EPIDEMIOLOGY OF MALARIA AND INTESTINAL HELMINTHS CO-INFECTION AMONG CHILDREN IN RURAL COMMUNITIES IN ONA-ARA LOCAL GOVERNMENT AREA, OYO STATE

Abstract

The malaria and Intestinal Helminth (H) parasites co-exist and are prevalent in the tropics due to favourable climatic conditions and poor sanitary practices. These parasites have adverse effects on cognitive development, educational performance and school attendance of children. The epidemiology of Malaria and intestinal Helminths Co-infections (MIHC) among children have not been fully documented in Nigeria and community-based studies are also limited. The epidemiology of MIHC among children in Ona-Ara Local Government Area (OLGA), Oyo State was therefore investigated. A cross-sectional survey was conducted. A two-stage cluster sampling technique was used to select 131 households having children 6 months-17 years from six settlements one from each of the six rural wards within OLGA. Information on socio-demographic characteristics, environmental hygiene preventive practices on helminthiasis and malaria from each household was obtained from household finds using a semi-structured questionnaire. Single stool and finger prick blood samples were collected from 376 children from selected households. Kato-katz and formol-ether techniques were employed to process stool samples for microscopy while Giemsa-stained thick blood smears were used to screen for malaria parasites. Subsequently, 123 children asymptomatic with malaria parasitaemia (irrespective of the presence or absence of IH) were followed-up for 6 weeks to detect acute malaria, thereafter second blood samples were collected to confirm Malaria Parasitaemia (MP). Data were analysed using descriptive statistics, Chi-square test and Kaplan-Meier statistics at 5% level of significance. Mean age of children was 6.5 ± 0.4 years and 52.9% were females; age distribution was 46.2%, 41.1% and 12.7% for 0-5 year, 6-11 year and 12-17 year age-groups respectively. Several (73.3%) sourced their drinking water from wells and 83.0% defecated in the bush. Only 9.0% used mosquito nets. Some (55.7%) used antihelminthic drugs to prevent worm infection, 21.0% used herbs while 23.3% did not practice deworrning. Number of children who submitted both samples, blood sample only and stool sample only were 162, 212 and 2 respectively. Prevalence of asymptomatic malaria, IH infections and MIHC were 51.1%, 37.0%, and 27.8% respectively. Ascaris Iumbricoides was the only IH species identified in stool samples. Among all age groups, the 0-5 year age-group had the highest prevalence of MP (57.3%), while the 6-11year age-group had the highest prevalences of MIHC (59.5%) and IH infection (52.1%). At follow up, MP clearance rate of 7.3% was detected; 92.7% remained positive and 36.6% of these developed acute malaria while 63.4% remained asymptomatic. Incidence rate was 5.3/100 person-weeks for co-infected children and 7.3/100 person-weeks for children infected with MP only. Overall mean survival time (time from recruitment into follow-up until incidence of acute malaria) was 5.2 ± 0.3 weeks. Intestinal helminth and its co-infection with malaria constitute a major health burden among children of 6-11 year age-group while those under five are more prone to malaria alone in the study area. In addition. modifiable risk practices which have potential for promoting malaria and intestinal helminth infections abound in the communities; hence community-based integrated control programmes among children and health education for caregivers is advocated.