Infection and Co-infection with Helminths and Plasmodium among School Children in Côte d’Ivoire: Results from a National Cross-Sectional Survey

Abstract

BackgroundHelminth infection and malaria remain major causes of ill-health in the tropics and subtropics. There are several shared risk factors (e.g., poverty), and hence, helminth infection and malaria overlap geographically and temporally. However, the extent and consequences of helminth-Plasmodium co-infection at different spatial scales are poorly understood.MethodologyThis study was conducted in 92 schools across Côte d’Ivoire during the dry season, from November 2011 to February 2012. School children provided blood samples for detection of Plasmodium infection, stool samples for diagnosis of soil-transmitted helminth (STH) and Schistosoma mansoni infections, and urine samples for appraisal of Schistosoma haematobium infection. A questionnaire was administered to obtain demographic, socioeconomic, and behavioral data. Multinomial regression models were utilized to determine risk factors for STH-Plasmodium and Schistosoma-Plasmodium co-infection.Principal FindingsComplete parasitological and questionnaire data were available for 5,104 children aged 5-16 years. 26.2% of the children were infected with any helminth species, whilst the prevalence of Plasmodium infection was 63.3%. STH-Plasmodium co-infection was detected in 13.5% and Schistosoma-Plasmodium in 5.6% of the children. Multinomial regression analysis revealed that boys, children aged 10 years and above, and activities involving close contact to water were significantly and positively associated with STH-Plasmodium co-infection. Boys, wells as source of drinking water, and water contact were significantly and positively associated with Schistosoma-Plasmodium co-infection. Access to latrines, deworming, higher socioeconomic status, and living in urban settings were negatively associated with STH-Plasmodium co-infection; whilst use of deworming drugs and access to modern latrines were negatively associated with Schistosoma-Plasmodium co-infection.Conclusions/SignificanceMore than 60% of the school children surveyed were infected with Plasmodium across Côte d’Ivoire, and about one out of six had a helminth-Plasmodium co-infection. Our findings provide a rationale to combine control interventions that simultaneously aim at helminthiases and malaria.

Sustaining the Control of Schistosoma mansoni in Western Côte d'Ivoire: Baseline Findings Before the Implementation of a Randomized Trial

“…This finding is in accordance with previous studies from Côte d'Ivoire and other parts of the world. 21,[43][44][45] The most likely explanation for a higher infection level in boys compared with girls is that boys are more actively exploring the environments of their settlements, including rivers and ponds, and hence, boys are more exposed to S. mansoni infection. 46 Previous research conducted in the village of Fagnampleu, in Tonkpi region, reported that prevalences of hookworm, A. lumbricoides, and T. trichiura were 60.0%, 3.4%, and 2.2%, respectively.…”

Human infections and co-infections with helminths in a rural population in Guichi, Anhui Province, China

“…We investigated the status of multiparasitism in a population from Guichi District, Anhui Province in eastern China as it was once one of the most endemic areas of schistosomiasis japonica in the country (Zhang et al, 2008;Zhao et al, 2005) and schistosomiasis usually overlaps with STHs (Yapi et al, 2014). A previous study (Ellis et al, 2007) indicated that one third of the population harboured at least two parasite species concurrently in an environmentally similar area in the same river basin.…”

“…Although great progress has been achieved with regard to control and/or local elimination of the disease through implementation of a multitude of control measures for more than six decades, approximately 65 million individuals are still at risk (Utzinger et al, 2005;Zhou et al, 2005) and the infection often overlaps with other parasitic worm infections, such as the soil-transmitted helminths (STHs), in particular Ascaris (A. ) lumbricoides, hookworm and Trichuris (T.) trichiura (Yapi et al, 2014). Soil-transmitted helminths are among the most common globally endemic geo-helminths, which are also widely spread in China (Hotez et al, 1997).…”

“…Although there is no systematic STH control in China, preventive chemotherapy is routinely used when these infections are discovered (Ellis et al, 2007). An exploration of risk factors associated with multiple diseases (e.g., schistosomiasis and ascariasis) would contribute to developing and implementing cost-effective control strategies (Yapi et al, 2014). Schistosome and STHs infections are likely to proliferate under favourable climatic and environmental conditions, especially in remote and poor areas where essential facilities, such as clean water and sanitation, are not available (Ziegelbauer et al, 2012).…”

The impact of irrigated rice on the transmission of schistosomiasis and geohelminthiasis in Niakaramandougou, Côte d’Ivoire

“…The ovular transmission is higher among girls than boys in both agro-ecosystems. Zongo et al (2012), Yapi et al (2014) reported a difference in prevalence by gender in Sahel with a higher infection in men than women. Socioanthropological surveys would provide clarification on the behavior of both sexes in contamination sources.…”