The epidemiology of polyparasitism and implications for morbidity in two rural communities of Côte d’Ivoire

Particle and Fibre Toxicology

Giovanna Raso³  Jürg Utzinger²  Eliézer K N’Goran¹  Mamadou Ouattara¹  Kigbafori D Silué¹  Bernadette A Kouadio⁴  Thomas Schmidlin³  Clarisse A Houngbedji⁵  Richard B Yapi¹  Eveline Hürlimann³ 

[1] Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire;University of Basel, Basel, Switzerland;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;Unité de Formation et de Recherche Communication, Milieu et Société, Université Allassane Ouattara, Bouaké, Côte d’Ivoire;Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, Abidjan, Côte d’Ivoire

关键词: Splenomegaly;    Polyparasitism;    Plasmodium;    Morbidity;    Malnutrition;    Helminth;    Côte d’Ivoire;    Anaemia;   

Others  :  811975
DOI  :  10.1186/1756-3305-7-81

 received in 2013-12-24, accepted in 2014-02-17,  发布年份 2014

【 摘 要 】

Background

Polyparasitism is still widespread in rural communities of the developing world. However, the epidemiology of polyparasitism and implications for morbidity are poorly understood. We studied patterns of multiple species parasite infection in two rural communities of Côte d’Ivoire, including associations and interactions between infection, clinical indicators and self-reported morbidity.

Methods

Between August and September 2011, two purposely selected rural communities in southern Côte d’Ivoire were screened for helminth, intestinal protozoa and Plasmodium infection, using a suite of quality-controlled diagnostic methods. Additionally, participants were examined clinically and we measured haemoglobin level, height, weight and mid-upper arm circumference to determine nutritional status. An anamnestic questionnaire was administered to assess people’s recent history of diseases and symptoms, while a household questionnaire was administered to heads of household to collect socioeconomic data. Multivariate logistic regression models were applied for assessment of possible associations between parasitic (co-)infections and morbidity outcomes.

Results

912/1,095 (83.3%) study participants had complete parasitological data and 852 individuals were considered for in-depth analysis. The rate of polyparasitism was high, with Plasmodium falciparum diagnosed as the predominant species, followed by Schistosoma haematobium, Schistosoma mansoni and hookworm. There were considerable differences in polyparasitic infection profiles among the two settings. Clinical morbidity such as anaemia, splenomegaly and malnutrition was mainly found in young age groups, while in adults, self-reported morbidity dominated. High parasitaemia of P. falciparum was significantly associated with several clinical manifestations such as anaemia, splenomegaly and fever, while light-intensity helminth infections seemed to have beneficial effects, particularly for co-infected individuals.

Conclusions

Clinical morbidity is disturbingly high in young age groups in rural communities of Côte d’Ivoire and mainly related to very high P. falciparum endemicity. Interactions between helminth infections and P. falciparum burden (parasitaemia and clinical morbidity) are evident and must be taken into account to design future interventions.

【 授权许可】

   
2014 Hürlimann et al.; licensee BioMed Central Ltd.

【 图 表 】

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