PARASITIC (HELMINTHIC) CONTAMINATION OF VEGETABLES IN SELECTED

MZUZU LOCAL MARKETS

BY

STANLEY MOYO (BPDVCW1721)

SUPERVISOR

DR. SAUL E. MWALE

RESEARCH DISSERTATION SUBMITTED TO BIOLOGICAL SCIENCEs DEPARTMENT,

FACULTY OF SCIENCE TECHNOLOGY AND INNOVATION IN PARTIAL FULFILMENT
OF THE REQUIREMENT FOR THE AWARD OF BACHELORS DEGREE IN
PARASITOLOGY AND DISEASE VECTOR CONTROL (HONOURS) OF MZUZU
UNIVERSITY.

MZUZU UNIVERSITY

P/BAG 201, LUWINGA

MZUZU 2

29th APRIL, 2024

Contents
DECLARATION............................................................................................................................................i

CERTIFICATE OF APPROVAL..................................................................................................................ii

DEDICATION..............................................................................................................................................iii

ACKNOWLEDGEMENT............................................................................................................................iv

ABSTRACT...................................................................................................................................................v

LIST OF ABBREVIATIONS.......................................................................................................................vi

1. INTRODUCTION.................................................................................................................................1

1.1. BACKGROUND INFORMATION..............................................................................................1

2. PROBLEM STATEMENT AND JUSTIFICATION............................................................................2

2.1. Problem statement..........................................................................................................................2

2.2. Justification....................................................................................................................................2

3. OBJECTIVES....................................................................................................................................3

Main objective.......................................................................................................................................3

Specific objectives.................................................................................................................................3

4. LITERATURE REVIEW......................................................................................................................4

4.1. Introduction....................................................................................................................................4

4.2. Global situation..............................................................................................................................4

4.3. In Africa.........................................................................................................................................5

4.4. In Malawi.......................................................................................................................................7

4.5 Risk factors for parasitic contamination of fruits and vegetables........................................................8

5. MATERIALS AND METHODS...........................................................................................................9

5.1. Type of research study...................................................................................................................9

5.2. Study population..........................................................................................................................10

Sample size and sampling technique.......................................................................................................10

5.3. Sample processing.......................................................................................................................10

5.4. Data collection.............................................................................................................................10

 5.5. Data management and analysis....................................................................................................10

5.6. Ethical considerations..................................................................................................................11

5.7. Possible constraints......................................................................................................................11

5.8. Dissemination of the results.........................................................................................................11

6. PRESENTATION OF RESULTS AND ANALYSIS.........................................................................12

6.0 DISCUSSION AND CONCLUSION..............................................................................................16

7. Recommendations............................................................................................................................18

8. Limitations.......................................................................................................................................18

9. Conclusion.......................................................................................................................................18

10. Appendix................................................................................................................................................19

References....................................................................................................................................................20

DECLARATION.................................................................................................................................................i

CERTIFICATE OF APPROVAL...........................................................................................................................ii

DEDICATION..................................................................................................................................................iii

ACKNOWLEDGEMENT...................................................................................................................................iv

ABSTRACT.......................................................................................................................................................v

LIST OF ABBREVIATIONS...............................................................................................................................vi

1. INTRODUCTION......................................................................................................................................1

1.1. BACKGROUND INFORMATION.......................................................................................................1

2. PROBLEM STATEMENT AND JUSTIFICATION.........................................................................................2

2.1. PROBLEM STATEMENT............................................................................................................2

2.2. JUSTIFICATION..........................................................................................................................2

3. OBJECTIVES........................................................................................................................................3

Main objective.......................................................................................................................................3

Specific objectives..................................................................................................................................3

4. LITERATURE REVIEW..............................................................................................................................4
 4.1. Introduction...................................................................................................................................4

4.2. Global situation..............................................................................................................................4

4.3. In Africa..........................................................................................................................................5

4.4. In Malawi........................................................................................................................................7

5. MATERIALS AND METHODS...................................................................................................................9

5.1. Type of research study...................................................................................................................9

5.2. Study population..........................................................................................................................10

Sample size and sampling technique.......................................................................................................10

5.3. Sample processing.......................................................................................................................10

5.4. Data collection.............................................................................................................................10

5.5. Data management and analysis...................................................................................................10

5.6. Ethical considerations..................................................................................................................11

5.7. Possible constraints.....................................................................................................................11

5.8. Dissemination of the results........................................................................................................11

6. PRESENTATION OF RESULTS AND ANALYSIS.......................................................................................12

7. DISCUSSION AND CONCLUSION...........................................................................................................15

8. Recommendations...........................................................................................................................17

9. Limitations........................................................................................................................................17

10. Conclusion....................................................................................................................................17

11. Appendix................................................................................................................................................18

References...................................................................................................................................................19
DECLARATION

I hereby declare that this work is a product of my own effort and has not been accepted in
substance for any other degree nor is it being concurrently submitted in candidature for any other
degree elsewhere other than Bachelor of Science in Parasitology and Disease Vector Control of
Mzuzu University.

Candidate: Stanley Moyo

Signature……………………………………………….

Date………………………………………………………………….

i
CERTIFICATE OF APPROVAL

This dissertation has been written under my supervision and has been submitted for the award of
the Degree of Bachelor of Science (Hons) in Parasitology and Disease Vector Control (PDVC)
with my approval as the supervisor.

Supervisor

Signature……………………………………………………………………………

Date………………………………………………………………………………………………

ii
DEDICATION

This research project is dedicated to all those whose passion for knowledge and commitment to
excellence inspire me every day.

To my entire family, Mum and Dad, whose unconditional love and unwavering support have
been the cornerstone of our journey, this work is a tribute to your unwavering belief in my
abilities.

To my mentors and teachers, whose guidance and wisdom have illuminated my path, I dedicate
this endeavor as a token of gratitude for your invaluable contributions to my intellectual growth.

To the countless individuals who generously shared their time, expertise, and experiences, your
willingness to collaborate has enriched this project beyond measure.

To the future generations of researchers and scholars, may this work serve as a beacon of
inspiration and a testament to the power of curiosity and perseverance.

In honor of all those who have touched my life and shaped my understanding, I dedicate this
research project with heartfelt appreciation and profound respect.

With deepest gratitude,

Stanley Moyo.

iii
ACKNOWLEDGEMENT

I extend my deepest gratitude to all those who have contributed to the completion of this research
project.

First and foremost, I would like to express my sincere appreciation to God, my highly esteemed
supervisor, Dr. Saul E. Mwale, for his invaluable guidance, unwavering support, and insightful
feedback throughout the duration of this study. His expertise and encouragement have been
instrumental in shaping the direction of our research.

I am also immensely thankful to the members of my research supporting team for their
dedication, cooperation, and collaborative spirit Wilson Damiano and Robert Jackson. Each
member has played a crucial role in the sample collection and laboratory examination analysis,
thereby enriching the quality of the findings.

Furthermore, I extend my heartfelt thanks to Mr. and Mrs. Mzembe, Ellen Juwao, and Susan
Banda for their contributions to this project through their input and encouragement towards the
whole process. Their input has significantly enriched the depth and breadth of our research.

I would also like to acknowledge the invaluable support provided by my families and friends,
whose encouragement and understanding have been a constant source of motivation throughout
this endeavor.

This project would not have been possible without the generous support and collaboration of all
those mentioned above. Thank you for your unwavering commitment and contributions.

Sincerely,

Stanley Moyo

iv
ABSTRACT

This study was aimed at assessing the parasitic contamination of fruits and vegetables in Mzuzu
local markets, with a specific emphasis on helminthic presence. Introduction: Consumption of
contaminated vegetables and fruits has proven to be the significant way of infecting people with
helminths, approximately 60% of the world harbors intestinal helminths. This study aimed at
determining the prevalence and predictors of parasitic contamination of fruits and vegetables
collected from 3 local markets in Mzuzu city, Northern Malawi.

Methods: A cross-sectional study was conducted from 1 to 21 September 2014 to determine the
level of parasitic contamination of fruits and vegetables sold in Mzuzu local markets. A total of
360 samples of different types of fruits and vegetables were soaked in Normal saline (0.9%),
followed by vigorous shaking with the aid of a mechanical shaker for 15 minutes and then
examined using the sedimentation concentration technique.

Results and discussion: Out of the 135 samples examined, 96 (69.6%) were contaminated with at
least one type of parasite. The highest contaminated produce was chinese at 93.3% and the least
contaminated were tomato and green paper at 53.3%. It was also observed that the parasitic
contamination was significantly associated with the location of the products (P < 0.041). Factors
influencing contamination included the type of produce, location of the location the local market.
There is need to implement regular monitoring, improve market hygiene, promote good
agricultural practices, enhance public awareness, upgrading market infrastructure.

Conclusion: The findings of this study demonstrates that there is a potentially high risk/chance of
contracting parasitic infections from the consumption of raw vegetables and fruits sold in Mzuzu
local markets. collaborative efforts should be made by the relevant officials and stakeholders to
reduce the rate of contamination of products

v
Keywords: Vegetable and fruits contamination, helminths, Health education.The study aimed to
identify the prevalence of helminthic contamination in Mzuzu local markets and determine
associated factors influencing this contamination. Vegetables and fruits were collected from 3
different local markets and subjected to microscopic examination in parasitology laboratory.

The study underscores the necessity for further research and interventions to mitigate the risks
associated with parasitic infections from raw vegetables and fruits. By addressing these
challenges and implementing measures such as regular monitoring of vegetable contamination
and promoting good agricultural practices, the local authorities and public health sector in Mzuzu
can work towards ensuring the safety and well-being of the community.

vi
LIST OF ABBREVIATIONS
IBD: inflammatory bowel disease

STH: soil transmitted helminths

WHO: World Health organization

vii
1. INTRODUCTION

[2.]
1.1.[2.1.] Background information
[2.2.]
Parasitic contamination of vegetables is a significant public health concern globally, which has
attracted huge attention on a global scale, studies conducted in various regions such as Ethiopia,
Nigeria, Iran, and Iraq have consistently reported high rates of parasitic contamination in fresh
vegetables (Alemu et al., 2019). The contamination of vegetables with parasites such as Giardia,
Ascaris, and Cryptosporidium poses a risk to consumers, especially when these vegetables are
washed with contaminated water (Li et al., 2020). Factors such as vegetable type and source have
been found to be significantly associated with the level of parasitic contamination, with leafy
vegetables often showing higher rates of contamination (Alemu et al., 2019).

The prevalence of parasitic contamination in vegetables varies across different regions, with
studies reporting contamination rates ranging from 13.8% to as high as 75.9% (Aliyu et al.,
2018). The use of unhygienic practices during transportation, marketing, and preparation of
vegetables contributes to the diverse occurrence of parasitic contaminants on post-harvest
vegetables (Tomass & Kidane, 2012). Additionally, the surface characteristics of vegetables play
a role in the attachment of parasites, with vegetables having large, bumpy surfaces being more
prone to contamination compared to those with smooth surfaces (Yusof, 2020).

Proper washing of vegetables has been emphasized as a crucial step in reducing parasitic
infections, as studies have shown that washing vegetables with portable water can significantly
reduce the presence of parasites such as Ascaris and Taenia. Malawi as a nation, there no
published data on the issue of helminthic contamination of vegetables, despite being a water
disaster prone there is need to thoroughly ascertain the prevalence of parasitic contamination if
any so as to strategize on control measures.

1
2.[3.] PROBLEM STATEMENT AND JUSTIFICATION

[4.]
2.1.[4.1.] Problem statement
[4.2.]
Certain vegetables are consumed raw in salads to maintain their natural flavor and preserve
nutrients that are sensitive to heat. However, the consumption of raw vegetables poses a risk for
transmitting various infectious diseases due to their complex surface and porous nature, which
facilitates the attachment and survival of helminths (El Said Said, 2012). Eating raw vegetables
without proper washing is a significant pathway for the transmission of parasitic
diseases(Punsawad et al., 2019). It is approximated that up to 60% of the global population
harbors intestinal parasites(Padmanandan et al., 2016). Despite the critical importance of food
safety, there is limited information on the extent of contamination and the factors contributing to
this issue in Mzuzu specifically the local markets. This study seeks to identify the prevalence of
parasitic contamination in fruits and vegetables from selected Mzuzu markets and determine the
associated factors influencing the contamination. Understanding these elements is essential for
developing targeted interventions to enhance food safety, reduce the incidence of foodborne
parasitic infections, and protect public health.

Conducting studies on parasitic contamination of vegetables is essential for protecting public

health, ensuring food safety, and promoting environmental and regulatory compliance. These
studies provide valuable insights that inform policy decisions, improve surveillance systems, and
enhance public awareness of foodborne risks.

In developing countries such as Malawi, poor sanitation, and substandard and crowded living
conditions lead to an increased risk of acquiring parasitic infections.

The study intended to assess the parasitic contamination in fruits and vegetables from the local
markets (Luwinga, Zigwagwa and St. Augustine).

2
 [4.3.] Justification
The problem of parasitic contamination in vegetables in Mzuzu local markets is a critical
concern that requires immediate attention and intervention. Studies conducted in other regions,
such as Ethiopia, Ghana, and Sudan, have highlighted the prevalence of parasitic contamination
in vegetables sold in local markets(Kudah et al., 2018) . These studies have shown that
contaminated vegetables can serve as a vehicle for transmitting parasites to humans, leading to a
range of health issues(Bekele & Shumbej, 2019) and (Alemu et al., 2019).

Furthermore, the lack of proper hygiene practices and sanitation measures in the handling and
transportation of vegetables from farms to markets in Mzuzu may contribute to the high levels of
parasitic contamination as this is a risk factor for contamination (Richard Sylvester Yale et al.,
2021). The use of contaminated water for irrigation and washing of vegetables, as observed in
other settings, can further exacerbate the problem ((Bekele & Shumbej, 2019)). Additionally, the
socio-cultural practices and market conditions in Mzuzu may also play a role in the spread of
parasitic contamination in vegetables.

Addressing the issue of parasitic contamination in vegetables in Mzuzu local markets is crucial
for safeguarding public health and preventing the transmission of parasitic infections.
Implementing measures such as regular monitoring of vegetable contamination, promoting good
agricultural practices, improving water quality for irrigation, and enhancing hygiene standards in
the vegetable supply chain are essential steps to mitigate this problem(Yusof, 2020). By
addressing these challenges, the local authorities and public health sector in Mzuzu can work
towards ensuring the safety and well-being of the community

3.[5.] OBJECTIVES
Main objective
The main of objective of the study was to assess parasitic (specifically helminthic) contamination
of fruits and vegetables in Mzuzu local markets easily accessible to Mzuzu university students.

Specific objectives
specific objectives were;

i. To identify the prevalence of parasitic(helminthic) contamination of fruits and

vegetables in fruits and vegetables in selected Mzuzu local markets.

3
 ii. To determine the associated factors of prevalence of helminthic contamination
in fruits and vegetables in selected Mzuzu local markets.

4.[6.] LITERATURE REVIEW

4
 4.1.[6.1.] Introduction

The helminths are worm-like parasites. The clinically relevant groups are separated according to
their general external shape and the host organ they inhabit. There are both hermaphroditic and
bisexual species. The definitive classification is based on the external and internal morphology of
egg, larval, and adult stages(Castro, 1996). A disproportionate burden of helminthiases in human
populations occurs in marginalized, low-income, and resource-constrained regions of the world,
with over 1 billion people in developing areas of sub-Saharan Africa, Asia, and the Americas
infected with one or more helminth species(Lebu et al., 2023). The morbidity caused by such
infections imposes a substantial burden of disease, contributing to a vicious circle of infection,
poverty, decreased productivity, and inadequate socioeconomic development. Furthermore,
helminth infection accentuates the morbidity of malaria and HIV/AIDS, and impairs vaccine
efficacy(Lustigman et al., 2012). Poly-parasitism is the norm in these populations, and infections
tend to be persistent. Hence, there is a great need to reduce morbidity caused by helminth
infections. The burden of helminth infections and their contamination in vegetables is a
significant public health concern that affects millions of people worldwide. Helminths, or
parasitic worms, are a diverse group of organisms that can cause a variety of diseases in humans,
particularly in regions with poor sanitation and hygiene practices.

4.2.[6.2.] Global situation

The global epidemiology of helminth infections, based on recent data, indicates that soil-
transmitted helminth (STH) infections remain one of the most common infections worldwide,
affecting an estimated 24% of the world's population. These infections are most prevalent in
tropical and subtropical areas, with the highest numbers reported from sub-Saharan Africa,
China, South America, and Asia(WHO., 2023).In terms of specific helminth species, the main
ones that infect humans are the roundworm (Ascaris lumbricoides), the whipworm (Trichuris
trichiura), and hookworms (Necator americanus and Ancylostoma duodenale)1. Another
significant helminth is Strongyloides stercoralis, which requires different diagnostic methods
and is not sensitive to the common treatments for other STHs. The burden of these infections is
particularly heavy on children, adolescent girls, and pregnant women living in areas with
intensive transmission, who require treatment and preventive interventions(Lebu et al., 2023).
Over 260 million preschool-age children, 654 million school-age children, 108 million

5
adolescent girls, and 138.8 million pregnant and lactating women are in need of such
interventions(WHO., 2024).

A recent study from Northeastern Thailand reported a prevalence of 5.05% for Opisthorchis
viverrini, followed by Taenia spp., hookworms, Trichuris trichiura, and Echinostoma spp.
(Chaiwat Srithai et al., 2021). This indicates that despite efforts to control these infections, they
remain a significant health issue in rural areas, with housing location being a major contributing
factor(Pongsakorn Martviset et al., 2023).

Despite global pandemic-related disruptions, a total of 76.9 million people received treatment for
schistosomiasis in 2020, representing a global coverage of 31.9%, compared with 105 million
treated in 2019(WHO., 2021). This shows the impact of global health crises on the continuity of
treatment programs for helminth infections. These figures underscore the ongoing challenge of
helminth infections and the need for sustained public health efforts to reduce their prevalence
and impact on affected populations

4.3.[6.3.] In Africa

In Northern Africa, studies have reported a considerable prevalence of geo-helminth parasites in

leafy vegetables sold in markets. For instance, a study in Anambra State, Nigeria, found an
overall prevalence of 56% of geo-helminth parasites in leafy vegetables, with Ascaris
lumbricoides being the most prevalent at 25.6%1. The study highlighted the importance of leafy
vegetables in the transmission of geo-helminth parasites to humans(Ezeagwuna et al., 2024).

Central Africa faces similar challenges with helminth contamination in vegetables. A study
conducted in Gabon reported baseline mapping of schistosomiasis and soil-transmitted
helminthiasis, which are critical for understanding the risk of contamination in agricultural
products (Sartolius et al.,2018). Another study from sub-Saharan Africa, which includes Central
African regions, showed a reduction in soil-transmitted helminth infections from 44% in 2000 to
13% in 2018, suggesting improvements in preventive measures4. However, the prevalence of
moderate-to-heavy intensity infection exceeding the 2% target threshold in 2018 was still present
in several countries, indicating ongoing risks of vegetable contamination4.

6
A study conducted in Maputo City revealed a high rate of contamination. The research assessed
the profile and frequency of parasites in lettuces and cabbages sold in selected markets. Out of
the 100 combined samples of lettuces and cabbages analyzed, 84% were contaminated with
parasites. The presence of E. coli (66%), Strongyloides stercoralis (40%), and other helminths
was noted(Sousa, Zucula, Nhancupe, Banze, Zacarias, & Noormahomed, 2021). This significant
level of contamination poses a serious public health risk, especially considering that vegetables
are often consumed raw or with minimal processing. The study underscores the need for
improved hygiene practices during production, transportation, and at the point of sale to reduce
the risk of helminth transmission through vegetables.

The findings from Mozambique are consistent with global concerns about the safety of
consuming raw vegetables and the potential for them to act as vectors for helminth transmission.
It highlights the importance of ongoing surveillance, public health education, and the
implementation of food safety measures to protect consumers from parasitic infections.

In Zambia, a study on the parasitic contamination of common vegetables sold in Lusaka, the
capital city, revealed a significant level of contamination. The study found that 35.8% of the
vegetable samples were contaminated with parasites1. The most prevalent parasite identified was
Giardia lamblia, found in 24.2% of the samples. Other helminths detected at varying prevalence
rates included Taenia spp. (9.5%), Trichuris trichiura (5.3%), Ascaris lumbricoides (3.2%),
Clonorchis sinensis (2.1%), Diphyllobothrium latum (2.1%), Paragonimus westermani (2.1%),
and Strongyloides stercoralis (2.1%)(Stanley Nyirenda et al., 2021). The study highlighted that
certain types of vegetables had higher rates of contamination, with Chinese cabbage being the
most contaminated, followed by rape, chilli, pigweed, pumpkin leaves, tomatoes, and cabbage1.
This indicates that vegetables sold at markets in Lusaka could be a potential source of parasitic
infections for consumers, emphasizing the need for improved food safety measures and public
health interventions to reduce the risk of helminth transmission through the consumption of
contaminated vegetables.

Recent studies in Tanzania have shed light on the issue of helminth contamination in vegetables,
highlighting the health risks associated with the use of wastewater for irrigation and the ongoing
transmission of soil-transmitted helminths (STH) among the adult population. One study focused
on the health risks of parasitic helminths associated with reused wastewater for vegetable

7
irrigation in Mbeya, Tanzania. The research aimed to assess the contamination levels of
vegetables irrigated with wastewater and the potential health implications for consumers
(Msoffe, 2019). Although the specific findings of this study are not detailed in the search results,
it underscores the importance of evaluating the safety of irrigation practices and the need for
proper wastewater treatment to prevent helminth contamination in vegetables.

Another study conducted a community-based cross-sectional survey in Muleba district,

Tanzania, to determine the current prevalence and risk factors associated with ongoing
transmission of STH infection among adults. The study reported a prevalence of 9.1% for STH
infection, with the prevalence of Hookworm spp., Ascaris lumbricoides, and Trichuris trichiura
being 7.43%, 0.91%, and 0.72%, respectively. The factors significantly associated with STH
infection were farming, the habit of not wearing shoes in general, and during garden
activities(Franco Zacharia, et al., 2023). This study highlights the need for integrated
management to address practices contributing to ongoing transmission. The findings from
Tanzania emphasize the need for continued vigilance and public health interventions to reduce
the risk of helminth transmission through contaminated vegetables and to improve the overall
health outcomes of the population.

The reviewed literature indicates that helminth contamination in vegetables is a widespread issue
globally and across Africa. The prevalence rates and types of helminths vary by region, but
common factors contributing to contamination include poor sanitation, inadequate washing and
handling of vegetables, and the use of contaminated water for irrigation. Public health initiatives
aimed at improving sanitation, educating communities about safe food handling practices, and
regular monitoring of vegetable contamination are essential to mitigate the risks associated with
helminth transmission through vegetables. Continued research and surveillance are necessary to
inform and guide these public health efforts.

4.4.[6.4.] In Malawi.

In Malawi there is little contemporary information available on helminth infection. Furthermore,

fragmented control measures, changing ecology (such as considerable water resource
development and deforestation in the last 10 years) and migration may have led to marked
changes in the prevalence of schistosomiasis within regions in Malawi since previous studies

8
were done.(Bowie et al., 2004). A study done in the southern part of Malawi by Bowie revealed
that there was also a low prevalence of STHs in all areas, though urban areas had the highest
rates for any STH (6.6%) and hookworm was most prevalent in the Northern Highland area
(2.6%). There were no STHs detected in the Central lakeshore school. Another study done by
Phiri K (2004) showed that there was a significant difference (p<0.001) in the prevalence of
helminth infections between the urban and rural communities, 16.5% and 3.6% respectively.
Most of the infections were light (93.2% for Ascaris lumbricoides, 85.7% for hookworm). Large
variance to mean ratios of egg intensity within age groups and the total study population
suggested a high degree of aggregation of the parasites in the communities(Phiri et al., 2000).
However, the study did not focus much on the association of infections and the practices of fruits
and vegetable handling as a potential source of the infections.

4.5 Risk factors for parasitic contamination of fruits and vegetables

Several studies have highlighted a number of associated risk factors of parasitic contamination,
the tendency to use untreated human fecal matter as manure is one of the risk factors that has
been previously documented.

9
5.[7.] MATERIALS AND METHODS

Mzuzu, a city located in the northern region of Malawi. Mzuzu is the third-largest city in the
country and serves as an important commercial and agricultural center. Mzuzu is situated in a
region known for its fertile soils and favorable climate for agricultural production. The area is
known for the cultivation of a variety of crops, including leafy vegetables such as spinach, rape,
cabbage, and lettuce. These vegetables are grown by local farmers and sold in the numerous
local markets scattered throughout the city.

10
The local markets in Mzuzu are bustling hubs of activity, where farmers bring their fresh
produce to sell to consumers. These markets play a vital role in the local food system, providing
a link between farmers and consumers. They offer a diverse range of vegetables, including
locally grown leafy greens, which are widely consumed by the local population. These markets
are known for their vibrant atmosphere, with vendors showcasing their produce in colorful
displays. They attract a mix of local residents, traders, and visitors, making them dynamic
spaces for the exchange of goods and cultural experiences.

The study involved selecting multiple local markets within Mzuzu city to collect samples of
leafy vegetables. The chosen markets represented the variety of leafy vegetables available in the
city, allowing for a comprehensive assessment of parasitic contamination, by focusing on local
markets, the research aims to capture the reality of pesticide contamination in the leafy
vegetables and fruits consumed by the local population. The unique characteristics of Mzuzu,
such as its agricultural significance and active local markets, make it an ideal study site for
investigating pesticide residues in leafy vegetables. The study intends to be conducted from
January to April 2024.

5.1.[7.1.] Type of research study

This study employed a Cross-sectional Design as the study collected data at a specific point in
time, providing a snapshot of parasitic contamination of leafy vegetables available in Mzuzu
local markets during the study period. This allowed an assessment of the then situation regarding
pesticide residues in the leafy vegetables without following up on the same samples over an
extended period.

5.2.[7.2.] Study population

The study population comprised of the vegetables and fruits; rape cabbage chinese, carrot,
tomato, avocado pear, green paper and banana sold in the local markets of Mzuzu during the
study period was used.

11
Sample size and sampling technique

The sample size was calculated using Cochran’s formula, but 135 samples were collected due to
time and cost related factors then the vendors were randomly selected using simple random
selection at each and every market that vegetables and fruits were bought.

5.3.[7.3.] Sample processing

[7.4.]
Equal numbers of samples (5 each, from 3 different local markets accessible by Mzuzu
university students; St Augustine, Luwinga and Zigwagwa local market totaling 135 samples) of
fruits and vegetables were collected from the selected markets, carried in separate bags and then
a portion (200 g) of each fruit and vegetable was washed separately in 500 mL of normal saline
to detach parasitic stages (ova, larvae,) followed by after overnight sedimentation of the washing
solution, 15 mL of the sediment was transferred to a centrifuge tube using a sieve to remove
undesirable matters, the tube was centrifuged at 3000 rpm for five minutes to concentrate the
parasitic stages. After centrifugation, the supernatant was decanted carefully without shaking.
Then the sediment was agitated gently by hand for redistributing the parasitic stages. Finally, the
sediment was examined under a light microscope (with the addition of a drop of iodine) using
×40 objective.

5.4.[7.5.] Data collection

Data was collected indicating location of the market, gender of the vendor and type of the
produce. The parasitic forms of helminths observed in the lab if any were recorded on a sheet of
paper that was designed and entered into excel sheet for data cleaning, a backup was done to
google drive.

5.5.[7.6.] Data management and analysis

Statistical analysis was performed with SPSS software version 20 (IBM, Chicago, IL, USA).
Probability values were considered to be statistically significant when the calculated P-value was
equal to or less than 0.05. The difference in parasitic contamination among the different

categories was compared using the Pearson’s chi-square test (χ2).

12
 5.6.[7.7.] Ethical considerations
[7.8.]
Ethical approval was sought from Mzuzu University Biological Department Ethics Committee
before conducting the research.

To protect the vendor’s integrity of their business, no names were recorded instead sample
identities were assigned and the fruits and vegetables were bought in a normal and at a normal
price to avoid alarms, this approach was adopted from Mwansa’s project (Mwansa, 2017).

5.7.[7.9.] Possible constraints

[7.10.]
The constraints were time factor, as the researcher had a fixed timeframe, the sample size was
not adequate hence it would affect the generalizability of the results in Mzuzu as a whole as well
as the costing of the produce.

5.8.[7.11.] Dissemination of the results

[7.12.]
The results were shared with the biological department as well as the Mzuzu library, for future
references.

13
6.[8.] PRESENTATION OF RESULTS AND ANALYSIS

[9.]
THE PREVALENCE OF PARASITIC(HELMINTHIC) CONTAMINATION OF FRUITS AND
VEGETABLES IN MZUZU LOCAL MARKETS

TABLE:1

FREQUENCY DISTRIBUTION OF PARASITOLOGICAL CONTAMINATION OF FRUITS

AND VEGETABLES IN SELECTED MZUZU LOCAL MARKETS

TYPE OFPRODUCE NUMBER # OF # OF

OF POSITIVE PARASITE
SAMPLE [%] SPECIES
S DETECTED

ONE [%] TWO[%] THREE[%]

CABBAGE 15 11[73.3] 7[46.7] 4[] 0

14
CHINESE 15 14[93.3] 9[60.0] 3[] 2[13.3]

AVOCADO PEAR 15 9[60.0] 9[60.0] 0 0

PUMPKIN LEAVES 15 11[73.3] 8[53.3] 9[] 2[13.3]

RAPE 15 13[86.7] 10[66.7] 8[] 1[6.7]

BANANA 15 10[66.7] 9[60.0] 9[] 0

CARROT 15 10[66.7] 10[66.7] 10[] 0

TOMATO 15 8[53.3] 8[53.3] 8[] 0

GREEN PAPER 15 8[53.3] 6 [40] 6[] 0

Total 135 94[69.6] 76[56.3] 13[9.6] 5[3.7]

TABLE :2:
PREVALENCE OF PARASITIC VEGETABLES IN FRUITS AND VEGETABLES SOLD AT
MZUZU LOCAL MARKETS

DETECTED FREQUENC PREVALENC

PARASITE Y E

15
Hookworm 27 25%
Trichuris 18 26.7%
Toxocara 11 10.2%
Ascaris Lumbricoides 7 6.5%
Fasciola 4 3.7%
Tinea 5 4.6%
Strongyloides 36 33.3%

Total 135 94[69.6]

TABLE 3:
FACTORS ASSOCIATED WITH PARASASITIC CONTAMINATION IN VEGETABLE
AND FRUITS

VARIABLE RESULTS: TOTAL X2 VALUE P-VALUE

POSITIVE

GENDER MALE 5 11 3.310 0.69

FEMALE 89 124

LOCATION LUWINGA 27 45 6.375 0.041

ST AUGUSTINE 31 45
ZIGWAGWA 37 45

PRODUCE CABBAGE 11 15 10.789 0.214

CHINESE 14 15
PUMPKIN 11 15
PEAR 9 15
RAPE 13 15

16
 BANANA 10 15
CARRROT 10 15
TOMATO 8 15
GREEN PAPER 8 15

In the tables above 94 samples were identified as being contaminated with at least one type
of parasite; the overall contamination was 69.6%. Table 1 summarizes what percentage of
each sample group was contaminated: 93.3% of the Chinese, 86.7% of cabbage, followed
by 73.3% pumpkin leaves and also cabbage, 66% for banana, carrot then avocado pear at
60% and lastly tomato and green paper at 53.3%.
It also shows coinfection where there were two, or three different parasite specie present no
produce exceeded three parasites in the same sample. The parasites detected (see Table 2)
included Hookworm (25%), Trichuris (36.7%), Toxocara (10.2%) Ascaris Lumbricoides (6.5%),
Fasciola (3.7%)
Tinea 5(.6%), Strongyloides (33.3%). Contamination with more than one parasite species was
observed in the fruit and vegetable samples examined in this study. More half (56.3%) of the
total samples were contaminated with one species of parasites, while 9.6% of the samples were
contaminated with two species and 3.7% were contaminated with three species. The results also
showed that samples collected from Zigwagwa (82.2%) had the highest contamination rate,
followed by samples collected from St. Augustine (68.9%), followed by Luwinga (60%). The
contamination rate of samples collected from the different markets was statistically significant
(P=0.041) (see Table 3). Other factors like gender and type of produce had no statistical
significance.

17
FIGURES

Strongyloide larvae hookworm egg

18
19
6.0 DISCUSSION AND CONCLUSION

Like many tropical countries, intestinal parasites are widely distributed in Malawi because of the
favorable climate and unsanitary conditions that facilitate fecal pollution of water, foodstuffs,
and soil. The market chain lends itself to fruits and vegetables passing through several hands and
as a result they might become contaminated with enteric bacteria, viruses, and parasitic
pathogens.

The present study attempted to assess the level of contamination and prevalence of different
intestinal parasites in various fruits and vegetables sold in local markets of Mzuzu, Northern side
of Malawi. The overall parasitic contamination rate was found to be 69.6%, which is in
agreement with other findings from Iran with 67% (n=190)(Shahnazi & Jafari-Sabet, 2010), as
well as Mozambique 84%(n=10084)(Sousa, Zucula, Nhancupe, Banze, Zacarias, & Virginia,
2021). It is also, however, higher than that reported in similar studies from, Zambia 35.8% (n=
95) Egypt 37.1%, and Ethiopia 57.8%(n=360).. The incongruity between this study and others
might be attributed to the variations in geographical locations, climatic and environmental
conditions, differences in the sample size, the techniques used, poor post-harvest handling
method and socioeconomic status.

Chinese (93.3%) was found to be the most frequently contaminated product, followed by rape
(86%), pumpkin leaves and cabbage (73.3%), carrot and banana (66.7%), Avocado pear (60%)
then tomato and green paper were found to be the least contaminated. The variation in

20
contamination between the products might be explained by the fact that vegetables such as
cabbage, have larger and uneven surfaces, which make the parasites attach more easily to the
surface. The smooth surface of avocado green paper, tomato might reduce the rate of parasitic
attachment hence explaining the lower contamination rate observed in this study.

In this study, Strongyloides stercoralis (detected 36 times representing 33%) was the most
frequently detected parasite with a prevalence of 33.3%. The predominance of A. lumbricoides
agrees with a study review conducted by F white and others, where it is highlighted of the
parasites terrestrial abundance, contamination in fruits and vegetables as a result of farmers using
human fecal contaminated manure (A. F. White et al., 2019). Another study done in Nigeria
agrees with findings and exposes the need for vendors to be educated in preparation of fruits and
vegetables to avoid further contamination, it was also noted that personal hygiene and poor
sanitation were catalyst of the contamination(Adenusi et al., 2015). The other important factor to
note is the ability of strongyloides to live as a free living parasite in the environment. This
helminth is set apart from others that commonly affect humans by the internal auto infective
cycle with auto infective larvae randomly migrating through tissue, parthenogenesis, and the
potential for lifelong infection in the host, the profound pathology occurring in hyper infection
and systemic manifestations of strongyloidiasis, and a limited external cycle with a single
generation of free-living adults(Page et al., 2018).

The second most prevalent contaminant was Trichuris with the prevalence of 26.7%. These
findings are contrary to a study done in Zambia, this could be as a result of variation in sample
size, vendors knowledge in handling the produce and other factors that have not been fully
explored in this research.

Contamination with multiple species was observed in many kinds of fruits and vegetables in this
study. This agrees with a study done in southern Ethiopia (Bekele & Shumbej, 2019). And might
indicate the possibility of a high-level contamination of fruits and vegetables, which perhaps
results in multiple parasitic infections in humans. It might also indicate the persistence of
intestinal parasitic infections in the area.

The coinfection may also have different implications on the immunity of a human host, some of
them being; Immune modulation effects, Soil-transmitted helminths can act as
immunomodulators on the human host's immune system, leading to synergistic or antagonistic

21
effects that modify the severity of other diseases. Understanding these mechanisms is crucial for
designing effective control strategies. For example, a study in Cameroon found that children co-
infected with STHs and malaria had a lower risk of severe anemia than those infected with
malaria alone, implying that malaria and helminth co-infection was protective against anemia in
that study context (Njua-Yafi et al., 2016), furthermore another study showed that there was an
inverse protection between soil transmitted helminthiasis with allergic reactions as well as
diseases like inflammatory bowel infections. The epidemiological data have linked helminth
exposure to protection from immune disorders that include a wide range of diseases, such as
allergies, autoimmune illnesses, and idiopathic inflammatory disorders of the gut, which are
grouped as inflammatory bowel diseases (IBD). Treatment of moderate to severe IBD involves
the use of immune modulators and biologics, which can cause life-threatening complications. In
this setting, their safety profile makes helminths or helminth products attractive as novel
therapeutic approaches to treat IBD or other immune disorders(Atagozli et al., 2023). On the
contrary, helminths are known for deliberating effects, for example, helminths are responsible
for iron deficiency anemia, this exposes the enormous complexity and multifaceted interactions
between the hos and pathogen interaction.

In general, this study observed a greater incidence of parasitic contamination in fruits and
vegetables compared to similar studies conducted in the region. Several factors may contribute to
this disparity, including geographical location, the quantity and variety of samples analyzed,
detection methods for intestinal parasites, irrigation water sources, and post-harvest handling
techniques, which vary across different countries. Additionally, individual hygiene practices,
sanitation facilities, and climatic conditions are all influential factors.

7.[10.] Recommendations

There is a need for further research to explore the knowledge attitudes and practices of both
farmers To address the high prevalence of parasitic contamination in fruits and vegetables from
these local markets, it is imperative to implement a routine monitoring and surveillance system,
enhance market hygiene practices, and promote public awareness about proper produce handling.
Good agricultural practices(GAP) should be adopted, including using clean irrigation water and

22
avoiding untreated waste as fertilizer. Further research is needed to identify contamination
sources and transmission pathways, supported by multi-sectoral collaboration between public
health, agriculture, and local governance.and vendors on parasitic contamination of vegetables
and fruits, another study in summer would help in determining seasonal variations. Farmers,
vendors, as well as consumers and transporters should be educated on the dangers of parasitic
contamination and proper produce handling and processing. A periodic deworming would
protect consumers from being infected as well as avoiding eating raw vegetables, washing
thoroughly fruits and vegetables. Health sector should establish a system for regular monitoring
of contamination of vegetables sold at local markets.

8.[11.] Limitations
Due to the fluctuations of the costings, limited resources and time frame the researcher did not
manage to buy and process the rest of the samples. As such these results may not be used to
generalize the findings for the whole area.

9.[12.] Conclusion
In conclusion, this study underscores the importance of addressing parasitic contamination in
fresh produce to safeguard public health and promote food safety in Mzuzu City, Malawi. The
findings of this study demonstrates that there is a potentially high risk/chance of contracting
parasitic infections from the consumption of raw vegetables and fruits sold in Mzuzu local
markets. Efforts should be made by the relevant officials to reduce the rate of contamination of
products.Further research and interventions are necessary to mitigate the risks associated with
parasitic infections from raw vegetables and fruits.

101. Appendix

23
Trichuris eggs strongyloides larvae

Strongyloides eggs Hookworm larva

24
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