Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren.
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.
Quihui
Luis
L
Department of Human Nutrition, Centro de Investigación en Alimentación y Desarrollo, A.C. Hermosillo, Sonora, México. lquihui@cascabel.ciad.mx
Valencia
Mauro E
ME
Crompton
David W T
DW
Phillips
Stephen
S
Hagan
Paul
P
Morales
Gloria
G
Díaz-Camacho
Silvia P
SP
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