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Distribution and risk factors for Plasmodium and helminth co-infections: a cross-sectional survey among children in Bagamoyo district, coastal region of Tanzania.

Salim N, Knopp S, Lweno O, Abdul U, Mohamed A, Schindler T, Rothen J, Masimba J, Kwaba D, Mohammed AS, Althaus F, Abdulla S, Tanner M, Daubenberger C, Genton B - PLoS Negl Trop Dis (2015)

Bottom Line: There are conflicting findings on potential association between these two parasites.A community-based cross-sectional survey was conducted among 1033 children.This calls for an integrated approach such as using mass chemotherapy with dual effect (e.g., ivermectin) coupled with improved housing, sanitation and hygiene for the control of both parasitic infections.

View Article: PubMed Central - PubMed

Affiliation: Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania; Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences (MUHAS), Dar es Salaam, United Republic of Tanzania; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

ABSTRACT

Background: Plasmodium and soil transmitted helminth infections (STH) are a major public health problem, particularly among children. There are conflicting findings on potential association between these two parasites. This study investigated the Plasmodium and helminth co-infections among children aged 2 months to 9 years living in Bagamoyo district, coastal region of Tanzania.

Methods: A community-based cross-sectional survey was conducted among 1033 children. Stool, urine and blood samples were examined using a broad set of quality controlled diagnostic methods for common STH (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, Enterobius vermicularis, Trichuris trichura), schistosoma species and Wuchereria bancrofti. Blood slides and malaria rapid diagnostic tests (mRDTs) were utilized for Plasmodium diagnosis.

Results: Out of 992 children analyzed, the prevalence of Plasmodium infection was 13% (130/992), helminth 28.5% (283/992); 5% (50/992) had co-infection with Plasmodium and helminth. The prevalence rate of Plasmodium, specific STH and co-infections increased significantly with age (p < 0.001), with older children mostly affected except for S. stercoralis monoinfection and co-infections. Spatial variations of co-infection prevalence were observed between and within villages. There was a trend for STH infections to be associated with Plasmodium infection [OR adjusted for age group 1.4, 95% CI (1.0-2.1)], which was more marked for S. stercoralis (OR = 2.2, 95% CI (1.1-4.3). Age and not schooling were risk factors for Plasmodium and STH co-infection.

Conclusion: The findings suggest that STH and Plasmodium infections tend to occur in the same children, with increasing prevalence of co-infection with age. This calls for an integrated approach such as using mass chemotherapy with dual effect (e.g., ivermectin) coupled with improved housing, sanitation and hygiene for the control of both parasitic infections.

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Flow of study participants and prevalence of Plasmodium and helminth infections.
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pntd.0003660.g001: Flow of study participants and prevalence of Plasmodium and helminth infections.

Mentions: A total of 1033 children were recruited. Of these, 41 (3.9%) did not submit stool samples which left 992 children as study analysis population (Fig 1). Demographic characteristics and intervention coverage are described in Table 2. Overall median age was 4.7 years with 25th of 2.3 and 75th quartiles of 6.5; 459 (46%) were represented by children above five years of age. Among children aged five years and above 185 (40.3%) were not schooling at the time of the survey. 494 (49.8%) were males. Eight hundred and twenty (82.7%) of the study population slept under a long lasting insecticide impregnated net (LLIN) the night before the survey. The parents/guardians reported use of albendazole and mebendazole past six months in 411 (41.4%) and 188 (18.9%) of their children respectively.


Distribution and risk factors for Plasmodium and helminth co-infections: a cross-sectional survey among children in Bagamoyo district, coastal region of Tanzania.

Salim N, Knopp S, Lweno O, Abdul U, Mohamed A, Schindler T, Rothen J, Masimba J, Kwaba D, Mohammed AS, Althaus F, Abdulla S, Tanner M, Daubenberger C, Genton B - PLoS Negl Trop Dis (2015)

Flow of study participants and prevalence of Plasmodium and helminth infections.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383605&req=5

pntd.0003660.g001: Flow of study participants and prevalence of Plasmodium and helminth infections.
Mentions: A total of 1033 children were recruited. Of these, 41 (3.9%) did not submit stool samples which left 992 children as study analysis population (Fig 1). Demographic characteristics and intervention coverage are described in Table 2. Overall median age was 4.7 years with 25th of 2.3 and 75th quartiles of 6.5; 459 (46%) were represented by children above five years of age. Among children aged five years and above 185 (40.3%) were not schooling at the time of the survey. 494 (49.8%) were males. Eight hundred and twenty (82.7%) of the study population slept under a long lasting insecticide impregnated net (LLIN) the night before the survey. The parents/guardians reported use of albendazole and mebendazole past six months in 411 (41.4%) and 188 (18.9%) of their children respectively.

Bottom Line: There are conflicting findings on potential association between these two parasites.A community-based cross-sectional survey was conducted among 1033 children.This calls for an integrated approach such as using mass chemotherapy with dual effect (e.g., ivermectin) coupled with improved housing, sanitation and hygiene for the control of both parasitic infections.

View Article: PubMed Central - PubMed

Affiliation: Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania; Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences (MUHAS), Dar es Salaam, United Republic of Tanzania; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

ABSTRACT

Background: Plasmodium and soil transmitted helminth infections (STH) are a major public health problem, particularly among children. There are conflicting findings on potential association between these two parasites. This study investigated the Plasmodium and helminth co-infections among children aged 2 months to 9 years living in Bagamoyo district, coastal region of Tanzania.

Methods: A community-based cross-sectional survey was conducted among 1033 children. Stool, urine and blood samples were examined using a broad set of quality controlled diagnostic methods for common STH (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, Enterobius vermicularis, Trichuris trichura), schistosoma species and Wuchereria bancrofti. Blood slides and malaria rapid diagnostic tests (mRDTs) were utilized for Plasmodium diagnosis.

Results: Out of 992 children analyzed, the prevalence of Plasmodium infection was 13% (130/992), helminth 28.5% (283/992); 5% (50/992) had co-infection with Plasmodium and helminth. The prevalence rate of Plasmodium, specific STH and co-infections increased significantly with age (p < 0.001), with older children mostly affected except for S. stercoralis monoinfection and co-infections. Spatial variations of co-infection prevalence were observed between and within villages. There was a trend for STH infections to be associated with Plasmodium infection [OR adjusted for age group 1.4, 95% CI (1.0-2.1)], which was more marked for S. stercoralis (OR = 2.2, 95% CI (1.1-4.3). Age and not schooling were risk factors for Plasmodium and STH co-infection.

Conclusion: The findings suggest that STH and Plasmodium infections tend to occur in the same children, with increasing prevalence of co-infection with age. This calls for an integrated approach such as using mass chemotherapy with dual effect (e.g., ivermectin) coupled with improved housing, sanitation and hygiene for the control of both parasitic infections.

Show MeSH
Related in: MedlinePlus