Impact of Helminth Co-Infections on Clinical Malaria Severity Among Febrile School-Age Children: A Study from Mvomero, Tanzania

Abstract

Helminths may influence clinical malaria severity. The current study examined the impact ofhelminth infections on malaria severity among children in Mvomero, Tanzania. This was ahospital-based cross-sectional study conducted from 2018-2019. Blood, stool and urinespecimens from febrile subjects attending four health facilities in Mvomero were examined formalaria and helminth infection. Overall, 326 febrile children were enrolled. The range and meanages were 5-17 and 10.2 years, respectively. Of 326 children, 46.8% (n = 153) had Plasmodiumfalciparum malaria, with prevalence being higher in males than females (p = 0.03). Amongpositive P. falciparum -infected children, 59.5% had malaria alone, and 40.5% were co-infectedwith helminths. Schistosoma haematobium was the most common parasite in malaria-positivechildren (p = 0.04), with the highest prevalence amongst the 11-13-year-olds (18.3%, p = 0.02).The prevalence of anemia among malaria malaria-positive individuals was 28%. Anemia wasmore common in children between 8 -10-year-old (p = 0.013). Malaria-positive children coinfected with hookworm and haematobium exhibited a reduced mean Hb concentration and anincreased P. falciparum parasitaemia ( p < 0.05). To conclude, co-infection with hookworm andschistosoma increases the severity of clinical malaria. An integrated malaria and helminthmanagement strategy for all individuals in Mvomero is crucial.