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بسم الله الرحمن الرحيم 1. INTESTINAL PARASITES AMONG STUDENTS OF A MULTI-NATIONALITY INTERMEDIATE SCHOOL IN JEDDAH DONE BY : ALI DEHIGI JAFAR AL-SHARDI.

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Presentation on theme: "بسم الله الرحمن الرحيم 1. INTESTINAL PARASITES AMONG STUDENTS OF A MULTI-NATIONALITY INTERMEDIATE SCHOOL IN JEDDAH DONE BY : ALI DEHIGI JAFAR AL-SHARDI."— Presentation transcript:

1 بسم الله الرحمن الرحيم 1

2 INTESTINAL PARASITES AMONG STUDENTS OF A MULTI-NATIONALITY INTERMEDIATE SCHOOL IN JEDDAH DONE BY : ALI DEHIGI JAFAR AL-SHARDI SUPPERVISED BY : DR. MAJED WAKID 2

3 CONTENTS INTRODUCTION AIMS OF PROJECT MATERIALS AND METHODS RESULTS DISCUSSION CONCLUSION 3

4 What is the parasite ? Parasite is an organism living in or on another living organism, obtaining from it part or all of its organic nutriment, usually to the detriment (harm) of its host. 4

5 What are the intestinal parasites? 5 Intestinal parasites are organisms that inhabit the gastro- intestinal tract of the host. They are often spread by poor hygiene related to feces, contact with animals, or poorly cooked food.

6 6 Intestinal parasites are one of the public health problems worldwide, especially in tropical and subtropical countries. Some 3.5 billion people are affected Some 450 million of them are symptomatic. 2,00,000 deaths annually are directly attributed to the intestinal parasites. WHO

7 How are intestinal parasites transmitted? Poor sanitation and hygiene. Contaminated foods & drinks. Lack health education. Via vectors. Skin penetration. 7

8 OF INTESTINAL PARASITES CLASSIFICATION PROTOZOAHELMINTHS 8

9 INTESTINAL PROTOZOA AmoebaFlagellateCiliate Coccidia E. histolyticaG. lambliaB. coliC. parvum 9

10 INTESTINAL HELMINTHS Trematoda Nematoda Cestoda Heterophyes heterophyes Ascaris lumbricoides Hymnolepis nana 10

11 AIMS OF THE PROJECT To study prevalence of intestinal parasitic infection among the chosen intermediate school in Jeddah. To compare the results between Retchie technique and direct technique. To study prevalence of Cryptosporidium parvum by using Modified Kinyouns Stain. To compare the result of Modified Kinyouns Stain with CERTEST CRYPTO CARD. To study prevalence of Giardia lamblia by using CERTEST GIARDIA CARD. To study the correlation between intestinal parasitic infection and several parameters. To study the correlation between intestinal parasitic infection and several parameters. 11

12 MATERIALS AND METHODS 12

13 IN COOPERATION WITH MINISTRY OF EDUCATION AND SCHOOL HEALTH UNIT 13

14 14 Questionnaire form

15 SAMPLES COLLECTION SAMPLES COLLECTION Stool samples were collected from students of an intermediate school 15

16 DIRECT SMEAR The steps of direct smear: Glass microscope slide Glass microscope slide Stool sample Stool sample Wooden stick Wooden stick Saline and Iodine Saline and Iodine 16

17 FORMAL ETHER SEDIMENTATION TECHNIQUE In this technique four layers formed: 1)Top layer of ether 2)Plug of debris 3)Layer of formalin 4)Sediment 17

18 MODIFIED KINYOUN STAIN This technique useful for detection Cryptospridium 1)Thin fecal smear was prepared 2)The smear was fixed with methanol for 1 min 3)Slide was stained with Kinyouns Carbol Fuchsin for 3 min 4)Decolonization with acidified alcohol to several dips 5) Water washing 6)Staining with methylene blue for 1 min 7)Water washing 8)Microscopic examination

19 CERTEST CRYPTO CARD 1) 150 mg of stool sample was dissolved well with diluente 2) 4 drops were dispensed. 3) at 10 minutes the colored band can be read. Principle of this test use one step immunochromatographic system and by using mouse monoclonal antibodies directed against antigen of Cryptosporidium

20 CERTEST GIARDIA CARD Principle of this test is immunochromatographic assay for detection Giardia in stool samples. The membrane is precoated with antibodies on the test band region against Giardia antigen. 1) 150 mg of stool sample was dissolved well with diluente 2) 4 drops was dispensed. 3) at 10 minutes the colored band can be read 3) at 10 minutes the colored band can be read.

21 Statistical analysis 21

22 RESULTS 22

23 23 Multi- nationalities male governmental intermediate school. 120 students were included in this study. Age ranged between 12 – 18 years (15 ± 1.38) NUMBER AND AGE OF STUDENTS

24 24 PERCENTAGE OF STUDENTS AGE 1.7% 19.2% 17.5% 28.3% 22.5% 7.5% 3.3%

25 NATIONALITIES OF STUDENTS The students were from 11 countries: Yemeni (30%) Saudi (21.7%) Afghani (20.8%) Palestinian (3.3%) Nigerian (2.5%) Chadian (13.3%) Somali (0.8%) Sudanese (5%) Turkish (0.8%) Pakistani (0.8%) Blushestani (0.8%) 25

26 PERCENTAGE OF NATIONALITIES 26

27 27 23 (19.2%) students were infected with intestinal parasites. 97 (80.8%) students were not infected. INFECTION AMONG STUDENTS

28 80.8% 19.2% PERCENTAGE OF INFECTED STUDENTS 28

29 Infected samplesTotal samples %b% aNo% Nationality Yemeni Saudi Afghani Palestinian Nigerian Chadian Somali Sudanese Turkish Pakistani Blushestani 100%19.2%23100%120Total %a: calculated to the total number %b: calculated to the infected number. 29

30 INFECTION PER NATIONALITY 30

31 31 Six parasites were detected among the students: Blastocystis hominis Endolimax nana Entameoba coli Entameoba histolytica Giardia lamblia Hymenolepis nana DETECTED PARASITES

32 DETECTION BY MICROSCOPIC TECHNIQUES ParasitesB. hominisE. nanaE. coliE. histolyticaG. lambliaH. nana Frequency %a %b %c %a calculated to the total number of students. %b calculated to the infected number of students. %c calculated to the total number of detected parasite. 32

33 DETECTION BY USIND MODIFIED KINYOUN STAIN Non of the 120 samples reacted positively for Cryptosporidium oocyst. 33

34 DETECTION BY USING CERTEST CRYPTO CARD Non of the 120 samples reacted positively with CERTEST CRYPTO CARD 34

35 DETECTION BY USING CERTEST GIARDIA CARD Among 120 samples, 4 samples reacted positively with CERTEST GIARDIA CARD 35

36 DISCUSSION AND CONCLUSION 36

37 DISCUSSION AND CONCLUSION Prevalence of parasitic infection was 19.2% Students were from 11 countries Students from six countries were infected, Yemenis (39.13%), Saudis (26.08%), Afghanis (13.4%), Chadians (8.7%), Sudanese (8.7%) and Palestinians (4.35%). 37

38 Only 12 samples were positive with direct smears. 23 samples were positive using Ritchie concentration technique. Non of the samples gave positive results for Cryptosporidium by staining and CERTEST CRYPTO CARD. All four positive samples of Giardia lamblia in microscopic examination reacted positively with CERTEST GIARDIA CARD 38

39 39 Illiterate fathers were 22.5% Illiterate mothers were 31.7% 37.5% of students have intestinal symptoms

40 % 62.5% PERCENTAGE OF SYMPTOMATIC AND ASYMPTOMATIC STUDENTS

41 % 23.3% 20% 24.2% 7.5% 1.7% 0.8% PERCENTAGE OF FATHER EDUCATION Father education

42 % 25% 16.7% 22.5% 2.5% 0.8% PERCENTAGE OF MOTHER EDUCATION Mother education

43 43 TotalNon infectedInfectedFather education 27234Illiterate 28226Primary 24213Secondary 29227University 972Master 211PhD 11-Read and write Total FATHER EDUCATION AND INFECTION

44 MOTHER EDUCATION AND INFECTION 44 TotalNon infectedInfectedMother education 38335Illiterate 30246Primary 20182Intermediate 27207Secondary 312University ---Master 1-1PhD 11-Read and write Total

45 There was no correlation between parasitic infection and parents education. (P = 0.8) 45

46 46 Blastocystis hominis was the common parasite (54.84%) then Entameoba coli (12.90%), Giardia lamblia (12.90%), Endolimax nana (9.68%) and Hymenolepis nana ( 3.23%)

47 47 Protozoan infection was 96.77% while helminthes infection was 3.23%. High incidence of infection was in Yemenis followed by Saudis due to the high number of students from these nationalities.

48 Detected parasites Nationality B. hominisE. nanaE. coliE. histolyticaG. lambliaH. nana Yemeni Saudi Afghani Palestinian Nigerian Chadian Somali Sudanese Turkish Pakistani Baluchi DISTRIBUTION OF INTESTINAL PARASITES PER STUDENTS NATIONALITY 48

49 There was no correlation between parasitic infection and nationality. (P = 0.8) 49

50 Infection with single parasite was in 73.96% of the infected students. Double infection was in 17.19%. Triple infection was in 8.85%. 50

51 80.8% 1.7% 3.3% 14.2% PERCENTAGE OF INFECTIONS TYPES 51

52 52 The majority of students, 108 (90%) were from south region of Jeddah and 20 (19%) of them were infected with intestinal parasites. There was no correlation between parasitic infection and region of residency in Jeddah. (P = 0.8)

53 HAND WASH AFTER WC AND INFECTION 53 TotalNot infectedInfectedHand wash after W.C Yes 1073No Total

54 HAND WASH BEFORE MEAL AND INFECTION 54 TotalNot infectedInfectedHand wash before meal Yes 18126No Total

55 Hand wash after WC

56 Hand wash before meal

57 57 There was no correlation between parasitic infection and hand wash after WC visiting and before meal. ( P = 0.70)

58 AGE AND INFECTION 58 Total Not infected InfectedAge Total

59 There was no correlation between parasitic infection and age of the students. (P = 0.3) 59 The highest infection was among the students of the age 14.

60 60 Each student was provided with a report about his diagnosis result, so the infected group get treatment and reexamination

61 RECOMMENDATION Health education and awareness programs for students regarding intestinal parasites. Increase the Cooperation between ministry of health and ministry of education regarding intestinal parasitic infection among students. Using other techniques in addition to direct smear such as: Ritchie tech, kits, acid fast stain and other technique. 61

62 ACKNOWLEDGMENT First, we would like to thank the Allah. Special thanks to our supervisor Dr. Majed Wakid for all what he gives us from support, time and teaching. We thank the Ministry of Education. We thank the cooperated intermediate school, manager, teachers and students. We thank School Health Unit and specially to Dr. Mohammed Khashugji. Finally, We would like to thank our parents and friends 62

63 Thank youThank you 63


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