Mwenji, Benedict M.2017-12-212017-12-212017-05http://ir-library.ku.ac.ke/handle/123456789/17973A Thesis Submitted in Fulfilment of the Requirements for the Award of the Degree of Doctor of Philosophy in Applied Parasitology in the School of Pure and Applied Sciences of Kenyatta University, May, 2017Geohelminthiases are infections caused by Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis and Trichuris trichiura leading to oedema, iron-deficiency, protein-energy malnutrition, electrolyte derangement, endocrine upsets and cardio-vascular failure. Resulting sequelae lead to poor health, physical fitness and anaemia. Geohelminthiases is widespread in areas with poor sanitation but empirical data on prevalence and its effects on growth, academic performance and cognitive functions is scanty. The current study aimed at determining effects of geohelminthiases on growth, Cognitive functions and academic performance of children in Kibera and Korogocho slums, Nairobi County. Kasarani (Korogocho slum), Lang’ata (Kibera slum) and Dagoretti (Kibera slum) sub-Counties were purposefully selected. Four schools were selected purposefully using cluster random sampling method: 2 from Kasarani, 1 from Dagoretti and 1 from Lang’ata sub-Counties. Sample size of 470 children in class 2-7 were selected by systematic random sampling method. Kato-Katz technique was used to estimate infection intensity. Point prevalence was determined by comparing total number of infected children against total number of sampled children, expressed as percentage. Information on Cognitive functions was obtained using Word Generation Semantic (WGS), Word Generation Initial (WGI), List Memory (LM), Standard Progressive Matrices (SPM), Coding-B (Cod-B), Symbol Search-B (SS-B) and Digit Span (DSP) tests. Anthropometric measurements were used for computing BMI. Data on absenteeism and academic performance was deduced from class records for 3 terms pre-treatment (400 mgs albendazole) and immediate 2 terms, post-treatment. Stool examination was repeated 3 months after treatment. Questionnaire was administered to collect information on family background to cater for confounders influencing cognitive functions. Pearson’s Product moment correlation was used to determine associations. ttest was used to determine differences between means of infected and non-infected children. ANOVA was used to determine relationships. Linear Regression was used to identify the confounders influencing Cognitive functions. Highest prevalence of geohelminths (51.9%) occurred in Dagoretti sub-County (Kibera slum). Highest prevalence occurred with A. lumbricoides (37.4%) and T. trichiura (33.2%). Highest light and moderate infections (16.5%) and (10.4%), respectively, occurred in 11-14 years-old children. Heavy infections (1.1%) occurred in 6-10 and 11-14 year-old children. Highest absenteeism (44.3%) was in Mbagathi school (Kibera slums) and highest prevalence (51.7%) in Olympic school (Kibera slum). Significant differences in infection intensities occurred between males and females (p < 0.05), with females having higher infections than males. Geohelminthiases negatively affected Growth (r = - 0.809; p < 0.05). Children with low BMI had high infection rates (p < 0.05). Geohelminthiases inversely correlated with Cognitive performance as measured in WGS, WGI, LM, SPM, Cod-B and DSP tests (p < 0.05). Infections positively correlated with Absenteeism (r = 0.971; p < 0.05) and adversely affected Academic performance (r = - 0.879; p < 0.05). Interestingly, chemotherapy with albendazole improved BMI, Cognitive functions and Academic performance. Data generated will support policy on control of geohelminthiases. It is recommend that regular mass-chemotherapy programmes be applied in schools and slum communities to improve children’s general health, growth, school attendance and academic performance.enThesis