title: Malaria, helminths, co-infection and anaemia in a cohort of children from Mutengene, south western Cameroon.
abstract: BACKGROUND
  Malaria and helminthiases frequently co-infect the same individuals in endemic zones. Plasmodium falciparum and helminth infections have long been recognized as major contributors to anaemia in endemic countries. Several studies have explored the influence of helminth infections on the course of malaria in humans but how these parasites interact within co-infected individuals remains controversial.
  
  
  METHODS
  In a community-based longitudinal study from March 2011 to February 2012, the clinical and malaria parasitaemia status of a cohort of 357 children aged 6 months to 10 years living in Mutengene, south-western region of Cameroon, was monitored. Following the determination of baseline malaria/helminths status and haemoglobin levels, the incidence of malaria and anaemia status was determined in a 12 months longitudinal study by both active and passive case detection.
  
  
  RESULTS
  Among all the children who completed the study, 32.5 % (116/357) of them had at least one malaria episode. The mean (±SEM) number of malaria attacks per year was 1.44 ± 0.062 (range: 1-4 episodes) with the highest incidence of episodes occuring during the rainy season months of March-October. Children <5 years old were exposed to more malaria attacks [OR = 2.34, 95 % CI (1.15-4.75), p = 0.019] and were also more susceptible to anaemia [OR = 2.24, 95 % CI (1.85-4.23), p = 0.013] compared to older children (5-10 years old). Likewise children with malaria episodes [OR = 4.45, 95 % CI (1.66-11.94), p = 0.003] as well as those with asymptomatic parasitaemia [OR = 2.41, 95 % CI (1.58-3.69) p < 0.001] were susceptible to anaemia compared to their malaria parasitaemia negative counterparts. Considering children infected with Plasmodium alone as the reference, children infected with helminths alone were associated with protection from anaemia [OR = 0.357, 95 % CI (0.141-0.901), p = 0.029]. The mean haemoglobin level (g/dl) of participants co-infected with Plasmodium and helminths was higher (p = 0.006) compared to participants infected with Plasmodium or helminths alone.
  
  
  CONCLUSIONS
  Children below 5 years of age were more susceptible to malaria and anaemia. The high prevalence of anaemia in this community was largely due to malaria parasitaemia. Malaria and helminths co-infection was protective against anaemia.
authors: Department of Animal Biology and Physiology, University of Yaounde I, Yaounde, Cameroon. njua.clarisse@ubuea.cm.|Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. njua.clarisse@ubuea.cm.
authors: Clarisse
authors: C
authors: Njua-Yafi
authors: Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon. achidi_e@yahoo.com.
authors: Eric A
authors: EA
authors: Achidi
authors: Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon. kuoh2000@yahoo.fr.
authors: Judith K
authors: JK
authors: Anchang-Kimbi
authors: Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon. apinjohtoby@yahoo.co.uk.
authors: Tobias O
authors: TO
authors: Apinjoh
authors: Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. mugri72@yahoo.com.
authors: Regina N
authors: RN
authors: Mugri
authors: Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. hanesh_chi@yahoo.com.
authors: Hanesh F
authors: HF
authors: Chi
authors: Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. rollandbantar@yahoo.com.
authors: Rolland B
authors: RB
authors: Tata
authors: Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. njumkengcharles@yahoo.com.
authors: Charles
authors: C
authors: Njumkeng
authors: Department of Medical Laboratory Science, University of Buea, Buea, Cameroon. jjnkockson@yahoo.com.
authors: Emmanuel N
authors: EN
authors: Nkock
authors: Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon. wifon@yahoo.com.
authors: Theresa
authors: T
authors: Nkuo-Akenji
mesh_terms: D000740:Anemia / Q000453:epidemiology* / Q000209:etiology*; D000818:Animals; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000150:complications / Q000453:epidemiology; D005260:Female; D006373:Helminthiasis / Q000150:complications* / Q000453:epidemiology*; D006376:Helminths / Q000502:physiology; D006801:Humans; D007223:Infant; D008288:Malaria / Q000150:complications* / Q000453:epidemiology*; D008297:Male