Table 5 - available via license: Creative Commons Attribution 4.0 International
Content may be subject to copyright.
Source publication
Malaria and intestinal helminths co-infection are major public health problems particularly among school age children in Nigeria. However the magnitude and possible interactions of these infections remain poorly understood. This study determined the prevalence, impact and possible interaction of Plasmodium falciparum and intestinal helminths co-inf...
Similar publications
Strongyloides stercoralis is widely distributed in the tropics and subtropics. The aim of this study was to determine the prevalence of S. stercoralis and other intestinal parasites and identify the risk factors for infection with S. stercoralis in a rural area of Angola. A cross-sectional study was conducted in school-age children (SAC) in Cubal,...
جمعت 30 عينة من المياه من مناطق مختلفة من شط العرب ونهر العشار ونهر الخورة لتقييم مستوى التلوث ببيوض الديدان الطفيلية المعوية.
أظهرت نتائج الدراسة فيما يتعلق بتواجد وإعداد بيوض الديدان . Ascaris lumbricoides, Trichuris trichiura والديدان الخطافية A. lumbricoides and Hymenolepis بأنها الأكثر في جميع العينات، حيث وصل أعداد بيوضهما إلى أكثر من 2000 بي...
Citations
... Anemia has been reported to be endemic in areas with a high schistosomiasis burden, thus presenting opportunities for integrating schistosomiasis control programs with micronutrient supplementation [17]. In Nigeria, emerging evidence shows that children infected with urinary schistosomiasis have poor anemic status [18][19][20]. This study, therefore aims to contribute to existing body of evidence in areas where schistosomiasis control programs are been implemented, but the relationship between anemia and urinary schistosomiasis are not yet known. ...
Schistosomiasis and anemia, are one of the leading global public health problem among children between age 5 and 14 years in marginalized settings. In this study, we provide prevalence and intensity data for both conditions in three southwestern states of Nigeria, where such are lacking. Epidemiological assessment involving parasitological analysis of urine and blood samples was conducted among 1783 consenting school-aged children in Ondo, Osun, Ekiti States of Nigeria. Participants’ age and sex data were obtained using field forms, and statistical analysis was performed in R software with a significance level of 95%. An overall prevalence of 26.8% and 29.5% was recorded for urinary schistosomiasis and anemia, respectively. Prevalence varied by location with (40.3% and 29.8%) in Ondo (34.4% and 37.5%) in Osun and (13.4% and 20.9%) in Ekiti for urinary schistosomiasis and anemia, respectively (p=0.00). Schistosoma infections were found among males (28.7%, p=0.05) and children between the age 9–11 years (30.0%, p=0.01). About 36% of children with anemia was also infected with schistosomiasis. Children who were positive for schistosomiasis (OR:1.51; 95% CI: 1.19, 1.93; p=0.001) and between the age category 15–16 years, (OR:1.86; 95% CI: 1.12, 3.09; p<0.05) were twice likely to become anemic. Our findings have shown that children infected with schistosomiasis are twice likely to become anemic than those without infection. It is important to complement ongoing MDA programmes targeted at schistosomiasis with nutrition intervention programs for example micronutrient supplementation for better impact and cost-effectiveness.
... For example, three studies investigated the integration of MDA and the administration of antimalarials in schools, recognizing the potential to coordinate efforts in a single venue (schools) to an at-risk population (school-aged children) [29][30][31]. The other five studies investigated the administration of one intervention to address both diseases (pharmaceutical and educational) [32][33][34][35][36]. An important feature to note is that 88% (7/8) of the interventions outlined in this scoping review include a pharmaceutical intervention. ...
... This combination of antimalarial was found to be effective with cure rates of 56% [35] and 92.6% [33] after four weeks. In the studies by Abay et al. (2012), and Adedoja et al. (2015), only confirmed cases of malaria were tested for intestinal schistosomiasis and urogenital schistosomiasis and treated with artemether-lumefantrine [34,36]. This combination of antimalarial was also found to be effective with cure rates of 100% for intestinal and urogenital schistosomiasis after four weeks[34,36]. ...
... In the studies by Abay et al. (2012), and Adedoja et al. (2015), only confirmed cases of malaria were tested for intestinal schistosomiasis and urogenital schistosomiasis and treated with artemether-lumefantrine [34,36]. This combination of antimalarial was also found to be effective with cure rates of 100% for intestinal and urogenital schistosomiasis after four weeks[34,36]. ...
Malaria and schistosomiasis are two important parasitic diseases that are a particular threat to young children and pregnant women in sub-Saharan Africa. Malaria and schistosomiasis prevention and control strategies primarily focus on the distribution of long-lasting insecticidal nets and the delivery of praziquantel tablets to at-risk populations in high burden settings through mass drug administration, respectively. The objective of this scoping review was to identify previous efforts to integrate malaria and schistosomiasis prevention and control programs in the literature and to summarize the strategies and approaches used in these programs following the PRISMA-ScR guidelines. We reviewed published and grey literature using a combination of keywords and search terms following themes surrounding “malaria”, “ Plasmodium falciparum” , “ Anopheles ”, “schistosomiasis”, “ Schistosoma haematobium” , “ Schistosoma mansoni” , and “snails”. Neither a date limit nor relevant terms for prevention and control were used. Out of 6374, eight articles were included in the scoping review—three articles investigated the integration of mass drug administration for schistosomiasis with the administration of antimalarials, four articles investigated the effect of administering antimalarials on malaria, schistosomiasis, and their co-infection, and one article assessed the impact of an educational intervention on malaria and schistosomiasis knowledge and preventative behaviors. Our findings suggest that there is an opportunity to link disease control programs to increase access and coverage of interventions to improve outcomes for malaria, schistosomiasis, and their co-infection. Further research is needed on the potential benefits, feasibility, and cost-effectiveness of integrating malaria and schistosomiasis prevention and control programs.
... Varying prevalence rates of schistosomiasis have been reported in different countries within the African Continent including 65.7% [18], 45.9% [19], 44.4% [20], 44.3% [21], and 7.1% [3] all in Nigeria as well as 26.2% in Gabon [22], 46.8% in Cameroon [23], 14.0 in Côte D'Ivoire [24], 76% in Zambia [25] and 10.4% [11] Controlling schistosomiasis, like many other tropical diseases, requires a multidisciplinary approach that encompasses environmental understanding, mode of transmission, immunology, enhanced access to diagnosis, treatment, and vaccine development. Current strategies focus on mass drug administration (MDA) as recommended by the WHO, primarily targeting the reduction of schistosomiasis morbidity among school-age children (SAC), preschool-age children (PSAC), and women of reproductive age [28]. ...
Background: Urinary schistosomiasis remains a major cause of public health concern with the global burden predominant in Sub-Sahara Africa. Over 78 countries are affected and approximately 800 million people are exposed to the disease in Sub-Saharan Africa (SSA) accounting for 90% of cases and an estimated 280,000 deaths each year. The disease poses a substantial public health challenge causing an estimated 70 million Disability-Adjusted Life Years. There is however no consolidated data on the prevalence of urinary schistosomiasis in West Africa. Aim: This study assessed the prevalence of urinary schistosomiasis in West Africa. Methods: This research employed a systematic literature review to meticulously gather and analyze existing data, with the primary aim of establishing the weighted prevalence of S. haematobium infection in West Africa rigorously adhering to the PRISMA guidelines between March 1 and March 12, 2023, spanning key databases including MEDLINE via PubMed, Scopus, and Google Scholar. Prevalence metrics were presented using proportion. Random effects model was used as significantly large heterogeneity was observed among the studies. The DerSimonian-Laird random effects method was used as the between study variance estimator in estimating the pooled proportion estimate and its confidence interval. Publication bias was assessed using the Egger’s test and the Beggs test as well as funnel plots. The MedCalc statistical software version 14 and OpenMeta [Analyst] meta-analysis tools were used for the meta-analysis. A p-value of <0.05 was considered statistically significant. Results: This review included 133 articles out of which 91 (68.40%) representing the majority were contributed by Nigeria. Overall, this review comprised 126508 participants out of which 40019 were identified to be infected with S. haematobium. The pooled prevalence based on the random effect model was 37.6% (95%CI: 33.9% - 41.3%). Pooled prevalence rates of 41.4% (95% CI: 36.1% - 46.7%), 40.2% (95% CI: 24.7% – 55.6%) and 23.9% (95% CI: 16.8% - 30.9%) were recorded among rural, suburban and urban dwellers respectively. A meta regression analysis revealed a significantly decreasing trend in the prevalence of schistosomiasis with advancement in year of publication (Coeff. -0.007, p=0.004). Conclusion: The result from this study highlights the positive impact of control measures instituted in fighting urinary schistosomiais in West Africa. Targeted interventions, especially in rural areas may further aid in the elimination of the schistosomiasis menace in the subregion. Age-specific disparities underscore the need for tailored approaches. This review emphasizes the importance of sustained control measures and continued research to achieve long-term disease reduction and, ultimately, elimination.
... The observed prevalence was lower than the rates reported in children from Kwara (33.5%), Nasarawa (36.5%), and Edo States (52.0%) (Adedoja et al., 2015;Abe et al., 2019;Isaac et al., 2019), but higher than the research conducted by Nzeukwu et al. (2022) andYaro et al. (2019). ...
Soil-transmitted helminths (STHs) and Plasmodium falciparum are known to the causative agents of neglected tropical diseases that continue to pose significant public health challenges in Nigeria and other endemic countries. This study was aimed at determining malaria and STHs coinfection in Kano metropolis, Kano state, Nigeria. The prevalence of malaria and STHs was determined using microscopy and formol ether concentration methods, respectively. Data on socio-demographic and risk factors were collected from three hundred (300) patients using structured questionnaires. The findings revealed a high prevalence of malaria (92.7%) and low STHs (19.0%). Malaria was more prevalent in males (52.3%) than females (40.3%), with the highest prevalence observed among individuals aged 6-12 years (25.7%). The difference in malaria prevalence based on age was not statistically significant (p>0.05), contrary to gender which showed a significant difference in their association (p<0.05). STHs infections were more common in participants aged between 6-12 years (11.3%), and the difference in prevalence among age groups was statistically significant (p<0.05). Among the study sites, patients exhibited a higher prevalence of Ascaris infection (14.3%) compared to Hookworm infection (4.6%). Co-infection was recorded in 19.0% of the patients, while 73.7% had malaria infection alone. During this study, malaria and STHs were prevalent in Kano metropolis and there was a co-infection of Malaria and STHs among patients attending the selected hospitals in Kano.
... Severe helminth infection is more likely to cause hospitalization than death. These outcomes are uncommon compared to the average patient's disease burden, which is characterized by sub-acute morbidities [7,8]. Nigeria, in particular, has a high incidence of intestinal parasites due to various factors, including climatic conditions, local traditions, and the use of human and animal fertilizers in agriculture [8,9]. ...
... These outcomes are uncommon compared to the average patient's disease burden, which is characterized by sub-acute morbidities [7,8]. Nigeria, in particular, has a high incidence of intestinal parasites due to various factors, including climatic conditions, local traditions, and the use of human and animal fertilizers in agriculture [8,9]. Ascaris lumbricoides, hookworms, Trichuris trichiura, Strongyloides stercoralis, Entamoeba histolytica, and Giardia lamblia are among the commonly encountered parasites that depend on poverty, poor personal hygiene, poor environmental care, poor health services, and lack of awareness [10][11][12]. ...
Background: Foodborne diseases are a significant public health issue globally, with approximately 30% of the population in developed countries suffering from diarrheal diseases caused mainly by foodborne microbial pathogens. In developing countries, food handlers, including meat sellers, are the primary determinants of food contamination due to poor regulatory systems for food hygiene. This cross-sectional study determined intestinal parasites’ prevalence and associated factors among meat sellers in Nigeria. Methods: Using convenience sampling, 139 meat sellers in four markets in Ilorin, Kwara State, were selected. Stool samples were collected from each participant using a clean and dry stool container. The stool samples were analyzed using direct smear saline and formal-ether concentration techniques. The parasites were identified and counted under a microscope. The primary outcome was the presence of one or more intestinal parasitic species in stool samples. Data were analyzed using descriptive statistics, the Chi-Square test, and binary logistics regression. Results: Of the 139 meat sellers in this study, 74(53.2%) were females, while 65(46.8%) were males. Most participants (43.9%) were in the age group 31-40 years compared to the age group 51-56 years (9.4%), with the least participants. The participants’ education levels varied, with those with primary education (46.8%) being the highest, followed by those with tertiary education (31.7%). Based on religion, 37 (26.6%) participants were Christians, while 102 (73.4%) were Muslims. 59.7% of the meat sellers haboured one or more intestinal parasites. The odds ratio for gender indicates that when holding all other variables constant, a female is 1.7 times more likely to have a parasite than a male. The odds ratios of those with primary and secondary education levels are 1.4 and 1.7, respectively, suggesting that despite the level of education, they were more likely to habour intestinal parasites. The age group did not significantly affect the presence of intestinal parasites (p>0.05). Conclusion: This study shows a high prevalence of intestinal parasites among meat sellers in Ilorin. The findings highlight the importance of implementing preventive measures and promoting awareness to reduce the burden of intestinal parasites in this community. In addition, large-scale screening and mass drug administration are recommended...
... [4] Empirical studies conducted across co-endemic countries have shown that variations in the prevalence of malaria and STH co-endemicity differed significantly across geographic locations. [5][6][7][8][9] Environmental factors such as temperature and humidity have been identified as the major driving factors for the widespread distributions of parasitic diseases such as malaria and STH. Using a combination model of temperature, rainfall and altitude, Brooker et al [1] predicted the continental distribution of each of the major STH species, which suggested that A. lumbricoides and T. trichiura were prevalent predominantly in equatorial, central and west, and southeast Africa, while the hookworm infection was ubiquitous in every African subregion. ...
... [14] Given the interplay of several complex factors promoting malaria-STH co-endemicity, limited understanding exists about the spatial distribution of this co-endemicity in vulnerable populations. Majority of the published studies targeting malaria-STH co-endemicity have focused on describing the transmission and burden among affected populations, [5,6,9,15] and have paid little attention to their concurrent spatial distribution. Previous systematic reviews have also reported an over-estimation of the relationship between malaria and helminths making it difficult to establish conclusively the burden of malaria-STH dual infections. ...
Background
Limited understanding exists about the interactions between malaria and soil-transmitted helminths (STH), their potential geographical overlap and the factors driving it. This study characterised the geographical and co-clustered distribution patterns of malaria and STH infections among vulnerable populations in sub-Saharan Africa (SSA).
Methodology/Principal findings
We obtained continuous estimates of malaria prevalence from the Malaria Atlas Project (MAP) and STH prevalence surveys from the WHO-driven Expanded Special Project for the Elimination of NTDs (ESPEN) from Jan 1, 2000, to Dec 31, 2018. Although, MAP provides datasets on the estimated prevalence of Plasmodium falciparum at 5km x 5km fine-scale resolution, we calculated the population-weighted prevalence of malaria for each implementation unit to ensure that both malaria and STH datasets were on the same spatial resolution. We incorporated survey data from 5,935 implementation units for STH prevalence and conducted the prevalence point estimates before and after 2003. We used the bivariate local indicator of spatial association (LISA analysis) to explore potential co-clustering of both diseases at the implementation unit levels among children aged 2–10 years for P . falciparum and 5–14 years for STH, living in SSA.
Our analysis shows that prior to 2003, a greater number of SSA countries had a high prevalence of co-endemicity with P . falciparium and any STH species than during the period from 2003–2018. Similar prevalence and distribution patterns were observed for the co-endemicity involving P . falciparum -hookworm, P . falciparum-Ascaris lumbricoides and P . falciparum-Trichuris trichiura , before and after 2003.
We also observed spatial variations in the estimates of the prevalence of P . falciparum -STH co-endemicity and identified hotspots across many countries in SSA with inter-and intra-country variations. High P . falciparum and high hookworm co-endemicity was more prevalent in West and Central Africa, whereas high P . falciparum with high A . lumbricoides and high P . falciparum with high T . trichiura co-endemicity were more predominant in Central Africa, compared to other sub-regions in SSA.
Conclusions/Significance
Wide spatial heterogeneity exists in the prevalence of malaria and STH co-endemicity within the regions and within countries in SSA. The geographical overlap and spatial co-existence of malaria and STH could be exploited to achieve effective control and elimination agendas through the integration of the vertical control programmes designed for malaria and STH into a more comprehensive and sustainable community-based paradigm.
... The coexistence of these infections has become an interesting area of research. In malaria and helminths co-infection, some studies reported increased risk of clinical malaria or an increased malaria parasite density (Le Hesran et al. 2004;Adedoja et al. 2015) while others reported protection against cerebral malaria or a reduced malaria parasite density in studies carried out in Thailand and Ethiopia (Nacher et al. 2000;Degarege et al. 2012). Malaria and HIV co-infection studies have also been evaluated in different populations with reports of increased episodes of clinical malaria or an increased parasite density (Thigpen et al. 2011;Berg et al. 2014), increased viral load (Kublin et al. 2005) and higher occurrences of placental malaria (Perrault et al. 2009). ...
Malaria, helminthiasis and HIV are widespread in developing countries taking a heavy toll on pregnant women. Due to similar environmental and human factors of transmission, they co-exist. The epidemiology and pathology of these diseases have been extensively studied but data on serum cytokine profile changes which is crucial in pregnancy is limited. The aim of this study was to evaluate the co-infections and their impact on peripheral blood cytokines. Blood and stool samples were collected from recruited 18-45-year-old pregnant women in different trimesters who were apparently healthy with no obvious complications in pregnancy. Pretested questionnaires were administered for personal and socio-demographic details. Malaria parasitemia in Giemsa-stained thick blood films was examined microscopically. Stool samples were screened for helminths using Kato-Katz method. Cytokine levels of TNF-α, IFN-γ, IL-1α, IL-2, IL-4, IL-6, IL-10, IL-12p70, IL-13 and IL-17 in 121 serum samples were determined using ELISA. Data were analysed using descriptive statistics and Mann–Whitney U test at α0.05. Relative to the single infections, there were significant reductions in IFN-γ and IL-13 in second and third trimesters respectively in those with Plasmodium and helminth co-infection. IFN-γ and IL-17 were elevated while IL-1α and IL-12p70 were reduced in co-infection of helminths and HIV. Co-infection of Plasmodium and HIV in second and third trimesters showed significant elevations in IL-1α, IL-10 and IL-17 while TNF-α, IL-4 and IL-12p70 were significantly reduced. HIV in pregnancy and its co-infection with Plasmodium resulted in significant distortions in the cytokine profile. However, helminth and its co-infection with Plasmodium or HIV produced less changes in the cytokine profile.
... and hookworm co-infection in Africa (34/37, 91.9%) [8][9][10][11][12][13]20, while the remaining studies were from Asia (1 Thai-Burmese border, 1 Indonesia) 51,52 or South America (Brazil) 53 . Most of the included studies conducted in Africa were in Nigeria (8/34, 23.5%) 11,24,28,32,33,45,46,50 , followed by Ethiopia (6/34, 17.6%) 8,9,12,13,31,42 , Tanzania (4/34, 11.8%) [38][39][40]49 , Uganda (4/34, 11.8%) 34,36,44,47 , Coˆted'Ivoire (3/34, 8.8%) 10,41,48 , Ghana (3/34, 8.8%) 26,27,35 , Kenya (2/34, 5.88%) 30,37 , Gabon (2/34, 5.88%) 20,25 and Cameroon. One study covered three countries, including Kenya, Ethiopia and Uganda 29 . ...
... Most of the included studies were conducted in school-age children (19/37, 51.4%) 9,20,24,29,30,[35][36][37][38][39][40][41][42][43][44][45]49,52,53 , pregnant women (7/37, 18.9%) 25,28,[32][33][34]46,51 , residents in the community (6/37, 16.2%) 10,11,26,27,47,48 , and acute febrile patients (4/37, 10.8%) 8,12,13,31 , while 1 study was conducted in voluntary donors 50 . Of the 37 studies included in the present analysis, 22,191 participants were confirmed to have malaria infection. ...
... Quality of the included studies. Ten studies 8,9,11,13,24,28,38,40,50,53 were rated as high-quality studies, since they reported the outcomes of interest, whereas the rest of the studies were rated as moderate quality, since they www.nature.com/scientificreports/ than in Plasmodium mono-infection, whereas one study 38 demonstrated a higher mean haemoglobin level in coinfection than in Plasmodium mono-infection (Fig. 6). ...
The dual effects of co-infection of Plasmodium spp. and hookworm on malaria remain under debate. This study investigated prevalence, prevalence odds ratio (POR) of co-infection and impact of co-infection on malaria parasite density and haemoglobin levels in comparison to Plasmodium mono-infection. The protocol for this systematic review and meta-analysis is registered at PROPERO under ID: CRD42020202156. Relevant literatures were obtained from PubMed, ISI Web of Science, and Scopus on 25 December 2020. Mean difference (MD) and confidence interval (CI) of malaria parasite density and haemoglobin were compared using a random effect model. Heterogeneity was assessed using Cochrane Q and I2 statistics. Publication bias was determined by visualising funnel plot asymmetry. Of 1756 articles examined, 22,191 malaria cases across 37 studies included 6096 cases of co-infection of Plasmodium spp. and hookworm. The pooled prevalence was 20% (95% CI 15–26%, I2 99.6%, 37 studies) and was varied in terms of geographical region. Co-infection occurred by chance (OR 0.97, p 0.97, 95% CI 0.73–1.27, I2 95%, 30 studies). The mean malaria parasite density for co-infection (478 cases) was similar to Plasmodium mono-infection (920 cases) (p 0.24, MD 0.86, 95% CI − 0.58–2.29, I2 100%, 7 studies). The mean haemoglobin level for co-infection (90 cases) was similar to Plasmodium mono-infection (415 cases) (p 0.15, MD − 0.63, 95% CI − 1.49–0.23, I2 98%, 4 studies). Co-infection was common and occurred by chance but varied by geographic region. Further studies are required to investigate the mechanism of hookworm infection on malaria severity. Additionally, detection of hookworm infections among patients with malaria in endemic areas of both diseases is recommended to prevent severe malaria.
... ASM positive cases were detected by var acidic terminal sequence-based (varATS) qPCR in children between 6 and 14 years (Umunnakwe et al., 2019). Significant numbers of ASM and helminth coinfections were also observed among school-age children of Osogbo (Ojurongbe et al., 2011a) and Kwara (Adedoja et al., 2015) of Nigeria. It has been observed that malaria during pregnancy is mostly asymptomatic, and pregnant women < 20 years were at high risk of ASM infection in Lagos (Agomo et al., 2009). ...
There has been a consistent rise in malaria cases in the last few years. The existing malaria control measures are challenged by insecticide resistance in the mosquito vector, drug résistance in parasite populations, and asymptomatic malaria (ASM) in healthy individuals.
The absence of apparent malaria symptoms and the presence of low parasitemia makes ASM a hidden reservoir for malaria transmission and an impediment in malaria elimination efforts.
This review focuses on ASM in malaria-endemic countries and the past and present research trends from those geographical locations. The harmful impacts of asymptomatic malaria on human health and its contribution to disease transmission are highlighted. We discuss certain crucial genetic changes in the parasite and host immune response necessary for maintaining low parasitemia leading to long-term parasite survival in the host. Since the chronic health effects and the potential roles for disease transmission of ASM remain mostly unknown to significant populations, we offer proposals for developing general awareness. We also suggest advanced technology-based diagnostic methods, and treatment strategies to eliminate ASM.
... The most vulnerable group to this cconcomitant infestation is children [5]. Concomitant infestations in children have been made known to harmfully influence their growth and learning abilities [5][6 [[7] and have been linked with increased inclination to other infections [5][8] [9]. An interaction between helminthiasis and malaria parasiteamia could work in either direction. ...
Helminthic infestation and malaria parasitaemia, separately or co- joined, can be present, in a host and still be asymptomatic. It is, therefore, crucial to assess the extent of co-infestation among individuals, particularly children who are most prone to parasitic infestations. Blood and Stool samples were collected from 557 pupils who were examined for intestinal helminths, malaria parasitaemia and anaemia. Formal acetate concentration method was used to analyse the stool specimens after which positive ones were further processed using Stolls method of counting helminths egg to determine the number of parasite per gram of stool. Thick film was used for malaria parasite test and malaria parasite density was calculated for the positive samples while anaemia was screened using cyanmethaemoglobin method. There were 235(42.2%) pupils co-infested with intestinal helminths and malaria parasitaemia Co-infestation of Ascaris lumbricoides and malaria parasitaemia 91(16.3%), and co-infection with hookworm and malaria parasitaemia 72(13.0%) had the highest prevalence. The percentage of pupils co-infested and anaemic were 130(23.3%) and is statistically significant (p > 0.05) across the communities. There was a negative correlation between haemoglobin concentrations (the indicator of anaemia), helminthic count with malaria parasite density count. This study revealed that intestinal helminths and malaria parasitaemia have a resurgence and concomitant infestation which constitutes a public menace. Co-infection increased the risk associated with anaemia and intensify the burden in Nigerian children. Keywords: Co-infestation, malaria parasitaemia, intestinal helminthiasis, anaemia, pupils
