Questionnaire-based approach to assess schoolchildren's physical fitness and its potential role in exploring the putative impact of helminth and Plasmodium spp. infections in Côte d'Ivoire

Abstract

BackgroundDisability weights (DWs) are important for estimating burden of disease in terms of disability-adjusted life years. The previous practice of eliciting DWs by expert opinion has been challenged. More recent approaches employed quality of life (QoL) questionnaires to establish patient-based DWs, but results are ambiguous.MethodsIn early 2010, we administered a questionnaire pertaining to physical fitness to 200 schoolchildren in Côte d'Ivoire. Helminth and Plasmodium spp. infections were determined and schoolchildren's physical fitness objectively measured in a maximal multistage 20 m shuttle run test. Associations between objectively measured and self-reported physical fitness and between self-reported physical fitness and infection status were determined. Spearman rank correlation coefficient, uni- and multivariable linear regression models adjusting for children's age and sex, ambient air temperature and humidity, Fisher's test, χ² and t-test statistics were used for statistical analysis.ResultsThe prevalence of Schistosoma haematobium, Plasmodium spp., Schistosoma mansoni, hookworm and Ascaris lumbricoides in 167 children with complete parasitological results was 84.4%, 74.9%, 54.5%, 14.4% and 1.2%, respectively. High infection intensities and multiple species parasite infections were common. In the 137 children with complete data also from the shuttle run test, we found statistically significant correlations between objectively measured and self-reported physical fitness. However, no statistically significant correlation between the children's parasitic infection status and self-reported physical fitness was identified. An attrition analysis revealed considerably lower self-reported physical fitness scores of parasitized children who were excluded from shuttle run testing due to medical concerns in comparison to parasitized children who were able to successfully complete the shuttle run test.ConclusionsOur QoL questionnaire proofed valid to assess children's physical fitness in the current study area. Reasons why no differences in self-reported physical fitness in children with different parasitic infections were found are manifold, but do not preclude the use of QoL questionnaires in the elicitation of DWs. Indeed, the questionnaire was particularly useful in assessing physical fitness of those children, who were - supposedly due to parasitic infections - unable to complete the shuttle run test. Hence, we encourage others to use QoL questionnaires to determine not only physical fitness, but also more subtle morbidities.

Evaluation of the Health-related Quality of Life of Children in Schistosoma haematobium-endemic Communities in Kenya: A Cross-sectional Study

“…Our results are in contrast to recent studies of other NTDs that suggest no clear differences in HrQoL between infected and non-infected health states [14], [16]. Increasing severity of intestinal schistosomiasis, whether caused by S. japonicum in P.R.…”

“…Measuring HrQoL is an important outcomes indicator in evaluating health-care interventions and treatments, in understanding the burden of disease, in identifying health inequalities, in allocating health resources, and in epidemiological studies and health surveys [19]. Unlike in other chronic conditions such cancer and sickle cell disease where HrQoL tools have been widely used, for NTDs these tools have only been used to assess the burden of advanced schistosomiasis (using EQ-5D plus or WHO QoL-bref questionnaires) [13], [15], [20], soil-transmitted helminthes (using both EQ-5D and SF-12) [16], and echinococcosis (using SF-12) [21], and to assess the burden of polyparasitism in Cote d'Ivoire (using SF-36v2 questionnaire but only the physical scale) [14]. SF-12 has also been used to describe the impact of acute schistosomiasis on quality of life in a group of travelers returning from a luxury safari trip in Tanzania [22].…”

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

“…haematobium , S . mansoni , hookworm, Ascaris lumbricoides and Plasmodium spp) [17], but this questionnaire focused on physical functioning and did not include an emotional dimension. Another Chinese study investigated the quality of life in patients with advanced schistosomiasis, but this only included patients above 30 years of age and is not comparable to the present study [16].…”

“…japonicum infections, and in Côte d’Ivoire another questionnaire (SF-36v2) was used to assess the physical burden of polyparasitism [17]. Currently, only two studies have quantified the effect of schistosome infection on overall wellbeing or quality of life using the Pediatric Quality of Life Inventory (PedsQL) [18,19].…”

Dynamics of Schistosoma haematobium egg output and associated infection parameters following treatment with praziquantel in school-aged children

“…The climate in the area is tropical with two rainy seasons lasting from April to July and from mid-September to November. The study site was selected based on previous work conducted in Grand Moutcho that had shown a high endemicity of S. haematobium [30,31] . All children attending grades 3, 4, 5 and 6 in the primary school Grand Moutcho I were invited to participate.…”