Prevalence of Intestinal Parasitosis among Mentally Ill Persons in Neuropsychiatric Hospital, Calabar, Nigeria

Abstract

Aim: The prevalence of intestinal parasitosis in relation to mental illness among inpatients of Federal Neuropsychiatric Hospital, Calabar was investigated with a view to improving the quality of their medical care. Study Design: This was cross sectional study. Ethical approval and patients’ informed consent were sought and obtained before collection and processing of samples. Place and Duration of Study: Federal Neuropsychiatric Hospital, Calabar, between February and August, 2016.  Methodology: We included 246 (126 patients, 120 apparently healthy) subjects. Intestinal parasites were detected by direct stool microscopy and formol ether concentration technique and the cellophane anal swab method for Enterobius vermicularis. Chi square analysis was used to compare percentages. Results: The prevalence of intestinal parasitosis among the 126 studied patients was 49.2% compared to 11.7% recorded among the 120 apparently healthy (control) subjects examined (P < 0.0001).  There was no significant association between intestinal parasites prevalence and gender in test as well as control subjects 60.0% v. 45.1%, respectively, p = 0.2022) and 14.3% v. 8.8%, respectively, P = 0.3113). Subjects with chronic mental cases insignificantly harbored more intestinal parasites than those with acute cases (53.8% v. 47.1%, respectively; P = 0.5699). Parasites detected in the study were Hookworm 34.6%, Entamoeba histolytica/dispar 25%, Ascaris lumbricoides 17.3%, Trichuris trichiura 9.6%, Enterobius vermicularis 5.8%, Giardia intestinalis 3.8%, Taenia species and Schistosoma mansoni 1.9% each.  Hookworm ranked highest 34.6% among the parasites encountered in the test subjects while Ascaris lumbricoides 33.3% took the lead in the control group. People diagnosed with Variance Psychosis disorder recorded highest infection rate (68.4%) while those with substance abuse had the least (28.0%). Conclusion: Intestinal parasitosis may possibly play aetiologic or enhancement role in mental ill health. For effective management of the mental challenge, periodic parasitic investigations and appropriate therapy before and after admittance should be effected in all psychiatric institutions.