Household Management of Endoparasitic Infection in a Border Community in Tamaulipas, Mexico

Fecal samples from 438 children in 217 families were examined for helminth eggs/larve and protozoan cysts to study the occurrence of parasitic infection and household knowledge of cholera preventive measures in a border community in Tamaulipas, Mexico. The age of the children ranged from 1 month to 16 years. Parasitic infections occurred in 30% of children residing in 79 of 217 households. Giardia lamblia accounted for 12.5% of all infections. Other endoparasitic species found in the children were: Hymenolepis nana, (28/438), Ascaris lumbricoides (16/438), Trichuris trichiura (6/438), Enterobius vermicularis (6/438), Ancylostoma-Necator (1/438),Strongyloides sercoralis (1/438), Entamoeba coli (27/438), Ent. hartmanni (24/438), Ent. histolytica (1/438), Endolimax nana (23/438), and Iodamoeba buetschlii (10/438). Infected children were older (mean age 6.32 years, p = .05) and often had infected sibling (odds ratio = 2.88, p < .01). Households with ≥ 3 children were also more likely to have an infected child (odds ratio = 4.76, p < .01). Household knowledge and attitudes about infection and prevention of endoparasites and cholera was also collected with a structured interview schedule. Knowledge of cholera preventive measures was found in 72% of parasite infected households, and 81% of uninfected households. Parasite infected households were distinguished by their inability to list ≥ 3 cholera prevention measures (odds ratio = 2.19, p < .01). Informants from these households were more inclined to accept parasitic infections as a consequence of everyday life and recognize that the adverse effects of parasitism can be controlled with highly effective medicines. In contrast, informants from uninfected households shared a model which regarded parasitic infection in children as a preventable health effect. Public health interventions that emphasize the economic benefits of preventing rather than curing parasitic infections and other hygiene-related diseases can be an important adjunct to existing community health programs aimed at reducing childhood morbidity and mortality. The relatively low frequency of endoparasitism in communities such as the one investigated in this research is encouragement that higiene es salud (hygiene is health) and that achievement of community-wide reductions in parasite-related morbidity is a public health problem for which there is a solution.