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Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Côte d'Ivoire.
Trop Med Int Health. 2005 Jan; 10(1):42-57.TM

Abstract

Differences in the state of health between rural and urban populations living in Africa have been described, yet only few studies analysed inequities within poor rural communities. We investigated disparities in parasitic infections, perceived ill health and access to formal health services among more than 4000 schoolchildren from 57 primary schools in a rural area of western Côte d'Ivoire, as measured by their socioeconomic status. In a first step, we carried out a cross-sectional parasitological survey. Stool specimens and finger prick blood samples were collected and processed with standardized, quality-controlled methods, for diagnosis of Schistosoma mansoni, soil-transmitted helminths, intestinal protozoa and Plasmodium. Then, a questionnaire survey was carried out for the appraisal of self-reported morbidity indicators, as well as housing characteristics and household assets ownership. Mean travel distance from each village to the nearest health care delivery structure was provided by the regional health authorities. Poorer schoolchildren showed a significantly higher infection prevalence of hookworm than better-off children. However, higher infection prevalences of intestinal protozoa (i.e. Blastocystis hominis, Endolimax nana and Iodamoeba butschlii) were found with increasing socioeconomic status. Significant negative associations were observed between socioeconomic status and light infection intensities with hookworm and S. mansoni, as well as with several self-reported morbidity indicators. The poorest school-attending children lived significantly further away from formal health services than their richer counterparts. Our study provides evidence for inequities among schoolchildren's parasitic infection status, perceived ill health and access to health care in a large rural part of Côte d'Ivoire. These findings call for more equity-balanced parasitic disease control interventions, which in turn might be an important strategy for poverty alleviation.

Authors+Show Affiliations

Raso G
Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland. giovana.raso@stud.unibas.ch
Utzinger J
No affiliation info available
Silué KD
No affiliation info available
Ouattara M
No affiliation info available
Yapi A
No affiliation info available
Toty A
No affiliation info available
Matthys B
No affiliation info available
Vounatsou P
No affiliation info available
Tanner M
No affiliation info available
N'Goran EK
No affiliation info available

MeSH

AdolescentAge DistributionChildComorbidityCote d'IvoireDeveloping CountriesEpidemiologic MethodsFemaleHealth Services AccessibilityHousingHumansHygieneMaleParasitic DiseasesPovertyRural HealthSex DistributionSocioeconomic Factors

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15655013

Citation

Raso, Giovanna, et al. "Disparities in Parasitic Infections, Perceived Ill Health and Access to Health Care Among Poorer and Less Poor Schoolchildren of Rural Côte D'Ivoire." Tropical Medicine & International Health : TM & IH, vol. 10, no. 1, 2005, pp. 42-57.
Raso G, Utzinger J, Silué KD, et al. Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Côte d'Ivoire. Trop Med Int Health. 2005;10(1):42-57.
Raso, G., Utzinger, J., Silué, K. D., Ouattara, M., Yapi, A., Toty, A., Matthys, B., Vounatsou, P., Tanner, M., & N'Goran, E. K. (2005). Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Côte d'Ivoire. Tropical Medicine & International Health : TM & IH, 10(1), 42-57.
Raso G, et al. Disparities in Parasitic Infections, Perceived Ill Health and Access to Health Care Among Poorer and Less Poor Schoolchildren of Rural Côte D'Ivoire. Trop Med Int Health. 2005;10(1):42-57. PubMed PMID: 15655013.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Côte d'Ivoire. AU - Raso,Giovanna, AU - Utzinger,Jürg, AU - Silué,Kigbafori D, AU - Ouattara,Mamadou, AU - Yapi,Ahoua, AU - Toty,Abale, AU - Matthys,Barbara, AU - Vounatsou,Penelope, AU - Tanner,Marcel, AU - N'Goran,Eliézer K, PY - 2005/1/19/pubmed PY - 2005/3/8/medline PY - 2005/1/19/entrez SP - 42 EP - 57 JF - Tropical medicine & international health : TM & IH JO - Trop Med Int Health VL - 10 IS - 1 N2 - Differences in the state of health between rural and urban populations living in Africa have been described, yet only few studies analysed inequities within poor rural communities. We investigated disparities in parasitic infections, perceived ill health and access to formal health services among more than 4000 schoolchildren from 57 primary schools in a rural area of western Côte d'Ivoire, as measured by their socioeconomic status. In a first step, we carried out a cross-sectional parasitological survey. Stool specimens and finger prick blood samples were collected and processed with standardized, quality-controlled methods, for diagnosis of Schistosoma mansoni, soil-transmitted helminths, intestinal protozoa and Plasmodium. Then, a questionnaire survey was carried out for the appraisal of self-reported morbidity indicators, as well as housing characteristics and household assets ownership. Mean travel distance from each village to the nearest health care delivery structure was provided by the regional health authorities. Poorer schoolchildren showed a significantly higher infection prevalence of hookworm than better-off children. However, higher infection prevalences of intestinal protozoa (i.e. Blastocystis hominis, Endolimax nana and Iodamoeba butschlii) were found with increasing socioeconomic status. Significant negative associations were observed between socioeconomic status and light infection intensities with hookworm and S. mansoni, as well as with several self-reported morbidity indicators. The poorest school-attending children lived significantly further away from formal health services than their richer counterparts. Our study provides evidence for inequities among schoolchildren's parasitic infection status, perceived ill health and access to health care in a large rural part of Côte d'Ivoire. These findings call for more equity-balanced parasitic disease control interventions, which in turn might be an important strategy for poverty alleviation. SN - 1360-2276 UR - https://www.unboundmedicine.com/medline/citation/15655013/Disparities_in_parasitic_infections_perceived_ill_health_and_access_to_health_care_among_poorer_and_less_poor_schoolchildren_of_rural_Côte_d'Ivoire_ DB - PRIME DP - Unbound Medicine ER -