Effect of Schistosomiasis and Soil-Transmitted Helminth Infections on Physical Fitness of School Children in Côte d'Ivoire

Abstract

BackgroundSchistosomiasis and soil-transmitted helminthiasis are important public health problems in sub-Saharan Africa causing malnutrition, anemia, and retardation of physical and cognitive development. However, the effect of these diseases on physical fitness remains to be determined.MethodologyWe investigated the relationship between schistosomiasis, soil-transmitted helminthiasis and physical performance of children, controlling for potential confounding of Plasmodium spp. infections and environmental parameters (i.e., ambient air temperature and humidity). A cross-sectional survey was carried out among 156 school children aged 7–15 years from Côte d'Ivoire. Each child had two stool and two urine samples examined for helminth eggs by microscopy. Additionally, children underwent a clinical examination, were tested for Plasmodium spp. infection with a rapid diagnostic test, and performed a maximal multistage 20 m shuttle run test to assess their maximal oxygen uptake (VO2 max) as a proxy for physical fitness.Principal FindingsThe prevalence of Schistosoma haematobium, Plasmodium spp., Schistosoma mansoni, hookworm and Ascaris lumbricoides infections was 85.3%, 71.2%, 53.8%, 13.5% and 1.3%, respectively. Children with single, dual, triple, quadruple and quintuple species infections showed VO2 max of 52.7, 53.1, 52.2, 52.6 and 55.6 ml kg−1 min−1, respectively. The VO2 max of children with no parasite infections was 53.5 ml kg−1 min−1. No statistically significant difference was detected between any groups. Multivariable analysis revealed that VO2 max was influenced by sex (reference: female, coef. = 4.02, p<0.001) and age (years, coef. = −1.23, p<0.001), but not by helminth infection and intensity, Plasmodium spp. infection, and environmental parameters.Conclusion/SignificanceSchool-aged children in Côte d'Ivoire showed good physical fitness, irrespective of their helminth infection status. Future studies on children's physical fitness in settings where helminthiasis and malaria co-exist should include pre- and post-intervention evaluations and the measurement of hemoglobin and hematocrit levels and nutritional parameters as potential co-factors to determine whether interventions further improve upon fitness.

Effect of deworming on school-aged children’s physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic area of Côte d’Ivoire

“…Our findings are in agreement with a recent study assessing physical fitness in Kenyan schoolchildren, which identified nutritional deficiencies as major predictors for impaired physical fitness performance, whilst there was no robust association with parasitic diseases [13]. These observations might also explain why the VO 2 max estimates from the current and a previous study in Côte d’Ivoire [14] were comparable with findings from the Kenyan study, where the extent of malnutrition and anaemia was similar. In contrast, a cohort of school-aged children in Yunnan province, People’s Republic of China, had a strikingly high rate of stunting and helminth infections [15, 21], and VO 2 max estimates and strength test scores were substantially lower than in age-matched African children [13, 14].…”

Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

“…Like two recently published studies evaluating the 20-m shuttle run as a tool for measuring exercise tolerance in polyparasitized children and other studies that tested running performance in children, [53][54][55] we did not find an association with S. mansoni infection. The 20-m shuttle run was originally developed and validated in children from developed countries as a tool to measure maximal exercise capacity by correlation to VO 2 max.…”

Infection with Schistosoma mansoni has an Effect on Quality of Life, but not on Physical Fitness in Schoolchildren in Mwanza Region, North-Western Tanzania: A Cross-Sectional Study

“…if the subject starts level 4 and only completes two of the shuttles, the recorder will note “4” as the highest level reached and “2” as the number of shuttles completed at the highest level. These numbers are correlated to a maximal oxygen uptake, the VO 2 max in mL/kg/min [12]. …”