The neglected cestode infection: Epidemiology of Hymenolepis nana infection among children in rural Yemen
| Nov 19, 2020
About this article
Article Category: Research Article
Published Online: Nov 19, 2020
Page range: 293 - 305
Received: Mar 12, 2020
Accepted: May 26, 2020
DOI: https://doi.org/10.2478/helm-2020-0038
Keywords
© 2020 H. M. Al-Mekhlafi, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Fig. 1
Fig. 2
Univariate analysis of factors associated with Hymenolepis nana infection among children in rural Yemen (n = 498).
| Variables | ||||
|---|---|---|---|---|
| No. examined | Infected n (%) | OR (95% CI) | ||
| Age (years) | ||||
| < 6 (preschool) | 133 | 39 (29.3) | 3.54 (1.84, 6.80) | < 0.001* |
| 6 – 12 | 222 | 33 (14.9) | 1.49 (0.78, 2.86) | 0.227 |
| > 12 | 143 | 15 (10.5) | 1 | |
| Gender | ||||
| Boys | 320 | 61 (19.1) | 1.38 (0.83, 2.27) | 0.209 |
| Girls | 178 | 26 (14.6) | 1 | |
| Family size | ||||
| > 7 members (large) | 215 | 41 (19.1) | 1.21 (0.76, 1.93) | 0.412 |
| ≤ 7 members | 283 | 46 (16.3) | 1 | |
| Father’s age (years) | ||||
| < 40 | 248 | 53 (21.4) | 1.73 (1.08, 2.77) | 0.028* |
| ≥ 40 | 250 | 34 (13.6) | 1 | |
| Residence | ||||
| Almahweet (Highland) | 242 | 53 (21.9) | 1.83 (1.14, 2.94) | 0.011* |
| Taiz (Coastal/foothill area) | 256 | 34 (13.3) | 1 | |
| Father’s educational level | ||||
| Non educated (< 6 years) | 281 | 52 (18.5) | 1.18 (0.74, 1.89) | 0.489 |
| Educated (≥ 6 years) | 217 | 35 (16.1) | 1 | |
| Father’s occupational status | ||||
| Not working | 80 | 20 (25.0) | 2.44 (1.13, 5.26) | 0.021* |
| Farmers and daily workers | 310 | 54 (17.4) | 1.54 (0.81, 2.95) | 0.189 |
| Government employees/professionals | 108 | 13 (12.0) | 1 | |
| Household monthly income | ||||
| < USD 80 (low) | 313 | 63 (20.1) | 1.69 (1.02, 2.82) | 0.042* |
| ≥ USD 80 | 185 | 24 (13.0) | 1 | |
| Presence of improved toilet in house | ||||
| No | 188 | 43 (22.9) | 1.79 (1.12, 2.86) | 0.013* |
| Yes | 310 | 44 (14.2) | 1 | |
| Source of drinking water | ||||
| Unimproved (well, streams, rain, dams) | 360 | 70 (19.4) | 1.72 (0.97, 3.04) | 0.061 |
| Improved (piped water) | 138 | 17 (12.3) | 1 | |
| Presence of domestic animals at household | ||||
| Yes | 321 | 59 (18.4) | 1.20 (0.73, 1.96) | 0.471 |
| No | 177 | 28 (15.8) | 1 | |
| Presence of other family members infected with |
||||
| Yes | 154 | 54 (29.2) | 2.97 (1.85, 4.77) | < 0.001* |
| No | 344 | 42 (12.2) | 1 | |
| Washing hands before eating | ||||
| No | 162 | 32 (19.8) | 1.26 (0.78, 2.04) | 0.351 |
| Yes | 336 | 55 (16.4) | 1 | |
| Washing hands after defecation | ||||
| No | 144 | 34 (23.6) | 1.76 (1.08, 2.85) | 0.021* |
| Yes | 354 | 53 (15.0) | 1 | |
| Washing hands after playing with soil | ||||
| No | 199 | 44 (22.1) | 1.69 (1.06, 2.69) | 0.026* |
| Yes | 299 | 43 (14.4) | 1 | |
| Indiscriminate defecation | ||||
| Yes | 325 | 60 (18.5) | 1.22 (0.76, 2.01) | 0.424 |
| No | 173 | 27 (15.6) | 1 | |
| Cutting nails periodically | ||||
| No | 278 | 52 (18.7) | 1.22 (0.76, 1.95) | 0.414 |
| Yes | 220 | 35 (15.9) | 1 | |
| Washing vegetables before eating | ||||
| No | 152 | 37 (24.3) | 1.91 (1.18, 3.07) | 0.008* |
| Yes | 346 | 50 (14.5) | 1 | |
| Washing fruits before eating | ||||
| No | 133 | 31 (23.3) | 1.68 (1.03, 2.74) | 0.038* |
| Yes | 365 | 56 (15.3) | 1 | |
| Boiling water before drinking | ||||
| No | 454 | 81 (17.8) | 1.38 (0.56, 3.36) | 0.483 |
| Yes | 44 | 6 (13.6) | 1 | |
General characteristics of the children participated in the study (n= 498).
| Characteristics | n (%) |
|---|---|
| Age (years) | |
| < 6 (preschool) | 133 (26.7) |
| 6 – 12 | 222 (44.6) |
| > 12 | 143 (28.7) |
| Gender | |
| Boys | 320 (64.3) |
| Girls | 178 (35.7) |
| Residence (governorate) | |
| Almahweet (Highland) | 242 (48.6) |
| Taiz (Coastal/foothill area) | 256 (51.4) |
| Father’s occupational status | |
| Not working | 80 (16.1) |
| Farmers and daily workers | 310 (62.2) |
| Government employees/professionals | 108 (21.7) |
| Father’s educational level (at least primary) | 217 (43.6) |
| Low household monthly income (< USD 80) | 313 (62.9) |
| Family size (≤ 7 members) | 283 (56.8) |
| Improved water supply at household | 138 (27.7) |
| Presence of improved toilet in house | 310 (62.2) |
| Presence of domestic animals at household | 321 (64.5) |
Distribution of clinical signs and symptoms among Hymenolepis nana-infected children in rural Yemen (n = 498).
| Signs and symptoms | Overall | |||
|---|---|---|---|---|
| Positive (n = 87) | Negative (n = 411) | χ2 ( |
||
| Abdominal pain | 148 | 34 (39.1) | 114 (27.7) | 4.423 (0.035)* |
| Diarrhoea | 90 | 19 (21.8) | 71 (17.3) | 1.010 (0.315) |
| Constipation | 33 | 5 (5.7) | 28 (6.8) | 0.132 (0.717) |
| Nausea | 97 | 16 (18.4) | 81 (19.7) | 0.079 (0.778) |
| Vomiting | 41 | 9 (10.3) | 32 (7.8) | 0.622 (0.430) |
| Loss of appetite | 115 | 19 (21.8) | 96 (23.4) | 0.093 (0.760) |
| Anal itching | 145 | 34 (39.1) | 111 (27.0) | 5.071 (0.024)* |
| Dizziness | 65 | 18 (20.7) | 47 (11.4) | 5.418 (0.020)* |
| Headache | 76 | 19 (21.8) | 57 (13.9) | 3.527 (0.060) |
| Fatigue | 61 | 8 (9.2) | 53 (12.9) | 0.914 (0.339) |
Multivariate analysis of factors associated with H. nana infection among participants in rural Yemen (n = 498).
| Variables | |||
|---|---|---|---|
| Adjusted OR | 95% CI | ||
| Age (< 6 years) | 4.28 | 2.04, 8.98 | < 0.001* |
| Gender (males) | 1.32 | 0.76, 2.29 | 0.332 |
| Father’s age (< 40 years) | 1.63 | 0.98, 2.55 | 0.060 |
| Residence (highland) | 2.87 | 1.56, 5.26 | 0.002* |
| Father’s occupational status (not working) | 1.68 | 0.64, 4.42 | 0.289 |
| Father’s occupational status (farmers and daily workers) | 0.94 | 0.40, 2.23 | 0.944 |
| Household monthly income (< USD 80) | 1.12 | 0.57, 2.37 | 0.679 |
| Presence of improved toilet in house (no) | 2.19 | 1.23, 3.88 | 0.008* |
| Source of drinking water (unimproved) | 1.37 | 0.73, 2.59 | 0.325 |
| Presence of other family member infected with |
2.48 | 1.45, 4.24 | 0.001* |
| Washing hands after defecation (no) | 1.88 | 1.08, 3.27 | 0.025* |
| Washing hands after playing with soil (no) | 1.50 | 0.86, 2.61 | 0.149 |
| Washing vegetables before eating (no) | 2.11 | 1.06, 4.19 | 0.034* |
| Washing fruits before eating (no) | 0.81 | 0.40, 1.62 | 0.549 |