Effect of Ivermectin Intake On the Nutritional and Health Status of School Children in Onchocerciasis Endemic Communities of Ebonyi State, Nigeria

ABSTRACT The study assessed the nutritional and health status of school-aged children (5-12 years) in onchocerciasis endemic communities of Ebonyi State and determined the effect of Ivermectin intake on haemoglobin and parasitic load of the children. The study was conducted in Ebonyi State of Nigeria. A multi stage random sampling technique was used in selecting respondents for the study. A total sample of 360 school aged children aged 5 – 12 years (made up of 194 males and 166 females) participated in the study. A structured, validated and pretested questionnaire was used to elicit vital information. The weight and height of the children were taken using standard procedures. Blood samples of the children were subjected to haematological analyses within 12 hours of collection. Haemoglobin levels were determined using cyanomethaemoglobin method. The WHO body mass index (BMI) for age z scores and the International Obesity Task Force (IOTF) were used to classify the children. Stool microscopy was carried out to detect parasitic infection. Secondary data were sourced from relevant documents of the Ebonyi State Ministry of Health, State Onchocerciasis Office and other relevant research materials. Data generated from this study were keyed into Excel spreadsheet and later summarized using SPSS 16.0 version. Frequency distribution, percentages, mean, charts and Chi - square were the statistical tools used for the analysis. The 24 hour dietary recall data showed that majority of the respondents ate cassava-based food for breakfast and dinner quite often. Less than 2.0% of the respondents frequently consumed chicken, egg and meat. Fruits were not frequently consumed by majority (73.6%) of the children. Irrespective of the standard used, the indicators of nutritional status showed high prevalence of malnutrition in these communities. The mean BMI of the boys and girls ranged from 14.77kg/m2 – 16.67 kg/m2 and 14.14kg/m2 – 16.75 kg/m2 , respectively. These values were both below the standards. The IOTF classified 94.7% of the xviii children as having various degrees of thinness and only 5.3% with normal BMI. The WHO percentile ranking showed that 11.4% of the children were underweight, 31.4% were at risk of underweight, 1.7% were overweight, 4.4% were at risk of overweight and 51.1% were probably normal. The haemoglobin concentrations of the children showed that 70% of the boys and girls were anaemic (haemoglobin concentration of 7>11gm/dl). Another, 12% of the boys and 16.7% of the girls were severely anaemic (haemoglobin concentration of < 7gm/dl) and about 18% and 13.3% of the boys and girls, respectively were normal. There was a significant positive association between ivermectin intake and nutritional status of the children (P 0.05). However, there were more anaemic children among those who did not take ivermectin. Stool microscopy detected presence of intestinal helminth (Hookworm and Ascaris lumbricoides ova) in the faeces of 32.5% of the children. There was a significant association between ivermectin consumption and parasitic load. This confirmed the speculation that ivermectin has a deworming effect. Factors that affected the nutritional and health status of these children were their food habit, which was found to be very monotonous and mainly based on starchy staples and some other socio-demographic variables. These findings suggest the need for targeted health and nutrition intervention in these communities and also raise the question of appropriate anthropometric standards for the Nigerian population.