Functional Significance of Low-Intensity Polyparasite Helminth Infections in Anemia

Ezeamama, Amara E.; Friedman, Jennifer F.; Olveda, Remigio M.; Acosta, Luz P.; Kurtis, Jonathan D.; Mor, Vincent; McGarvey1,3, Stephen T.
December 2005
Journal of Infectious Diseases;12/15/2005, Vol. 192 Issue 12, p2160
Academic Journal
Background. We wanted to quantify the impact that polyparasite infections, including multiple concurrent lowintensity 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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