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Background  Helminth infection and malaria remain major causes of ill-health in the tropics and subtropics. There are several shared risk factors (e.g., poverty), and hence, helminth infection and malaria overlap geographically and temporally. However, the extent and consequences of helminth- Plasmodium  co-infection at different spatial scales are poorly understood.    Methodology  This study was conducted in 92 schools across Côte d’Ivoire during the dry season, from November 2011 to February 2012. School children provided blood samples for detection of  Plasmodium  infection, stool samples for diagnosis of soil-transmitted helminth (STH) and  Schistosoma mansoni  infections, and urine samples for appraisal of  Schistosoma haematobium  infection. A questionnaire was administered to obtain demographic, socioeconomic, and behavioral data. Multinomial regression models were utilized to determine risk factors for STH- Plasmodium  and  Schistosoma-Plasmodium  co-infection.    Principal Findings  Complete parasitological and questionnaire data were available for 5,104 children aged 5-16 years. 26.2% of the children were infected with any helminth species, whilst the prevalence of  Plasmodium  infection was 63.3%. STH- Plasmodium  co-infection was detected in 13.5% and  Schistosoma-Plasmodium  in 5.6% of the children. Multinomial regression analysis revealed that boys, children aged 10 years and above, and activities involving close contact to water were significantly and positively associated with STH- Plasmodium  co-infection. Boys, wells as source of drinking water, and water contact were significantly and positively associated with  Schistosoma-Plasmodium  co-infection. Access to latrines, deworming, higher socioeconomic status, and living in urban settings were negatively associated with STH- Plasmodium  co-infection; whilst use of deworming drugs and access to modern latrines were negatively associated with  Schistosoma-Plasmodium  co-infection.    Conclusions/Significance  More than 60% of the school children surveyed were infected with  Plasmodium  across Côte d’Ivoire, and about one out of six had a helminth- Plasmodium  co-infection. Our findings provide a rationale to combine control interventions that simultaneously aim at helminthiases and malaria.

Infection and Co-infection with Helminths and Plasmodium among School Children in Côte d’Ivoire: Results from a National Cross-Sectional Survey