title: Multiple parasite infections and their relationship to self-reported morbidity in a community of rural Côte d'Ivoire.
abstract: BACKGROUND
  Concomitant parasitic infections are common in the developing world, yet most studies focus on a single parasite in a narrow age group. We investigated the extent of polyparasitism and parasite associations, and related these findings to self-reported morbidity.
  
  
  METHODS
  Inhabitants of 75 randomly selected households from a single village in western Côte d'Ivoire provided multiple faecal specimens and a single finger prick blood sample. The Kato-Katz technique and a formol-ether concentration method were employed to screen faecal samples for Schistosoma mansoni, soil-transmitted helminths and intestinal protozoa. Giemsa-stained blood smears were analysed for malaria parasites. A questionnaire was administered for collection of demographic information and self-reported morbidity indicators.
  
  
  RESULTS
  Complete parasitological data were obtained for 500/561 (89.1%) participants, similarly distributed among sex, with an age range from 5 days to 91 years. The prevalences of Plasmodium falciparum, hookworms, Entamoeba histolytica/E. dispar, and S. mansoni were 76.4%, 45.0%, 42.2%, and 39.8%, respectively. Three-quarters of the population harboured three or more parasites concurrently. Multivariate analysis revealed significant associations between several pairs of parasites. Some parasitic infections and the total number of parasites were significantly associated with self-reported morbidity indicators.
  
  
  CONCLUSIONS
  Our data confirm that polyparasitism is very common in rural Côte d'Ivoire and that people have clear perceptions about the morbidity caused by some of these parasitic infections. Our findings can be used for the design and implementation of sound intervention strategies to mitigate morbidity and co-morbidity.
authors.affiliation: Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Raso
authors.forename: Anne
authors.initials: A
authors.lastname: Luginbühl
authors.forename: Cinthia A
authors.initials: CA
authors.lastname: Adjoua
authors.forename: Norbert T
authors.initials: NT
authors.lastname: Tian-Bi
authors.forename: Kigbafori D
authors.initials: KD
authors.lastname: Silué
authors.forename: Barbara
authors.initials: B
authors.lastname: Matthys
authors.forename: Penelope
authors.initials: P
authors.lastname: Vounatsou
authors.forename: Yulan
authors.initials: Y
authors.lastname: Wang
authors.forename: Marc-Emmanuel
authors.initials: ME
authors.lastname: Dumas
authors.forename: Elaine
authors.initials: E
authors.lastname: Holmes
authors.forename: Burton H
authors.initials: BH
authors.lastname: Singer
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Eliézer K
authors.initials: EK
authors.lastname: N'goran
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D007560:Cote d'Ivoire / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010272:Parasitic Diseases / Q000453:epidemiology*; D010349:Patient Compliance; D011528:Protozoan Infections / Q000453:epidemiology; D012423:Rural Health; D012555:Schistosomiasis mansoni / Q000453:epidemiology; D017678:Sex Distribution