Prevalence and Risk Factors of Ascaris lumbricoides, Trichuris trichiura and Cryptosporidium Infections in Elementary School Children in Southwestern China: A School-Based Cross-Sectional Study

Abstract

<i>Background</i>: Intestinal parasitic infections pose great public health challenges in school children in developing countries. The aim of this study was to assess the prevalence of <i>A. lumbricoides</i>, <i>T. trichiura</i> and <i>Cryptosporidium</i> among elementary school children in rural southwestern China. <i>Methods</i>: A school-based cross-sectional study involving 321 elementary school children was conducted in 2014 in the southwest of China. They were invited to provide a stool sample and interviewed about the sanitary situation and hygiene behavior. Stool specimens were examined for <i>A. lumbricoides</i> and <i>T. trichiura</i> using the Kato-Katz fecal thick-smear technique. The presence of <i>Cryptosporidium</i> was determined using a modified acid-fast staining method. <i>Results</i>: The prevalence of infection was 10.0% (95% CI: 6.9⁻13.8%) for <i>A. lumbricoides</i>, 25.2% (95% CI: 20.6⁻30.4%) for <i>T. trichiura</i> and 2.4% for (95% CI: 1.1⁻4.9%) <i>Cryptosporidium</i>. The prevalence of co-infection was 3.7% (95% CI: 1.9⁻6.4%) for <i>A. lumbricoides</i>/<i>T. trichiura</i>, 0.3% (95% CI: 0⁻1.7%) for <i>A. lumbricoides</i>/<i>Cryptosporidium</i> and 0.9% (95% CI: 0.2⁻2.7%) for <i>T. trichiura</i>/<i>Cryptosporidium</i>. Children from households using well or river water were associated with a greater odds of <i>A. lumbricoides</i> infection (aOR = 2.61, 95% CI: 1.12⁻6.05). Having a household lavatory was associated with a lower odds of <i>T. trichiura</i> infection (aOR = 0.50, 95% CI: 0.30⁻0.84). Children who had three meals at the school canteen on week days were at a lower risk of <i>Cryptosporidium</i> infection. The use of spring water as a water source was associated with lower odds of any intestinal infection (aOR = 0.56, 95% CI: 0.35⁻0.91). <i>Conclusions</i>: Our study calls for an intervention program of school-based deworming combined with health education, hygiene promotion and provision of safe water and improved sanitation.