Malaria and helminths co-infection-Effects on anaemia, iron and folate deficiencies in paediatric population in Ghana.

Background: Helminthiasis co-exists with malaria in endemic areas; this co-existence can influence anaemia, iron, and folate levels in patients. This study was aimed at assessing the effect of malaria, helminthiasis, and co-infection on anaemia, iron, and folate deficiencies in children.

Methods: The study participants comprised of 1003 children, from whom venous blood and stool samples were obtained. Structured questionnaires were used to assess sociodemographic and household data. Venous blood from children (aged 1-15 years) was analysed for malaria parasitaemia and full blood count. Kato Katz and formol ether concentration techniques were used to analyse stool samples for intestinal parasites. Indirect ELISA was performed on the serum samples to determine iron and folate levels.

Results: Overall, malaria and intestinal helminths prevalence were 54.4% (546/1003) and 15.7% (172/1003), respectively. Ascaris lumbricoides, Taenia spp., hookworm, Trichuris trichiura and Strongyloides stercoralis were identified as mono-infection or in co-infection with malaria (11.4%) or intestinal protozoa (1.5%). These prevalence rates were significantly higher in less urbanised northern study sites (p < 0.0001) and among younger children (p < 0.0001). Malaria (p < 0.0320), intestinal helminths (p < 0.0001) and malaria-helminthiasis co-infection (p < 0.0320) were independent predictors of anaemia. Malaria and intestinal helminths co-infection significantly worsens anaemia (p < 0.001), folate deficiency (p < 0.001) and iron deficiency (p < 0.001) compared to those with malaria only.

Conclusion: Malaria and helminthiasis predominantly affect children and are influenced by age, gender, locality, and urbanisation. Co-infection exacerbates the adverse outcomes associated with malaria.