Schistosomiasis, soil-transmitted helminthiasis, and sociodemographic factors influence quality of life of adults in Côte d'Ivoire.
BACKGROUND
Burden of disease estimates are widely used for priority setting in public health and disability-adjusted life years are a powerful "currency" nowadays. However, disability weights, which capture the disability incurred by a typical patient of a certain condition, are fundamental to such burden calculation and their determination remains a widely debated issue.


METHODS
A cross-sectional epidemiological survey was conducted in the recently established Taabo health demographic surveillance system (HDSS) in south-central Côte d'Ivoire, to provide new, population-based evidence on the disability caused by schistosomiasis and soil-transmitted helminthiasis. Parasitological results from stool, urine, and blood examinations were juxtaposed to quality of life (QoL) questionnaire results from 187 adults. A multivariable linear regression model with stepwise backward elimination was used to identify significant associations, considering also sociodemographic characteristics obtained from the Taabo HDSS database.


RESULTS
Prevalences for hookworm, Plasmodium spp., Trichuris trichiura, Schistosoma haematobium and Schistosoma mansoni were 39.0%, 18.2%, 2.7%, 2.1% and 2.1%, respectively. S. mansoni and T. trichiura infections of any intensity reduced the participants' self-rated QoL by 16 points (95% confidence interval (CI): 4-29 points) and 13 points (95% CI: 1-24 points), respectively, on a scale from 0 (worst QoL) to 100 points (best QoL). The only other statistically significant effect was a 1-point (95% CI: 0.1-2 points) increase on the QoL scale per one unit increase in a calculated wealth index.


CONCLUSIONS
We found consistent and significant results on the negative effects of schistosomiasis and soil-transmitted helminthiasis on adults' self-rated QoL, also when taking sociodemographic characteristics into account. Our results warrant further investigation on the disability incurred by helmintic infections and the usefulness of generic QoL questionnaires in this endeavor.
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Thomas
T
Fürst
Kigbafori D
KD
Silué
Mamadou
M
Ouattara
Dje N
DN
N'Goran
Lukas G
LG
Adiossan
Yao
Y
N'Guessan
Fabian
F
Zouzou
Siaka
S
Koné
Eliézer K
EK
N'Goran
Jürg
J
Utzinger
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001769:Blood / Q000469:parasitology; D007560:Cote d'Ivoire / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D006373:Helminthiasis / Q000453:epidemiology*; D006376:Helminths / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D014556:Urine / Q000469:parasitology; D055815:Young Adult