Co-infection with malaria, hookworm and schistosomiasis among school children in Zambezi: a school-based rapid survey

Abstract

Introduction: A school based rapid survey was conducted from the 17th to the 19th of May 2011in Zambezi District of Zambia to determine the prevalence and coinfection rate of malaria, hookworm and schistosomiasis in schoolchildren in other to inform decision maker.
Methodology: The study design, sampling methods, sample collection and processing used have been described in WHO's guidelines for the evaluation of soiltransmitted helminthiasis and schistosomiasis at community level. Additionally height, weight and haemoglobin were measured and malaria screened.
Results: We report high prevalence of parasitic infections in schoolchildren in Zambezi district with 79.4% (n = 253; 95% CI: 74.1% - 84.1%) of the children tested positive at least to one parasitic infection. Estimated prevalence of malaria, hookworm, haematuria, S. haematobium, S. mansoni, and E. vermicularis were 50.6% (95% CI: 44.5-56.6%), 42.4% (95% CI: 36.4- 48.5%), 37.9% (95% CI: 32.2-43.9%), 29.5% (95% CI: 24.2-35.2%), 14.5% (95% CI: 10.6-19.2%), and 1.2% (95% CI: 0.3-3.2%) respectively. Generally these were low intensity infections with the exception of S. haematobium. High prevalence of anaemia (46%; 95%CI: 40-52.1) and nutritional deficiency (79.1%; 73.9- 83.7) were also detected. The prevalence of multiparasitism was 44.3% (95%CI: 38.2-50.4%) representing 55.7% of all parasitic infections.
Conclusion and recommendations: There is high prevalence and wide distribution of malaria, hookworm and schistosomiasis resulting in high coinfection rates with these parasites in schoolchildren in Zambezi District. Studies are needed to understand the public health importance of this coinfection in the Zambian context. Nevertheless integration of anti malaria and iron status improvement activities in the School Health Nutrition programme is urgently needed to reduce morbidity and accelerate the reduction in the prevalence of parasitic infections.