Risk factors for intestinal parasite portage in an informal suburb on the West coast of Madagascar

The deprived area of the Metzinger Valley in the city of Mahajanga has many healthcare concerns due to repeated flooding during the rainy season. Improving this health situation requires a better knowledge of the pathogens present in this area and of the risk factors favoring their propagation. The aim of this study was to analyze the relationship between the household socioeconomic status and the presence of parasites in the faeces of children between 1 and 10 years of age in order to determine the risk factors for intestinal parasitosis. The study included 746 children, of whom 30% were infected with parasites. Entamoeba coli, a good indicator of environmental fecal contamination, was the most prevalent parasite with an observation frequency of 16.7% followed by Giardia lamblia with a prevalence of 10%. For helminths, Trichuris and Ascaris were the most prevalent respectively 5.4% and 1.8%. A large heterogeneity in the prevalence of parasites was observed from one neighborhood to another. However, multivariate analysis showed that these differences were not related to environmental factors or household structure, but rather to the economic level of the family, the education level of the mother as well as the age of the child. For example, the prevalence of Giardia decreased from 23.5% to 8% for children of mothers with little education to those with higher education, respectively. For E. coli, the prevalence is higher among poor households and school-aged children. In the frame of IRCOD project, mothers are being sensitized to hygiene and risk factors for transmission by intestinal parasites and the present study proposes a multidimensional approach as an assessment tool.