Gastrointestinal infections and under nutrition among children between 0 and 5 years old. Case of Mareba sector, Bugesera district, eastern province, Rwanda

ABSTRACT

Gastrointestinal infections and malnutrition affect millions of under five years old children worldwide. The presented study was concerned on gastrointestinal infections and under nutrition among 50 under five years old children who attended Mareba Health Center in Bugesera District. Children stool samples were tested at Mareba Health Center laboratory using the optic microscope and their parents were interviewed using a prepared questionnaire about their children feeding habits. 5 causal agents were identified at different proportions among the 38 infected children detected for a given pathogens.

Bacteria were found at the prevalence of (8%), Entamoeba histolytica (8%), Trichomonas intestinalis (14%), yeasts (30%) and the blood parasite such as Plasmodium malaria (16%). According to age, most infected children were between 13 months and 5 years old (34% each) as the children grow up and begin to take food without their parents while it was less among the 0-12 groups of age.

The study shown that 100% of children from 0 to 6 months do not eat anything, they are breastfeed on their mothers. The consummation of vegetables and beans was high among all age groups, but the percentage of children eating vegetable increased slightly from 7-12 months (62.5%) to 25 months-5 years (75%), while the one of beans increased from 87.5% to 93.8%. The consummation of fruits is quite low among children from 7-12 months (25%), but reach 68.7% for the children over 25 months. The children consuming meats, eggs and milk remains below 20% throughout all age groups and most of children were eating less than 2 times per day then 4% severely wasted. As a result, 8% of the children were wasted and among them 44% were moderately underweighted.

A positive relationship seems to exist between Trichomonas intestinalis and underweight, as 100% of the children infected by Trichomonas intestinalis were moderately underweight. Also, 66.6% of the children with double infections (bacteria and yeasts) were also moderately underweight.

LIST OF SIGNS AND ABREVIATIONS

CSVA&N: Comprehensive Food Security and Vulnerability Assessment & Nutrition Survey

FAO: Food and Agriculture Organization

GII: Gastrointestinal infections

GS: Growth Standard

HIV: Human Immuno deficiency Virus

L/A: Length for Age

MUAC: Mid-Upper Circumference

NK: Natural killer

PCM: Protein Calorie Malnutrition

PEM: Protein Energy Malnutrition

PM: Protein Malnutrition

RDHS: Rwanda Demographic and Health Survey

UNICEF: United Nations Children's Fund

W/A: Weight for Age

W/H: Weight for Height

WBCs: White Blood Cells

WHO: World Health Organization

ìg: Microgram

TABLE OF CONTENTS

DECLARATION i

APPROVAL ii

DEDICATION iii

ACKNOWLEDGEMENTS iv

ABSTRACT v

LIST OF SIGNS AND ABREVIATIONS vi

TABLE OF CONTENTS vii

LIST OF TABLES ix

LIST OF FIGURES x

CHAPTER I. GENERAL INTRODUCTION 1

I. 1.BACKGROUND OF THE STUDY 1

I.2. STATEMENT OF THE PROBLEM 2

I.3. RESEARCH OBJECTIVES 2

I.4. HYPOTHESIS 3

I.5. RESEARCH QUESTIONS 3

I.6. SIGNIFICANCE OF THE STUDY 3

I.7. LIMITATION AND DELIMITATION 3

CHAP II. LITERATURE REVIEW 4

II.1. DEFINITION OF GASTROINTESTINAL INFECTIONS 4

II.2.PREVALENCE OF GASTROINTESTINAL INFECTIONS 4

II.2.1. Prevalence of gastrointestinal infections worldwide 4

ll.2.2. Prevalence of gastrointestinal infection in different African countries 4

II.2.3. Prevalence of gastrointestinal infections in Rwanda 5

II.3. INFECTIOUS AGENTS OF GASTROINTESTINAL INFECTIONS 5

II.3.1. Protozoa 5

II.3.2. Bacteria 6

II.3.3. Virus 7

II.3.4. Helminthes 7

II.4. RISK FACTORS OF GASTROINTESTINAL INFECTIONS AMONG CHILDREN 8

II.4.1. Poor hygiene 8

II.4.2. Contact with animals 8

II.4.3. Contaminated water 8

II.4.4. Contaminated soil 9

II.4.5. Malnutrition 9

ll.5.4. Prevalence of malnutrition 11

ll.5.6. Causes of malnutrition 12

ll.5.7. Malnutrition in Rwanda 13

II.6. MEASURES TO PREVENT MALNUTRITION 15

ll.6.1. What should be eaten to prevent malnutrition 15

ll.6.2. How malnutrition decrease immune system and lead to gastrointestinal infections? 16

ll.6.3. How infections could be avoided by well nutrition 17

CHAPTER III. METHODOLOGY DESCRIPTION 18

III.1.STUDY SITE AND STUDIED POPULATION 18

III.2. SAMPLE STOOLS COLLECTION 18

III.3. STOOLS SMEAR PREPARATION 18

III.3.1. MICROSCOPIC EXAMINATION 18

III.5. RISK FACTORS INVESTIGATION 18

III.6. IDENTIFICATION OF MALARIA 19

III.7. IDENTIFICATION OF MALNUTRITION AMONG CHILDREN 19

CHAPTER IV. RESULTS INTERPRETATION 20

CHAPTER V. DISCUSSION 27

CHAP VI. CONCLUSION AND RECOMANDATION 30

VI.1.CONCLUSION 30

VI.2.RECOMANDATION 30

GROSSARY 32

REFERENCES 33

APENDICES 36

ANNEXES 42