Prevalence of Hookworm Infection Among Patients Attending Aminu Kano Teaching Hospital Kano, Nigeria

Bajopas Volume 3 Number 2 December, 2010
Bayero Journal of Pure and Applied Sciences, 3(2): 84 - 86

Received: August, 2010
Accepted: September, 2010
ISSN 2006 - 6996
PREVALENCE OF HOOKWORM INFECTION AMONG PATIENTS ATTENDING

AMINU KANO TEACHING HOSPITAL KANO, NIGERIA
*Ibrahim, S. and Zubairu, M. L.
Department of Biological Sciences, Bayero University, P. M. B. 3011, Kano, Nigeria
*Correspondence author: [email protected]
ABSTRACT
Prevalence rate of hookworm infection among patients attending Aminu Kano Teaching Hospital
(AKTH) Kano, Nigeria was determined between September and November 2009. The procedure
involved collecting and processing of stool samples in accordance with standard parasitological
techniques. Out of 577 samples collected and processed, 50 (8.7%) were positive for hookworm
infection with a peak in those subjects in the age group 21– 30 years (3.3%), followed by 51– 60
years (1.6%) and then 31 – 40 years (1.3%). No case of infection was detected among patients of
71 years and above. This study showed that the prevalence of infection was higher among females
(5.7%) than males (3.0%), and significant difference exists in the rate of infection between the
two sexes at P = 0.05. The above prevalence rate of infection could become higher in years to come
and therefore become more threatening due to increase in birth rate and other socio-economic
factors. Consequently, it is suggested that laying emphasis on personal and community hygiene can
be achieved through promoting health education in addition to early diagnosis and treatment of the
infection will go a long way in checking the spread of this infection in our community especially as
it causes maternal death.
Keywords: Community health, hookworm, hospital, infection, Kano Keywords: Herbalism, Phytoch
Phytochemicals, Scent, Benin
INTRODUCTION recognised as one of the leading causes of child
Hookworm is a parasitic nematode that lives in the morbidity in the developing countries of the tropics
small intestine of its host, which may be a mammal and sub-tropics. Hence, in susceptible children this
such as dog, cat or human (Markell et al., 2006). Two infection affects their intellectual cognitive and causes
species of hookworm commonly infect humans, growth retardation; intra-uterine growth retardation
Ancylostoma dueodenale and Necator americanus. (IUGR), prematurity and low birth weight (LBW)
Hookworms are thought to infect more than 600 among new borns in infected mothers are also
million people world wide. Both A. duodenalis and N. associated by this kind of infection (Markell et al.,
americanus are found in Africa, Asia and America 2006).
(Markell et al., 2006). Infection by hookworm is the Since determining prevalence rate of a disease is an
second most common human helminth infection after important information that can be used in sensitizing
ascariasis. In contrast to most intestinal helminthiasis, government and other stakeholders interested in
where the heaviest parasitic loads tend to occur in disease prevention and control towards taking
children, hookworm prevalence and intensity can be appropriate measures before the situation goes out of
higher among adult males. Indeed, in most endemic hand, this study was conducted with the view to
areas Hotez et al. (2005) reported that adult women determining the prevalence of hookworm infection
are the most severely affected by anaemia, mainly among the patients attending Aminu Kano Teaching
due to their much higher need for iron as a result of Hospital by screening them for the presence of eggs
menstruation and repeated pregnancy in addition to of the hookworms through microscopic stool sample
the fact that customarily they have access to much analysis.
poorer food than men. Hotez et al. (2005) added that
majority of the infected individuals live in poverty- MATERIALS AND METHODS
stricken areas with poor sanitation. Study Area
Although this infection is rarely fatal, but anaemia can The study area was Aminu Kano Teaching Hospital
be significant in heavily infected individuals, thus (AKTH), located along Zaria Road, Tarauni Local
Gyorkos et al. (2006) reported that 56% of all Government Area, Kano State, Nigeria. The
pregnant women in developing countries are suffering predominant tribes attending the hospital are Hausa-
from anaemia out of which 20% of all maternal deaths Fulani with other tribes like Yoruba, Igbo, Kanuri, and
are either directly or indirectly related to anaemia. other minority tribes that live within and outside Kano.
The infection of the host is caused by the larvae and The importance of this hospital is so enormous as a
not the eggs, caused by walking bare footed through number of the patients come on referral in addition to
areas contaminated with faecal matter (Hawdon and those that attend the out patient unit.
Hotez, 1996). This kind of infection has been
84

Kano State is located on latitude 12o09' N and Adeyeba and Essiet, 2001). Similarly, the higher
longitude 7o41' S of the equator (Antwi, 1991). prevalence rate of 3.3% recorded among patients
According to National Population Commission (2007) between 21 – 30 years could probably be due to their
the population of Kano during the 2006 National higher involvement with the above activities and
Population Census was 2163225, with 964889 males therefore they became more at risk of infection by the
and 1198336 females. Kano is within the savannah disease. Moreover, the complete absence of infection
region of Nigeria, with rainy season usually from May from among patients of 71 and above years and only
to October and the cold dry season is within the 0.2% from those between 0 – 10 years could be
months of November to April (Oyeyi et. al., 2009). attributed to their old age and tender age
respectively, and hence their non-participatory
Sample Collection manner on the above risk factors that normally expose
Five hundred and seventy seven (577) samples were individuals to the hookworm infection. In addition, the
collected and analysed from patients on the basis of observation that adult women between 21 – 70 years
clinical information written on the patients’ Laboratory had higher prevalence rate of this infection in this
Request Form issued by Consultants between 14th study of 0.3 – 2.4% as against their male
September and 13th November 2009. Fresh stool counterparts in the same age group with 0.2 – 0.9%
sample for hookworm screening was collected from only, further upheld the report of Hotez et al. (2005)
each of the patients in a dry, clean, leak proof and that says adult women are the most severely affected
sterilized sample container, while making sure that no by anaemia in most endemic areas due to their much
urine, water, soil or other contaminants get into the higher needs for iron because of menstruation,
container. The fresh stool samples were processed repeated pregnancy and the fact that they get poorer
and examined microscopically (Cheesbrough, 2005). food than men (Bethony et al., 2006), which can be
directly related to over dependence of most of them
Microscopy and Identification on men for their daily needs.
The faecal samples were processed and examined for Comparing this prevalence rate with what was
the presence of the hookworm eggs. Microscopic obtained in similar studies else where such as
examination of the stool samples was done by direct Darjeeling, India with 42.8% (Pal et al., 2007),
saline preparation for ova and cysts (Cheesbrough, Hoabinh, North western Vietnam with 52% prevalence
2005). On a microscope slide, emulsified small stool out of 526 tested households tested (Verle et al.,
specimen was added on to a normal saline (sodium 2003), Xiulongkan village, China with 60% infection
chloride 0.9 w/v) and on one edge of the side cover rate (Gandhi et al., 2001) and Minas Gerais, Brazil
slip was carefully placed on the suspensions avoiding with 62.8% as reported by Fleming et al. (2006), one
over floating and air bubbles. The samples were can say that the prevalence rate of 8.7% found in this
microscopically examined, identified and confirmed study is relatively very low. This can be attributed to
using x10 and x40 objective lenses (Cheesbrough, the fact that the hospital is city–based, where a
2005). significant number of those patronizing it have better
awareness compared to those in the rural areas
Statistical Analysis although some of the cases could be referral type
The data generated was analysed for significant from other hospitals. It should however be noted that
difference between the rate of hookworm infection the above prevalence rate could be different if the
recorded between males and females tested during study was extended to cover rainy season.
the study using Chi-square test as described by
Mukhtar (2003). CONCLUSION AND RECOMMENDATIONS
The above prevalence rate of infection is low but
RESULTS AND DISCUSSION could become higher and more threatening in the
Table 1 shows the summary of the results obtained future due to increase in birth rate and continued
during this study. The result indicated that out of 577 deterioration in other socio-economic factors, such as
patients examined, 50 (8.6%) were infected by the .lack of quality food that is sometimes associated with
hookworm, with 17 (3.0%) being males and 33 poverty, which is common among most Nigerians and
(5.7%) being females and significant difference exists especially when walking in poor hygienic environment
in the rate of infection between the two sexes (P = bare footed. Consequently, it was suggested that
0.05). The higher prevalence found among the laying emphasis on personal and community hygiene
females could be due to the fact that they are can be achieved through promoting health education
normally involved more in household activities such as in addition to early diagnosis and treatment of the
food preparation, cleaning of surroundings and water infection especially among pregnant women, will go a
fetching in which they work barefooted, thus possibly long way in checking the spread of this infection in
stepping on areas contaminated with faecal matter our community especially due to its devastating effect
containing the larvae (Hawdon and Hotez, 1996; in causing maternal death.
85

Table 1: Prevalence of Hookworm Infection Among Patients Attending Aminu Kano Teaching
Hospital by Age and Sex
Age Sex Number Number Infected Infection (%)
(yrs.) Examined (by sex) Sub-total
0 – 10 M 56 1 0.2 01 (0.2)*
F 56 0 0.0
11 – 20 M 87 3 0.5 06 (1.0)
F 69 3 0.5
21 – 30 M 107 5 0.9 19 (3.3)
F 65 14 2.4
31 – 40 M 51 2 0.3 08 (1.3)
F 31 6 1.0
41 – 50 M 15 1 0.2 03 (0.5)
F 7 2 0.3
51 – 60 M 12 4 0.7 09 (1.6)
F 8 5 0.9
61 – 70 M 3 1 0.2 04 (0.7)
F 3 3 0.5
71 – 80 M 1 0 0.0 00 (0.0)
F 2 0 0.0
81 – 90 M 3 0 0.0 00 (0.0)
F 1 0 0.0
S/total M 335 17 3.0
F 242 33 5.7
G/ total 577 50 8.7 50 (8.7)
*Values in parentheses are percentages

Key: M = male, F = female
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Bajopas Volume 3 Number 2 December, 2010

Bayero Journal of Pure and Applied Sciences, 3(2): 84 - 86

PREVALENCE OF HOOKWORM INFECTION AMONG PATIENTS ATTENDING

*Values in parentheses are percentages

REFERENCES Process. Curr. Opin. Genet. Dev. 6 (5): 618 –

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