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The neglected cestode infection: Epidemiology of Hymenolepis nana infection among children in rural Yemen

Open Access
|Nov 2020

Figures & Tables

Fig. 1

A geographic map showing the districts and governorates involved in the study (6 districts within two governorates). The map was created using a licensed Esri ArcGIS 10.7 software.
A geographic map showing the districts and governorates involved in the study (6 districts within two governorates). The map was created using a licensed Esri ArcGIS 10.7 software.

Fig. 2

Prevalence of Hymenolepis nana infection among the participants according to their age and gender (n = 498).
Prevalence of Hymenolepis nana infection among the participants according to their age and gender (n = 498).

Univariate analysis of factors associated with Hymenolepis nana infection among children in rural Yemen (n = 498)_

VariablesH. nana infection


No. examinedInfected n (%)OR (95% CI)P value
Age (years)
< 6 (preschool)13339 (29.3)3.54 (1.84, 6.80)< 0.001*
6 – 1222233 (14.9)1.49 (0.78, 2.86)0.227
> 1214315 (10.5)1
Gender
Boys32061 (19.1)1.38 (0.83, 2.27)0.209
Girls17826 (14.6)1
Family size
> 7 members (large)21541 (19.1)1.21 (0.76, 1.93)0.412
≤ 7 members28346 (16.3)1
Father’s age (years)
< 4024853 (21.4)1.73 (1.08, 2.77)0.028*
≥ 4025034 (13.6)1
Residence
Almahweet (Highland)24253 (21.9)1.83 (1.14, 2.94)0.011*
Taiz (Coastal/foothill area)25634 (13.3)1
Father’s educational level
Non educated (< 6 years)28152 (18.5)1.18 (0.74, 1.89)0.489
Educated (≥ 6 years)21735 (16.1)1
Father’s occupational status
Not working8020 (25.0)2.44 (1.13, 5.26)0.021*
Farmers and daily workers31054 (17.4)1.54 (0.81, 2.95)0.189
Government employees/professionals10813 (12.0)1
Household monthly income
< USD 80 (low)31363 (20.1)1.69 (1.02, 2.82)0.042*
≥ USD 8018524 (13.0)1
Presence of improved toilet in house
No18843 (22.9)1.79 (1.12, 2.86)0.013*
Yes31044 (14.2)1
Source of drinking water
Unimproved (well, streams, rain, dams)36070 (19.4)1.72 (0.97, 3.04)0.061
Improved (piped water)13817 (12.3)1
Presence of domestic animals at household
Yes32159 (18.4)1.20 (0.73, 1.96)0.471
No17728 (15.8)1
Presence of other family members infected with H. nana
Yes15454 (29.2)2.97 (1.85, 4.77)< 0.001*
No34442 (12.2)1
Washing hands before eating
No16232 (19.8)1.26 (0.78, 2.04)0.351
Yes33655 (16.4)1
Washing hands after defecation
No14434 (23.6)1.76 (1.08, 2.85)0.021*
Yes35453 (15.0)1
Washing hands after playing with soil
No19944 (22.1)1.69 (1.06, 2.69)0.026*
Yes29943 (14.4)1
Indiscriminate defecation
Yes32560 (18.5)1.22 (0.76, 2.01)0.424
No17327 (15.6)1
Cutting nails periodically
No27852 (18.7)1.22 (0.76, 1.95)0.414
Yes22035 (15.9)1
Washing vegetables before eating
No15237 (24.3)1.91 (1.18, 3.07)0.008*
Yes34650 (14.5)1
Washing fruits before eating
No13331 (23.3)1.68 (1.03, 2.74)0.038*
Yes36556 (15.3)1
Boiling water before drinking
No45481 (17.8)1.38 (0.56, 3.36)0.483
Yes446 (13.6)1

General characteristics of the children participated in the study (n= 498)_

Characteristicsn (%)
Age (years)
< 6 (preschool)133 (26.7)
6 – 12222 (44.6)
> 12143 (28.7)
Gender
Boys320 (64.3)
Girls178 (35.7)
Residence (governorate)
Almahweet (Highland)242 (48.6)
Taiz (Coastal/foothill area)256 (51.4)
Father’s occupational status
Not working80 (16.1)
Farmers and daily workers310 (62.2)
Government employees/professionals108 (21.7)
Father’s educational level (at least primary)217 (43.6)
Low household monthly income (< USD 80)313 (62.9)
Family size (≤ 7 members)283 (56.8)
Improved water supply at household138 (27.7)
Presence of improved toilet in house310 (62.2)
Presence of domestic animals at household321 (64.5)

Distribution of clinical signs and symptoms among Hymenolepis nana-infected children in rural Yemen (n = 498)_

Signs and symptomsOverallHymenolepis nana infection
Positive (n = 87)Negative (n = 411)χ2 (P)
Abdominal pain14834 (39.1)114 (27.7)4.423 (0.035)*
Diarrhoea9019 (21.8)71 (17.3)1.010 (0.315)
Constipation335 (5.7)28 (6.8)0.132 (0.717)
Nausea9716 (18.4)81 (19.7)0.079 (0.778)
Vomiting419 (10.3)32 (7.8)0.622 (0.430)
Loss of appetite11519 (21.8)96 (23.4)0.093 (0.760)
Anal itching14534 (39.1)111 (27.0)5.071 (0.024)*
Dizziness6518 (20.7)47 (11.4)5.418 (0.020)*
Headache7619 (21.8)57 (13.9)3.527 (0.060)
Fatigue618 (9.2)53 (12.9)0.914 (0.339)

Multivariate analysis of factors associated with H_ nana infection among participants in rural Yemen (n = 498)_

VariablesH. nana infection
Adjusted OR95% CIP-value
Age (< 6 years)4.282.04, 8.98< 0.001*
Gender (males)1.320.76, 2.290.332
Father’s age (< 40 years)1.630.98, 2.550.060
Residence (highland)2.871.56, 5.260.002*
Father’s occupational status (not working)1.680.64, 4.420.289
Father’s occupational status (farmers and daily workers)0.940.40, 2.230.944
Household monthly income (< USD 80)1.120.57, 2.370.679
Presence of improved toilet in house (no)2.191.23, 3.880.008*
Source of drinking water (unimproved)1.370.73, 2.590.325
Presence of other family member infected with H. nana (yes)2.481.45, 4.240.001*
Washing hands after defecation (no)1.881.08, 3.270.025*
Washing hands after playing with soil (no)1.500.86, 2.610.149
Washing vegetables before eating (no)2.111.06, 4.190.034*
Washing fruits before eating (no)0.810.40, 1.620.549
DOI: https://doi.org/10.2478/helm-2020-0038 | Journal eISSN: 1336-9083 | Journal ISSN: 0440-6605
Language: English
Page range: 293 - 305
Submitted on: Mar 12, 2020
Accepted on: May 26, 2020
Published on: Nov 19, 2020
Published by: Slovak Academy of Sciences, Mathematical Institute
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year

© 2020 H. M. Al-Mekhlafi, published by Slovak Academy of Sciences, Mathematical Institute
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.