Current Epidemiological Assessment of Plasmodium falciparum and Helminth Co-Infections in Children after a Decade of Implementation of Control Programs in Morogoro Region, Tanzania

Abstract

A school based cross-sectional study was conducted from July to November 2018 to assess the burden of asymptomatic Plasmodium falciparum, Schistosoma and soil transmitted helminth (STH) infections in Mvomero. A total of 374 children (age range =  5–16 years, mean age = 11.3 years) were recruited from five primary schools. Prevalence of asymptomatic P. falciparum infections were 29.9%, S. haematobium 49.7%, hookworm 20.3%, Ascaris lumbricoides 12.6%, Taenia saginata 0.5% and S. mansoni 0.3%. Malaria parasite density increased with increasing children age (r = 0.99). Only 6.5% (12/186) of S. haematobium infected children were presented with heavy infections, whereas all STH-positive children harboured light infections. The overall P. falciparum-helminths co-infection rate was 11%. Schistosoma haematobium and hookworm infections positively influenced P. falciparum parasitaemia (R² = 0.55 and 0.73, respectively). Being between 11 and 13 years of age, father being a farmer, poor housing, not sleeping under insecticide treated net, working in rice and sugarcane fields were the major factors associated with asymptomatic P. falciparum-helminth co-infections (all p < 0.05). Prevalence of both asymptomatic P. falciparum infections and P. falciparum-helminths-co-infections has decreased by over 40%. However prevalence of S. haematobium and hookworm infections is alarmingly high, calling for community based-integrative control measures incorporating strategies to combat both P. falciparum and helminths infection reservoirs in Mvomero.

Keywords:          Asymptomatic Plasmodium falciparum; malaria; Soil transmitted helminths; Schistosoma haematobium; Mvomero; Tanzania