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Published on: August 22, 2012
Functional significance of low-intensity polyparasite helminth infections in anemia
Amara E Ezeamama1, Jennifer F Friedman, Remigio M Olveda
1International Health Institute, Brown University, Providence, RI 02912, USA. Amara_Ezeamama@brown.edu
Insights
Polyparasite infections, even at low intensity, significantly increase anemia risk in children. Concurrent infections with multiple parasites heighten the odds of anemia, indicating substantial clinical impact.
Area of Science:
- Infectious Diseases
- Public Health
- Pediatrics
Background:
- Polyparasitism, the concurrent infection with multiple parasites, is prevalent in developing regions.
- The impact of low-intensity, multiple parasitic infections on anemia remains underquantified.
Purpose of the Study:
- To quantify the association between polyparasite infections and anemia in children.
- To investigate the effect of infection intensity and multiplicity on anemia risk.
Main Methods:
- Cross-sectional study of 507 children in Leyte, Philippines.
- Stool sample analysis using the Kato-Katz method to determine infection intensity for geohelminths and Schistosomiasis japonicum.
- Logistic regression models to assess the odds of anemia (hemoglobin <11 g/dL) based on polyparasite infection profiles.
Main Results:
- Children with low-intensity polyparasite infections had nearly 5-fold increased odds of anemia (P = .052).
- Infection with 3 or 4 parasite species at moderate/high intensity increased anemia odds 8-fold (P < .001).
Conclusions:
- Low-intensity polyparasite infections are significantly associated with increased anemia odds.
- Concurrent infections with multiple parasite species, common globally, contribute to clinically significant morbidity.
- Public health strategies should consider the cumulative impact of polyparasitism on anemia.
Background:
We wanted to quantify the impact that polyparasite infections, including multiple concurrent low-intensity infections, have on anemia.
Methods:
Three stool samples were collected and read in duplicate by the Kato-Katz method in a cross-sectional sample of 507 children from Leyte, The Philippines. The number of eggs per gram of stool was used to define 3 infection intensity categories--uninfected, low, and moderate/high (M+)--for 3 geohelminth species and Schistosomiasis japonicum. Four polyparasite infection profiles were defined in addition to a reference profile that consisted of either no infections or low-intensity infection with only 1 parasite. Logistic regression models were used to quantify the effect that polyparasitism has on anemia (hemoglobin level <11 g/dL).
Results:
The odds of having anemia in children with low-intensity polyparasite infections were nearly 5-fold higher (P = .052) than those in children with the reference profile. The odds of having anemia in children infected with 3 or 4 parasite species at M+ intensity were 8-fold greater than those in children with the reference profile (P < .001).
Conclusion:
Low-intensity polyparasite infections were associated with increased odds of having anemia. In most parts of the developing world, concurrent infection with multiple parasite species is more common than single-species infections. This study suggests that concurrent low-intensity infections with multiple parasite species result in clinically significant morbidity.
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