Hymenolepis nana, commonly known as the dwarf tapeworm, affects 50 to 75 million people worldwide. To date, no studies have explored the disease burden of H. nana infection in Sudan. This study aimed to determine the national prevalence of H. nana across 189 districts and 18 states in Sudan and the number of individuals infected with H. nana who did not receive treatment during the mass drug administration (MDA) campaign targeting schistosomiasis. In addition, the study sought to evaluate the extent of co-infection of H. nana with schistosomiasis and soil-transmitted helminthiasis. This involved a secondary analysis of a nationwide survey conducted in 2017 in Sudan. Binomial family generalized linear models with a logarithmic link function were used to estimate the prevalence ratio of potential risk factors, including sex and water and sanitation conditions in schools and households. For the nationwide survey, a 2-stage sampling method was used, in which 105,167 students were selected from 1,772 schools. A total of 96,679 stool samples were collected, of which 4,706 (4.9%) tested positive for H. nana. Of these, fewer than 1% were co-infected with schistosomiasis (either Schistosoma haematobium or Schistosoma mansoni), and a mere 0.1% had co-infections with soil-transmitted helminths. At an 8% threshold for village-based MDA, approximately 1.1 million infected adults are ineligible to receive praziquantel from the village-based MDA. Children residing in households with improved latrines had a lower odds of H. nana infection than those without improved latrines did (adjusted odds ratio=0.87, 95% confidence interval=0.80–0.94, p=0.001). In countries where H. nana is endemic, such as Sudan, providers making MDA decisions should consider the prevalence of either H. nana or schistosomiasis, rather than focusing solely on the latter.
Intestinal parasitic infections are a public health burden and a major cause of illness in developing countries. The diseases lead to various health threats, including growth retardation and mental health-related disorders, especially in children. We assessed the risk factors for intestinal parasitic infections among children aged 12–59 months residing in Nyamasheke District, Rwanda. A cross-sectional descriptive study was conducted using secondary data from 1,048 children aged 12–59 months whose stool samples were examined for the presence of intestinal parasites and whose results were registered in the laboratory information system in 2020. The prevalence of intestinal parasites in children aged 12–59 months was 53.2%. The dominant parasites were Ascaris lumbricoides (13.1%), followed by Giardia lamblia (10.9%), Entamoeba histolytica (7.9%), Trichuris trichiura (6.5%), hookworms (1.7%), and Taenia species (1.4%). A significant association was observed between intestinal parasites and the literacy of mothers or children’s caregivers (odds ratio (OR)=5.09, P<0.001). Children from farming households were 2.8-fold more likely to contract intestinal parasitic infections than those from nonfarming households (OR=2.8, P<0.001). A significant association was also observed between intestinal parasites and food safety (OR=4.9, P<0.001). Intestinal parasitic infections were significantly associated with hand hygiene practices after using the toilet and washing fresh fruits before eating (P<0.001). The information gathered will help public health providers and partners develop control plans in highly endemic areas in Rwanda.
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