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Type Journal Article - BMC Infectious Diseases
Title Enterobiasis and strongyloidiasis and associated co-infections and morbidity markers in infants, preschool-and school-aged children from rural coastal Tanzania: a cross-sectional study
Volume 14
Issue 1
Publication (Day/Month/Year) 2014
Page numbers 644
URL https://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-014-0644-7?site=http://bmcinfectdis.​biomedcentral.com
Background: There is a paucity of data pertaining to the epidemiology and public health impact of Enterobius
vermicularis and Strongyloides stercoralis infections. We aimed to determine the extent of enterobiasis, strongyloidiasis, and
other helminth infections and their association with asymptomatic Plasmodium parasitaemia, anaemia, nutritional status,
and blood cell counts in infants, preschool-aged (PSAC), and school-aged children (SAC) from rural coastal Tanzania.
Methods: A total of 1,033 children were included in a cross-sectional study implemented in the Bagamoyo district
in 2011/2012. Faecal samples were examined for intestinal helminth infections using a broad set of quality controlled
methods. Finger-prick blood samples were subjected to filariasis and Plasmodium parasitaemia testing and full blood
cell count examination. Weight, length/height, and/or mid-upper arm circumference were measured and the nutritional
status determined in accordance with age.
Results: E. vermicularis infections were found in 4.2% of infants, 16.7%, of PSAC, and 26.3% of SAC. S. stercoralis
infections were detected in 5.8%, 7.5%, and 7.1% of infants, PSAC, and SAC, respectively. Multivariable regression
analyses revealed higher odds of enterobiasis in children of all age-groups with a reported anthelminthic treatment
history over the past six months (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.22 - 3.79) and in SAC with a higher
temperature (OR: 2.21; CI: 1.13 - 4.33). Strongyloidiasis was associated with eosinophilia (OR: 2.04; CI: 1.20-3.48) and with
Trichuris trichiura infections (OR: 4.13; CI: 1.04-16.52) in children of all age-groups, and with asymptomatic Plasmodium
parasitaemia (OR: 13.03; CI: 1.34 - 127.23) in infants. None of the investigated helminthiases impacted significantly on
the nutritional status and anaemia, but moderate asymptomatic Plasmodium parasitaemia was a strong predictor for
anaemia in children aged older than two years (OR: 2.69; 95% CI: 1.23 – 5.86).
Conclusions: E. vermicularis and S. stercoralis infections were moderately prevalent in children from rural coastal
Tanzania. Our data can contribute to inform yet missing global burden of disease and prevalence estimates for
strongyloidiasis and enterobiasis. The association between S stercoralis and asymptomatic Plasmodium parasitaemia
found here warrants further comprehensive investigations.

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