The association between multiple intestinal helminth infections and blood group, anaemia and nutritional status in human populations from Dore Bafeno, southern Ethiopia

Degarege, Abraham; Animut, Abebe; Medhin, Girmay; Legesse, Mengistu; Erko, Berhanu

doi:10.1017/s0022149x12000855

Cited by 32 publications

(38 citation statements)

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“…The observed association between intestinal parasite infection and anemia was expected, as intestinal parasites are risk factors for anemia (64-66). Reduced food intake because of inflammatory reactions induced by lesions in the intestinal mucosa and impaired iron absorption due to worm infections could partly explain this association (58, 67).…”

Section: Discussionmentioning

confidence: 81%

Intestinal parasites among rural school children in southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model

Amare

Lindtjørn

2019

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16Background: Over 28 million school-aged children are at risk of intestinal parasite infection in Ethiopia. Few studies have 17 investigated household-level risk factors or applied multilevel analysis to account for the nested data structure. This study aimed to 18 assess the prevalence, intensity, and risk factors of parasite infection among schoolchildren in rural South Ethiopia. 19Methodology/Principal Findings: Using multistage random sampling, we recruited 864 students in the Wonago district. We 20 applied multilevel-logistic and zero-inflated negative binomial regression models (ZINB). Risk factors were concentrated at the 21 individual level; school-level and class-level variables explained less than 5% of the variance. The overall intestinal parasite 22 prevalence was 56% (479/850); Trichuris trichiura prevalence was 75.2% (360/479); and Ascaris lumbricoides prevalence was 33.2% 23 (159/479). The rate of infection increased among children with anemia (AOR: 1.45 [95% CI: 1.04, 2.03]), wasting (AOR: 1.73 [95% 24 CI: (1.04, 2.90]), mothers who had no formal education (AOR: 1.08 [95% CI: 1.25, 3.47]), and those in households using open 25 containers for water storage (AOR: 2.06 [95% CI: 1.07, 3.99]). In the ZINB model, A. lumbricoides infection intensity increased with 26 increasing age (AOR: 1.08 [95% CI: 1.01, 1.16]) and unclean fingernails (AOR: 1.47 [95% CI: 1.07, 2.03]). Handwashing with soap 27 (AOR: 0.68 [95% CI: 0.48, 0.95]), de-worming treatment [AOR: 0.57 (95% CI: 0.33, 0.98)], and using water from protected sources 28 [AOR: 0.46 (95% CI: 0.28, 0.77)] were found to be protective against parasitic infection. 3 29Conclusions/Significance: After controlling for clustering effects at the school and class levels and accounting for excess zeros 30 in fecal egg counts, we found an association between parasite infections and the following variables: age, wasting, anemia, unclean 31 fingernails, handwashing, de-worming treatment, mother's education, household water source, and water storage protection. 32Improving hygiene behavior, providing safe water at school and home, and strengthening de-worming programs is required to 33 improve the health of schoolchildren in rural Gedeo. 34 35 36Author summary 37 Intestinal parasite infections are common among school-aged children in Ethiopia. Several cross-sectional studies have investigated 38 the prevalence and risk factors of these intestinal parasite infections. However, most were conducted in an urban setting in northern 39 Ethiopia; they collected household-level risk factor information from the children, not the parents; and they restricted intestinal 40 parasite infection data to binary outcomes. Therefore, we aimed to assess the prevalence and intensity of intestinal parasite infections 41 and the related individual-, household-, and school-level risk factors among rural schoolchildren in southern Ethiopia. Using a 42 multivariate, multilevel, regression model, we found minimal variation across class-and school-level factors for intestinal parasite 4...

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Section: Discussionmentioning

confidence: 81%

Intestinal parasites among rural school children in southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model

Amare

Lindtjørn

2019

Preprint

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“…In addition, the increased odds of helminth infection among children with blood type A might be due to the possibility that blood type A antigens could contain an increased amount of glycolipid substances that serve as adhesion receptors for hookworm, S. mansoni and A. lumbricoides antigens (Berger et al, 1989). Another study in Ethiopia also documented a significantly lower mean haemoglobin level among patients with blood type AB and slightly lower haemoglobin level in those with blood types A and B than in patients with blood type O (Degarege et al, 2014). Previous studies have also documented high prevalence or intensity of S. mansoni infection in children with blood type A (Ndamba et al, 1997;Degarege et al, 2015).…”

Section: Discussionmentioning

confidence: 97%

“…This could be due to the nature of the study participants. In addition, variation in socioeconomic and other genetic factors (such as human leucocyte antigen, glyoxalase I system) that may affect an individual's susceptibility for helminth infection may contribute to the unseen difference in the risk of helminth infection between the different blood types in previous studies (Gabr & Mandour, 1991;Cooper et al, 1993;Degarege et al, 2014). As a result, the effect of ABO blood type on helminth infection might have been underestimated.…”

Section: Discussionmentioning

confidence: 99%

The relationship between helminth infections and low haemoglobin levels in Ethiopian children with blood type A

et al. 2016

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The current study was conducted to evaluate the nature of association of ABO blood type with helminth infection and related reduction in haemoglobin concentration. Stool samples were collected from 403 school-age children attending Tikur Wuha Elementary School from February to April 2011. Helminth infection was examined using formol-ether concentration and thick Kato-Katz (two slides per stool specimen) techniques. Haemoglobin level was determined using a HemoCue machine and ABO blood type was determined using the antisera haemagglutination test. Nutritional status was assessed using height and weight measurements. Out of 403 children examined, 169, 120, 96 and 18 had blood type O, A, B and AB, respectively. The prevalences of helminth infections were 46.9% for hookworm, 24.6% for Schistosoma mansoni, 4.2% for Ascaris lumbricoides, 1.7% for Trichuris trichiura and 58.3% for any helminth species. The relative odds of infection with at least one helminth species was significantly higher among children with blood type A (adjusted odds ratio (AOR), 2.10; 95% confidence interval (CI), 1.28-3.45) or blood type B (AOR, 2.08; 95% CI, 1.22-3.56) as compared to children with blood type O. Among children infected with helminths, mean haemoglobin concentration was lower in those with blood type A than those with blood type O (β, -0.36; 95% CI, -0.72 to -0.01). The relative odds of hookworm infection (AOR, 1.78; 95% CI, 1.08-2.92) and related reduction in haemogobin levels (β, -0.45; 95% CI, -0.84 to -0.04) was higher among children with blood type A as compared to those with blood type O. Although the difference was not significant, the relative odds of S. mansoni or A. lumbricoides infections and related reduction in haemoglobin levels was also higher in children with blood type A or B as compared to children with blood type O. In conclusion, children with blood type A are associated with an increased risk of helminth, particularly hookworm, infection and related reduction in haemoglobin level. The mechanisms by which blood type A makes children susceptible to helminth infection and a related reduction in haemoglobin level ought to be investigated.

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“…Given the lower prevalence of malaria in the anemia hotspot areas (eastern Ethiopia), it is less likely that malaria is the cause for the geospatial inequality of anemia in Ethiopia. Furthermore, many studies In Ethiopia revealed that infections such as acute respiratory tract infection, diarrhea and soil-transmitted infection are important contributors in the etiology of anemia (32)(33)(34)(35)(36). However, these infections are not highly concentrated in the eastern part of compared to other parts of Ethiopia (6).…”

Section: Discussionmentioning

confidence: 99%

Geospatial Inequality of Anemia Among Children in Ethiopia

Endris

Dinant

Gebreyesus

et al. 2020

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Background: Anemia remains a severe public health problem among children in Ethiopia. The lack of progress in the trend of anemia infers the failure of national anemia prevention and control programs. If there are considerable geospatial differences in the prevalence of anemia in Ethiopia, targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. This study aimed to identify and locate anemia hotspots among children in Ethiopia. Methods: Data analysis was performed using Ethiopia Demographic and Health Survey (EDHS) 2016 Data. Blood specimens for anemia testing were collected from children age 6-59 months. Hemoglobin analyses were placed in a HemoCue photometer and the results were recorded onsite for 9,268 children. The outcome variable anemia was categorized into a dichotomous variable (anemic and not anemic); a child was considered as anemic if the blood-hemoglobin count was less than 11.0 g/dl. We applied Kulldorf’s spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran LISA (local indicator of spatial association) and the Getis-Ord Gi(d) local statistics to detect and locate hotspots of anemia. We ran multilevel multivariable analysis to identify risk factors for anemia clustering.Result: More than half (57%) of children aged 6-59 months were anemic in Ethiopia. Higher prevalence of anemia was found among children who live in Somali region (83%), in rural area (58%), in the lowest wealth quintile (68%), and among children of mothers’ with no education (59%). We found significant geospatial inequality of anemia among children in Ethiopia. We identified one anemia cluster (hotspot) in the eastern part of Ethiopia. Women anemia, stunting and high fertility were associated with anemia clustering.Conclusion: Anemia clustering was found in the eastern part of Ethiopia. We recommend that policy makers and programmers should especially target this area for accelerated reduction of anemia.

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The association between multiple intestinal helminth infections and blood group, anaemia and nutritional status in human populations from Dore Bafeno, southern Ethiopia

Cited by 32 publications

References 37 publications

Intestinal parasites among rural school children in southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model

Intestinal parasites among rural school children in southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model

The relationship between helminth infections and low haemoglobin levels in Ethiopian children with blood type A

Geospatial Inequality of Anemia Among Children in Ethiopia

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