title: The effect of hookworm infection and urinary schistosomiasis on blood hemoglobin concentration of schoolchildren living in northern Mozambique.
abstract: This study aims to assess the association between schistosomiasis and hookworm infection with hemoglobin levels of schoolchildren in northern Mozambique. Through a cross-sectional survey, 1,015 children from five to 12 years old in the provinces of Nampula, Cabo Delgado and Niassa were studied. Hookworm infection and urinary schistosomiasis were diagnosed, through Ritchie and filtration methods, with a prevalence of 31.3% and 59.1%, respectively. Hemoglobin levels were obtained with a portable photometer (Hemocue®). The average hemoglobin concentration was 10.8 ± 1.42 g/dL, and 62.1% of the children presented levels below 11.5 g/dL, of which 11.8% of the total number of children had hemoglobin levels below 9 g/dL. A multiple linear regression analysis demonstrated negative interactions between hemoglobin levels and ancylostomiasis, this being restricted to the province of Cabo Delgado (β = -0.55; p < 0.001) where an independent interaction between hemoglobin levels and urinary schistosomiasis was also observed (β = -0.35; p = 0.016). The logistical regression model indicated that hookworm infection represents a predictor of mild (OR = 1.87; 95% CI = 1.17-3.00) and moderate/severe anemia (OR = 2.71; 95% CI = 1.50 - 4.89). We concluded that, in the province of Cabo Delgado, hookworm and Schistosoma haematobium infections negatively influence hemoglobin levels in schoolchildren. Periodical deworming should be considered in the region. Health education and improvements in sanitary infrastructure could achieve long-term and sustainable reductions in soil-transmitted helminthiases and schistosomiasis prevalence rates.
authors.affiliation: Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique.
authors.forename: Verónica
authors.initials: V
authors.lastname: Casmo
authors.affiliation: Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique.
authors.forename: Gerito
authors.initials: G
authors.lastname: Augusto
authors.affiliation: Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique.
authors.forename: Rassul
authors.initials: R
authors.lastname: Nala
authors.affiliation: Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique.
authors.forename: Acácio
authors.initials: A
authors.lastname: Sabonete
authors.affiliation: Laboratório de Epidemiologia e Sistemática Molecular/Laboratório de Virologia Comparada e Ambiental, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Filipe Anibal
authors.initials: FA
authors.lastname: Carvalho-Costa
mesh_terms: D000740:Anemia / Q000097:blood / Q000469:parasitology*; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D006441:Hemoglobin A / Q000032:analysis*; D006725:Hookworm Infections / Q000097:blood / Q000150:complications*; D006801:Humans; D008297:Male; D009073:Mozambique; D012553:Schistosomiasis haematobia / Q000097:blood / Q000150:complications*; D012720:Severity of Illness Index
chemical_list: D006441:Hemoglobin A