Mechanism of Anemia in Schistosoma mansoni–Infected School Children in Western Kenya

Butler, Sara E.; Muok, Erick M. O.; Montgomery, Susan P.; Odhiambo, Keziah; Mwinzi, Pauline; Secor, W. Evan; Karanja, Diana M. S.

doi:10.4269/ajtmh.2012.12-0248

Cited by 39 publications

(38 citation statements)

References 32 publications

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“…The likelihood of anemia in school children, when it was compared with uninfected, increased 148 times for both Ascaris lumbericoides -Schistosoma mansoni coinfection, 38 times for Hook worm, 20 times for Schistosoma mansoni and 3 times for Ascaris lumbericoides mono-infection. But in Kenya S. mansoni mono-infection was reported to associate with anaemia and the likelihood of anemia in Schistosoma infection was 3.68 times compared with noninfected children[37]. Except for one school child (0.3%), there was no problem of overweight in the current study in school age children.…”

contrasting

confidence: 52%

“…This type of association in which intestinal helminthes infections aggravate the situation of malnutrition was reported to be common in children [36]. Prevalence of stunting and anaemia were reported higher in male than in female in Kenyia [37]. But, gender did not show any difference (p>0.05) for prevalence of stunting or anaemia in the school children studied (Table 4).…”

Section: Discussionmentioning

confidence: 82%

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Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.

Tarekegn

Birhanie

Lemma

2019

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Background: In Ethiopia Stunting, underweight and wasting in school children are very common. The aim of this research was to evaluate the impact of intestinal helminthes and schistosomiasis on malnutrition, anaemia and haematological indices in the school age children of Azezo Elementary School in Gondar town. Methods: Kato Katz technique was performed to determine infection and intensity of intestinal helminth infections. AnthroPlus software version 1.04 was used to get malnutrition indices while fully-automated haematological analyzers were used to determine haematological and biochemical parametrs. Results: Atotal of 384 school children were recruited in this study. The overall prevalence of helminth infections was 45.8% (178/384) with the leading Ascaris lumbericoides infection (20.6%) compared to the second leading Schistosoma mansoni (17.4%) and third leading hook worm infections (13.3%). The prevalences of body mass indexes for age Z-scores (BAZ) indices were 9.6% (37) very sever thinnes, 17.2% (66) sever thinness, 38.3% (147) thinness, 34.4% (132) normal and 0.5% (2) overweight. On the other hand, the prevalences of height for age Z-scores (HAZ) indices were 12.2% (47) stunt, 87% (334) normal and 0.8% (3) over height. Of the total 384 school age children, 335 (87.2%) had normal blood glucose level (70 – 110 mg/dL) while the remaining 49 (12.8%) school age children were hypoglycemic. The number of the school children with normal total protein level (6.6 – 8 g/dL) was 259 (67.4%) while the remaining 125 (32.6%) school children were hypo-proteinaemic. The prevalence of anemia in the school age children was 33.1% (127). Intestinal helminth infections were statistically significantly associated (p = 0.000) with hypo-glycemia, hypo-proteinaemia and anemia compared with non-infected school children. The likelihood of anemia in intestinal helminth infected school children, when it was compared with uninfected was 148 times higher for both Ascaris lumbericoides-Schistosoma mansoni co-infection, 38 times for Hookworm, 20 times for Schistosoma mansoni and 3 times for Ascaris lumbericoides mono-infection. Conclusion: Intestinal helminth infections in school age children aggravate malnutrition. Prolonged malnutrition and intestinal helminth infections could result in stunting in school-age children. Key Words: school children; malnutrition; intestinal helminth infections; nutritional indices; Gondar town.

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confidence: 52%

Section: Discussionmentioning

confidence: 82%

Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.

Tarekegn

Birhanie

Lemma

2019

Preprint

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“…Furthermore, HIV prevalence among infants in western Kenya is estimated to be 10%,31 which could cause inflammation as well as anemia and severe anemia 32,33. Schistosomiasis, present in school-aged children in the region, can also cause anemia and inflammation 34,35. It is possible that children had multiple parasitic infections, resulting in inflammation and anemia that has been seen in other developing country settings 36…”

Section: Discussionmentioning

confidence: 99%

Determinants of Anemia among Preschool Children in Rural, Western Kenya

Foote¹,

Sullivan²,

Ruth³

et al. 2013

The American Society of Tropical Medicine and Hygiene

109

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Although anemia in preschool children is most often attributed to iron deficiency, other nutritional, infectious, and genetic contributors are rarely concurrently measured. In a population-based, cross-sectional survey of 858 children 6–35 months of age in western Kenya, we measured hemoglobin, malaria, inflammation, sickle cell, α-thalassemia, iron deficiency, vitamin A deficiency, anthropometry, and socio-demographic characteristics. Anemia (Hb < 11 g/dL) and severe anemia (Hb < 7 g/dL) prevalence ratios (PRs) for each exposure were determined using multivariable modeling. Anemia (71.8%) and severe anemia (8.4%) were common. Characteristics most strongly associated with anemia were malaria (PR: 1.7; 95% confidence interval [CI] = 1.5–1.9), iron deficiency (1.3; 1.2–1.4), and homozygous α-thalassemia (1.3; 1.1–1.4). Characteristics associated with severe anemia were malaria (10.2; 3.5–29.3), inflammation (6.7; 2.3–19.4), and stunting (1.6; 1.0–2.4). Overall 16.8% of anemia cases were associated with malaria, 8.3% with iron deficiency, and 6.1% with inflammation. Interventions should address malaria, iron deficiency, and non-malarial infections to decrease the burden of anemia in this population.

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“…1,2,4,9,[15][16][17][18][19][20][21] The predominant underlying mechanism seems to be anemia of inflammation, involving pro-inflammatory cytokines including tumour necrosis factor (TNF)-alpha and Interleukin-6. [22][23][24] Other mechanisms include ulcerative passage of eggs through the intestinal wall, causing extracorporeal blood loss, splenic sequestration, and autoimmune hemolysis. 17,25,26 Lake Albert in western Uganda provides the optimum habitat for Biomphalaria snails, the intermediate host for S. mansoni, making it a hub for S. mansoni transmission.…”

Section: Introductionmentioning

confidence: 99%

Schistosoma mansoni Infection as a Predictor of Low Aerobic Capacity in Ugandan Children

Smith

McLachlan

Shehri

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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Using the 20-meter shuttle run test (20mSRT) as a morbidity metric, we assessed whether Schistosoma mansoni infection was associated with decreased aerobic capacity in Ugandan children across a range of altitudes, either at low (∼600 m) or high (∼1,000 m) altitudes. A total of 305 children were recruited from six schools within the Buliisa District, Lake Albert, Uganda. A subset (n = 96) of these had been previously assessed and treated for schistosomiasis ± malaria 2 weeks prior. Fitness scores on the 20mSRT were translated into VO2max using a standardized equation. Unadjusted and multivariable-adjusted analyses were performed using VO2max as the primary outcome. Analysis of fitness scores from 304 children, inclusive of the subset follow-up cohort, revealed a median VO2max of 45.4 mL kg −1 min −1 (interquartile range: 42.9-48.0 mL kg −1 min −1 ). Children residing at high altitudes demonstrated increased aerobic capacities (46.3 versus 44.8 mL kg −1 min −1 , P = 0.031). The prevalence of stunting, wasting, S. mansoni egg patent infection, malaria, giardiasis, anemia, and fecal occult blood were 36.7%, 16.1%, 44.3%, 65.2%, 21.4%, 50.6%, and 41.2%, respectively. Median VO2max was elevated in those previously treated, compared with those newly recruited (46.3 versus 44 mL kg −1 min −1 , P < 0.001). Multivariable-adjusted analysis revealed a strong negative association between S. mansoni egg patent infection and VO2max at low altitude (beta coefficient: −3.96, 95% CI: −6.56 to −137, P = 0.004). This is the first study to document a negative association between S. mansoni infection and aerobic capacity at low altitudes using the 20mSRT.

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Mechanism of Anemia in Schistosoma mansoni–Infected School Children in Western Kenya

Cited by 39 publications

References 32 publications

Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.

Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.Impact of intestinal helminth infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.

Determinants of Anemia among Preschool Children in Rural, Western Kenya

Schistosoma mansoni Infection as a Predictor of Low Aerobic Capacity in Ugandan Children

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