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Relationships between environmental risk factors, parasitic infections and health outcomes in an urban African setting

The relationships between parasitic infections, environmental and living conditions, and health outcomes were studied in subdivisions of lower (LSES) and higher (HSES) socio-economic status Lubumbashi, Zaire. The two LSES subdivisions had higher prevalences of Plasmodium infection and higher rates of stunting, abdominal pain and low packed cell volume (PCV) than the HSES subdivision. The prevalence and intensity of Ascaris lumbricoides and Trichuris trichiura was not associated with socio-economic status. Maternal education was a significant predictor of A. lumbricoides intensity in both LSES and HSES subdivisions. Factors related to poor sanitation were risk factors for A. lumbricoides in LSES subdivisions, whereas a high ratio of relatives to immediate family members per household predicted high intensity infection in the HSES subdivision. The risk of stunting was higher in children with A. lumbricoides, that of wasting was higher in children with A. lumbricoides or T. trichiura whereas the risk of kwashiorkor was high with T. trichiura but very reduced in those with A. lumbricoides. The four most common clinical conditions were diarrhea, abdominal pain, fever and low PCV. Hookworm infection, T. trichiura infection, young age and residence in LSES subdivisions were determinants of diarrhea. T. trichiura infection, young age and living in a LSES subdivision were risk factors for abdominal pain. Plasmodium infection and young age were associated with fever. LSES was predictive of low PCV. No combination of parasites had antagonistic or synergistic effects on clinical indicators examined. Based on this study, it is suggested that one parasite will increase the risk of infection with another. Although maternal education should be improved in all subdivisions, attention to sanitation, crowding and diet in the LSES subdivisions, and to the role of relatives and visitors in parasite transmission in the HSES subdivision should be priorities.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.40014
Date January 1995
CreatorsTshikuka Mulumba, Jose-Gaby
ContributorsScott, M. E. (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageDoctor of Philosophy (Institute of Parasitology.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001488801, proquestno: NN12500, Theses scanned by UMI/ProQuest.

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