INTRODUCTION
Environment, sanitation and health are inextricably interlinked. An environment with poor amenities such as polluted air, poor sanitation, unkempt drinking water and poor housing, has been seen to have a negative effect on the health status of individuals and wellbeing of people. Such places have added to communicable disease and also in the prolonging of epidemiological transition. Physical environmental factors and socio-cultural issues which are cumulative also lead to disease of greater burden. The environment in the medical sense includes what affects an organism with regards to influence and condition and also the surroundings. For the purpose of this paper, environment by the International Epidemiological Association can be defined as “All that which is external to the human host. This can be divided into physical, biological, social, cultural, etc., any or all of which can influence health status of populations.” From this definition, anything that is not genetic would be included in the environment. However, this can be argued because considering genes for instance whether in the short or long term, they are influenced by the environment.
Looking the globe as a whole, the health burden is on the increase; even the so-called developed world deal with pollutants that emerge every now and then which pose a considerable threat to human health. Urbanization is on an alarming rate in the developing countries. In 2001, according to the United Nations, Nigeria had a population of 167 million which affected the housing demand in the urban area. As such, haphazard development for new migrants or less privileged ones has resulted in slum development. In contrast to this background study, there is the crucial need for action to aid with the reduction of environmental health burden within the rural areas
of the country. The rural or slum development is commonly seen in developing countries. This has built up problems that can be witnessed in different urban centers where infrastructure provided lag behind in city expansion and population growth. The group which is most vulnerable to environmental burdens is the occupants of the rural area.
Similarly, in developing countries, gastroenteritis can be seen to represent morbidity in children. Within these developing countries, the annual diarrhea rate is estimated to 3.2 events per child (). Zones that are considered to be endemic, colonization of these parasites are the norm. This can be as a result of malnutrition which is also a cause of immune deficiency. Parasitic diarrhea is frequent and acute among children that are not well fed or malnourished, children who are well-fed on the other hand remain healthy carriers. More so, diarrhea can be seen as a possible cause and concern of malnutrition. Diarrhea also stunts children’s growth, malnutrition increase the diarrhoeic frequency which creates a vicious cycle.
The negative effect of diarrhea infection on the state of nutrition can be due to the following reasons: by increasing catabolism and the stocking of micro nutrients needed for tissue growth and formation intestinal absorption and appetite reduction. The case of retarded growth in a quarter to a third per case is due to intestinal infection as explained by mathematical models.
Dating back to the 1980’s, even the mildest form has been seen or known for weakening immune defenses. Micro-nutrients play a role which allows adequate immune responses to attacks which is now being accepted and the effects which are pathological of the most common deficiency types are also recognized.
With the aforementioned, this paragraph delves into malaria owing to the fact that it is part of the case study also side malaria, diarrhea and intestinal worms.
Malaria and intestinal helminth parasites co-exist in the tropic as a result of climatic conditions that are prevailing and also due to poor sanitary practices. The effects of these parasites are cognitive in development, school attendance of children and also educational performance. The full documentation of these parasites has not been fully recorded in Nigeria due to the fact that community-based studies are limited. The general plasmodium prevalence parasites which are asexual, intestinal helminth infections and helminth malaria infections were about 52.3% and 57.1% respectively (WHO, 2012). It should also be known that in children Ascaris lumbricoides was the only intestinal species identifies amongst children.
Malaria and helminth infections are distributed widely in both tropical and subtropical areas which of course are both of public health concern. Children under the age of five die from malaria every 30 seconds (Ekundayo, 2011). In Nigeria, intestinal helminth infections with Trichuris trichuiris, Ascaris lumbricoides and hook worm, have remained dominant. The latest report shows about 102 countries still endemic for malaria with about 219, 000, 000 cases and 660, 000 deaths (Ekundayo, 2011). Nigeria and the democratic republic of Congo account for 40% total of the estimated deaths related to malaria and also 40% of the malaria cases globally.
These diseases are common amongst children because they are more susceptible to the two infections owing to the incomplete development and their greater immunological vulnerability, lower standard hygiene and morbidity (Montresor and Crampton, 2002). Helminth that is soil transmitted amount for about 10% of any
population understudied. The most vulnerable are school children. 28.6% to 75.6% of ascariasis is prevalent amongst school children and factors such as poor hygiene, poor water supply, and poverty, limited access to preventive measures, health care and lack of protective clothing.
Some few decades ago, there have been similar infections with regards to worm and malaria. The relations between these two studies of infection have been reported to be proactively different or to aggravate prevalence of acute malaria. Despite environmental conditions and socio-economic factors that affect the distribution of malaria and helminthes, especially with regards to children and the rural communities, a brief explanation of what studies has revealed can be viewed within the next paragraph.
Findings from these studies have demonstrated a serious persistence of intestinal helminth infections, asymptomatic malaria infections and anemia commonly found amongst children in rural areas. An overall prevalence of falciparum malaria accounts for about 52.3% which is hyper-endemic for malaria. However, the high prevalence of asymptomatic malaria which is more rampant during the dry season is a cry for attention because this could be one of the reasons why malaria is hyper- endemic within the study area. Children under the age of five have been seen to have an immunity which develops progressively form childhood to adolescence.
Socio-economic status basically affects three areas of health which are healthcare in general, health behavior and environmental exposure. Considering the United States, it has been found that health worsens especially from families who stay in low income areas with little or no education. On the other hand with an improvement in
socio-economic status, so did the overall health outcome. This can also be said about African children as well as Hispanic with same indicators of health improving as income and education levels change.
There was an overall prevalence which was observed for intestinal helmith infections in which children were used for the understudy, this showed a decline in prevalence which when compared to the 2005 report. The reason for the decrease in helminth could be as a result of campaign or Ivermectin, however the case maybe.
Another study showed that children without intestinal helminth infections were about two times likely to have a positive test for malaria parasite as compared to children already with the infection. This study has been in contraction and arguable according to findings by Ojurongbe in Osun state, this study and similar studies in Thailand shows a rather positive and statistical relationship between malarial infection and geohelminth respectively. The reasons for such cannot be explained and requires a deeper research into why such occurs. To support such findings, a research was done in Ghana there was a relation between helminth and increased levels of Interleukin which is known to inhibit the protective immune responses against malaria parasites which can also be seen in exacerbating parasitemia common to plasmodium infection. This result from Ghana suggests that the infections cause by helminth may have an alteration towards the immune response of antimalarial through the suppression of proinflammatory activity.
The above study has showed that malaria and co-infection are mostly common to children within the rural areas. Most importantly, for parasitic infections, age is an independent factor for both parasitic infections. The findings serve as a guide to
future research on prevention and control of children that reside in rural areas of Nigeria. This also provides a ground as to how to tackle the issues of malaria within the rural communities.
According to Corvalán in 2006, the estimated global disease burden and death percentage are 24 and 23 respectively which in most cases can be attributed to environmental factors, which in a sense can be averted with environmental modification which include provision of safe water, adequate hygiene and standard sanitation. International bodies such as The United Nations Children’s Emergency Fund (UNICEF), the World Health Organization but to mention a few have proved to be concerned and in some cases lend a helping hand to curb environmental issues in various parts of the globe. The risk posed by environmental factors contributes at least 80% of major diseases in the world today (). Within the developing countries, the rate of environmental disease is a burden, if compared to the developed countries the difference is fifteen times higher (Smith et al 1999). “Available global evidence suggests that (a) lack of access to clean water and sanitation and (b) indoor air pollution are the two principal risk factors of illness and death, mainly affecting children and women in poor families.”
