Abstract

BackgroundMalaria and helminthiases frequently co-infect the same individuals in endemic zones. Plasmodium falciparum and helminth infections have long been recognized as major contributors to anaemia in endemic countries. Several studies have explored the influence of helminth infections on the course of malaria in humans but how these parasites interact within co-infected individuals remains controversial.MethodsIn a community-based longitudinal study from March 2011 to February 2012, the clinical and malaria parasitaemia status of a cohort of 357 children aged 6 months to 10 years living in Mutengene, south-western region of Cameroon, was monitored. Following the determination of baseline malaria/helminths status and haemoglobin levels, the incidence of malaria and anaemia status was determined in a 12 months longitudinal study by both active and passive case detection.ResultsAmong all the children who completed the study, 32.5 % (116/357) of them had at least one malaria episode. The mean (±SEM) number of malaria attacks per year was 1.44 ± 0.062 (range: 1–4 episodes) with the highest incidence of episodes occuring during the rainy season months of March–October. Children <5 years old were exposed to more malaria attacks [OR = 2.34, 95 % CI (1.15–4.75), p = 0.019] and were also more susceptible to anaemia [OR = 2.24, 95 % CI (1.85–4.23), p = 0.013] compared to older children (5–10 years old). Likewise children with malaria episodes [OR = 4.45, 95 % CI (1.66–11.94), p = 0.003] as well as those with asymptomatic parasitaemia [OR = 2.41, 95 % CI (1.58–3.69) p < 0.001] were susceptible to anaemia compared to their malaria parasitaemia negative counterparts. Considering children infected with Plasmodium alone as the reference, children infected with helminths alone were associated with protection from anaemia [OR = 0.357, 95 % CI (0.141–0.901), p = 0.029]. The mean haemoglobin level (g/dl) of participants co-infected with Plasmodium and helminths was higher (p = 0.006) compared to participants infected with Plasmodium or helminths alone.ConclusionChildren below 5 years of age were more susceptible to malaria and anaemia. The high prevalence of anaemia in this community was largely due to malaria parasitaemia. Malaria and helminths co-infection was protective against anaemia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1111-2) contains supplementary material, which is available to authorized users.

Highlights

  • Malaria and helminthiases frequently co-infect the same individuals in endemic zones

  • Participants were categorized into three groups: those without detectable malaria parasitaemia by microscopy and no clinical manifestation of malaria (P− M−), those who were asymptomatic but were positive for malaria parasitaemia (P+ M−) and those who were febrile and malaria parasitaemic plus at least one sign/symptom of malaria (P+ M+)

  • We found that children

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Summary

Introduction

Malaria and helminthiases frequently co-infect the same individuals in endemic zones. Several studies have explored the influence of helminth infections on the course of malaria in humans but how these parasites interact within co-infected individuals remains controversial. Various studies have explored the influence of helminth infections on the course of malaria in humans but whether and how these two parasites interact within co-infected hosts remains controversial [1, 2, 4, 7, 11, 12]. Recent studies have shown a positive association between hookworm infection and asymptomatic Plasmodium falciparum parasitaemia [8], while individuals with light Trichuris trichiura and Ascaris lumbricoides infections had lower Plasmodium densities than those with moderate or heavy infection [9]. No association was found between STH infection and malaria in Uganda [2]

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