title: Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren.
abstract: BACKGROUND
  Intestinal parasitic infections are a public health problem in developing countries such as Mexico. As a result, two governmental programmes have been implemented: a) "National Deworming Campaign" and b) "Opportunities" aimed at maternal care. However, both programmes are developed separately and their impact is still unknown. We independently investigated whether a variety of socio-economic factors, including maternal education and employment levels, were associated with intestinal parasite infection in rural school children.
  
  
  METHODS
  This cross-sectional study was conducted in 12 rural communities in two Mexican states. The study sites and populations were selected on the basis of the following traits: a) presence of activities by the national administration of albendazole, b) high rates of intestinal parasitism, c) little access to medical examination, and d) a population having less than 2,500 inhabitants. A total of 507 schoolchildren (mean age 8.2 years) were recruited and 1,521 stool samples collected (3 per child). Socio-economic information was obtained by an oral questionnaire. Regression modelling was used to determine the association of socio-economic indicators and intestinal parasitism.
  
  
  RESULTS
  More than half of the schoolchildren showed poliparasitism (52%) and protozoan infections (65%). The prevalence of helminth infections was higher in children from Oaxaca (53%) than in those from Sinaloa (33%) (p < 0.0001). Giardia duodenalis and Hymenolepis nana showed a high prevalence in both states. Ascaris lumbricoides, Trichuris trichiura and Entamoeba hystolitica/dispar showed low prevalence. Children from lower-income families and with unemployed and less educated mothers showed higher risk of intestinal parasitism (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.6-22.6; OR 4.5, 95% CI 2.5-8.2; OR 3.3, 95% CI 1.5-7.4 respectively). Defecation in open areas was also a high risk factor for infection (OR 2.4, 95% CI 2.0-3.0).
  
  
  CONCLUSIONS
  Intestinal parasitism remains an important public health problem in Sinaloa (north-western Mexico) and Oaxaca (south-eastern Mexico). Lower income, defecation in open areas, employment status and a lower education level of mothers were the significant factors related to these infections. We conclude that mothers should be involved in health initiatives to control intestinal parasitism in Mexico.
authors.affiliation: Department of Human Nutrition, Centro de Investigación en Alimentación y Desarrollo, A.C. Hermosillo, Sonora, México. lquihui@cascabel.ciad.mx
authors.forename: Luis
authors.initials: L
authors.lastname: Quihui
authors.forename: Mauro E
authors.initials: ME
authors.lastname: Valencia
authors.forename: David W T
authors.initials: DW
authors.lastname: Crompton
authors.forename: Stephen
authors.initials: S
authors.lastname: Phillips
authors.forename: Paul
authors.initials: P
authors.lastname: Hagan
authors.forename: Gloria
authors.initials: G
authors.lastname: Morales
authors.forename: Silvia P
authors.initials: SP
authors.lastname: Díaz-Camacho
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001196:Ascariasis / Q000453:epidemiology; D001827:Body Height; D001835:Body Weight; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005873:Giardiasis / Q000453:epidemiology; D006373:Helminthiasis / Q000453:epidemiology; D006801:Humans; D006920:Hygiene / Q000193:education; D006925:Hymenolepiasis / Q000453:epidemiology; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009035:Mothers / Q000193:education*; D010270:Parasite Egg Count; D015995:Prevalence; D012423:Rural Health / Q000706:statistics & numerical data*; D012574:Schools