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. 2015 Oct 29;9(10):e0004193.
doi: 10.1371/journal.pntd.0004193. eCollection 2015.

Influence of Schistosoma mansoni and Hookworm Infection Intensities on Anaemia in Ugandan Villages

Goylette F Chami  1 , Alan Fenwick  2 , Erwin Bulte  3 , Andreas A Kontoleon  4 , Narcis B Kabatereine  5 , Edridah M Tukahebwa  6 , David W Dunne  7
Affiliations

Influence of Schistosoma mansoni and Hookworm Infection Intensities on Anaemia in Ugandan Villages

Goylette F Chami et al. PLoS Negl Trop Dis. .

Erratum in

Abstract

Background: The association of anaemia with intestinal schistosomiasis and hookworm infections are poorly explored in populations that are not limited to children or pregnant women.

Methods: We sampled 1,832 individuals aged 5-90 years from 30 communities in Mayuge District, Uganda. Demographic, village, and parasitological data were collected. Infection risk factors were compared in ordinal logistic regressions. Anaemia and infection intensities were analyzed in multilevel models, and population attributable fractions were estimated.

Findings: Household and village-level predictors of Schistosoma mansoni and hookworm were opposite in direction or significant for single infections. S. mansoni was found primarily in children, whereas hookworm was prevalent amongst the elderly. Anaemia was more prevalent in individuals with S. mansoni and increased by 2.86 fold (p-value<0.001) with heavy S. mansoni infection intensity. Individuals with heavy hookworm were 1.65 times (p-value = 0.008) more likely to have anaemia than uninfected participants. Amongst individuals with heavy S. mansoni infection intensity, 32.0% (p-value<0.001) of anaemia could be attributed to S. mansoni. For people with heavy hookworm infections, 23.7% (p-value = 0.002) of anaemia could be attributed to hookworm. A greater fraction of anaemia (24.9%, p-value = 0.002) was attributable to heavy hookworm infections in adults (excluding pregnant women) as opposed to heavy hookworm infections in school-aged children and pregnant women (20.2%, p-value = 0.001).

Conclusion: Community-based surveys captured anaemia in children and adults affected by S. mansoni and hookworm infections. For areas endemic with schistosomiasis or hookworm infections, WHO guidelines should include adults for treatment in helminth control programmes.

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Conflict of interest statement

GFC, AAK, DWD, and EB declare no conflicts of interest. AF is the Executive Director of the Schistosomiasis Control Initiative (SCI) and NBK is employed by SCI. EMT is the Assistant Commissioner of Health Services for the Vector Control Division of Ministry of Health and the National Coordinator for SCI of the NTD Control/Elimination Programme in Uganda. This does not alter our adherence to all PLOS policies on sharing data and materials.

Figures

Fig 1
Fig 1. Overlaid plot of S. mansoni and hookworm infection intensities and anaemia prevalence against age.
The first axis and red line (solid line) represent anaemia prevalence for each age group. The second axis and short dashed line portray the arithmetic mean of S. mansoni eggs per gram (EPG) for each age group. Similarly, the third axis and long-dashed line represent the arithmetic mean of hookworm EPG by age group.
See this image and copyright information in PMC

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