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Epidemiology of intestinal nematodes in school-age children of the Kumba Urban Area, south west Cameroon.

BACKGROUND
The urban slums, poorly disposed garbage and inadequate toilet facilities in many homes, coupled with the high temperatures, rainfall and humidity that characterise the Kumba urban area, favour the development and transmission of helminth parasites in the area. School-age children are particularly at risk of infection.


OBJECTIVE
To determine the pattern of soil-transmitted nematode infections in the Kumba urban area as affected by seasonal changes.


DESIGN
Longitudinal study.


SETTING
Ten primary schools in the Kumba urban area.


SUBJECTS
Five hundred and eighty seven randomly selected pupils aged between four and fifteen years of both sexes.


RESULTS
Significantly (P<0.005) more children were infected towards the end (69%) than in the early months (38.3%) of the rainy season. The infection rate recorded in December/January (dry season) was significantly reduced in April/May (early months of the rainy season) in male and female (P<0.01) children of different age groups (P<0.005) and classes (P<0.05). Then after, the rate increased significantly (P<0.005) in all the groups to reach a peak in October/November (last months of the rainy season). The intensity of infection more or less followed the same pattern as prevalence, except in hookworms where prevalence increased progressively and significantly (P>0.05) from 10.7% in December/January to 19.4% in October/November, while the worm load decreased. Single and mixed species infections constituted 50.8% and 49.2% respectively of the infections investigated, with Ascaris lumbricoides accounting for the highest number of infections. The most common combination of mixed species infections was Ascaris/Trichuris.


CONCLUSION
The study has revealed that, in general, progressively more school-age children are infected with soil-transmitted nematodes in the course of the rainy season while acquisition of infections in the dry season progressively reduce to the low levels observed in the early months of the rainy season.