[Intestinal parasitoses in a village of Côte d'Ivoire. I: Control and prevention plan]

The goal was to develop a complex medical, hygienic, sanitary and educational plan for control and prevention of intestinal parasitic infections in the rural areas in Ivory Coast. In a village situated at the border of the Ebrié lagoon, 416 persons were examined: 371 children, of which 343 were school and preschool children, aged 4 to 15 years (195 boys and 148 girls), 28 young children aged 6 months to 3 years, and a group of 45 adults. The parasitologic exams included perianal swabs (Graham's method), stool examination using saline solution, iodized solution (Lugol) and preparation Kato-Miura's method in thick layer. Parasitic intensity was done for helminths and worm burden have been carried after specific treatment of roundworms. Hygienic conditions as environment, school, dwelling and personal hygiene, eating habits, drinking water sanitation, garbage disposal, toilets, reproduction areas of hematophagous and mechanical vectors etc. have recorded. The prevalence of intestinal parasites was 84.8% in children (with 76.7 % polyparasites) and 29.0 % in adults. The results pointed out a hyperendemic zone. Parasitic infectious transmitted from person to person was frequent among children: 37.3% pinworms in school children, 30.3% amoeba cysts and 30.3% flagellate. Infections transmitted by soil were predominant, with 62.1 % roundworms (78.6 % in children aged 7 to 10 years) presenting an important parasitic intensity and worm burden. The parasitoses transmitted as larvae were frequent, only Strongyloides stercoralis being most frequent parasite in adults compared to children. A feasible plan of control the intestinal parasites has been established in collaboration with the local hospital, village leaders and health workers. Short-term measures have been carefully chosen, targeting especially the schools, teachers and health workers. The first health education measure concerns the hand cleanliness at home and at schools. It was suggested that a bucket of water be used per class, that the water be changed more often during the day, and soap be made available at all time. Lessons on the ways of transmission of parasites will be introduced in schools. A door-to-door education plan was discussed with village health workers and hospital nurses and laboratory technicians during the maternal-infantile prophylactic visits. The health education problems have been discussed extensively with village health workers. As a preliminary example, the prevention and campaign against the pinworm, a common parasite in children was chosen, whose transmission mechanism from person to person can be easily understood by children and mothers. Simultaneously the prevention of parasitic infections contributes extensively to the prevention of other serious diseases, as the typhoid fever etc. which are endemic in the region. Long-term preventive measures have been discussed with village leaders. The first measure is to fix the deep-well drinking water pump station of the village, financed by outside parties, with labour provided by the village. Measures for proper maintenance of the water pump station have also been discussed with representatives of the village. The program of the World Health Organization and National Institute of Hygiene of Ivory Coast concerning the periodic treatment of intestinal helminths, especially A. lumbricoides, given to all school aged children was discussed.