Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
PLoS Negl Trop Dis. 2014 Jun 5;8(6):e2913. doi: 10.1371/journal.pntd.0002913. eCollection 2014 Jun.
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.
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.
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.
在热带和亚热带地区，寄生虫感染和疟疾仍然是导致健康不良的主要原因。存在一些共同的风险因素（例如，贫困），因此，寄生虫感染和疟疾在地理和时间上存在重叠。然而，在不同的空间尺度上，寄生虫-疟原虫混合感染的程度和后果还了解甚少。
本研究于 2011 年 11 月至 2012 年 2 月在科特迪瓦的 92 所学校进行，研究对象为在校儿童。采集儿童的血液样本用于检测疟原虫感染，粪便样本用于诊断土壤传播的寄生虫（STH）和曼氏血吸虫感染，尿液样本用于评估曼氏血吸虫感染。此外，还通过问卷调查的方式收集了有关儿童人口统计学、社会经济学和行为的数据。本研究利用多项回归模型确定了 STH-疟原虫和曼氏血吸虫-疟原虫混合感染的风险因素。
共获得了 5104 名 5-16 岁儿童的完整寄生虫学和问卷调查数据。26.2%的儿童感染了任何一种寄生虫，而疟原虫感染的流行率为 63.3%。13.5%的儿童同时感染了 STH 和疟原虫，5.6%的儿童同时感染了曼氏血吸虫和疟原虫。多项回归分析表明，男孩、10 岁及以上的儿童以及与水密切接触的活动与 STH-疟原虫混合感染显著正相关。男孩、水井作为饮用水源以及与水接触与曼氏血吸虫-疟原虫混合感染显著正相关。使用厕所、驱虫、较高的社会经济地位和居住在城市地区与 STH-疟原虫混合感染呈负相关；而使用驱虫药物和使用现代厕所与曼氏血吸虫-疟原虫混合感染呈负相关。
结论/意义：在所调查的科特迪瓦在校儿童中，超过 60%的儿童感染了疟原虫，大约六分之一的儿童同时感染了寄生虫和疟原虫。我们的研究结果为同时针对寄生虫病和疟疾的综合控制干预措施提供了依据。
