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 of helminth infections on malaria severity among children in Mvomero, Tanzania. This was a hospital-based cross-sectional study conducted from 2018-2019. Blood, stool and urine specimens from febrile subjects attending four health facilities in Mvomero were examined for malaria and helminth infection. Overall, 326  febrile children were enrolled. The range and mean ages were 5-17 and 10.2 years, respectively. Of 326 children, 46.8% (n = 153) had Plasmodium falciparum  malaria, with prevalence being higher in males than females (p = 0.03). Among positive P. falciparum -infected children, 59.5% had malaria alone, and 40.5% were co-infected with helminths. Schistosoma haematobium was the most common parasite in malaria-positive children (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 was more common in children between 8 -10-year-old (p = 0.013). Malaria-positive children co-infected with hookworm and haematobium exhibited a reduced mean Hb concentration and an increased P. falciparum  parasitaemia ( p < 0.05). To conclude, co-infection with hookworm and schistosoma increases the severity of clinical malaria. An integrated malaria and helminth management strategy for all individuals in Mvomero is crucial.