communities in the estate sector is known to be poorer than in the rest of Sri Lanka. Objective: To ascertain the prevalence of soil-transmitted helminth (STH) infections and malnutrition among children attending primary schools in estates in Badulla, Kandy, Kegalle and Ratnapura Districts. Methods: In each District, 24-26 estate schools were selected by cluster sampling, in each school, 20 children attending Grade 4 in 2009 were selected by random sampling. If there were less than 20, all children were included. Faecal samples were examined using the modified Kato-Katz technique. Information on de-worming and feeding programmes in school was obtained from the school principal, and on de-worming and latrine use, from the child's principal caretaker. Each child's weight, height and haemoglobin level was measured. Date of birth was recorded from school registers. Height for age Z-scores and percentage with normal Body Mass Index (BMI) for age and sex were calculated using WHO standards. Haemoglobin was corrected for altitude and percentage anaemic calculated according to WHO thresholds. Results: A total of 1,621 children (52% boys) in 98 schools were examined. Eighty schools (81.6%) had ongoing Mid-Day Meal programmes. Of 1,513 children (93.3%) who provided faecai samples, 21.3% had roundworm infections, 6,4% had whipworm, and 5.9% had hookworm. Nearly half (n=758, 46.8%) had received anthelmintics during the last six months. Among household members of the index children, only 5.9% were reported not to regularly use a latrine for defaecation. The prevalence of stunting was 26.4-32.7%. Only 53-62.4% of children had a normal BMI, all others being excessively thin. The prevalence of anaemia was 10.8-18.8%. Conclusions: Among 9-10 year old school children in the estate sector in Ratnapura, Kegalle., Kandy and Badulla Districts, the combined prevalence of STH infection was 27.5%. 29.3% were stunted; 44.8% were underweight and 13% were anaemic.