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

LIST OF TABLES

Table 1: CLASSIFICATION OF CHILDREN MALNUTRITION. 11

Table 2: THE PREVALENCE OF GASTROINTESTINAL INFECTION ACCORDING TO IDENTIFIED PARASITES IN 50 INFECTED CHILDREN. 35

Table 3: CLASSIFICATION OF CHILDREN AGES AND INFECTIONS 35

Table 4: GENDER PRESENTATION OF CHILDREN INFECTED BY GASTROINTESTINAL PARASITE 35

Table 5: CHILDREN STATUS, CALCULATION OF NUTRITION AND LABORATORY RESULTS 35

Table 6: CALCULATION OF MALNUTRITION WITH RELATED INFECTIONS 37

Table 7: PREVALENCE OF MALNUTRITION AMONG CHILDREN ACCORDING TO THE INFECTIOUS AGENTS 37

Table 8: CHILDREN NUTRITION 37

Table 9: PARENTS SUGGESTIONS 38

Table 10: CHILDREN HYGIENE 38

Table 11: CHILDREN HEALTH 39

Table 12: ORDER OF TAKING MEAL 39

LIST OF FIGURES

Figure 1: Direct and indirect causes of malnutrition. 13

Figure 2: Relationship between nutrition and infection. Adapted from (Brown, 2003). 17

Figure 3: The prevalence of gastrointestinal infection according to identified parasites in 50 infected children. 20

Figure 4: Classification of children ages and infections 20

Figure 5: Gender presentation of children infected by gastrointestinal parasite. 21

Figure 6: Category of malnutrition according to different methods 21

Figure 7: Prevalence of malnutrition among children according to the infectious agents 22

Figure 8: Percentage of parents who agree that their children have sufficient nutrition and sufficient weight 23

Figure 9: Order of taking meal. 24

Figure 10: Classification of children ages and percentage of children taking food. 25

Figure 11: Children habits. 26

Figure 12: Children health. 26

CHAPTER I. GENERAL INTRODUCTION

I. 1.BACKGROUND OF THE STUDY

Intestinal parasites are organisms that live in gastrointestinal tract of animals, including humans. They are among the most common and widely distributed animal parasites of man. Infections with intestinal parasites rank among the most important persistent public health problem across the globe and they are important in African children (Cox, 1982).

The World Health Organization (WHO) estimates that 3.5 billion people worldwide are infected with some type of intestinal parasites and as many as 450 million of them are sick as a result and children are most frequently infected with these parasites (WHO, 1997). Intestinal parasites spread in area with poor sanitation and most common areas are in tropical developing countries on the African, Asian, and South American continents. Housing has been identified as a major factor affecting the health of aboriginal people. Inadequate or poorly maintained housing and the absence of functioning infrastructure can pose serious health risk. Overcrowded dwellings and poor quality housing lead to the spread of infectious diseases (Australian Bureau of Statistics & Australian Institute of Health and Welfare, 2008).

Usually, gastrointestinal infections which affect the organs of digestive system cause abdominal cramping followed by diarrhea, fever, loss of appetite, nausea, vomiting, weight loss, dehydratation, mucus or blood in the stool which cause under nutrition.

Increasing evidence suggests that protein-calorie malnutrition (PCM) is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and gastrointestinal infections represent a serious public health problem and mechanisms underlying the malnutrition induced by intestinal helminthes have been described (Mofft, 2003). The increased incidence and severity of infections in malnourished children is largely due to deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. There is a cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease and metabolic responses that further alter nutritional status.

The consequences of malnutrition are diverse and included: increased susceptibility to infections, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways (Leonor, 2011).