CONCOMITANT CO-INFECTIONS OF MALARIA AND SCHISTOSOMIASIS AMONG SCHOOL GOING CHILDREN IN KWALE COUNTY, KENYA

Abstract

Background: The wide and overlapping distribution of parasites in Africa often results in high co-infection rates. The main factors influencing this phenomenon, also known as multi-parasitism, include high frequencies of parasites in the same population, similar geographical distribution of parasites, shared risk factors, and common transmission methods. Kwale County has a number of risk factors and a favorable geographical location on the Coast of Kenya. The main risk factors include large fresh water bodies, the ocean, high temperatures, humidity and a high poverty index within the community. Materials and Methods: A malaria/schistosomiasis co-infection prevalence study was carried out between the months of September and October 2015 in areas surrounding mining and sugarcane growing areas of Kwale County. This was done as part of a Health Impact Assessment (HIA) Study. Children between the ages of 5 and 15 from selected schools in the large scale mineral and industrial projects areas were tested for Schistosomiasis and malaria. Participants’ demographic data were collected via the administration of questionnaires. Blood and urine samples were collected from the study participants. 181 children were tested for malaria; 151 children were tested for both malaria and schistosomiasis. Malaria Rapid Diagnostic tests were used to assess children for malaria. Urine filtration tests were used to establish presence of schistosomiasis. Chi-square test and Fisher’s exact test were used to test for significance between the independent and dependent variables. Results: Twelve out of 151 malaria infected children were co-infected (7.9%, n= 151) with schistosomiasis. The extent of co-infection was associated with playing in water/swimming and history of recent malaria infection (2 weeks). Sixty three out of 181 had malaria (35%, n= 181), 18 out of 151 had schistosomiasis (12%, n=151). xiv Conclusion: These findings suggest that malaria-schistosomiasis co-infections exist among school going children between ages 5-15 in Kwale County. Co-infection rate was associated with patient characteristics. Children who had schistosomiasis had malaria infection too except for few cases 4 % (6) that had only schistosomiasis infection. Malaria cases were higher than schistosomiasis which calls for integrated disease control interventions to mitigate both malaria and schistosomiasis and consequent co-infection. Key Words: Malaria; schistosomiasis; malaria-schistosomiasis co-infection