Epidemiological Study of the Association Between Malaria and Helminth Infections in Nigeria

Akinwale Michael Efunshile Institute of Medical Microbiology and Infectious Disease Epidemiology, Medical Faculty, University of Leipzig, Leipzig, Germany; Federal Teaching Hospital, Abakaliki, Nigeria; Department of Medical Microbiology and Parasitology, University of Lagos, Lagos, Nigeria; Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark; Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark

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Temitope Olawale Institute of Medical Microbiology and Infectious Disease Epidemiology, Medical Faculty, University of Leipzig, Leipzig, Germany; Federal Teaching Hospital, Abakaliki, Nigeria; Department of Medical Microbiology and Parasitology, University of Lagos, Lagos, Nigeria; Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark; Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark

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Christen Rune Stensvold Institute of Medical Microbiology and Infectious Disease Epidemiology, Medical Faculty, University of Leipzig, Leipzig, Germany; Federal Teaching Hospital, Abakaliki, Nigeria; Department of Medical Microbiology and Parasitology, University of Lagos, Lagos, Nigeria; Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark; Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark

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Jørgen A. L. Kurtzhals Institute of Medical Microbiology and Infectious Disease Epidemiology, Medical Faculty, University of Leipzig, Leipzig, Germany; Federal Teaching Hospital, Abakaliki, Nigeria; Department of Medical Microbiology and Parasitology, University of Lagos, Lagos, Nigeria; Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark; Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark

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Brigitte König Institute of Medical Microbiology and Infectious Disease Epidemiology, Medical Faculty, University of Leipzig, Leipzig, Germany; Federal Teaching Hospital, Abakaliki, Nigeria; Department of Medical Microbiology and Parasitology, University of Lagos, Lagos, Nigeria; Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Centre for Medical Parasitology, Department of Clinical Microbiology, Copenhagen University Hospital, Copenhagen, Denmark; Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark

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The relationship between intestinal helminth infection and susceptibility to malaria remains unclear. We studied the relationship between these infections. Seven schools in Ilero, Nigeria referred all pupils with febrile illness to our study center for free malaria treatment during a 3-month study period. At the end, all pupils submitted a stool sample for microscopic investigation for helminth eggs. We used an unmatched case-control design to calculate the odds ratios for helminth infection in children with at least one attack of malaria (cases) and children with no malaria episodes during the study (controls). We recorded 115 malaria cases in 82 of 354 (23.2%), 16 of 736 (2.2%), and 17 of 348 (4.7%) children ages ≤ 5, 6–10, and 11–15 years old, respectively (P = 0.001). Helminth infection rate in cases was 21 of 115 (18.3%) compared with 456 of 1,327 (34.4%) in controls. Weighted odds ratio stratified by age group for helminth infection in cases versus controls was 0.50 (95% confidence interval = 0.2–0.84, P < 0.01). Ascaris and hookworm were the most common helminths detected, with prevalence rates of 14 (12.2%) and 6 (5.2%) among cases compared with 333 (25.1%) and 132 (10.0%) in controls, respectively (P = 0.001). The negative association between helminth infection and malaria may be of importance in the design of deworming programs.

Author Notes

* Address correspondence to Akinwale Michael Efunshile, Institute of Medical Microbiology and Epidemiology of Infectious Diseases, Medical Faculty, University of Leipzig, Liebigstrasse 21, D-04103 Leipzig, Germany. E-mail: drefunshile@yahoo.com

Authors' addresses: Akinwale Michael Efunshile, Institute of Medical Microbiology and Infectious Disease Epidemiology, University of Leipzig, Leipzig, Germany, and Medical Microbiology and Parasitology, Ebonyi State University, Ebonyi, Nigeria, E-mail: drefunshile@yahoo.com. Temitope Olawale, Department of Medical Microbiology and Parasitology, University of Lagos, Lagos, Nigeria, E-mail: temitopeolawale69@yahoo.com. Christen Rune Stensvold, Department of Bacteriology, Mycology and Parasitology, Statens Serum Institut, Copenhagen, Denmark, E-mail: RUN@ssi.dk. Jørgen A. L. Kurtzhals, Centre for Medical Parasitology, Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark, E-mail: joergen.kurtzhals@regionh.dk. Brigitte König, Institute of Medical Microbiology and Infectious Disease Epidemiology, University of Leipzig, Leipzig, Germany, E-mail: brigitte.koenig@medizin.uni-leipzig.de.

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