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Background  Schistosomes and soil-transmitted helminths (STH) (hookworm,  Trichuris trichiura  and  Ascaris lumbricoides ) are widely distributed in developing countries where they infect over 230 million and 1.5 billion people, respectively. The parasites are frequently co-endemic and many individuals are co-infected with two or more of the species, but information on how the parasites interact in co-infected individuals is scarce. The present study assessed  Schistosoma haematobium  and STH infection and morbidity patterns among school children in a hyper-endemic focus in the Tana River delta of coastal Kenya.    Methods  Two hundred and sixty-two children aged 5–12 years from two primary schools were enrolled in the study. For each child, urine was examined for  S. haematobium  eggs and haematuria, stool was examined for STH eggs, peripheral blood was examined for eosinophilia and haemoglobin level, the urinary tract was ultrasound-examined for  S. haematobium -related pathology, and the height and weight was measured and used to calculate the body mass index (BMI).    Results  Prevalences of  S. haematobium , hookworm,  T. trichiura  and  A. lumbricoides  infection were 94, 81, 88 and 46 %, respectively. There was no significant association between  S. haematobium  and STH infection but intensity of hookworm infection significantly increased with that of  T. trichiura . Lower BMI scores were associated with high intensity of  S. haematobium  (difference =−0.48,  p  > 0.05) and  A. lumbricoides  (difference =−0.67,  p  < 0.05). Haematuria (both macro and micro) was common and associated with  S. haematobium  infection, while anaemia was associated with high intensity of  S. haematobium  (OR = 2.08,  p  < 0.05) and high hookworm infections OR = 4.75;  p  < 0.001). The majority of children had eosinophilia, which was significantly associated with high intensity of hookworm infection (OR = 5.34,  p  < 0.05). Overall 38 % of the children had ultrasound-detectable urinary tract morbidity, which was associated with high intensity of  S. haematobium  infection (OR = 3.13,  p  < 0.05).    Conclusion  Prevalences of  S. haematobium  and STH infections among the primary school children were high and the parasites were responsible for significant morbidity. A clear synergistic interaction was observed between hookworm and  T. trichiura  infections. Increased coverage in administration of praziquantel and albendazole in the area is recommended to control morbidity due to these infections.

bmc infectious diseases

Schistosoma haematobium and soil-transmitted Helminths in Tana Delta District of Kenya: infection and morbidity patterns in primary schoolchildren from two isolated villages