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Co‐infections with Plasmodium , Ascaris and Giardia among Rwandan schoolchildren
Author(s) -
Geus Dominik,
Sifft Kevin C.,
Habarugira Felix,
Mugisha Jean Claude,
Mukampunga Caritas,
Ndoli Jules,
Bayingana Claude,
Sendegeya Augustin,
Martus Peter,
Fraundorfer Kira,
SamsonHimmelstjerna Georg,
Gahutu Jean Bosco,
Klotz Christian,
Aebischer Anton,
Mockenhaupt Frank P.
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13206
Subject(s) - ascaris , giardia , deworming , malaria , medicine , epidemiology , asymptomatic , ascariasis , malnutrition , environmental health , immunology , pediatrics , helminths , veterinary medicine
Objectives Co‐infections with Plasmodium , Ascaris and Giardia are common in sub‐Saharan Africa but epidemiological and clinical data are rare. We examined factors associated with co‐infections and their clinical manifestation among Rwandan schoolchildren. Methods Schoolchildren aged 6–10 years attending 12 schools in Huye district, Rwanda, were recruited preceding routine deworming. Data on socioeconomic status ( SES ) and children′s histories were obtained, and children were clinically and anthropometrically examined. Blood and stool samples were collected, and infections with Plasmodium , Ascaris and Giardia were determined by microscopy and PCR assays. Results Among 878 schoolchildren, Plasmodium , Ascaris and Giardia were present in 22%, 35% and 36%, respectively. Co‐infections with two or more parasites were found in 24%; only one‐third of the children did not harbour any of the parasites examined. Factors associated with parasite (co‐)infections largely overlapped and reflected low SES , in addition to a few specific risk factors. Clinically, most children were asymptomatic but anaemia (38%), underweight (17%), and reported signs and symptoms in the preceding 2 weeks (46%) were common. Many of the reported and assessed signs and symptoms were associated with Plasmodium infection, and co‐infection with Ascaris and/or Giardia did basically not modify the clinical picture. One exception was malnutrition, which was pronounced in Ascaris–Giardia co‐infection vs . individual mono‐infections. Conclusions Parasitic co‐infections are common in Rwandan schoolchildren, and are associated with a rather silent clinical manifestation that nevertheless may affect school performance and long‐term development. School‐based health interventions should target such co‐infections in an integrated manner.