Factors associated with water borne diseases among pupils in Kiganjo Location Nyeri District Kenya

School children are exposed to various types of water borne diseases. There are different factors that contribute to the occurrence of these diseases in different schools. Water borne diseases are intricately linked to quality water, sanitation and hygiene. Sanitation is an environmental factor that is associated to occurrence of diseases such as intestinal worms, and other water borne diseases, while hygiene is equally import in occurrence of water borne diseases. Deforestation of the water catchment's towers at the Aberdare, Mau and Mt. Kenya forests have reduced the water quantities in the region. This may have compromised the water quantity and quality as well as sanitation and hygiene standards of Nyeri district which lead to occurrence of water borne diseases. There is scarce information on water borne diseases in Nyeri district and more recent information needs to be documented. The study was conducted in Kiganjo location of Nyeri district to determine the factors associated with the infection of water borne diseases among the pupils in the location as well as the levels of infection. The study area, being disadvantaged by its aridity and dependency on the depleting water sources from Mt Kenya and Aberdares, was purposively selected to represent Nyeri district. A random selection of schools from this location was done using the random numbers to select schools across the lccation. Pupils were selected using the systematic random sampling fro~ the school's registers. A total of 375 pupils were sampled for the study. Data was . collectedby recording of the results on stool examination done to the respondents, and by using an observation checklist in the selected schools. Data on water quality was collected by carrying out a bacteriological water analysis on all the water sources in the location and recording the results for comparison with the infection rates of respondents. Secondary information was gathered from the location's health centre where school children get their medical services. Data was processed using SPSS soft ware and then analyzed using chi-square test to determine the associations between age, sex and infection, as well as infection rate and independence of the school. The results of the study showed that prevalence of water borne diseases was 54.4%. Of this prevalence, 38% was infection by E. histolytica, 7.2% by G. lamblia, and 21.65% by intestinal worms, the rest being E. coli which is a normal flora in the gastro intestinal track. The infection by water borne diseases was independent of school (chi-square = 13.680, p = 0.033). rThere was a significant relationship between the class category according to age and the infection by parasites that are water borne. The lower age group of 5 10 years being more infected (chi-square = 5.953, P = 0.015). The schools with poorer water quality, sanitation and hygiene had more infections by the water borne diseases. There was a significant correlation in hand washing and the infection (r = -0.986, p = 0.005), indicating the leading factor associated with infection of water borne diseases in the region. The availability of toilets in relation to infection was significant (r = -0.9765, P = 0.005) and was next to hand washing. It was recommended that health workers provide prompt treatment to the infected and also undertake regular deworrning. Schools should adhere to the sanitation and hygiene standards set by MOEST together with the Public Health Act CAP 242 L.O. K. NYEW ASCO should extend the supply of treated water to all the primary schools in Kiganjo location and other schools in Nyeri district. CHAPTER ONE: INTRODUCTION 1.1 Background information Inthe developing countries, there exists a high prevalence of water and sanitation related diseaseswith millions of the world's poorest dying from preventable diseases caused by inadequatewater supply and sanitation services (WHO, 1999). Water borne diseases are the singlemost important cause of death and illness in the developing world (Winbad, 1996). Morethan three million people die annually due to water borne diseases (Winbad, 1996). Childrenare the main victims of the sickness that results due to inadequate water and sanitationservices (OFID, 1998). The major causes of morbidity and mortality in Kenya are diseas~sand conditions that are preventable through proper environmental management, or basichygiene. The existing environmental problems relate to the low level of safe drinking water,poor environmental sanitation and refuse disposal. As a result, water borne diseases such as typhoid and cholera among others have become major threats (Rukwaro, 2005). Inadequateand poorly maintained sewerage systems, untreated water supplies as well as lack of toilet facilities lead to water borne diseases (GOK, 1999). Globally, about 1.7 million deathsoccur each year which are attributed to unsafe water, sanitation and hygiene, of which nineout of-ten of such deaths are in children and virtually all such deaths are in developing countries(WHO, 2002). Waterborne diseases are transmitted by water such that water acts a passive vehicle for the infectingagents and depend also on poor sanitation (Rukunga, 2001). They arise from the contaminationof water by human or animal faeces or urine infected by infectious material,