A Cross-Sectional Study of Co-Infection with Helminths and Malaria: The Effect on Hemoglobin Levels among Luo Children in Rural Western Kenya
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Soil-transmitted helminths, also known as intestinal worms, are ubiquitous in Sub-Saharan Africa (SSA). In SSA, malaria accounts for 80-90% of all worldwide cases (WHO Malaria Report 2011), and there is significant geographical overlap between these parasites (Brooker et al 2004). In this study, the goal was to study the effect of co-infection of soil-transmitted helminths and malaria on hemoglobin concentrations, along with the modifying effects of acute inflammation and nutritional status among Luo children younger than 13 years. In a clinic sample of 227 children, 53% of the children were anemic. The majority of children had either malaria (49%) or a helminthic infection (42%) or both (21%). A multivariate regression analysis demonstrated that only malarial-helminth co-infection was significantly related to hemoglobin levels (overall model p=0.0001, r2=0.2644). Stratifying by gender and the presence of helminths, malarial infection was only statistically significant in boys with helminths (p=0.0158, r2=0.2012). Furthermore, acute inflammation played a significant role in the absence of a helminth infection (p=0.0001). Body-mass index, a surrogate measure of nutritional status, was negatively associated with anemia when tested alone (p=0.005), but was not significant in the multivariate regression models that explain the variance in hemoglobin. This cross sectional study portrays the complicated relationship of parasitic co-infections and the need for community research to address the long-term consequences on children.