Anemia and undernutrition in intestinally parasitized schoolchildren from Gakenke district, Northern Province of Rwanda.

María José Irisarri-Gutiérrez,Carla Muñoz-Antolí,Fernando Jorge Bornay-Llinares,Lucrecia Acosta,José Guillermo Esteban,Rafael Toledo,Lucy Anne Parker,Srinivas Goli

doi:10.1371/journal.pone.0262361

Abstract

BackgroundRwanda is a sub-Saharan country, where intestinal parasite infections, anemia and undernutrition coexist. The purpose of this research is to study the relationship between intestinal parasite infections and undernutrition/anemia to clarify the priorities of intervention in the rural area of Gakenke district in the Northern Province of Rwanda.Materials and methodsA total of 674 students from Nemba I School, participated in a cross-sectional study, in which their parasitological and nutritional status were analysed. Statistical analysis was performed by χ2 test, univariate analysis and Odds ratios (OR).ResultsA total of 95.3% of children presented intestinal parasitism, most of whom (94.5%) infected by protozoa and 36.1% infected by soil-transmitted helminths (STH), with Trichuris trichiura (27.3%) being the most prevalent. Multiple infections were found to be high (83.8%), with protozoa and STH co-infections in 30.6%. STH infections were mainly of low/moderate intensity. Neither infection nor STH infection of any intensity profile, was significantly related to anemia. In addition, STH infection, regardless of the intensity profile, was not associated with stunting, underweight or thinness. There was no difference between genders nor among ages in odds of anemia and nutritional status in STH-infected schoolchildren.ConclusionMultiparasitism remains high among Rwandan schoolchildren and is likely to cause nutritional problems. This work emphasizes the importance of keeping up health programs to reduce the prevalence of infection.

Highlights

According to the Food and Agriculture Organization of the United Nations, the majority of undernourished individuals live in sub-Saharan Africa, Southern Asia and the Caribbean [1]
There was no difference between genders nor among ages in odds of anemia and nutritional status in soil-transmitted helminth (STH)-infected schoolchildren
Of schoolchildren affected by stunting, 57.4% were males and they were more frequently stunted compared to females (38% of males compared to 27% of females, p = 0.018)

Summary

Introduction

According to the Food and Agriculture Organization of the United Nations, the majority of undernourished individuals (mainly involving stunting, underweight and thinness) live in sub-Saharan Africa, Southern Asia and the Caribbean [1]. Multiparasite infections at various intensities might have different effects on the undernutrition and anemia status of children [5], with chronic intestinal protozoa infections being one of the most recognized causes [4]. In the tropics and subtropics, where soil-transmitted helminth (STH) infections are common parasitic infections [5], several studies have found associations between these infections and child malnutrition through a subtle reduction in digestion and absorption, chronic inflammation and loss of nutrients, leading to stunting, underweight and thinness [3, 6,7,8,9]. Rwanda is a sub-Saharan country, where intestinal parasite infections, anemia and undernutrition coexist. The purpose of this research is to study the relationship between intestinal parasite infections and undernutrition/anemia to clarify the priorities of intervention in the rural area of Gakenke district in the Northern Province of Rwanda

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Discussion

Conclusion