Health impact of sanitation programme in Kakamega district
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The World Health Organisation estimates that inadequate water supplies and sanitation are responsible for about 80% of all diseases and sicknesses. Improved water supplies and sanitation can have a positive health, social, economic and environmental impact in the communities. Different indicators, direct and indirect ones can be used to evaluate the impact of such programmes. A cross-sectional study was carried out in Bunyala Division, KakamegaDistrict in February 1994. The main aim of this study was to evaluate the health impact of a sanitation programme. As an indicator, this study used intestinal helminths in children aged between 1-15 years. Both the prevalence and intensity of intestinal helminths were measured in this study. A total of 838 children from 305 households with and without latrines living in 15 vilages in Bunyala Division were included into the study. 392 children came from 143 households with latrines and 446 children from 162 households without latrines. It was found that 44.6% of chi Idren from households with latrines had an infection with one or more intestinal helminths. Ascaris lumbricoides was the most common intestinal helminth and was found in 33.7% of children. Hookworm infections were found in 21.2% of children from households with latrines. out of all children from households without latrines 48.2% had an infection with one or more intestinal helminths . A.lumbricoides infections were found in 31.6% of children, hookworm infections in 25.8% of children. The intensity of intestinal helminths was found to be low. Most childrenwith an A.lumbricoides infection had less than 5000 eggs per gram of stool and the majority of children with a hookworm infection had less than 500 eggs per gram of stool. No difference in prevalence and intensity of intestinal helminths was found between children from households wi th latrines and children from households without latrines. There was a positive significant relationship between the age of children and hookworm infections. The older chi ldren had a higher prevalence and intensity of hookworm infections. There was no significant relationship between the age of children and prevalence and intensity of A.lumbricoides infections. A statistically significant relationship was found between the prevalence of intestinal helminths and the socio-economic status of the households. The socio-economic status was measured by the type of house the family was living in and the number of cattle the household owned. A.lumbricoides infections were significantly lower in children living in better houses. Hookworm infections were significantly lower in children from households owning more cattIe. The prevalence and intensity of hookworm infections in children was significantly lower in children when parents/guardians had a higher level of education. The prevalence and intensity of A. lumbricoides infections was not associated with the parents level of education. The presence of latrines in homesteads and provision of water supplies did not reduce the prevalence and intensity of intestinalhelminths in children. An additional health education with an emphasis on causes, routes of transmission and ways of prevention of intestinal helminths infections are recommended. Development of a latrine well adapted to childrens use with the communities and further research are also seen as important.