title: Intestinal helminthiasis in children with chronic neurological disorders in Benin City, Nigeria: intensity and behavioral risk factors.
abstract: BACKGROUND
  Behavioral aberrations such as nail biting, finger sucking, and pica have been postulated as risk factors that enhance helminths ova transmission. These aberrations may present commonly in children with chronic neurological disorders and predispose them to heavy intensity of intestinal helminthiasis. This comparative cross-sectional study was to determine the prevalence, intensity, and behavioral risk factors for intestinal helminthiasis in children with chronic neurological disorders and apparently healthy controls.
  
  
  METHODS
  Fresh stool samples from 155 children (2-17 years) with chronic neurological disorders seen at the child neurology clinic and 155 age and sex matched controls from nursery and primary schools in Benin City were analyzed using the Kato-Katz technique for detection of ova of helminths from November 2008 to April 2009.
  
  
  RESULTS
  The prevalence of intestinal helminthiasis (31.0%) was significantly higher in children with chronic neurological disorders compared with the controls (19.4%) (P=0.03). The intensity of infections in both groups was light ranging 24-144 eggs per gram. Ascaris lumbricoides, Trichuris trichiura and hookworm were the intestinal helminths isolated in both groups. Behavioral aberrations were significantly more represented in the subjects than in the controls (P<0.0001, OR=2.8). Nail biting and encopresis were the most significant independent predictors of intestinal helminthiasis (P=0.025 and 0.001, respectively) in the subjects only. Hand washing with water and soap after defecation and frequent de-worming exercise were practices significantly associated with decreased prevalence of intestinal helminthiasis in the subjects and controls.
  
  
  CONCLUSIONS
  Behavioral modification in children with chronic neurological disorders should be an integral part of the control program for intestinal helminthiasis.
authors.affiliation: Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. damiannwaneri@yahoo.com
authors.forename: Damia Uchechukwu
authors.initials: DU
authors.lastname: Nwaneri
authors.forename: Michael Okoeguale
authors.initials: MO
authors.lastname: Ibadin
authors.forename: Gabriel Egberue
authors.initials: GE
authors.lastname: Ofovwe
authors.forename: Ayebo Evawere
authors.initials: AE
authors.lastname: Sadoh
mesh_terms: D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000209:etiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006373:Helminthiasis / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000453:epidemiology*; D007411:Intestinal Diseases, Parasitic; D008297:Male; D009422:Nervous System Diseases / Q000150:complications* / Q000453:epidemiology*; D009549:Nigeria; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D014504:Urban Health