Epidemiological burden of persistent co-transmission of malaria, schistosomiasis, and geohelminthiasis among 3-15 years old children during the dry season in Northern Cameroon

Abstract

Abstract Background The double burden of malaria and helminthiasis in children poses an obvious public health challenge particularly in terms of anemia morbidity. While both diseases geographically overlap, most studies focus on mono-infection and general prevalence surveys without molecular analysis. The current study investigated the epidemiological determinants of malaria, schistosomiasis and geohelminthiasis transmission among children in the North Region of Cameroon Methodology: School and pre-school children aged between 3–15 years were enrolled from three communities in March 2021 using a community cross sectional design. Capillary-blood samples were obtained, and each was examined for malaria parasites using RDT, microscopy and PCR while hemoglobin level was measured using a hemoglobinometer. Stool samples were analyzed for Schistosoma mansoni, S. guineensis and STH infections using Kato Katz method and urine samples were assessed for the presence of S. haematobium eggs using the standard urine filtration technique. Result A malaria prevalence of 56% (277/495) was recorded by PCR as opposed to 31.5% (156/495) by microscopy and 37.8% (186/495) by RDT. Similarly, schistosomiasis was observed at prevalence levels of up to 13.3% (66/495) overall [S. haematobium (8.7%); S. mansoni (3.8%); mixed Sh/Sm (0.6%); mixed Sh/Sm/Sg (0.2%). Both infections were higher in males and the 3–9 years age group. A high frequency of PCR reported P. falciparum mono-infection of 81.9% (227/277) and mixed P. falciparum/P. malariae infection of 17.3% (48/277) was observed. Malaria-helminths co-infections were observed at 13.1% (65/495) with marked variation between P. falciparum/S. haematobium (50.8%, 33/65); P. falciparum/S. mansoni (16.9%, 11/65) and P. falciparum/Ascaris (9.2%, 6/65) (χ2 = 17.5, p = 0.00003). Anemia prevalence was 32.9% (163/495), categorically associated with P. falciparum (45.8%, 104/227), and Pf/Sh (11.5%, 26/227) and Pf/Sm (3.9%, 9/227) polyparasitism. Conclusion Polyparasitism with malaria and helminth infections are common in school children despite periodic long lasting insecticide treated nets (LLINs) distribution and regular school-based Praziquantel and Albendazole campaigns. Co-existence of Plasmodium parasites and helminths infections notably Schistosoma species among children may concurrently lead to an increase in the force of Plasmodium infection and an enhanced the risk of anemia, highlighting the necessity of an integrated approach for disease control interventions.