Anemia in 3 months to 6 years old Children infected with S. mansoni and intestinal Protozoans in the Western region (Tonkpi) of Côte d`Ivoire.
Main Article Content
Abstract
Background: Anaemia is serious public health problem affecting nearly 42% of children less than 5 years of age globally. In Cote d`Ivoire, 72% of the children aged 6-59 months were anemic in 2019. Anemia is defined as a reduction in the hemoglobin level in the peripheral blood below the normal threshold set for a particular population. Very commonly in the subtropics, helminthes, protozoans or malaria co-infects the same person, causing morbidities that vary according to age and region. This research study aims to characterize the type of anemia observed in 6 years old children infected with helminthes and protozoans in the Western part of Côte d`Ivoire, in order to improve the recommended strategy of care.
Methods: The study was carried out from March 2020 to May 2021 in 22 villages of Biankouma and Man, in Tonkpi Region, with a cohort of 451 children, both male and female, aged from 3 months to 6 years. The children provided venous blood samples for the diagnosis and characterization of anemia (full blood count), urines and stool samples were used for the diagnosis of helminthiasis and protozoosis. Univariate analysis (Chi-2 test (χ2) and P: (Probability) were used for comparison between groups. Significant test was considered at a threshold of 0.05.
Results: Of the 451 children who completed the study, 221 (49.0%) were female and 230 (51.0%) were male. Helminthes infections (230, 51.0%) were more prevalent than the protozoans’ infections (40, 8.9%). 50.0% of children infected by intestinal helminthes (S. mansoni) were anemics (33.9% mild, 64.4% moderate and 1.7% severe). The characterization of anemia revealed that hypochromic microcytic anemia (HMA) was the predominant type, being found in 87 (74.8%) children. It was followed by normochromic microcytic anemia (12 children, 10.4%), normochromic normocytic anemia (09 children, 7.8%), and, finally, hypochromic normocytic anemia (08 children, 7.0%).
Conclusion: S. mansoni infection was highly prevalent among 6 years old children in both sex and in different age groups, although the number of helminthes parasites present during infections was greatest in older children. Similarly, the prevalence of anemia was high, with moderate anemia and HMA being more prevalent in 6 years old children in the western region of Côte d’Ivoire.
Keywords:
Prevalence, Characterization of anemia, 6 years old Children, Schistosomiasis, Protozoans, Côte d’Ivoire
Article Details
How to Cite
EHOUMAN, Mocket Adolphe et al.
Anemia in 3 months to 6 years old Children infected with S. mansoni and intestinal Protozoans in the Western region (Tonkpi) of Côte d`Ivoire..
Medical Research Archives, [S.l.], v. 11, n. 12, dec. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4817>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v11i12.4817.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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31. Stoltzfus RJ, Chway HM, Montresor A et al. Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly anthelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children. J Nutrition. 2004; 134: 348-56.
32. WHO. Guideline: Preventive Chemotherapy to Control Soil-Transmitted Helminth Infections in at Risk Population Groups. Geneva: World Health Organization. 2017; 87p.
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34. Al-Haidari S.A, Mahdy MAK, Al-Mekhlafi A.M et al. Intestinal schistosomiasis among schoolchildren in Sana’a Governorate, Yemen: Prevalence, associated factors and its effect on nutritional status and anemia. PLOS Neglected Tropical Diseases. 2021; 15: e0009757.
35. Balarajan Y., Ramakrishnan U., Özaltin E., Shankar A.H. & Subramanian S.V. 2011. “Anaemia in low-income and middle-income countries”. The Lancet, 378 (9809): 2123–2135.
36. Vivek RG, Halappanavar AB, Vivek PR., Halki SB, Maled VS, Deshpande PS. “Prevalence of Anemia and its epidemiological”. Determinants in Pregnant Women. 2012; 5 (3): 216–223.
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40. Hasswane N, Bouziane A, Mrabet M, Laamiri FZ, Aguenaou H, Barkat A. Prevalence and factors associated with anemia pregnancy in a group of Moroccan pregnant women. J Biosciences and Medicines. 2015; 3: 88-97.
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42. Koum DK, Tsakeu END, Sack FN, Ngalagou PTM, Kamanyi A, Mandengue SH. Aspects cliniques et biologiques des anémies pédiatriques dans un hôpital de District urbain au Cameroun. The Pan African Medical Journal. 2013; 16: 91-97.
43. Adebo A.A. & Yessoufou A.G. 2018. Anémie chez les enfants de moins de 5 ans reçus en consultation au service de pédiatrie de l’Hôpital de Zone d’Abomey-Calavi/So-Ava (Sud du Bénin). J Applied Biosciences, 123: 12373-12378.
44. Yessoufou AG, Béhanzin J, Ahokpè M, Djinti SA, Bossou R, Sezan A. La prévalence de l’anémie nutritionnelle chez les enfants malnutris de 6 à 59 mois hospitalisés dans le service de pédiatrie du Centre Hospitalier Départemental du Zou-Collines (CHD/Z-C) dans le plateau d’Abomey (Centre du Bénin). Internat J Biological and Chemical Sciences. 2015; 9 (1): 82-90.
45. Senan L. Métabolisme de Fer: Guide de l’anémie nutritionnelle. Edition Sight and Life Presse, Paris, France. 2007; 18-20.
46. Ehouman MA, N`Goran KE, Gaoussou Coulibaly. Malaria and anemia in children under 7 years of age in the western region of Côte d’Ivoire. Front. Trop. Dis. 2022; 3: 957166.
47. Gupta PM, Perrine CG, Mei Z, Scanlon KS. Iron, Anemia, and Iron Deficiency Anemia among Young Children in the United States. Nutrients. 2016; 8: 330-336.
48. Physicians Committee for Responsible Medicine. Nutrition_Guide_for_Clinicians_2022. Available at:
https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342090/all/Iron_Deficiency_Anemia#:~:text=Iron%20deficiency%20anemia%20is%20usually,iron%20supplementation%20may%20be%20needed (Accessed 03 March 2023).
2. Ross AG, Olveda RM, Chy D et al. Can mass drug administration lead to the sustainable control of schistosomiasis? J Infectious Diseases. 2015; 211:283-9.
3. Gebreweld A, Neima A, Radiya A, Temesgen F. Prevalence of anemia and its associated factors among children under five years of age attending at Guguftu health center, South Wollo, Northeast Ethiopia. PLoS ONE. 2019; 14 (7): e0218961.
4. Ross AGP, Chau TN, Inobaya MT, Olveda R.M, Li Y, Harn DA. A new global strategy for the elimination of schistosomiasis. Inter J Infectious Disease. 2017; 54:130-137.
5. WHO, 2022. Schistosomiasis. Available from: https://www.who.int/news-room/fact-sheets/detail/schistosomiasis (Accessed on 03 March 2023).
6. Singh P, Gupta ML, Thakur TS, Vaidya NK, 1991. Intestinal parasitism in Himachal Pradesh. Indian Journal Medical Sciences. 1991; 45: 201-204.
7. Bahmani P, Afshin M, Shahram S, Behzad S, Esmaeil G. Prevalence of Intestinal Protozoa Infections and Associated Risk Factors among Schoolchildren in Sanandaj City, Iran. Iran J Parasitology. 2017; 12: 108–116.
8. Assaré RK, Tian-Bi YN, Yao PK et al. Sustaining Control of Schistosomiasis mansoni in Western Côte d’Ivoire: Results from a SCORE Study, One Year after Initial Praziquantel Administration. PLOS Neglected Tropical Diseases. 2016; 10 (1): e0004329.
9. Bassa FK, Eze IC, Assaré RK et al. Prevalence of Schistosoma mono- and co-infections with multiple common parasites and associated risk factors and morbidity profile among adults in the Taabo health and demographic surveillance system, South-Central Côte d’Ivoire. Infectious Disease of Poverty. 2022; 11: 3-12.
10. Ehouman MA, N`Goran KE, Ehouman AA, Dosso NP. Characterization of Anemia in Children Less Than 7 Years Old in the Western Region (Man) of Côte D`Ivoire. Infect Dis Diag Treat. 2023; 7: 205-213.
11. Darlan DM, Ananda FR, Sari MI, Arrasyid NK, Sari DI. Correlation between iron deficiency anemia and intestinal parasitic infection in school-age children in medan. Earth Environ Sci. 2018; 125:1–6.
12. Anthony L, Cacoub P, Macdougall IC, Peyrin-Biroulet P. Iron deficiency anaemia. Lancet. 2016; 387: 907-916.
13. Stevens GA, Finucane MM, De-Regil LM et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data. Lancet Global Health. 2013; 1: e16-25.
14. NHLBI and NIH (2022). What is anemia? Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/anemia (Accessed on 15 Mach 2023).
15. Katz N, Chaves A,Pellegrino J. A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni. Revista Do Instituto De Medicina Tropical De Sao Paulo. 1972; 14: 397-400.
16. WHO. Basic laboratory methods in medical parasitology. Geneva: WHO. 1991; p. 1–69.
17. Ritchie L. An ether sedimentation technique for routine stool examination. Bulltin of US Army Medical Department. 1948; 8: 326.
18. Utzinger J, Botero-Kleiven S, Castelli F et al. Microscopic diagnosis of sodium acetate-acetic acid- formolin-fixed stool samples for helminths and intestinal protozoa: a comparison among European reference laboratories. Clinical Microbiology and Infection. 2010 ; 16: 267- 273.
19. Plouvier S, Leroy JC, Colette J. A propos d’une technique simple de filtration des urines dans le diagnostic de la bilharziose urinaire en enquête de masse. Medecine Tropicale. 1975; 35: 229-230.
20. N'Zi KC, Ouattara M, Assaré KR, Bassa FK, Diakité NR, N'Goran EK. Risk Factors and Spatial Distribution of Schistosoma mansoni Infection among Preschool-Aged Children in Blapleu, Biankouma District, Western Côte d'Ivoire. J Tropical Medicine. 2021; 2021: e6224401.
21. Kouassi WYR, Perrotey S, Bassa KF, Bohoussou KH, N’Goran KE. Parasites Gastro-Intestinaux des Populations Humaines du Parc National de Taï, Côte d’Ivoire. European Scientific Journal. 2019; 36: 1857-7881.
22. Adoubryn KD, Kouadio-Yapo CG, Ouhon J, Aka NAD, Bintto F, Assoumou A. Parasitoses intestinales infantiles à Biankouma, régiondes 18 Montagnes (ouest de la Côte d'Ivoire): etude de l'efficacité et de la tolérance du praziquantel et de l'albendazole. Médecine et Santé Tropicales. 2012; 22: 170-176.
23. Agersew A, Yalewayker T, Demekech D, Mulugeta M. Schistosoma mansoni and soil-transmitted helminths among preschool-aged children in Chuahit, Dembia district, Northwest Ethiopia: prevalence, intensity of infection and associated risk factors. BMC Public Health. 2016; 16:422.
24. Arinaitwe M., Moses A., Brian K., Edridah M.T., Christina L.F. & Poppy H.L. 2021. Residence Time, Water Contact, and Age-driven Schistosoma mansoni Infection in Hotspot Communities in Uganda. The American Journal of Tropical Medicine and Hygiene, 105: 1772-1781.
25. Mujumbusi L, Nalwadda E, Ssali A et al. Understanding perceptions of schistosomiasis and its control among highly endemic lakeshore communities in Mayuge, Uganda. Lamberton. PLoS Neglected Tropical Disease. 2023; 17 (1): e0010687.
26. Kinung’hi MS, Humphrey DM, David WD et al. Coinfection of intestinal schistosomiasis and malaria and association with haemoglobin levels and nutritional status in school children in Mara region, Northwestern Tanzania: a cross‑sectional exploratory study. BMC Res Notes. 2017; 10: 583-600.
27. Kabuyaya M, Chimbari MJ, Manyangadze T, Mukaratirwa S. Schistosomiasis risk factors based on the infection status among school-going children in the Ndumo area, Mkhanyakude district, South Africa. S Afr J Infect Dis. 2017; 32:67–72.
28. Angora EK, Boissier J, Menan H et al. Prevalence and risk factors for schistosomiasis among schoolchildren in two settings of Cote d’Ivoire. Trop Med Int Health. 2019; 4: 110-117.
29. MSHP, 2016. Plan National Multisectoriel de Nutrition 2016 – 2020. Côte d'Ivoire, 37p.
30. Adugna S, Kebede Y, Moges F, Tiruneh M. Efficacy of mebendazole and albendazole for Ascaris lumbricoides and hookworm infections in an area with long time exposure for antihelminthes, Northwest Ethiopia. Ethiopian Medical Journal. 2007; 45: 301‐306.
31. Stoltzfus RJ, Chway HM, Montresor A et al. Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly anthelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children. J Nutrition. 2004; 134: 348-56.
32. WHO. Guideline: Preventive Chemotherapy to Control Soil-Transmitted Helminth Infections in at Risk Population Groups. Geneva: World Health Organization. 2017; 87p.
33. Yimam Y, Degarege A, Erko B. Effect of anthelminthic treatment on helminth infection and related anaemia among school-age children in northwestern Ethiopia. BMC Infectious Diseases. 2016; 16: 613.
34. Al-Haidari S.A, Mahdy MAK, Al-Mekhlafi A.M et al. Intestinal schistosomiasis among schoolchildren in Sana’a Governorate, Yemen: Prevalence, associated factors and its effect on nutritional status and anemia. PLOS Neglected Tropical Diseases. 2021; 15: e0009757.
35. Balarajan Y., Ramakrishnan U., Özaltin E., Shankar A.H. & Subramanian S.V. 2011. “Anaemia in low-income and middle-income countries”. The Lancet, 378 (9809): 2123–2135.
36. Vivek RG, Halappanavar AB, Vivek PR., Halki SB, Maled VS, Deshpande PS. “Prevalence of Anemia and its epidemiological”. Determinants in Pregnant Women. 2012; 5 (3): 216–223.
37. Demmouche A, Moulessehoul S. Anémie maternelle pendant la grossesse et la supplémentation en fer. Antropo. 2011; 24: 21-30.
38. FAO. Profil nutritionnel de pays. Royaume du Maroc, Division de la nutrition et de la protection des consommateurs. Rome (Italie): FAO. 2011; 60p.
39. Alene KA, Dohe AM. Prevalence of anemia and associated factors among pregnant women in an urban area of Eastern Ethiopia. Anemia. 2014; 2014: 1-7.
40. Hasswane N, Bouziane A, Mrabet M, Laamiri FZ, Aguenaou H, Barkat A. Prevalence and factors associated with anemia pregnancy in a group of Moroccan pregnant women. J Biosciences and Medicines. 2015; 3: 88-97.
41. Tchente C.N., Tsakeu E.N.D., Nguea A.G., Njamen T.N., Ekane G.H. & Priso E.B. 2016. Prévalence et facteurs associés à l’anémie en grossesse à l’Hôpital général de Douala. The Pan African Medical Journal, 25: 133.
42. Koum DK, Tsakeu END, Sack FN, Ngalagou PTM, Kamanyi A, Mandengue SH. Aspects cliniques et biologiques des anémies pédiatriques dans un hôpital de District urbain au Cameroun. The Pan African Medical Journal. 2013; 16: 91-97.
43. Adebo A.A. & Yessoufou A.G. 2018. Anémie chez les enfants de moins de 5 ans reçus en consultation au service de pédiatrie de l’Hôpital de Zone d’Abomey-Calavi/So-Ava (Sud du Bénin). J Applied Biosciences, 123: 12373-12378.
44. Yessoufou AG, Béhanzin J, Ahokpè M, Djinti SA, Bossou R, Sezan A. La prévalence de l’anémie nutritionnelle chez les enfants malnutris de 6 à 59 mois hospitalisés dans le service de pédiatrie du Centre Hospitalier Départemental du Zou-Collines (CHD/Z-C) dans le plateau d’Abomey (Centre du Bénin). Internat J Biological and Chemical Sciences. 2015; 9 (1): 82-90.
45. Senan L. Métabolisme de Fer: Guide de l’anémie nutritionnelle. Edition Sight and Life Presse, Paris, France. 2007; 18-20.
46. Ehouman MA, N`Goran KE, Gaoussou Coulibaly. Malaria and anemia in children under 7 years of age in the western region of Côte d’Ivoire. Front. Trop. Dis. 2022; 3: 957166.
47. Gupta PM, Perrine CG, Mei Z, Scanlon KS. Iron, Anemia, and Iron Deficiency Anemia among Young Children in the United States. Nutrients. 2016; 8: 330-336.
48. Physicians Committee for Responsible Medicine. Nutrition_Guide_for_Clinicians_2022. Available at:
https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342090/all/Iron_Deficiency_Anemia#:~:text=Iron%20deficiency%20anemia%20is%20usually,iron%20supplementation%20may%20be%20needed (Accessed 03 March 2023).