Assesment of Public Health Implication of Malaria-Hookworm Co-Infection in Asendabo South West Ethiopia
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Date
2007-08
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Addis Ababa University
Abstract
Malaria and geo-helminth infections are causes of severe illness and poor economic
growth. The present study aimed at investigating the public health importance of
Malaria-hookworm co-infection with emphasis on anemia the leading co-morbid disease
condition in Asendabo, south west Ethiopia during the months of October and November
2006. A total of 370 suspected malaria cases and additional 100 school children
participated in the study. Modified Kato-Katz and formal-ether concentration techniques
were used for stool examination. Harada Mori hookworm culture was established for
identification of hookworm species. Thick and thin blood films and Paramax-3TM rapid
antigen capture assay were used for detection of malaria parasites. A total of 61.6%
individuals were positive for at least one intestinal helminth and/or protozoan infection.
Hookworm was the most prevalent (38%) followed by Ascaris (19.2%) and Trichuris
trichiura (10.3%). The majority (92.0%) of hookworm infections were N. americanus and
the rest (8.0%) were A. duodenale. Furthermore, 32.4% of the study participants were
positive for either of the two Plasmodium species of which 64.3% were P. falciparum and
the rest 35.7% were P. vivax. Compared with Geimsa stained microscopy, Paramax-3TM
was sensitive (90.1%) and specific (93.3%) for identification of total malaria with
positive and negative predictive values of 86.4% and 95.0%, respectively. Hemoglobin
measurement detected 27.6% anemic cases and both hookworm and malaria infections
were significantly associated with anemia (P<0.05). 20.8% of study participants were
co-infected with malaria and any helminth. Hookworm and malaria positive individuals
had low mean hemoglobin concentration than their respective negative counter parts and
the difference was significant (P<0.05). Furthermore, mean hemoglobin concentration
was significantly lowered in malaria-hookworm co-infected individuals than in
individuals infected with either hookworm or malaria infection alone (F=69.39,
P=0.000). The study has revealed that malaria co-infections with hookworm as well as
other intestinal helminths worsens hemoglobin loss and that individuals co-infected must
receive prompt health care to control anemia morbidity / mortality. Furthermore, deworming
of the population must be considered concurrently with malaria control.
Keywords:-Hookworm, Malaria, Co-infection, Paramax-3 TM, Anemia, Helminth,
Asendabo, Ethiopia.
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Keywords
Hookworm, Malaria, Co-infection, Paramax-3 TM,, Anemia, Helminth, Asendabo Ethiopia