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 coinfected 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.