A Cross-sectional Study on the Influence of Altitude and Urbanisation on Co-infection of Malaria and Soil-transmitted Helminths in Fako Division, South West Cameroon.
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Date
2015
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Abstract
Aims: Malaria and soil-transmitted helminth (STH) infections are parasitic diseases afflicting
populations that are impoverished and malnourished. The aim of this study was to assess the
influence of altitude and urbanisation on Co-infection of malaria and soil-transmitted helminths in
Fako Division, South West Cameroon.
Study Design/Place and Duration of Study: It was a cross-sectional survey carried out from 2012
to 2014 involving 1138 children aged 4 – 15 years in Fako Division.
Methodology: Structured questionnaire was administered to obtain demographic and socioeconomic
data. Blood samples were collected by pricking the finger. Malaria parasite prevalence,
density and species were determined from Giemsa-stained thick and thin blood smears
respectively. Quantitative estimation of helminth eggs was done by Kato-Katz thick smear
technique. Based on height above sea level (a.s.l.), the study sites were classified as Lowland
(<200 m.a.s.l), Lower middle belt (>200 but ≤ 400 m.a.s.l), Upper middle belt (>400 but ≤600
m.a.s.l.) and Highland (>600 m.a.s.l). The study communities were also classified into rural, semiurban
and urban areas.
Results: The overall prevalence was 38.1% (433) for malaria, 2.5% (29) for STHs and 0.9% (10)
for malaria-STH co-infection. The prevalence of malaria was significantly highest (χ2 = 84.6, P
<0.001) in urban areas (52.2%, 263) than in the semi-urban (29.4%, 152) and rural areas (15.4%,
18). Malaria prevalence was significantly highest (χ2 = 123.4, P <0.001) at the lowest altitude
(60.5%, 182) and decreased as altitude increased to a minimum of 15.4% (18) at highland (>600
m.a.s.l). Only two species of soil-transmitted STH [Ascaris lumbricoides (1.9%) and Trichuris
trichiura (0.6%)] were found. The prevalence of STH was significantly higher (χ2= 33.8, P <0.0001)
in rural (13.6%, 16) than urban (0.39%, 2) areas. The prevalence of STH was significantly highest
(χ2 = 33.8, P <0.0001) at high altitude (13.6%, 16) than the upper middle-belt (2.0%, 8), lower
middle-belt (1.2%, 4) and lowlands (0.7%, 2). The prevalence of co-infection varied significantly
(χ2 = 72.2, P <0.0001) with level of urbanisation with the highest level of co-infection occurring in the
rural areas (2.6%, 3) and the lowest level in the urban areas (0.2%, 1).
Conclusion: Malaria control measures need to be intensified especially in the lowland and urban
areas. Deworming campaigns are yielding positive results in Fako Division.
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Keywords
Malaria, soil-transmitted helminths, co-infection, prevalence, altitude, urbanisation, socioeconomic class, anaemia
Citation
Ndamukong-Nyanga Judith Lum, Kimbi Helen Kuokuo, Sumbele Irene Ule Ngole, Nana Yannick, Bertek Sunjo Cyrilla, Ndamukong Kenneth J N, Lehman Leopold Gustave. A Cross-sectional Study on the Influence of Altitude and Urbanisation on Co-infection of Malaria and Soil-transmitted Helminths in Fako Division, South West Cameroon. International Journal of TROPICAL DISEASE & Health. 2015; 8(4): 150-164.