Intestinal parasitic infection with special reference to taeniid tapeworms in school children of Malakand region, Pakistan

Taeniids have a worldwide distribution (Garcia et al., 2003). The two groups of taeniid and diphyllobothriid tapeworms, which include Taenia solium, Taenia saginata, and Echinococcus granulosus, respectively, are the most important cestodes that infect humans. Both adult and larval forms (of different species) can infect humans and cause taeniasis or cysticercosis, depending on the stage of the infection. People can unintentionally eat eggs or larval stages of Taenia by eating undercooked meat. Human neurocysticercosis is the most prevalent cestode infection of the central nervous system in areas where it is endemic. Taeniasis was found in 16 % of neurocysticercoses (NCC) patients with minor to moderate infections and in 82 % of those with substantial infections, providing compelling evidence that persistent autoinfection may be a risk factor for developing NCC (Galman et al., 2000). These actions include mass drug administration to treat T. solium taeniasis as a preventative step for entire human and pig communities (Haby et al., 2020) community health education, meat inspection in slaughterhouses together with mass screens, and vaccination of pigs.

According to (Millago et al., 2012; Sahlu et al., 2019), human infections with Taenia solium, Taenia saginata, and Taenia asiatica are the leading causes of taeniosis, which is linked to consuming raw or undercooked beef or pork because proglottids and eggs discharged in the feces can infect humans through environmental pollution and result in lethal neurocysticercosis. In contrast to T. asiatica infections, cases of neurocysticercosis brought on by T. solium have grown in non-taeniasis endemic regions (Ito et al., 2006; Schantz et al., 1992; Hira et al., 2004). According to Ayalew et al. (2011), the incidence of tapeworms of the species Taenia was higher in children whose mothers had less education, in children who regularly ate raw or unwashed vegetables, in children who drank unprotected well or spring water, and in children who did not wash their hands before meals. The application of these techniques is still mostly restricted to epidemiological research projects due to a lack of pricey laboratory equipment and state-sponsored screening programs despite T. solium infections being a widespread public health concern that affects extensive rural regions across several continents.

Globally distributed tapeworm infection is prevalent in Pakistan and Southeast Asia. There may be a human Taenia strain distinct from Taenia saginata and Taenia solium, according to the epidemiology of Taeniasis in Asia. Most T. solium carriers would not seek medical assistance in a communal setting. They would instead continue to provide risks to NCC for themselves, their families, and the society at large. These neglected tropical diseases are generally caused by a lack of access to clean water, better sanitation, adequate hygiene, low socioeconomic position, illiteracy, a hot and humid tropical climate, and inadequate medical care (Wegayehu et al., 2013; Strunz et al., 2014; Stocks et al., 2014). Additionally, sewage units, gutters, and other contaminated areas around human habitations and congested or unsanitary living conditions all contribute to an increase in intestine parasites. Additionally, the living conditions of people in crowded or poor settings and contaminated environments such as trash heaps, gutters, and sewage units in and around human dwellings increase the prevalence of intestinal parasite agents (Wegayehu et al., 2013). The symptoms were abdominal pain, constipation, nausea or vomiting, stomach pain, blotting, and diarrhea, which appeared after the taeniid infection and were reported in the study region. This study is designed to identify risk factors associated with taenia infestation.

Some of the work has been conducted In the Malakand area, Pakistan by (Rahman et al., 2022; Rahman et al., 2022; Ullaq et al., 2021; Khan et al., 2022; Khan et al., 2020; Arshad et al., 2019; Khan et al., 2019; Khan et al., 2018b, Khan et al., 2017a, Khan et al., 2016; Khan et al., 2015; Ullah et al., 2014; Khan et al., 2012; Khan et al., 2011). However, a study on Taniid tapeworm parasites has not yet been conducted. This survey is designed to determine the risk factor associated with Taeniid tapeworm infection in school children of the Malakand region, Pakistan.

This study was conducted according to ethical guidelines for human-related research at the Abdul Wali Khan University Mardan, Pakistan, and by the declaration of Helsinki. The informed consent was obtained from the respondents at the time of information collection.

The transmission of parasitic infection is a serious health problem that is more prevalent in poor nations. The current study sets out to identify the elements that raise a child’s risk of becoming infected with harmful parasites. Three hundred and sixty students were included in the study. The study’s analysis of the participants’ stools revealed a frequency of 38.8 % for intestinal parasitic infection. Our study’s findings outperform those of the one conducted by (Khan et al., 2017a, Pandya et al., 2017; Ansari et al., 2018)) who reported that the frequency of intestinal taeniid parasites was 8.98 %, 0.99 %, and 0.4 % respectively. The incidence of single, double, triple, and quadruple infections was 50 %, 27.1 %,15.7 %, and 7.1 %, respectively, which is higher than the study conducted by (Khan et al., 2017a, Kosar et al., 2017).

This study demonstrated the relationships between parasitic infection and various factors, including the sex and age of the schoolchildren, hand washing after using the washroom and before handling food, preparing food while ill with diarrhea, fingernail health, living circumstances, level of poverty, personal and environmental hygiene, accessibility to clean water supply, suitability of medical facilities, and sanitation practices. Each of the factors studied was of considerable importance and had a high impact on the prevalence of parasites, which may be due to the close association of school children with their practices. Parasitic infections were found in both genders in the current study, 40.7 % in males and 33.3 % in females, which is comparable with a study conducted in Larkana, Punjab, Pakistan, 38.8 % in males and 40 % in females (Ansari et al., 2018) and in Rawalpindi (40.33 %) males and 26.67 % in females (Kosar et al., 2017). However, a study conducted in an urban slum in Nigeria found that 49 % of males and 17.4 % of females (Gyang et al., 2019) were higher than the present study. Another study conducted in Iran was lower than the present study 25.5 % in males and 82.9 % in females (Kiani et al., 2016)

The present study was conducted among schoolchildren of different age groups. The most important age group was 8 – 10 years 48.8 %, which is comparable with the study conducted in Rawalpindi 35.97 % (Kosar et al., 2017) and higher than the study conducted in an urban slum of Nigeria 23.4 % and lower than the study conducted in Ethiopia 48.4 % (Ayalew et al., 2011). It also shows that from 1 – 3 class 46.34 % which is higher than the study conducted in Ethiopia 32.6 % by (Ayalew et al., 2011), and from 4 – 5 grade (52.46 %) which is lower than those conducted in Ethiopia 67.4 % by (Ayalew et al., 2011)Based on location urban 42.18 % and rural 54.16 % were studied in the present study which is comparable with a study conducted in Rawalpindi 35.06 % in urban and 30.82 % in rural areas (Kosar et al., 2017) while the current study is higher than study conducted in western Iran 20.1 % and 23.6 % by (Kiani et al., 2016) and lower than study conducted in Ethiopia 63.7 % and 36.3 %.

The current study found that 64.70 % and 64.42 % of mothers and fathers were illiterate or uneducated, which is comparable to studies that found that 59 % (Gyang et al., 2019) and 57.8 % (Ayalew et al., 2011) of mothers had at least some college education. A similar study by (Kiani et al., 2016; Ayalew et al., 2011) found that parents who are illiterate or have not completed high school are more likely to have parasite infections. According to (Celiksoz et al., 2005), a more significant proportion of babies were born to moms without formal education.

Eating semi-cooked meat and vegetables or raw vegetables, similar to a study conducted, was another factor that exposed kids to intestinal parasite infection (Kosar et al., 2017). The current study is lower than the study conducted by (Mahmoudvand et al., 2018); 63 % of those who used open-field defecation had a higher infection rate. A similar study was conducted by (Ayalew et al., 2011). House conditions of children play a significant role in the transmission of parasite eggs. Earthen and brick-made houses have a higher risk of parasitic infection, comparable to a study conducted (Kosar et al., 2017). Animals also play an important role in the transmission and infection of parasites and their eggs. Pet animal keeping has a high risk of parasitic infection, comparable to the study conducted by (Mahmoudvand et al., 2018). According to the study’s assessment of related symptoms, the majority of the children with intestinal parasite infections exhibited abdominal pain, nausea or vomiting, bloating, diarrhea, and dysentery. In additional studies (Ansari et al., 2018; Kosar et al., 2017; Kiani et al., 2016), most of the children experienced abdominal pain, nausea or vomiting, diarrhea, and dysentery.

The students used tap water, and parents who had cattle had a 3 times higher rate of taeniid infection than people who used spring water and parents who did not raise cattle. Fewer parasites spread among pupils who wash their hands before eating than among those who don’t. The practice of washing hands before and after using the bathroom. The study’s findings show that those who wash their hands both before and after defecating are less likely to get the taeniid infection than those who wash their hands before eating. Students who had not used anthelminthic medications were 1.5 times more likely to get the disease than those who did. According to a recent study, children whose fathers worked for the government, as well as their mothers, were more likely to be infected than children whose fathers did not.

Tanied infection is still a major public health issue in Pakistan. Level of education, eating habits, fingernail health, hand washing before and after meals, use of semi-cooked meals, defecation source, BMI, and upper arm circumference were the most important risk factors for taeniid intestinal parasitic infection, along with animal ownership, access to water supplies, and prior drug use. Health education campaigns should be launched to reduce intestinal parasite infection in the local population.