Effect of Ivermectin Intake on the Nutritional And Health Status of School Children In Onchocerciasis Endemic Communities of Ebonyi State, Nigeria
– Effect of Ivermectin Intake on the Nutritional And Health Status of School Children In Onchocerciasis Endemic Communities of Ebonyi State, Nigeria –
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ABSTRACT
The study assessed the nutritional and health status of school-aged children (5-12 years) in onchocerciasis endemic communities of Ebonyi State and determined the effect of Ivermectin intake on haemoglobin and parasitic load of the children.
The study was conducted in Ebonyi State of Nigeria. A multi stage random sampling technique was used in selecting respondents for the study. A total sample of 360 school aged children aged 5 – 12 years (made up of 194 males and 166 females) participated in the study.
A structured, validated and pretested questionnaire was used to elicit vital information. The weight and height of the children were taken using standard procedures. Blood samples of the children were subjected to haematological analyses within 12 hours of collection.
Haemoglobin levels were determined using cyanomethaemoglobin method. The WHO body mass index (BMI) for age z scores and the International Obesity Task Force (IOTF) were used to classify the children. Stool microscopy was carried out to detect parasitic infection. Secondary data were sourced from relevant documents of the Ebonyi State Ministry of Health, State Onchocerciasis Office and other relevant research materials.
Data generated from this study were keyed into Excel spreadsheet and later summarized using SPSS 16.0 version. Frequency distribution, percentages, mean, charts and Chi – square were the statistical tools used for the analysis. The 24 hour dietary recall data showed that majority of the respondents ate cassava-based food for breakfast and dinner quite often.
TABLE OF CONTENT
Title page——————————————- i
Approval page—————————————— iii
Certification————————————————– iv
Dedication—————————————————— v
Acknowledgement—————————————— vi
Table of content——————— viii
List of tables———————————— xiii
List of figures ———————- xvi
Abstract—————————————– xvii
CHAPTER ONE
INTRODUCTION——————– 1
1.1 Background———————– 1
1.2 Problem statement —————————- 4
1.3 Objectives of the study———————— 6
1.4 Significance of the study——————– 7
CHAPTER TWO
LITERATURE REVIEW——————————— 9
2.1 Onchocerciasis —————————————- 9
2.2 Causes of onchocerciasis ——————————— 10
2.3 Effect of onchocerciasis on people ——– 11
2.4 Clinical manifestation of onchocerciasis ————- 14
2.4.1 Skin disease ————————————- 14
2.4.2 Eye disease ————————— 15
2.5 Treatment of onchocerciasis ———- 17
2.6 Role of Vitamin A in child health —————————– 19
2.7 Role of iron in child health —————————– 21
2.8 Indicators of nutritional status ————————— 24
CHAPTER THREE
MATERIALS AND METHODS——————– 27
3.1 Area of study —————————————- 27
3.2 Study population ——————————— 30
3.3 Sample size and sampling procedure ——————— 30
3.4 Data collection and measurement of variables ——- 31
3.4.1 Questionnaire method——————–31
3.4.2 Anthropometric measurement———————— 31
3.4.3 Biochemical analysis —————————————- 32
3.4.4 Stool microscopy——————————– 32
3.5 Data handling and analyses ——————- 33
CHAPTER FOUR
RESULTS ———————————- 36
4.1 General characteristics ————————— 37
4.1.1 Children demographic characteristics ———————— 36
4.1.2 Family characteristics of children aged 5 – 12 years————- 37
4.1.3 Socio-economic characteristics of parents————- 38
4.1.4 Parental estimated monthly income———- 39
4.1.5 Housing / toilet facilities of children————— 40
4.1.6 Sources of drinking water, water handling/ treatment and refuse disposal system–40
4.2 Ivermectin consumption and de-worming of children ———— 42
4.2.1 Ivermectin intake ———————— 42
4.2.2 Sources of Ivermectin and its perceived effects on children’s well being —- 43
4.2.3 De-worming frequency and drugs used for de-worming ————- 43
4..3 Food habits and dietary intake ————————- 44
4.3.1 Types of food mostly eaten and meal pattern of chidren———————- 43
4.3.2 24-Hour dietary recall ——————- 46
4.3.3 Fruit consumption pattern of children ————– 47
4.3.4 Frequently consumed roots/ tubers, cereals, legumes and vegetables ——– 47
4.3.5 Frequently consumed fruits and vegetables ———- 49
4.3.6 Frequently consumed fish / meat———– 50
4.4 Nutritional status of children in onchocerciasis endemic communities of Ebonyi state ——–52
4.4.1 Anthropometric measurement and BMI (Boys) ——— 52
4.4.2 Anthropometric measurement and BMI (Girls) ——— 53
4.4.3 BMI categorization of the children according to sex and age ranges using IOTF reference BMI for age ——- 54
4.4.4 Wasting, under weight and stunting (by gender) using ± 2SD of the NCHS standard as cut-off points —– 56
4.4.5 Body Mass Index (BMI) of boys and girls using the 2007 WHO percentile ranking —– 57
4.5 Health status of children in onchocerciasis endemic communities of Ebonyi state —– 57
4.6 Level of parasitic infection in the children in onchocerciasis endemic communities of Ebonyi state ——– 58
4.7 Association of ivermectin intake with nutritional status, health status
and parasitic load of children in the study area —- 59
4.7.1 Ivermectin intake and body mass index —————- 59
4.7.2 Ivermectin intake and BMI percentile ranking of children———– 59
4.7.3 Ivermectin intake and weight for height (Wasting), weight for age
(Under weight) and height for age (Stunting) using ± 2SD ———-60
4.7.4 Ivermectin intake and health status / parasitic load of the children ———- 61
4.7.5 Parasitic load with Hb level of children ———– 63
4.8 Relationship between socioeconomic characteristics of parents, children’s age and sex on the nutritional status of the children —- 64
4.8.1 Relationship between nutritional status of the children and father’s socioeconomic status (using IOTF reference BMI for age)——- 64
4.8.2 Relationship between nutritional status of the children and mother’s socioeconomic status (using IOTF reference BMI for age)—– 65
4.8.3 Relationship between nutritional status of the children and parental monthly income (using IOTF reference BMI for age) ————– 66
4.8.4 Relationship between nutritional status of the children and father’s socioeconomic status (using BMI percentile ranking of children) —- 67
4.8.5 Relationship between nutritional status of the children and mother’s educational status (using BMI percentile ranking of children) —- 69
4.8.6 Relationship between nutritional status of the children and parental monthly incomes(using BMI percentile ranking of children) —– 70
CHAPTER FIVE
DISCUSSION ————————— 72
5.1 Socio-demographic and economic characteristics of parents of the children—— 72
5.2 Living conditions of children and their parents ———– 72
5.3 Food patterns and dietary intake of children ————- 74
5.4 Nutritional and health status of children and factors affecting them —- 76
5.5 Ivermectin Intake ————-78
5.6 Effect of ivermectin intake on nutritional and health statuses ———- 78
5.7 Relationship between socio-economic characteristics of parents and children’s age and sex on nutritional status –79
CHAPTER SIX
SUMMARY, CONCLUSION AND RECOMMENDATIONS ———— 81
5.1 Summary ——————— 81
5.2 Conclusion ———————– 82
5.3 Recommendation ———————— 83
REFERENCES —————- 84
INTRODUCTION
Good health in a child, as in an adult, result from many interacting factors in the society, the environment and the individual (Canadian Partnership for Children’s Health and Environment (CPCHE), 2003). The importance of good health cannot be over emphasized, particularly because of its link to child poverty and development of adult human capital (Olaniyan, 2002).
Good health is essential for learning and cognitive ability. In other words, ensuring good health when children are of school age can boost attendance and educational achievement. Poor health and malnutrition are important underlying factors for low school enrollment; absenteeism, poor classroom performance and early school dropout (Focusing Resources on Effective School Health (FRESH), 2000).
The Partnership for Child Development Report (2003) asserted that there have been substantial reduction in child death rates; gains in health; immunization levels; improved nutrition programmes and disease prevention over the past 50 years in both developed and developing countries.
The report further stated that more than 90 percent of the world’s children are now surviving beyond the age of 5 years and as a result there are now more children of school age and higher proportion of children attending school than ever before.
REFERENCES
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Akogun, O.B., Akogun, M.K. and Audu, Z. (2000). Community perceived benefits of Ivermectin treatment in north-eastern Nigeria. Social Science and Medicine, 50 (10), 1451-1456.
Amazigo, U. Noma, M., Boatin, B.A., Ekyciale Seketeli, A., and Dadzie, K. Y. (1998). Delivery systems and cost recovery in Ivermectin treatment for Onchocerciasis. Annals, of Tropical Medicine and Parastiology, (suppl. 1) 523 – 31.
Anyika, J. U., Uwaegbute, A. C., Onimawo, O. A. and Echendu, A. C. (2008). Factors influencing food intake of adolescent female secondary and university students in Umuahia North and Ikwuano Local Government Areas of Abia State, Nigeria. Nigerian Journal of Nutritional Sciences, 29, 1,125 – 132.
CSN Team.
