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Prevalence of Intestinal Helminths Among Mogadishu Residents Attending Somali Sudanese Specialized Hospital, Mogadishu, Somalia

Received: 25 March 2024     Accepted: 22 April 2024     Published: 10 May 2024
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Abstract

Intestinal helminths infection remains a public health concern in the developing countries. Over 1.5 billion people on a global scale are infected with one or more intestinal helminths. Sub - Saharan Africa is considered among the most affected areas with helminths infections. These infection rates are linked with factors such as socioeconomic status, personal hygiene, overcrowding and poor waste management. This study aimed to investigate the frequency of intestinal helminths infections among Mogadishu residents attending Somali Sudanese specialized hospital. The presented study was designed as a descriptive cross - sectional hospital - based study conducted at Somali Sudanese specialized hospital at Mogadishu, Somalia, during the period from November 2022 to April 2023. Stool samples were collected from 1865 Mogadishu residents attending Somali Sudanese Specialized Hospital. Helminths infections were confirmed by identification of the diagnostic stage of the parasite under light microscope. The study findings indicated that the prevalence of intestinal helminths was 2.0%. The distribution of the parasitic infections was 0.7%, 0.6%, 0.4%, 0.3% (Trichuris trichiura, Enterobius vermicularis, Hymenolepis nana, and Ascaris lumbricoides) respectively. This result showed that the most common infection is caused by Trichuris trichiura followed by Enterobius vermicularis with Ascaris lumbricoides being the least common. The high prevalence of intestinal helminths infections among Mogadishu residents highlights a poor personal hygiene.

Published in American Journal of Laboratory Medicine (Volume 9, Issue 1)
DOI 10.11648/j.ajlm.20240901.12
Page(s) 8-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Helminths, Trichiura, Vermicularis, Nana, Lumbricoides, Somalia

1. Introduction
“An intestinal parasite is an organism that infects the human (and other animals) gastrointestinal tracts”. Even though they prefer to live on the walls of the intestines, they may be found in other parts. They are transmitted through the ingestion of under-cooked food, infected water or through penetration via the skin .
Intestinal parasites are a group of parasites that include protozoan and helminths . Symptoms of infection range from fatigue, anemia, malnutrition to fever, dehydration and vomiting . Helminths infections may last a long time within the body, even up to 20 years .
The infections caused by intestinal helminths are distributed all around the world. The ten most prevalent infections worldwide include Ascariasis, hookworm infection, and trichuriasis .
On a global scale, over one and half billion people are infected with one or more intestinal helminths, Additionally, 700 million were contaminated with hookworm, 807 million were tainted with Ascariasis lumbricoides, and 587 million were Trichuris trichiura. Intestinal helminths contaminations are common among children under 5 years old with diverse causes such as playing with soil, sucking fingers, and defecation in an open field, All-inclusive .
Most areas affected by helminths are sub-saharan Africa, Asia, Latin America and Caribbean. Reported frequencies of helminthiasis in sub-Sahara Africa ranges from 9.1% to 90.3% .
The prevalence of intestinal parasite infections is linked to various factors. Studies conducted in different parts of the world suggested that different infection rates depended on socioeconomic status, sanitary and environmental conditions, water access, overcrowding, malnutrition, and poor waste management .
Primary data for the prevalence of intestinal helminths provides general view about the magnitude of helminths infections and serves as corner stone for control programs and policies that target reduction of tropical diseases.
There is insufficiency of data when it comes to the prevalence of helminths infections in Somalia, This necessitates further investigation. To address this gap, the presented study was designed to determine the prevalence of intestinal helminths in Somalia.
2. Materials and Methods
The presented study was descriptive cross-sectional hospital-based study executed at Somali Sudanese Specialized Hospital (SSSH) in Mogadishu, Somalia during the time between November 2022 to April 2023. 1,865 study subjects in total have participated in this study, all Mogadishu residents attending Somali Sudanese Specialized Hospital during the aforesaid study time were included in this study, while subjects who refused to give consent were excluded. Fresh stool samples were collected into clean, pre-labeled and spoon-covered stool containers for microscopic detection. A small amount of the specimen was placed on a microscope slide, it was mixed with one drop of normal saline. Two smears were prepared on each slide and a coverslip was placed on top of the slide. The cover slip area was systematically scanned using the 10x objective lens of a light microscope, and higher magnification was used for confirmation . A positive case indicates morphological identification of the diagnostic stage for helminths. A structural designed questionnaire was used to collect this data, later on to be statistically analyzed using the statistical package for social science (SPSS) 26.0 statistical software (SPSS Inc., USA). Additionally, this study was licensed by the ethical committee of SSSH.
3. Results
1865 samples in total were received from the study group. The participants age had a range from (1 month - 104 years) with a mean age of 23.7 ± 21.9 years. 1032 of these study subjects were females (55.3%), while the remaining 833 were males (44.7%). (2%) of the total study subjects were found to be infected with intestinal helminths. The most frequent infection was Trichuris trichura (0.7%), followed by Enterobius vermicularis (0.6%), while Hymenolepis nana and Ascaris lumbricoides were (0.4%) and (0.3%) respectively. One study subject had mixed infection with two helminths; Trichuris trichura and Hymenolepis nana. Regarding to the month of infections, the highest infections were on December, 2022 and February, 2023 (0.4%) while the remaining study period showed a constant infections rate of (0.3%), however, the link between the infections rate and the months of infection was found to be insignificant (p value 0.798). There was no significant difference regarding prevalence of infections between males and females (p value 0.41), as there was insignificant difference between infections rate among different age groups (p value 0.42). The results are illustrated in Tables 1, 2, 3, 4, 5, 6.
Table 1. Gender diversity in the study group.

Gender

Frequency

Percent

Female

1032

55.3

Male

833

44.7

Total

1865

100.0

Table 2. Age diversity in the study group.

Age (years)

Frequency

Percent

≤ 9

705

37.8 %

10 – 19

153

8.2 %

20 – 29

358

19.2 %

30 – 39

228

12.2 %

40 – 49

127

6.8 %

50 – 59

126

6.8 %

≥ 60

168

9.0 %

Total

1865

100.0 %

Table 3. Frequency of intestinal helminths infections in the study group.

Helminths frequency

Frequency

Percent

No parasite

1828

98.0 %

Trichuris trichura

13

0.7 %

Ascaris lumbricoides

6

0.3 %

Enterobius vermicularis

12

0.6 %

Hymenolepis nana

7

0.4 %

Total

1866

100.0 %

Table 4. Frequency of intestinal helminths infections among gender groups.

Helminths detection

Total

No infection

Helminths infection

Gender

Female

Count

1014

18

1032

% of Total

54.4%

1.0%

55.3%

Male

Count

814

19

833

% of Total

43.6%

1.0%

44.7%

Total

Count

1828

37

1865

% of Total

98.0%

2.0%

100.0%

Table 5. Frequency of intestinal helminths infections throughout study duration.

Helminths detection

Total

No infection

Helminths infection

Month

November

Count

297

5

302

% of Total

15.9%

0.3%

16.2%

December

Count

343

9

352

% of Total

18.4%

0.4%

18.9%

January

Count

300

5

305

% of Total

16.1%

0.3%

16.3%

February

Count

260

8

268

% of Total

13.9%

0.4%

14.4%

March

Count

293

6

299

% of Total

15.7%

0.3%

16.0%

April

Count

335

5

340

% of Total

18.0%

0.3%

18.2%

Total

Count

1828

37

1865

% of Total

98.0%

2.0%

100.0%

Table 6. Frequency of intestinal helminths infections among different age groups.

Helminths detection

Total

No infection

Helminths infection

Age group (years)

≤ 9

Count

693

12

705

% of Total

37.2%

0.6%

37.8%

10 - 19

Count

148

5

153

% of Total

7.9%

0.3%

8.2%

20 - 29

Count

348

10

358

% of Total

18.7%

0.5%

19.2%

30 - 39

Count

225

3

228

% of Total

12.1%

0.2%

12.2%

40 - 49

Count

126

1

127

% of Total

6.8%

0.1%

6.8%

50 - 59

Count

125

1

126

% of Total

6.7%

0.1%

6.8%

≥ 60

Count

163

5

168

% of Total

8.7%

0.3%

9.0%

Total

Count

1828

37

1865

% of Total

98.0%

2.0%

100.0%

4. Discussion
Intestinal helminths represent a major public health problem in tropical and subtropical countries. Infections caused by these helminths can cause diarrhea, nutritional depletion, weakness and poor immunity in infants. The current study was a descriptive cross sectional hospital based study executed at Somali Sudanese specialized hospital in Mogadishu, Somalia, to estimate the intestinal helminths prevalence rate among Mogadishu residents attending the hospital.
1865 stool samples in total were received from the study subjects, their age falls between 1 month to 104 years with a mean age of 23.7 ± 21.9 years. The helminths infection rates did not have a significant relation with the age. These results disagree with a research conducted by Liyih M, et al, who found the odds of having intestinal helminths infections in children up to the age of 14 years were 1.66 times higher than in adults . This disagreement could be a result of the environmental variation and different living circumstances of the study group.
Regarding gender, there was no significant difference between infection rates between males and females. This finding are consistent with a research done by Tadege B, et al , and K. Mohammed, et al .
Regarding to the frequency of intestinal helminths infections; 2% of the total study participants had intestinal helminths infections, The prevalence of the infections in this study was lower when compared with the results reported by Liyih M which showed a high percentage of infection rate (33.35%), the results reported by Yong TS which concluded an infection rate of (26.2%), the results presented by Periago MV that showed an infection rate of (11.1%) of intestinal helminths, and the results reported by Teshale T which showed a higher percentage of infection rate (12.7%), this difference might be due to demographic differences as well as characteristics of the populations.
5. Conclusion
The presence of intestinal helminths infections highlights a poor personal hygiene. The study shows that the most common intestinal helminths infections among Mogadishu residents were Trichuris trichiura, Enterobius vermicularis, Hymenolepis nana, and Ascaris lumbricoides respectively. Larger prevalence studies that cover different regions needs to be conducted, and the association between these prevalence rates and the environmental conditions and behavioral differences of residents of each region needs to be explored.
Abbreviations
SPSS: Social Package for Statistical Science
SSSH: Somali Sudanese Specialized Hospital
Ethics Approval
Written ethical approval has been obtained by the author in accordance to the international standard.
Consent to Participate
Written consent from the study participants has been obtained by the author in accordance to the international standard.
Author Contributions
Motaz Obeidallah Hamad Mohammed is the sole author. The author read and approved the final manuscript.
Conflicts of Interest
The author declares no conflicts of interest.
References
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[2] Periago MV, García R, Astudillo OG, Cabrera M, Abril MC. Prevalence of intestinal parasites and the absence of soil-transmitted helminths in Añatuya, Santiago del Estero, Argentina. Parasit Vectors. 2018 Dec 14; 11(1): 638.
[3] A. Tigabu, S. Taye, M. Aynalem, and K. Adane, “Prevalence and associated factors of intestinal parasitic infections among patients attending Shahura Health Center, Northwest Ethiopia,” BMC Research Notes, vol. 12, no. 1, p. 333, 2019.
[4] Njoku MO, Iloh KK, Okike CO, Njoku GC, Ojinnaka NC. The prevalence and intensity of intestinal helminths among institutionalized children in three states of South-East Nigeria. Niger J Clin Pract 2022; 25: 718-24.
[5] Yeshi K, Ruscher R, Loukas A and Wangchuk P (2022) Immunomodulatory and biological properties of helminth-derived small molecules: Potential applications in diagnostics and therapeutics. Front. Parasitol. 1: 984152.
[6] Flammer PG, Ryan H, Preston SG, Warren S, et al. (2020) Epidemiological insights from a large-scale investigation of intestinal helminths in Medieval Europe. PLOS Neglected Tropical Diseases 14(8): e0008600.
[7] Bąska P, Norbury LJ. The Role of the Intestinal Epithelium in the “Weep and Sweep” Response during Gastro—Intestinal Helminth Infections. Animals. 2022; 12(2): 175.
[8] WHO Expert Committee (1987). Public health significance of intestinal parasitic infections. WHO Expert Committee. Bulletin of the World Health Organization, 65(5), 575–588.
[9] World health organization. Prevention and control of intestinal parasitic infections: WHO Technical Report Series N°749. available at:
[10] Centers for disease control and prevention. Laboratory identification of parasites of public health concern; 2016. Available at:
[11] Minichil Liyih, Destaw Damtie, and Dires Tegen. Prevalence and Associated Risk Factors of Human Intestinal Helminths Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis. The Scientific World Journal Volume 2022, Article ID 3905963, 15 pages
[12] Tadege B, Mekonnen Z, Dana D, Tiruneh A, et al. (2022) Assessment of the nail contamination with soil-transmitted helminths in schoolchildren in Jimma Town, Ethiopia. PLoS ONE 17(6): e0268792.
[13] Yong TS, Chai JY, Sohn WM, Eom KS, et al. Prevalence of intestinal helminths among inhabitants of Cambodia (2006-2011). Korean J Parasitol. 2014 Dec; 52(6): 661-6. Epub 2014 Dec 23.
[14] Teshale T, Belay S, Tadesse D, Awala A, Teklay G. Prevalence of intestinal helminths and associated factors among school children of Medebay Zana wereda; North Western Tigray, Ethiopia 2017. BMC Res Notes. 2018 Jul 4; 11(1): 444.
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  • APA Style

    Mohammed, M. O. H. (2024). Prevalence of Intestinal Helminths Among Mogadishu Residents Attending Somali Sudanese Specialized Hospital, Mogadishu, Somalia. American Journal of Laboratory Medicine, 9(1), 8-13. https://doi.org/10.11648/j.ajlm.20240901.12

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    ACS Style

    Mohammed, M. O. H. Prevalence of Intestinal Helminths Among Mogadishu Residents Attending Somali Sudanese Specialized Hospital, Mogadishu, Somalia. Am. J. Lab. Med. 2024, 9(1), 8-13. doi: 10.11648/j.ajlm.20240901.12

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    AMA Style

    Mohammed MOH. Prevalence of Intestinal Helminths Among Mogadishu Residents Attending Somali Sudanese Specialized Hospital, Mogadishu, Somalia. Am J Lab Med. 2024;9(1):8-13. doi: 10.11648/j.ajlm.20240901.12

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  • @article{10.11648/j.ajlm.20240901.12,
      author = {Motaz Obeidallah Hamad Mohammed},
      title = {Prevalence of Intestinal Helminths Among Mogadishu Residents Attending Somali Sudanese Specialized Hospital, Mogadishu, Somalia
    },
      journal = {American Journal of Laboratory Medicine},
      volume = {9},
      number = {1},
      pages = {8-13},
      doi = {10.11648/j.ajlm.20240901.12},
      url = {https://doi.org/10.11648/j.ajlm.20240901.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20240901.12},
      abstract = {Intestinal helminths infection remains a public health concern in the developing countries. Over 1.5 billion people on a global scale are infected with one or more intestinal helminths. Sub - Saharan Africa is considered among the most affected areas with helminths infections. These infection rates are linked with factors such as socioeconomic status, personal hygiene, overcrowding and poor waste management. This study aimed to investigate the frequency of intestinal helminths infections among Mogadishu residents attending Somali Sudanese specialized hospital. The presented study was designed as a descriptive cross - sectional hospital - based study conducted at Somali Sudanese specialized hospital at Mogadishu, Somalia, during the period from November 2022 to April 2023. Stool samples were collected from 1865 Mogadishu residents attending Somali Sudanese Specialized Hospital. Helminths infections were confirmed by identification of the diagnostic stage of the parasite under light microscope. The study findings indicated that the prevalence of intestinal helminths was 2.0%. The distribution of the parasitic infections was 0.7%, 0.6%, 0.4%, 0.3% (Trichuris trichiura, Enterobius vermicularis, Hymenolepis nana, and Ascaris lumbricoides) respectively. This result showed that the most common infection is caused by Trichuris trichiura followed by Enterobius vermicularis with Ascaris lumbricoides being the least common. The high prevalence of intestinal helminths infections among Mogadishu residents highlights a poor personal hygiene.
    },
     year = {2024}
    }
    

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    T1  - Prevalence of Intestinal Helminths Among Mogadishu Residents Attending Somali Sudanese Specialized Hospital, Mogadishu, Somalia
    
    AU  - Motaz Obeidallah Hamad Mohammed
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    AB  - Intestinal helminths infection remains a public health concern in the developing countries. Over 1.5 billion people on a global scale are infected with one or more intestinal helminths. Sub - Saharan Africa is considered among the most affected areas with helminths infections. These infection rates are linked with factors such as socioeconomic status, personal hygiene, overcrowding and poor waste management. This study aimed to investigate the frequency of intestinal helminths infections among Mogadishu residents attending Somali Sudanese specialized hospital. The presented study was designed as a descriptive cross - sectional hospital - based study conducted at Somali Sudanese specialized hospital at Mogadishu, Somalia, during the period from November 2022 to April 2023. Stool samples were collected from 1865 Mogadishu residents attending Somali Sudanese Specialized Hospital. Helminths infections were confirmed by identification of the diagnostic stage of the parasite under light microscope. The study findings indicated that the prevalence of intestinal helminths was 2.0%. The distribution of the parasitic infections was 0.7%, 0.6%, 0.4%, 0.3% (Trichuris trichiura, Enterobius vermicularis, Hymenolepis nana, and Ascaris lumbricoides) respectively. This result showed that the most common infection is caused by Trichuris trichiura followed by Enterobius vermicularis with Ascaris lumbricoides being the least common. The high prevalence of intestinal helminths infections among Mogadishu residents highlights a poor personal hygiene.
    
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