Worms outbreak stifles learning in Nyanza

By Nicholas Anyuor

Schools start re-opening on Tuesday, but things are not rosy for school-going children living near Lake Victoria — because most of them are infested with worms, a research has established.

Due to the diseases brought about by worms, experts note that a sizeable number of these poor minors will be absent from class for several years. Furthermore, learning for majority of those who are strong enough to hang on will be slowed down to a bare minimum.

Through a study conducted by scientists from the Kenya Medical Research Institute (Kemri) and America’s Centre for Disease Control (CDC), worm infections in this region has substantially reduced academic performance, especially in the primary school level.

The experts say worms that cause bilharzia and those that are responsible for soil-transmitted infections (mainly helminthiases) are common in the Lake Victoria Basin and are associated with contact with the lake water and contaminated environments.

"In addition to severe diseases, these worms can cause degree of morbidity to poor health outcomes in infected persons, particularly children," said Pauline Mwinzi, a principal researcher at Kemri and who led the survey.

Curbing the situation

This means fisher communities are highly exposed to the risks of worm infections, coupled with HIV and Aids that spread in the region as a result of lifestyle and poor access to health services, Mwinzi noted.

The research was carried out in Kisumu East, Kisumu West, Kisumu Municipality, Nyakach, Rachuonyo and Rarieda constituencies, and covered over 1,000 pupils who were then in classes One, Three, Four and Five.

It was established that higher intensity of infection was associated with increased prevalence diseases.

To curb the situation in Western Kenya and particularly along the lakeshores, the two institutions have recommended the involvement of the ministries of Education and Public Health and Sanitation, school heads, healthcare educators, awareness campaigns and follow-up meetings from an integral part of this evaluation.

The report suggests that to control bilharzia, knowledge about the disease among the populace in endemic areas has proved to be an effective tool.

Vital information that people should know, they say, include parasite cycle, modes of transmission, available remedial measures in case of infection, and need for mass treatments in affected communities.

Moreover, the experts argue that the presence of any worms in human bodies can also be a barrier to the treatment of HIV, Aids, tuberculosis and malaria for the adults.

Worms, they add, would again affect children by exposing them to co-infections.

The report says worm infections weaken the immune system of school-going children and expose them to risks of co-infections and reduced academic performance.

Mwinzi argues that children who have worms are generally at higher risk of being infected by other diseases such as malaria, tuberculosis, and anaemia. Worn infestation further makes pupils uncomfortable in class.

To ameliorate the situation, the experts say, regular de-worming is necessary. This contributes to good health and nutrition for children of school age.

More study

This in turn leads to increased enrolment and attendance, reduced class repetition, and increased educational attainment.

"In the schools we have visited and carried out preliminary studies, we have found that many children who are affected by this calamity have even dropped out of schools while others were not comfortable in class," she says.

At an annual symposium of the Neglected Tropical Diseases branch held in Kisumu whose theme was Research for Control and Elimination, the experts concurred that children who had not been de-wormed were weak and not attentive in class.

They cited bilharzia (schistosomiasis) as one of the leading diseases that is caused by the schistosoma manosoni worm. They identified it as a major public health problem for children in the Lake Victoria region.

In their survey entitled Geospatial Distribution of Schistosoma Manosoni and other Soil Transmitted Worm Infections along Shores of Lake Victoria in Western Kenya, the researchers recommend frequent evaluation and mapping of schistosome infections to guide disease control programmes.

"Schistosomiasis treatment should be incorporated into on-going de-worming activities in at least all schools within 2.2km from the lakeshore," the survey reveals.

Again, it says, children in schools within a kilometre from the shoreline should be de-wormed annually while those between one and 2.2km from the lakeshore should be de-wormed once every two years.

According to the report, control of bilharzia and soil-transmitted infections (helminthiases) is hampered by poverty, inadequate clean water, occupational hazards and poor sanitation.

The most disadvantaged children are girls and those from poor backgrounds who suffer most from ill health and malnutrition, the research points out.

For the adults, worms have serious effect on HIV and Aids treatment and the experts advise that one should be de-wormed first before starting taking ARVs.

The study was conducted in Nyanza among 93 adult HIV-positive fishermen and fish handlers occupationally exposed to schistosoma manosoni.