title: Polyparasite helminth infections and their association to anaemia and undernutrition in Northern Rwanda.
abstract: BACKGROUND
  Intestinal schistosomiasis and soil-transmitted helminth (STH) infections constitute major public health problems in many parts of sub-Saharan Africa. In this study we examined the functional significance of such polyparasite infections in anemia and undernutrition in Rwandan individuals.
  
  
  METHODS
  Three polyparasite infection profiles were defined, in addition to a reference profile that consisted of either no infections or low-intensity infection with only one of the focal parasite species. Logistic regression models were applied to data of 1,605 individuals from 6 schools in 2 districts of the Northern Province before chemotherapeutic treatment in order to correctly identify individuals who were at higher odds of being anaemic and/or undernourished.
  
  
  RESULTS
  Stunted relative to nonstunted, and males compared to females, were found to be at higher odds of being anaemic independently of polyparasite infection profile. The odds of being wasted were 2-fold greater for children with concurrent infection of at least 2 parasites at M+ intensity compared to those children with the reference profile. Males compared to females and anaemic compared to nonanaemic children were significantly more likely to be stunted. None of the three polyparasite infection profiles were found to have significant effects on stunting.
  
  
  CONCLUSIONS
  The present data suggest that the levels of polyparasitism, and infection intensities in the Rwandan individuals examined here may be lower as compared to other recent similar epidemiological studies in different regions across sub-Saharan Africa. Neither the odds of anaemia nor the odds of stunting were found to be significantly different in the three-polyparasite infection profiles. However, the odds of wasting were higher in those children with at least two parasites at M+ intensity compared to those children with the reference profile. Nevertheless, despite the low morbidity levels indicated in the population under study here, we recommend sustainable efforts for the deworming of affected populations to be continued in order to support the economic development of the country.
authors.affiliation: Access Project, Kigali, Rwanda.
authors.forename: Denise
authors.initials: D
authors.lastname: Mupfasoni
authors.forename: Blaise
authors.initials: B
authors.lastname: Karibushi
authors.forename: Artemis
authors.initials: A
authors.lastname: Koukounari
authors.forename: Eugene
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authors.lastname: Ruberanziza
authors.forename: Teddy
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authors.lastname: Kaberuka
authors.forename: Michael H
authors.initials: MH
authors.lastname: Kramer
authors.forename: Odette
authors.initials: O
authors.lastname: Mukabayire
authors.forename: Michee
authors.initials: M
authors.lastname: Kabera
authors.forename: Vianney
authors.initials: V
authors.lastname: Nizeyimana
authors.forename: Marie-Alice
authors.initials: MA
authors.lastname: Deville
authors.forename: Josh
authors.initials: J
authors.lastname: Ruxin
authors.forename: Joanne P
authors.initials: JP
authors.lastname: Webster
authors.forename: Alan
authors.initials: A
authors.lastname: Fenwick