See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/349916708

PREVALENCE OF INTESTINAL PARASITES AND POLYPARASITISM AMONG

CHILDREN LESS THAN FIVE YEARS IN THE LOGBABA DISTRICT HOSPITAL IN
DOUALA, CAMEROON

Article · January 2021

CITATION READS

1 416

6 authors, including:

Hamit Mahamat Mahamat Alio Abakar Idriss Lawane

Faculty of Sciences Health Human of University of N'Djamena (Chad) University of N’Djamena
20 PUBLICATIONS 108 CITATIONS 14 PUBLICATIONS 21 CITATIONS

SEE PROFILE SEE PROFILE

Issa Ramat Adam

4 PUBLICATIONS 4 CITATIONS

SEE PROFILE

All content following this page was uploaded by Abakar Idriss Lawane on 09 March 2021.

The user has requested enhancement of the downloaded file.

ejbps, 2021, Volume 8, Issue 2, 38-44. Research Article SJIF Impact Factor 6.044

Ndifor et al. European Journal

Europeanof Biomedical
Journal ISSN 2349-8870
of Biomedical and Pharmaceutical Sciences
Volume: 8
AND Pharmaceutical sciences Issue: 2
38-44
http://www.ejbps.com Year: 2021

PREVALENCE OF INTESTINAL PARASITES AND POLYPARASITISM AMONG

CHILDREN LESS THAN FIVE YEARS IN THE LOGBABA DISTRICT HOSPITAL IN
DOUALA, CAMEROON

Fombotioh Ndifor*1, Hamit Mahamat Alio1, Abakar Idriss Lawane1,2, Noukeu Ngoya Christelle3, Issa Ramat
Adam1 and Brahim Boy Otchom4
1
Department of Biomedical Sciences and Pharmacy, Faculty of Human Health Sciences, University of N’Djamena.
P.O. Box: 1117, N’Djamena, Chad.
2
Laboratory of Biochemistry and Applied Immunology (LABIA), Joseph KI-ZERBO University, Burkina Faso, 03.
P.O. Box 7021, Ouagadougou, Burkina Faso.
3
ESTUAIRE University Institute, P.O. Box: 4100, Douala, Cameroon.
4
Departement of Biomedical and Pharmaceutical Sciences, Toumai University, P.O. Box: 1764, Chad, N’Djamena.

*Corresponding Author: Fombotioh Ndifor

Department of Biomedical Sciences and Pharmacy, Faculty of Human Health Sciences, University of N’Djamena. P.O. Box: 1117,
N’Djamena, Chad.

Article Received on 01/12/2020 Article Revised on 21/12/2020 Article Accepted on 11/01/2021

ABSTRACT
The prevalence of intestinal parasites and polyparasitism was studied among children less than five years in the
Logbaba District Hospital from July to October 2020. Stool and blood samples were collected from 200 children
consisting of 100 males and 100 females consulted at the hospital. Stool samples were processed using direct wet
smear and Lugol stain method. Thick malaria blood smear and thin smear were prepared using blood collected
from finger tips of children. Parasites detected in stool and blood samples were Entamoeba histolytica, Ascaris
lumbricoides, Fungi and Plasmodium falciparum. The overall prevalence of parasitic infection in children was 80
(40%). From a total of 200 subjects studied, male children 44 (55%) were more infected than females 36 (45%).
Children between 3 months to 1 year were the least infected 7 (28%). There was no significant difference between
gender infection (P > 0.05). On the rate of occurrence of parasites in children, P. falciparum was the highest, 33
(41.25%). Parasitic infection was highest in childern who drank borehole water. High prevalence of Fungi was
noticed in children 27 (57.44%). Polyparasitism was strongest between E. histolytica + Fungi 14 (31.11%) and
least between E. histolytica + A. lumbricoides 2 (4.44%). Polyparasitism was highest among oldest subjects (P <
0.05). Impregnated mosquito nets greatly reduced malaria infection (P < 0.05). Intestinal parasite and
polyparasitism represent a real public health problem among children in Douala. Health education, personal
hygiene, proper sanitation, safe drinking water, clean environment and the use of mosquito nets should be
encouraged in order to reduce the prevalence of parasitism.

KEYWORDS: intestinal parasites, polyparasitism, children, Logbaba District Hospital, Douala.

INTRODUCTION zones where climatic conditions are favorable to parasitic

Parasitic infections are still causing morbidity and development.[4] The absence of adequate hygienic
mortality in various parts of the wold. In 2009, it was measure, poor socio-economic conditions, waste disposal
reported that more than 3 million persons were infected and congestion are some of the contributing factors for
with intestinal parasites, from which a total of 450 multiple parasite infections.[5] The health problems
million were seriously ill.[1] Many deaths are caused by related to multiple infectional parasitosis are very
parasitic diseases. Dianou et al.[2], reported that parasites common in African population and to other populations
were one of the major causes of morbidity and mortality. of the world and children are among the victims.[6] Many
Endemicity of various parasites can be found in some reasons are advocated by various authors concerning the
areas of the world. In fact, there are widespread parasitic hight prevalence of parasitc infections in children. Some
infections throughout the tropics and sud-tropics. of the reasons include a combination of hot humit
Infection with multiparasite species is the norm rather climate, poor sanitation, personal hygiene and
than the expectation. Despite the ubiquity of ignorance[7] and.[8]
polyparasitsm, its public health significance has been
inadequately studied.[3] This is true especially in tropical

www.ejbps.com │ Vol 8, Issue 2, 2021. │ ISO 9001:2015 Certified Journal │ 38

Ndifor et al. European Journal of Biomedical and Pharmaceutical Sciences

Transmissible diseases by contaminated food or water Nigeria, West Africa Obiukwu et al.[13] reported several
along side illneses like HIV/AIDS and hepatitis species of parasites in school children in Mbaukwu
constitude a serious public health problem. These Anambra State. The study of polyparasitism is very
diseases can lead to servere symptoms and eventually important because it may lead to a better understanding
result to dead. For exemple Entamoeba histolytica is the of parasitism.
second cause of mortality among protozoa.[9] The
intensity and prevalence of parasitic diseases are The present paper is designed to study the prevalence of
specially higher in rural areas, peripheral milieu, in intestinal parasites and polyparasitism in children less
children less than 5 years and in subjects who are always than 5 years in Logbaba District Hospital, Douala
in contact with dirty water and soil.[10] In children, Cameroon. The existence or not of some factors that
parasitic diseases can be very severe and engender may favour polyparasitism and to determine the most
malnutrition, anemia, reduced resistance to infections frequent types of polyparasitism encountered.
and even augmentation in mortality.
MATERIALS AND METHODS
In Cameroon, parasitic diseases in infants remain an Study area and population
important public health problem. Nkengazong et al.[11] Permission for the study was sought and obtained from
reported that out of 420 infants studied, 178(42.5%) were the Cameroon Ministry of Public Health in collaboration
infected with parasites. The study was done in Barombi, with the Logbaba District Hospital (LDH) in Douala,
a village in South West of Cameroon. Cameroon. Douala is the economic capital of Cameroon
located in Central Africa. This region is in tropical
Polyarasitism is defined as the co-existance of more than Africa. LDH is located in the 3rd district in the city of
one or more species of parasites in one host or subject. Douala between latitude 04˚ 02’ 18” N and longitude 09˚
Previous studies done in the city of Douala in Cameroon 45’ 33” E (fig. 1). This is the unique public hospital that
indicated that some of the patients consulted in various serves about 24000 inhabitants. Services offered include
hospitals, harboured more than one species of family planning, maternity, parasitology laboratory,
parasites.[5] This is true in many tropical countries. serology, hematology, bacteriology and biochemistry.
Keiser et al.[12] in Ivory Coast, West Africa reported that This hospital was chosen for our study because of its
two thirds of the population studied were infected with at strategic suburban location and the frequent high
least three species of parasites, at the same time. In attendance by patients.

Figure 1: Location of Logbaba in Douala, is represented by the star in the map.

www.ejbps.com │ Vol 8, Issue 2, 2021. │ ISO 9001:2015 Certified Journal │ 39

Ndifor et al. European Journal of Biomedical and Pharmaceutical Sciences

Criteria for acceptance or refusal of candidates 10x and finally 40x under a light microscope. For
Parents who brought their children for medical microscopic examination after coloration with Lugol. A
consultation and willingly accepted to participate in our pinch of stool sample was mixed with a drop of Lugol on
study were given free diagnosis and treatment. Those a slide and covered with a coverslip. Observation was
who refused to participate or whose children were more done using 10x and 40x. A subject was considered
than five years old, were not included in our work. A parasitized when the stool examined revealed the
total of 200 children consisting of 100 male and 100 presence of a minimum of an intestinal parasite or one
female children less than 5 years old participated in our form of resistance (eggs or cysts).
study.
Microscopic Examination of Blood
Collection of each sample Thick malaria blood smear was done and colored with
Prior to the collection of stool and blood samples, a Giemsa diluted to 1/10 concentration for 15 minutes. The
questionnaire sheet was given to each parent. The sheet slide containing the sample and Giemsa was rinsed,
contained questions related to our research and dried, immersion oil put on it and observed with 100x for
information on the children and their parents. Privacy the presence of malaria trophozoites. The second
and ethical measures were highly respected. The parents examination was concerned with thin blood smear. After
were instructed on the proper method of stool collection preparing the smear on a slide it was allowed to dry at
in order to avoid contamination. Labelled stool vials and room temperature. May Grunwald was put on the smear,
spatulas were given to them for fresh stool collection allowed to wait for 3 minutes. After which the same
from their children. The stool samples were collected in quantity of clean water was added to the preparation. The
the morning and immediately processed in the hospital mixture was again left to react for 3 minutes and the
laboratory. Blood samples were collected from finger supernatant was thrown away. Finally Giemsa diluted to
tips of patients by laboratory technicians and processed 1/20 concentration was put on the smear and left at room
immediately. temperature for 15 – 20 minutes. After this period the
composite on the slide was rinsed and dried. Immersion
Macroscopic and Microscopic Examination of Stool oil was added to the preparation and observed using 100x
Macroscopic examination was done by visual for detection of malaria trophozoites.
observation noting the consistency, appearance, color,
the presence of glair, adult worms, mucus and blood. For Statical Analysis
microscopic examination of fresh stool, each of the Statistical analysis was performed using Excel and SPSS
samples was well mixed to obtain a homogeneous version 18.0. The Chi-2 test was used to search for
concentration. A pinch of each sample was put on a slide associations between the parasites and the socio-
and mixed with a drop of physiological saline using an demographic characteristics of the children studied. A
applicator stick. A coverslip placed on the preparation difference was considered statistically significant (p-
and examined. Observation of parasites was done using value < 0.05).

RESULTS
Table 1: Prevalence of parasites according to age range.
Age range (N=200)
3 months–1year 1–2 years 2- 3 years 3- 4 years 4-5 years
Parasites
(N= 25) (N=30) (N=40) (N=50) (N=55)
n % n % n % n % n %
P.falciparum 3 12 4 13.3 6 15 8 16 12 21.8
E. histolytica 2 8 3 10 1 2.5 2 4 3 5.4
A.lumbricoides 1 4 2 6.6 2 5 3 6 1 1.8
Fungi 1 4 2 6.6 6 15 7 14 11 20
Total 7 28 11 36.6 15 37.5 20 40 27 49.1
N= number of subjects studied ; n = number of infected patients

The above table indicates that out of the 200 children

investigated 80(40%) were infected. From the 25
children between 3 months - 1 year studied 7(28%) were
infected, followed by 1-2 years 11(36.6%), 2-3 years
15(37.5%), 3-4 years 20(40%) and 4-5 years 27(49.1%)
infected respectively in accordance to the N number
studied. The youngest children, age range between 3
month - 1 year had the lowest prevalence of parasitic
infection, while the oldest children 4-5 years had the
highest prevalence (P>0.05).

www.ejbps.com │ Vol 8, Issue 2, 2021. │ ISO 9001:2015 Certified Journal │ 40

Ndifor et al. European Journal of Biomedical and Pharmaceutical Sciences

Table 2: Prevalence of parasites according to gender.

Parasites Gender
Male Female
N= 100 N=100
n % n %
P.falciparum 18 40.90 15 41.66
E. histolytica 5 11.36 6 16.66
A.lumbricoides 5 11.36 4 11.11
Fungi 16 36.36 11 30.55
Total 44 100 36 100
N= number of children studied; n= number of children infected

Parasitic prevalence according to gender does not seem parasites. However the total number of infected males
to present a significant difference as observed in table 2. 44(55%) was slightly higher than of females 36 (45%)
Male and female sexes were infected by the four (P>0.05).

Figure 2: Rate of occurrence of parasites in children less than 5 years.

On the rate of the occurrence of parasitic infection, P. fungi, 27 (33.75%), the third was E. histolytica 11
falciparum had the highest infection rates in children 33 (13.75%) and A. lumbricoides 9 (11.25%) (figure 2).
(41.25%). The second infection registed was that of

Table 3: Prevalence of parasitic infection according to water supply sources.

Tap water Minerale Borehole/spring Proportion
Parasites Borehole N=50
N=50 N=50 N=50 infected
n % n % n % n % n %
E. histolytica 6 20.68 3 27.27 0 0 2 33.33 11 23.40
A.lumbricoides 5 17.24 3 27.27 0 0 1 16.66 9 19.14
Fungi 18 62.06 5 45.45 1 100 3 50 27 57.44
Total 29 100 11 100 1 100 6 100 47 100
N= number of children studied; n= number of children infected

Distribution of parasites according to water supply children who drank tap water. Those children who
showed the following findings (table 3): the biggest sometimes drank water from boreole or spring water had
number of infected children, 29 of them who drank lower contamination (6 of them) and the least
borehole water regularly, followed by 11 infected contaminated (1 child) regularly drank mineral water.

www.ejbps.com │ Vol 8, Issue 2, 2021. │ ISO 9001:2015 Certified Journal │ 41

 Ndifor et al. European Journal of Biomedical and Pharmaceutical Sciences

Table 4: Prevalence of polyparasitism according to age range.

Age range Proportion of
3 Months-1 1-2 2-3 3-4 4-5 children with
polyparasites
Year (N= 25) (N=30) (N=40) (N=50) (N=55) polyparasitism
n % n % n % n % n % n %
P. falciparum + E. histolytica 1 4 2 6.66 2 5 3 6 3 5.45 11 24.44
P. falciparum + A.lumbricoides 1 4 1 3.33 2 5 3 6 3 5.45 10 22.22
A.lumbricoides + Fungi 0 0 1 3.33 1 2.50 2 4 4 7.27 8 17.77
E. histolytica + Fungi 0 0 1 3.33 3 7.50 4 8 6 10.90 14 31.11
E. histolytica + A.lumbricoides 0 0 0 0 0 0 1 2 1 1.81 2 4.44
Total 2 8 5 16.66 8 20 13 26 17 30.90 45 100
N= number of children studied; n= number of children infected

Polyparasitism was detected between fungi + E. P. falciparum + A. lumbricoides 10( 22.22%). The fourth
histolytica 14(31.11%). This was the greatest number of was between A.lumbricoides + Fungi 8(17.77%) and E.
co-infection observed. The second number of histolytica + A. lumbricoides 2(4.44%) was the least.
polyinfection was between P. falciparum + E. Polyparasitism was highest in oldest children, (P>0.05).
histolytica 11(24.44%). The third was between

Table 5: Prevalence of malaria according to the usage or not of impregnated mosquito net.
Number of subjects
Positive Negative
Characteristics studied
N (%) n+ (%) n- (%)
Utilisation 100 50 2 6.06 98 58.68
Non Utilisation 100 50 31 93.93 69 41.31
Total 200 100 33 100 167 100
Legand: N= number of subjects studied ; n+ = number of positive patients; n- = number of negative subjects.
Utilisation of mosquito net greatly reduced malaria infection, only 2(6.06 %) infected as compared to those who did not
frequently use mosquito net 31(93.93%) (P < 0.05). (Table 5).

DISCUSSIONS AND CONCLUSION between 1-2 years. Being more active may imply that
Our study was concerned with the prevalence of they play a lot even in dirty ground and could eat food
intestinal parasites and polyparasitisms in children less that is contaminated due to ignorance. Some children
than 5 years. Patients consisting of 100 male and 100 also love sucking their fingers and this may contribute to
female children were studied. Parasites detected in parasitic infection.
infected patients were: P. falciparum, E. histolytica,
A.lumbricoides and fungi. Out of a total of 200 children Parasitic infection was highest in subjects who drank
investigated, 80(40%) were infected with parasites. borehole water. This was followed by tap water and
Infected males, 44(55%) were higher than infected borehole/ spring water respectively. Mineral water
females 36(45%). Our finding is in accord with those of presented the best option. High prevalence of Fungi
other authors[6], who indicated that the prevalence of 27(57.44%), E. histolytica 11 (23.40%) and
infection was generally higher in male (57.6%) than A.lumbricoides 9 (19.14%) was noticed. Water is an
female (42.40%) children in the River States of Nigeria. essential commodity for human survival. The above
In a recent study conducted in a hospital in N’Djamena, results suggest that contamination might have occored on
Chad by Fombotioh et al.[14], highlighted similar results some of the sources of water supply. During the raining
showing that the prevalence of parasitic infection was season, flooding may contaminate boreholes, tap water
higher in male than female children. This may be and even some spring water. Our work was carried out
justified by the fact that boys love playing more than during this season which is prone to flooding, conducive
girls do and sometimes roll themselves on the ground to parasitic development and dissemination. Other
during their games. Concerning the distribution of authors[16] reported that significant negatif association
parasitic infection according to the age range, it was was obseved between use of tap water and high
discovered that infectivity increased with age range. prevalence of E. histolytica infection. Contrally, our
Children between 3 month to 1 year had lowest number results showed that those who used tap water were not
of infection, 7(28%) as compared to 4-5 years who had only infected by E. histolytica but by A.lumbricoides and
highest cases, 27(49.1%). Our results are closely similar fungi. Hence cofirming our suggestion of possible flood
to those obtained by other investigated[15] who reported contamination. On the prevalence of polyparasitism in
that children above two years had higher prevalence of accordance with age range, the association with E.
parasitic infestation than those between 1-2 years old. histolytica + Fungi was dominant, 14(31.11%).
Children from 4-5 years are more active than those Polyparasitism involving P. falciparum and E. histolytica

www.ejbps.com │ Vol 8, Issue 2, 2021. │ ISO 9001:2015 Certified Journal │ 42

Ndifor et al. European Journal of Biomedical and Pharmaceutical Sciences

was the second with a prevalence of 11(24.44%), the assessment of the infectious forms of intestinal
third was P. falciparum + A.lumbricoides 10(22.22%). helminths in school children from Chad. Journal of
The fourth was between A.lumbricoides + Fungi Biology and Life Sciences, 4(2) : 341.
8(17.77%) and E. histolytica + A. lumbricoides 5. Fogwe, Z. N., & Ndifor, F. C. (2010). Tropical city
2(4.44%) was the least. The highest number of infected milieux and disease infection: the case of Douala,
children with polyparasitism were those within the ages Cameroon. Journal of Human Ecology, 30(2): 123-
of 4-5 years (P < 0.05). Polyparasitism with malaria in 130.
children was also reported in Nigeria.[17] The authors 6. Abah, A. E., & Arene, F. O. I. (2015). Status of
found a very high associassion between P. falciparum intestinal parasitic infections among primary school
and A.lumbricoides in children. Our work showed that children in Rivers State, Nigeria. Journal of
the association between P.falciparum and A.lumbricoides parasitology research, 2015.
infection occupied the second position. In fact the 7. Sam-Wobo, S. O., Mafiana, C. F., & Amusan, A. A.
differences between our work and that of the above S. (2005). Health knowledge and hygiene behaviors
authors are slim because polyparasitism between P. among schoolchildren in relation to Ascariasis in
falciparum and other intestinal parasites were confirmed Ogun State, Nigeria. Tanzania Journal of Health
by both findings. Impregnated mosquito nets reduced Research, 7(2): 62-66.
mosquitoes.[18] The impact of mosquito net use on 8. Opara, K. N., Udoidung, N. I., Opara, D. C., Okon,
malaria prevension was also highlited by many O. E., Edosomwan, E. U., & Udoh, A. J. (2012). The
authors.[19, 20, and 21] impact of intestinal parasitic infections on the
nutritional status of rural and urban school-aged
The utilisation of mosquito nets is crucial in the fight children in Nigeria. International Journal of MCH
against mosquito bites. It was discovered that the and AIDS, 1(1): 73.
children who used mosquito nets were significantly less 9. Maladies Tropicales. By P. Bouree. 396 pages.
infected with malaria than those who did not (P<0.05). ISBN 2 225 80700 0. Masson, Paris, 1987. FF 130.
Our finding are in accord with those of the above 10. Tyoalumun, K., Abubakar, S., & Christopher, N.
authors. (2016). Prevalence of intestinal parasitic infections
and their association with nutritional status of rural
CONCLUSION and urban pre-school children in Benue State,
Our work indicates that intestinal parasites and Nigeria. International Journal of MCH and AIDS,
polyparasitism are real in children less than 5 years in the 5(2): 146.
city of Douala. The prevalence of P. falciparum, fungi, 11. Nkengazong, L., Njiokou, F., Wanji, S., Teukeng,
E. histolytica and A. lumbricoides represent a public F., Enyong, P., & Asonganyi, T. (2010). Prevalence
health problem. The use of mosquito nets should be of soil transmitted helminths and impact of
reinforced. More study is needed especially concerning Albendazole on parasitic indices in Kotto Barombi
fungi infection because this protozoa has long been and Marumba II villages (South-West Cameroon).
neglected. Polyparasitism may be caused by a African Journal of Environmental Science and
combination of multiple hygienic factors: unclean Technology, 4(3).
drinking water, poor sociocultural and economic 12. Keiser, J., N'Goran, E. K., Traoré, M., Lohourignon,
conditions, environemental problems and ignorance. K. L., Singer, B. H., Lengeler, C., ... & Utzinger, J.
Health education is necessary to all children and parents. (2002). Polyparasitism with Schistosoma mansoni,
Children should regularly be diagnosed and treated geohelminths, and intestinal protozoa in rural Côte
against parasitic infections in order to ascertain their d'Ivoire. Journal of parasitology, 88(3): 461-466.
smooth health development. 13. Obiukwu, M. O., Umeanaeto, P. U., Eneanya, C. I.,
& Nwaorgu, G. O. (2008). Prevalence of gastro-
REFERENCES intestinal helminths in school children in Mbaukwu,
1. Hotez, P. J., Fenwick, A., Savioli, L., & Molyneux, Anambra State, Nigeria. Nigerian Journal of
D. H. (2009). Rescuing the bottom billion through Parasitology, 29(1): 15-19.
control of neglected tropical diseases. The Lancet, 14. Fombotioh N., Hamit M. A., Issa R. A., Abakar I. L.
373(9674): 1570-1575. & Foumsou L . (2020). Giardia intestinalis and
2. Dianou, D., Poda, J. N., Savadogo, L. G., Sorgho, Entamoeba histolytica: Their Prevalence and
H., Wango, S. P., & Sondo, B. (2004). Parasitoses Hematological Effects on Children between Seven
intestinales dans la zone du complexe hydroagricole Months to Seven Years at the Mother and Child
du Sourou au Burkina Faso. VertigO-la revue Teaching Hospital in N’Djamena, Chad. African
électronique en sciences de l'environnement, 5(2). Journal of Parasitology Research. 7(11): 001-006.
3. Pullan, R., & Brooker, S. (2008). The health impact 15. Soumana, A., Kamaye, M., Saidou, D., Dima, H.,
of polyparasitism in humans: are we under- Daouda, B., & Guéro, T. (2016). Les parasitoses
estimating the burden of parasitic diseases?. intestinales chez les enfants de moins de cinq ans a
Parasitology, 135(7): 783. Niamey au Niger. Mali medical, 31(4).
4. Alio, H. M., Tidjani, A., Otchom, B. B., Tidjani, M. 16. Ouattara, M., N'Guéssan, N. A., Yapi, A., &
T., & Felix, B. B. C. (2013). An epidemiological N'Goran, E. K. (2010). Prevalence and spatial

www.ejbps.com │ Vol 8, Issue 2, 2021. │ ISO 9001:2015 Certified Journal │ 43

 Ndifor et al. European Journal of Biomedical and Pharmaceutical Sciences

distribution of Entamoeba histolytica/dispar and

Giardia lamblia among schoolchildren in Agboville
area (Côte d'Ivoire). PLoS neglected tropical
diseases, 4(1): e574.
17. Odoemene, S. N., Oluwole, A. S., Mogaji, H. O.,
Adegbola, M. V., Omitola, O. O., Bayegun, A. A., ...
& Ekpo, U. F. (2020). Polyparasitism with Malaria
and Intestinal Parasite Infections among Infants and
Preschool-Aged Children in Egbedore, Osun State,
Nigeria. Journal of Parasitology Research, 2020.
18. Agusto, F. B., Del Valle, S. Y., Blayneh, K. W.,
Ngonghala, C. N., Goncalves, M. J., Li, N., ... &
Gong, H. (2013). The impact of bed-net use on
malaria prevalence. Journal of theoretical biology,
320: 58-65.
19. Ntonifor, N. H., & Veyufambom, S. (2016).
Assessing the effective use of mosquito nets in the
prevention of malaria in some parts of Mezam
division, Northwest Region Cameroon. Malaria
journal, 15(1): 390.
20. Lengeler, C. (2004). Insecticide‐treated bed nets and
curtains for preventing malaria. Cochrane database
of systematic reviews, (2).
21. World Health Organization. (2016). World malaria
report 2015. World Health Organization.

www.ejbps.com │ Vol 8, Issue 2, 2021. │ ISO 9001:2015 Certified Journal │ 44

View publication stats