Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Coke d'Ivoire

Raso, Giovanna, Utzinger, Jürg, Silue, Kigbafori D., Ouattara, Mamadou, Yapi, Ahoua, Toty, Abale, Matthys, Barbara, Vounatsou, Penelope, Tanner, Marcel and N'Goran, Eliézer K. (2005) Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Coke d'Ivoire. Tropical Medicine & International Health, 10 1: 42-57. doi:10.1111/j.1365-3156.2004.01352.x


Author Raso, Giovanna
Utzinger, Jürg
Silue, Kigbafori D.
Ouattara, Mamadou
Yapi, Ahoua
Toty, Abale
Matthys, Barbara
Vounatsou, Penelope
Tanner, Marcel
N'Goran, Eliézer K.
Title Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Coke d'Ivoire
Journal name Tropical Medicine & International Health   Check publisher's open access policy
ISSN 1360-2276
Publication date 2005-01
Sub-type Article (original research)
DOI 10.1111/j.1365-3156.2004.01352.x
Volume 10
Issue 1
Start page 42
End page 57
Total pages 16
Place of publication Oxford, England
Publisher Blackwell Publishing Ltd
Language eng
Subject 1117 Public Health and Health Services
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 Cote 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 Cote d'Ivoire. These findings call for more equity-balanced parasitic disease control interventions, which in turn might be an important strategy for poverty alleviation.
Keyword Public, Environmental & Occupational Health
Tropical medicine
Access to health care
Concentration index
Cote d'Ivoire
Health inequities
Household assets ownership
Parasitic infections
Ascaris-lumbricoides Infection
Insecticide-treated Nets
Schistosoma-mansoni
Cote-divoire
Risk-factors
Malaria Control
Tanzania
Africa
Equity
Kenya
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Public Health Publications
 
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Created: Fri, 25 Jan 2008, 16:27:17 EST