Malaria and Helminth Co-Infections in School and Preschool Children: A Cross-Sectional Study in Magu District, North-Western Tanzania
Malaria and Helminth Co-Infections in School and Preschool Children: A Cross-Sectional Study in Magu District, North-Western Tanzania
复制标题
DOI：
10.1371/journal.pone.0086510
复制
发表时间：
2014-01-29
期刊：
影响因子：
3.7
通讯作者：
Vennervald, Birgitte J.
中科院分区：
文献类型：
--
作者：
Kinung'hi, Safari M.;Magnussen, Pascal;Vennervald, Birgitte J.
背景：疟疾、血吸虫病和土壤传播蠕虫感染(STH)是撒哈拉以南非洲地区重要的寄生虫感染，那里有相当大比例的人暴露于一种以上寄生虫的混合感染中。在坦桑尼亚，这些感染是一个主要的公共卫生问题，特别是在学校和学龄前儿童中。目前的研究调查了坦桑尼亚马古区学龄儿童和学龄前儿童中疟疾和蠕虫的混合感染和贫血。方法：参加一项横断面研究。采用Kato Katz技术检测粪便样本中的曼氏血吸虫和STH感染。用尿液滤过法检测尿样中的血吸虫。血液样本分别用Giemsa染色和Haemoque方法检测疟疾寄生虫和血红蛋白浓度。主要结果：在1546名接受检查的儿童中，1079人(69.8%)感染了一种或多种寄生虫。在276名儿童中观察到疟疾和蠕虫混合感染(占所有恶性疟原虫感染儿童的60%)。疟疾寄生虫在钩虫感染儿童中的流行率显著高于未感染钩虫儿童(p=0.046)。然而，在多因素Logistic回归分析中，这种关联并不显著(OR=1.320，p=0.064)。随着曼氏血吸虫感染强度的增加和混合感染蠕虫种数的增加，疟疾寄生虫密度降低。贫血患病率为34.4%，与疟疾感染、血吸虫感染和多种寄生虫感染显著相关。曼氏疟原虫感染是疟疾寄生虫密度的显著预测因子，恶性疟原虫和血吸虫感染是贫血的显著预测因子。结论/意义：马谷区学龄儿童和学龄前儿童普遍存在多重寄生虫感染。恶性疟原虫、曼氏沙门氏菌和血瘤沙门氏菌的并发感染增加了较低的Hb水平和贫血的风险，这反过来要求采取综合的疾病控制干预措施。这项研究中发现的疟疾和蠕虫感染之间的联系需要进一步调查。
Background: Malaria, schistosomiasis and soil transmitted helminth infections (STH) are important parasitic infections in Sub-Saharan Africa where a significant proportion of people are exposed to co-infections of more than one parasite. In Tanzania, these infections are a major public health problem particularly in school and pre-school children. The current study investigated malaria and helminth co-infections and anaemia in school and pre-school children in Magu district, Tanzania.Methodology: School and pre-school children were enrolled in a cross-sectional study. Stool samples were examined for Schistosoma mansoni and STH infections using Kato Katz technique. Urine samples were examined for Schistosoma haematobium using the urine filtration method. Blood samples were examined for malaria parasites and haemoglobin concentrations using the Giemsa stain and Haemoque methods, respectively.Principal Findings: Out of 1,546 children examined, 1,079 (69.8%) were infected with one or more parasites. Malaria-helminth co-infections were observed in 276 children (60% of all children with P. falciparum infection). Malaria parasites were significantly more prevalent in hookworm infected children than in hookworm free children (p = 0.046). However, this association was non-significant on multivariate logistic regression analysis (OR = 1.320, p = 0.064). Malaria parasite density decreased with increasing infection intensity of S. mansoni and with increasing number of co-infecting helminth species. Anaemia prevalence was 34.4% and was significantly associated with malaria infection, S. haematobium infection and with multiple parasite infections. Whereas S. mansoni infection was a significant predictor of malaria parasite density, P. falciparum and S. haematobium infections were significant predictors of anaemia.Conclusions/Significance: These findings suggest that multiple parasite infections are common in school and pre-school children in Magu district. Concurrent P. falciparum, S. mansoni and S. haematobium infections increase the risk of lower Hb levels and anaemia, which in turn calls for integrated disease control interventions. The associations between malaria and helminth infections detected in this study need further investigation.