Malaria, schistosomiasis and soil transmitted helminth burden and their correlation with anemia in children attending primary schools in Kinshasa, Democratic Republic of Congo.
BACKGROUND
Anaemia reduces cognitive potential in school children, retards their growth and predisposes them to other diseases. As there is a paucity of data on the current burden of P. falciparum, S. mansoni and soil transmitted helminths (STH) infections and their correlation with schoolchildren's anemia in the Democratic Republic of Congo (DRC), we collect these data.


METHODS
This study reports baseline data collected from a randomized controlled trial investigating the impact of IPT with SP and SP-PQ on anemia and malaria morbidity in Congolese schoolchildren (Trial registration: NCT01722539; PACTR201211000449323). S. mansoni and STH infections were assessed using kato-katz technique. Malaria infection and hemoglobin concentration were assessed using Blood smear and Hemocontrol device, respectively.


RESULTS
A total of 616 primary schoolchildren from 4 to 13 years old were enrolled in the study. The prevalence of Plasmodium spp. infection was 18.5% (95%CI:15.6-21.9). Amongst those infected, 24 (21%), 40 (35.1%), 40 (35.1%), 10 (8.8%), had light, moderate, heavy, very high malaria parasite density, respectively. Above 9 years of age (p = 0.02), male and history of fever (p = 0.04) were both associated with malaria infection. The overall prevalence of S. mansoni infection was 6.4% (95%CI:4.4-9.1). Girls were associated with S. mansoni infection (p = 0.04). T. trichiura was the most prevalent STH infection (26.3%), followed by A. lumbricoides (20.1%). Co-infection with malaria-S. mansoni and malaria-STH was, respectively, 1.5% (CI95%:0.7-3.3) and 6.4% (CI95% 4.4-9.1). The prevalence of anemia was found to be 41.6% (95%CI:37.7-45.6) and anemia was strongly related with Plasmodium ssp infection (aOR:4.1; CI95%:2.6-6.5;p<0.001) and S. mansoni infection (aOR:3.3;CI95%:1.4-7.8;p<0.01).


CONCLUSIONS
Malaria and S. mansoni infection were strongly associated with high prevalence of anemia in schoolchildren. Therefore, specific school-based interventions, such as intermittent preventive treatment or prophylaxis, LLITN distribution, anthelminthic mass treatment and micronutrient supplementation are needed to improve school children's health.
Département de Médecine Tropicale, Université de Kinshasa, Kinshasa, République Démocratique du Congo; Department of Epidemiology, University of Antwerp, Antwerp, Belgium.
Junior R
JR
Matangila
Department of Epidemiology, University of Antwerp, Antwerp, Belgium.
Joachim Yorokpa
JY
Doua
Institut National de Recherche Biomédicale, Kinshasa, République Démocratique du Congo.
Sylvie
S
Linsuke
Research Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium.
Joule
J
Madinga
Department of Epidemiology, University of Antwerp, Antwerp, Belgium.
Raquel
R
Inocêncio da Luz
Department of Epidemiology, University of Antwerp, Antwerp, Belgium.
Jean-Pierre
JP
Van Geertruyden
Département de Médecine Tropicale, Université de Kinshasa, Kinshasa, République Démocratique du Congo; Institut National de Recherche Biomédicale, Kinshasa, République Démocratique du Congo.
Pascal
P
Lutumba
D000293:Adolescent; D017677:Age Distribution; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D060085:Coinfection; D003223:Congo / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006373:Helminthiasis / Q000150:complications* / Q000469:parasitology / Q000635:transmission; D006801:Humans; D008288:Malaria / Q000150:complications / Q000469:parasitology; D008297:Male; D009752:Nutritional Status; D012307:Risk Factors; D012552:Schistosomiasis / Q000150:complications* / Q000469:parasitology; D012574:Schools; D012987:Soil / Q000469:parasitology*; D013334:Students
D012987:Soil