A Cross-sectional Study on the Influence of Altitude and Urbanisation on Co-infection of Malaria and Soil-transmitted Helminths in Fako Division, South West Cameroon
Judith Lum Ndamukong-Nyanga *
Department of Biological Sciences, Higher Teachers Training College, University of Yaoundé I, Yaoundé, Cameroon and Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O.Box 63, Buea, SWR, Cameroon.
Helen Kuokuo Kimbi
Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O.Box 63, Buea, SWR, Cameroon.
Irene Ule Ngole Sumbele
Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O.Box 63, Buea, SWR, Cameroon.
Yannick Nana
Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O.Box 63, Buea, SWR, Cameroon and Department of Medical laboratory Sciences, Saint Francis Higher Institute of Medical and Biomedical Sciences (Aka Biaka), P.O.Box 77, Buea, SWR, Cameroon.
Sunjo Cyrilla Bertek
Department of Medical laboratory Sciences, Saint Francis Higher Institute of Medical and Biomedical Sciences (Aka Biaka), P.O.Box 77, Buea, SWR, Cameroon.
Kenneth J. N. Ndamukong
Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O.Box 63, Buea, SWR, Cameroon.
Leopold Gustave Lehman
Department of Animal Biology, Faculty of Science, University of Douala, P.O.Box 2701, Douala, Cameroon.
*Author to whom correspondence should be addressed.
Abstract
Aims: Malaria and soil-transmitted helminth (STH) infections are parasitic diseases afflicting populations that are impoverished and malnourished. The aim of this study was to assess the influence of altitude and urbanisation on Co-infection of malaria and soil-transmitted helminths in Fako Division, South West Cameroon.
Study Design/Place and Duration of Study: It was a cross-sectional survey carried out from 2012 to 2014 involving 1138 children aged 4 – 15 years in Fako Division.
Methodology: Structured questionnaire was administered to obtain demographic and socio-economic data. Blood samples were collected by pricking the finger. Malaria parasite prevalence, density and species were determined from Giemsa-stained thick and thin blood smears respectively. Quantitative estimation of helminth eggs was done by Kato-Katz thick smear technique. Based on height above sea level (a.s.l.), the study sites were classified as Lowland (<200 m.a.s.l), Lower middle belt (>200 but ≤ 400 m.a.s.l), Upper middle belt (>400 but ≤600 m.a.s.l.) and Highland (>600 m.a.s.l). The study communities were also classified into rural, semi-urban and urban areas.
Results: The overall prevalence was 38.1% (433) for malaria, 2.5% (29) for STHs and 0.9% (10) for malaria-STH co-infection. The prevalence of malaria was significantly highest (χ2 = 84.6, P <0.001) in urban areas (52.2%, 263) than in the semi-urban (29.4%, 152) and rural areas (15.4%, 18). Malaria prevalence was significantly highest (χ2 = 123.4, P <0.001) at the lowest altitude (60.5%, 182) and decreased as altitude increased to a minimum of 15.4% (18) at highland (>600 m.a.s.l). Only two species of soil-transmitted helminths [Ascaris lumbricoides (1.9%) and Trichuris trichiura (0.6%)] were found. The prevalence of STH was significantly higher (χ2= 33.8, P <0.0001) in rural (13.6%, 16) than urban (0.39%, 2) areas. The prevalence of STH was significantly highest (χ2 = 33.8, P <0.0001) at high altitude (13.6%, 16) than the upper middle-belt (2.0%, 8), lower middle-belt (1.2%, 4) and lowlands (0.7%, 2). The prevalence of co-infection varied significantly (χ2 = 72.2, P <0.0001) with level of urbanisation with the highest level of co-infection occurring in the rural areas (2.6%, 3) and the lowest level in the urban areas (0.2%, 1).
Conclusion: Malaria control measures need to be intensified especially in the lowland and urban areas. Deworming campaigns are yielding positive results in Fako Division.
Keywords: Malaria, soil-transmitted helminths, co-infection, prevalence, altitude, urbanisation, socio-economic class, anaemia