Influence of Schistosoma mansoni and Hookworm Infection Intensities on Anaemia in Ugandan Villages

Abstract

BackgroundThe association of anaemia with intestinal schistosomiasis and hookworm infections are poorly explored in populations that are not limited to children or pregnant women.MethodsWe sampled 1,832 individuals aged 5–90 years from 30 communities in Mayuge District, Uganda. Demographic, village, and parasitological data were collected. Infection risk factors were compared in ordinal logistic regressions. Anaemia and infection intensities were analyzed in multilevel models, and population attributable fractions were estimated.FindingsHousehold and village-level predictors of Schistosoma mansoni and hookworm were opposite in direction or significant for single infections. S. mansoni was found primarily in children, whereas hookworm was prevalent amongst the elderly. Anaemia was more prevalent in individuals with S. mansoni and increased by 2.86 fold (p-value<0.001) with heavy S. mansoni infection intensity. Individuals with heavy hookworm were 1.65 times (p-value = 0.008) more likely to have anaemia than uninfected participants. Amongst individuals with heavy S. mansoni infection intensity, 32.0% (p-value<0.001) of anaemia could be attributed to S. mansoni. For people with heavy hookworm infections, 23.7% (p-value = 0.002) of anaemia could be attributed to hookworm. A greater fraction of anaemia (24.9%, p-value = 0.002) was attributable to heavy hookworm infections in adults (excluding pregnant women) as opposed to heavy hookworm infections in school-aged children and pregnant women (20.2%, p-value = 0.001).ConclusionCommunity-based surveys captured anaemia in children and adults affected by S. mansoni and hookworm infections. For areas endemic with schistosomiasis or hookworm infections, WHO guidelines should include adults for treatment in helminth control programmes.

Intestinal parasitosis and anaemia among patients in a Health Center, North Ethiopia

“…In the present study, peak hookworm infection was recorded in participants of age 35–39 years. This result was in line with reports from Northwest Ethiopia [23], Southern Ethiopia [22], Uganda [15] and Nigeria [20, 32, 33]. Persistence of hookworms with age might be attributed to ignorance of foot wear among the adult agrarian males [20].…”

“…For instance, hookworm infection cause anaemia by increasing blood and iron loss in the intestinal tract [15]. Some other species such as Ascaris lumbricoides, Entamoeba histolytica, Trichuris trichiura, Strongyloides stercoralis and Giardia lamblia have also been found to have great effect on nutritional status due to increased metabolic rate, anorexia and diarrhoea [15, 16].…”

“…For instance, hookworm infection cause anaemia by increasing blood and iron loss in the intestinal tract [15]. Some other species such as Ascaris lumbricoides, Entamoeba histolytica, Trichuris trichiura, Strongyloides stercoralis and Giardia lamblia have also been found to have great effect on nutritional status due to increased metabolic rate, anorexia and diarrhoea [15, 16]. IPs cause decreased intake or a functional increase in the body’s nutrient requirement by their interference with absorptive surfaces, physical obstruction of intestinal lumen, production of proteolytic substances, and consumption of nutrients intended for the body [14, 17, 18].…”

The Efficacy of Single-Dose versus Double-Dose Praziquantel Treatments onSchistosoma mansoniInfections: Its Implication on Undernutrition and Anaemia among Primary Schoolchildren in Two On-Shore Communities, Northwestern Tanzania

“…It has further been shown that S. mansoni infections contribute to the burden of anaemia among schoolchildren in endemic areas [59]. Although our earlier study in the study area could not associate Schistosoma mansoni infections with anaemia [34], we assessed the comparative implication of single-dose and repeated-dose Praziquantel treatments on the burden of anaemia among study participants.…”

Schistosoma mansoni Infections, Undernutrition and Anaemia among Primary Schoolchildren in Two Onshore Villages in Rorya District, North-Western Tanzania

“…mansoni not well studied [12,13,14]. There have been very limited studies on the impact of Schistosome infections on anaemia and undernutrition [8,15,16,17,18]. Further, the few available studies have produced contradicting findings.…”