Prevalence of Gastrointestinal Parasites among Sickle Cell Patients in Delta State, Nigeria

Abstract

Sickle cell anemia crisis and death in the under-developed nations constitute one of the most challenging global public health problems. It is estimated that each year out of the three hundred thousand babies born worldwide with severe forms of hemoglobin disorders, sickle cell disease constitute more than half of this figure. Sickle cell disorder is an abnormal hemoglobin condition caused by the inheritance of abnormal hemoglobin (Hbs) genes from both parents. This study was aimed at determining the prevalence of gastrointestinal parasites among sickle cell subjects in Delta State. Stool samples were collected from a total of 320 subjects, 160 each from Delta South (Warri) and Delta North (Agbor). Questionnaires and informed consent forms were given to the subjects that are of age and to the parents of the minors before sample collection. The stool samples were examined both macroscopically and microscopically for gastrointestinal parasites .InWarri, 40% (64/160) of SCA subjects infected with either gastrointestinal heamoparisites were male, while 48.1% were females. In Agbor, 47.5% were males, while 43.8% were females. This was statistically significant (p< 0.05). The greatest frequency of infection was observed in SCA subjects within the age bracket of 1-10. (42.5%) in warri and 56.2%atAgbor. In Warri A.lumbricoides, hookworm, T.trichuria, E coliand malaria parasites were observed, 18.1%, 5.6%, 2.5%, 1.3% and 60.6% respectively among sickle cell subjects infected with either gastrointestinal haemoparasites. No microfilaria was isolated among subjects in warri, but was isolated at Agbor (0.6%).Also at Agbor, A. lumbricoides, hookworm, T.trichuria, E. coli,and malaria parasites had prevalence of16.8%, 2.5%, 1.3%, 1.9% and 68.1%respectively. In Warri, SCA subjects without parasitic infection have a mean PCV of 23.27% as against those with parasitic infection having a mean PCV of 12.88%. At Agbor, those without infection have a mean PCV of 22.84% as against 19.72% among those with parasitic infection. Among SCA subjects with either gastrointestinal or haemoparasites in warri, 24.4%, 50.0% 13.7% resides in rural, urban and riverine Communities respectively. At Agbor 60%, 31.3% resides in rural & urban communities respectively. The prevalence of infection among those who deworm always, occasionally only and those who never deworm were 32.5%, 53.1% and 2.5% respectively in Warri and, 10%, 60% & 21.3% respectively in Agbor. All sampled SCA subjects received blood transfusion always or occasionally as 70.6% and 17.8% respectively in Warri, as 85.0% and 6.3% respectively in Agbor. Prevalence of infection among subjects who use water closet and latrine were 18.7% and 6.9% respectively. Subjects who never wash their hands before and after eating have prevalence of 7.2% while those who wash their hands before and after eating always were 18.4%. The prevalence of malaria parasites 60.6% and 66.8%, Warri and Agbor respectively. Overall, the prevalence of parasitic infections among SCA subjects in Warri was 88.1%. Of this 48.1% were females.SCA subjects between the ages of 1-10 were mostly infected. A. lumbricoides (18.1%) was the gastrointestinal parasite mostly isolated. This study concludes that prevalence of gastrointestinal and haemoparasite among sickle cell subjects is very high in Delta State. Therefore, the need for all sickle cell anemic subjects to strictly use insecticide treated nets is highly advocated.