Analysis of the prevalence of infection and associations between human gastrointestinal nematodes among different age classes living in the urban and suburban communities of Port Harcourt, Nigeria.

Fresh stool samples from 300 subjects presenting at out-patient clinics in two major hospitals in Port Harcourt were analysed for the prevalence and intensity of gastrointestinal (GI) nematode infections and 85.3% were found to carry at least one of the four species of GI nematodes recognized during the study. The most common species was Ascaris lumbricoides (54%), followed by Trichuris trichiura (43.7%) and Necator americanus (42.7%) and lastly Strongyloides stercoralis (33%). Peak prevalence for A. lumbricoides was among the < or = 9 years age cohorts, whilst those for the remaining species all coincided among the 15-19 years age cohort. The frequencies of single, double and triple-species infection categories, across the species and within most of the specific combinations were lower than the expected frequencies calculated from overall prevalence data for each species. Observed cases of non-infected individuals and those carrying all four species were higher than expected, suggesting that a greater than expected subset of the population was free from infection, particularly among subjects > or = 30 years old and another subset more prone to infection by all four species, predominantly among the age cohorts < or = 29 years. N. americanus and T. trichiura were more commonly encountered among multiple species infection combinations than expected, but the intensity of the former declined as the number of other concurrently infecting species increased. In contrast, the intensity of infection with S. stercoralis increased as the number of other species increased. Positive associations between A. lumbricoides and T. trichiura, N. americanus and S. stercoralis, and T. trichiura and N. americanus were identified in respect of greater than expected co-occurrence of these combinations and significant positive correlations between their respective intensities of infection. These were related to specific age cohorts which were identified as particularly prone to multiple infections.