Confounding influences of malnutrition and Plasmodium falciparum and Schistosoma haematobium infections on haematological parameters in school children in Muyuka, Cameroon

Abstract

Background School-aged children (SAC) are a high-risk demographic group for infectious diseases and malnutrition. The objective of this study was to assess the burden and the effect of Plasmodium falciparum and Schistosoma haematobium infections on the haematological indices in SAC and the confounding influence of malnutrition on the outcomes. Methods This cross-sectional study was conducted in SAC 4–14 years old living in Ikata, Bafia and Mile 14-Likoko in Muyuka, Cameroon. Anthropometric measures of malnutrition were obtained and blood samples collected were used for detection of malaria parasites by Giemsa-stained blood films using light microscopy and complete blood count analysis using an automated haematology analyser. Urine samples collected were used to detect micro haematuria with the aid of reagent strips and the eggs of S. haematobium by urine filtration technique. Multiple linear regression model was used to examine influence of independent variables on haematological parameters. Results Out of the 606 SAC examined, the prevalence of single infections with Plasmodium or S. haematobium and co-infection with both parasites was 16.2, 16.3 and 8.3%, respectively. Overall, malaria parasite (MP), urogenital schistosomiasis, malnutrition, anaemia, haematuria, microcytosis and thrombocytopenia was prevalent in 24.4, 24.6, 25.9, 74.4, 12.2, 45.4 and 11.1% of SAC, respectively. A significant linear decline (P = 0.023) in prevalence of P. falciparum infection with the severity of stunting was observed. Factors that significantly influenced haematological parameters included haemoglobin: age, stunting and MP; haematocrit: age and MP; white blood cell count: age; red blood cell count; age and MP; lymphocyte counts: stunting; mean cell volume: age; mean cell haemoglobin: age and stunting; mean cell haemoglobin concentration: sex, stunting and red cell distribution width-coefficient of variation: sex, age and stunting. Conclusions Malnutrition, Plasmodium and S. haematobium infections are common while anaemia is a severe public health problem in Muyuka, Cameroon. The interaction between haematological parameters with malaria parasites as well as linear growth index was negative and other interactions indicate systemic inflammation. While findings provide contextual intervention targets to ensure the judicious use of the limited resources, there is need for regular monitoring and proper treatment to improve the health of the underserved population.

Co-infection of urogenital schistosomiasis and malaria and its association with anaemia and malnutrition amongst schoolchildren in Dutse, Nigeria

“…This showed that the schoolchildren in the villages were severely anaemic -an indication of a huge public health problem. 17 The higher prevalence of anaemia in schoolchildren is comparable to the findings o Nyarko et al 41 in Ghana, Deribew et al 42 in Ethiopia and Sumbele et al 7 in Cameroon who reported an anaemia prevalence of 59.9%, 81.8% and 74.4%, respectively. However, in northwestern Nigeria, a lower anaemia prevalence of 11.7% was reported by Oladele et al 40 Although there are many causes of anaemia, the high prevalence of anaemia in Warwade, Saya Saya and Jigawar Daha is probably due to the high prevalence and infection intensity of S. haematobium and Plasmodium.…”

“…However, co-infection is lower than that reported by Nyarko et al 41 in Ghanian schoolchildren and Deribew et al 42 in Ethiopian schoolchildren (0.9% and 2.84%, respectively). Notwithstanding this, in a recent study by Sumbele et al 7 in Cameroon, a relatively higher 8.3% co-infection prevalence of S. haematobium and P. falciparum was reported. Moreover, S. haematonium and Plasmodium may modulate the effect of each other within their host.…”

“…18,19 The intensity of infection was categorised as either heavy (>50 eggs/10 mL of urine) or light (<50 eggs/10 mL of urine). 7,18…”

“…6 Epidemiological studies have highlighted that individuals co-infected with more than one parasite species are at risk of increased morbidity, increased severity of the infecting parasite species and increased susceptibility to other infections. 7 In sub-Saharan Africa, anaemia and malnutrition are the most frequent conditions encountered in field surveys and parasitic infections are among the major causes of these conditions. 8 Mechanisms through which parasitic infections cause anaemia and malnutrition include damage to intestinal mucosa which results in impaired digestion and absorption of nutrients, intestinal blood loss, interference with processes leading to production of blood cells in the bone marrow, and impaired immune development.…”

Epidemiological burden of persistent co-transmission of malaria, schistosomiasis, and geohelminthiasis among 3-15 years old children during the dry season in Northern Cameroon

“…However, beyond the under-ve age category, school-aged children (SAC) (5-15 years) represent a relevant demographic group due to ease of accessibility in primary schools although epidemiological data on their malaria burden is lacking [12,13]. Due to repeated exposure to malaria and acquisition of partial immunity to disease in high transmission settings, SAC are frequently subjected to prolonged carriage of untreated asymptomatic parasitemia thereby serving as potential infectious reservoirs for sustaining transmission [14,15].…”