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Sanitation, hookworm, anemia, stunting, and wasting in primary school children in southern Ethiopia: baseline results from a study in 30 schools

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Title: Sanitation, hookworm, anemia, stunting, and wasting in primary school children in southern Ethiopia: baseline results from a study in 30 schools
Authors: Grimes, JET
Tadesse, G
Gardiner, IA
Yard, E
Wuletaw, Y
Templeton, MR
Harrison, WE
Drake, LJ
Item Type: Journal Article
Abstract: Background Inadequate nutrition; neglected topical diseases; and insufficient water, sanitation, and hygiene (WASH) are interrelated problems in schools in low-income countries, but are not routinely tackled together. A recent three-year longitudinal study investigated integrated school health and nutrition approaches in 30 government primary schools in southern Ethiopia. Here, we report on baseline associations between sanitation, hookworm infection, anemia, stunting, and wasting. Methods In each school, the Schistosoma mansoni, S. haematobium, and soil-transmitted helminth infection intensities; blood hemoglobin concentrations; heights; and weights of approximately 125 students were assessed. Of these 125 students, approximately 20 were randomly selected for student WASH surveys. Of these 20, approximately 15 were randomly selected for household sanitation observations. School WASH was also assessed through a combination of observations and questions to the headteacher. Mixed-effects logistic regression was used to compare household sanitation with hookworm infection (the other parasites being much less prevalent); and hookworm infection with anemia, stunting, and wasting. Findings Blood, stool, and urine samples were provided by 3,729 children, and student WASH and household WASH surveys were conducted with 596 and 448 of these students, respectively. Hookworm, Ascaris lumbricoides, Trichuris trichiura, and S. mansoni infections had prevalences of 18%, 4.8%, 0.6%, and 0.3%, respectively, and no S. haematobium infections were found. Anemia, stunting, and wasting had prevalences of 23%, 28%, and 14%, respectively. No statistically significant associations were found between latrine absence or evidence of open defecation at home, and hookworm infection (adjusted odds ratio, OR = 1.28, 95% confidence interval, CI: 0.476–3.44; and adjusted OR = 1.21, 95% CI: 0.468–3.12; respectively); or between hookworm infection and anemia, stunting, or wasting (adjusted OR = 1.24, 95% CI: 0.988–1.57; adjusted OR = 0.992, 95% CI: 0.789–1.25; and adjusted OR = 0.969, 95% CI: 0.722–1.30; respectively). Conclusions In this setting, no statistically significant associations were found between sanitation and hookworm; or between hookworm and anemia, stunting, or wasting. More evidence on best practices for integrated school health interventions will be gathered from the follow-up surveys in this study.
Issue Date: 9-Oct-2017
Date of Acceptance: 9-Sep-2017
URI: http://hdl.handle.net/10044/1/51769
DOI: https://dx.doi.org/10.1371/journal.pntd.0005948
ISSN: 1935-2727
Publisher: Public Library of Science
Journal / Book Title: PLoS Neglected Tropical Diseases
Volume: 11
Issue: 10
Copyright Statement: © 2017 Grimes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: 06 Biological Sciences
11 Medical And Health Sciences
Tropical Medicine
Publication Status: Published
Article Number: e0005948
Appears in Collections:Civil and Environmental Engineering
Faculty of Engineering