Prevalence of parasitic co-infections and their association with the Hb-level and the anthropometric status in children aged 1-5 years in Lambaréné, Gabon

Abstract

In 2000, the Millenium Committee, convened by the United Nations, established the 8 Millenium Development Goals that should be addressed by the year 2015. Among others, these goals concern the reduction of child mortality and the struggle against HIV/AIDS, malaria and other diseases. To achieve a decline in child mortality, it is indispensable to focus on parasitic (co-) infections as these are known to account for a great burden in children. The WHO therefore recommends preventive chemotherapy in endemic areas. This study aims at filling the gap of information concerning parasitic (co-) infections in preschool children. Furthermore, the impact of parasitic infections on physical development of children is assessed to better understand their burden.

In this cross-sectional study, faecal, urine and blood samples were obtained from children aged 1-5 years in Lambaréné, Gabon. The samples were analyzed to identify (co-) infections with soil-transmitted helminths, S. haematobium and P. falciparum and to determine the level of hemoglobin concentrations in these children. In addition, anthropometric parameters were collected and compared to sex- and age-specific reference values. The anthropometric and haematological data was then analyzed and described in dependence on the observed (co-) infections.

A total of 444 participants were included of which 327 provided complete data allowing parasitological, anthropometric and haematological analysis. At least one species of parasites was found in 49% (166/339), whereas soil-transmitted helminths, S. haematobium and P. falciparum were present in 33% (130/394), 10% (39/407) and 15% (59/401), respectively. Co-infections were detected in 16% (55/339) of all participants. Seventy-seven percent (334/436) showed hemoglobin levels lower than 11 g/dl and were therefore classified as anaemic. Age and infection with P. falciparum (p=0.0025) were determined as significant risk factors for anaemia. Stunting, as defined by low height-for-age, was present in 20% (87/429) while 0.9% (6/429) of them were wasted, thus showed low weight-for-height. Age was identified as significant risk factor for stunting. The prevalence of stunting was higher in co-infected children, but these effects were non-significant.

The high rates of parasite infections and anaemia and the negative impact of parasitic co-infections on the nutritional condition highlight the necessity of stepping up efforts concerning preventive chemotherapy and education of parents and caretakers.