IJE Advance Access originally published online on July 15, 2004
International Journal of Epidemiology 2004 33(5):1092-1102; doi:10.1093/ije/dyh241
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IJE vol.33 no.5 © International Epidemiological Association 2004; all rights reserved.
Article |
Multiple parasite infections and their relationship to self-reported morbidity in a community of rural Côte d'Ivoire
1 Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland
2 Centre Suisse de Recherches Scientifiques, 01 BP 1303, Abidjan 01, Côte d'Ivoire
3 Institute for Infectious Diseases, University of Bern, CH-3010 Bern, Switzerland
4 Département de Sociologie, Université de Cocody, Abidjan, Côte d'Ivoire
5 UFR Biosciences, Université de Cocody, 22 PB 770, Abidjan 22, Côte d'Ivoire
6 Biological Chemistry, Biomedical Sciences Division, Faculty of Medicine, Imperial College, London SW7 2AZ, UK
7 Office of Population Research, Princeton University, Princeton, NJ 08544, USA
Correspondence: Jürg Utzinger, Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland. E-mail: juerg.utzinger{at}unibas.ch
Background Concomitant parasitic infections are common in the developing world, yet most studies focus on a single parasite in a narrow age group. We investigated the extent of polyparasitism and parasite associations, and related these findings to self-reported morbidity.
Methods Inhabitants of 75 randomly selected households from a single village in western Côte d'Ivoire provided multiple faecal specimens and a single finger prick blood sample. The Kato-Katz technique and a formol-ether concentration method were employed to screen faecal samples for Schistosoma mansoni, soil-transmitted helminths and intestinal protozoa. Giemsa-stained blood smears were analysed for malaria parasites. A questionnaire was administered for collection of demographic information and self-reported morbidity indicators.
Results Complete parasitological data were obtained for 500/561 (89.1%) participants, similarly distributed among sex, with an age range from 5 days to 91 years. The prevalences of Plasmodium falciparum, hookworms, Entamoeba histolytica/E. dispar, and S. mansoni were 76.4%, 45.0%, 42.2%, and 39.8%, respectively. Three-quarters of the population harboured three or more parasites concurrently. Multivariate analysis revealed significant associations between several pairs of parasites. Some parasitic infections and the total number of parasites were significantly associated with self-reported morbidity indicators.
Conclusions Our data confirm that polyparasitism is very common in rural Côte d'Ivoire and that people have clear perceptions about the morbidity caused by some of these parasitic infections. Our findings can be used for the design and implementation of sound intervention strategies to mitigate morbidity and co-morbidity.
Keywords Malaria, Schistosoma mansoni, soil-transmitted helminths, intestinal protozoa, polyparasitism, self-reported morbidity indicators, infection intensity, Côte d'Ivoire
Accepted 5 May 2004
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