UJMR, Volume 5 Number 1, June, 2020, pp 82 - 85 ISSN: 2616 – 0668

https://doi.org/10.47430/ujmr.2051.013

Received: 11th May, 2020 Accepted: 17th June, 2020

Co-Infection of Schistosomiasis and Helminthiasis among School-Aged Children in Kura
Local Government Area, Kano State

* Sule, H., Kumurya, A. S. and Ishaq, A.

Department of Medical laboratory Science Faculty of Allied Health Sciences, College of Health
Sciences, Bayero University, Kano
Corresponding Author:[email protected]:+2348036062021
Abstract
Schistosomiasis and helminthiasis are serious course for concern in developing countries,
especially among children; because of their effect on health economy any affected patient and
the population at large. This study was a cross-sectional survey aimed to determine the co-
infection of these two important groups of parasites, among primary school pupils in some
communities of Kura Local Government Area, Kano State, Nigeria. Freshly produced urine and
stool samples were collected from 165 apparently healthy pupils and examined using
microscopic and macroscopic standard methods. Out of the 165 pupils examined, 15 (9.0%)
were found to be co-infected with both groups of the parasites. About the identified parasites,
A. lumbricoides was the most prevalent soil-transmitted helminths (STH) encountered, with a
prevalence rate of 7.27%, followed by Hook worms (3.03%), while infection with Schistosomes
revealed S. haematobium 26.7% and S. mansoni 6.7%. Males were found to be at higher risk
with 60.0% prevalence rate than females that had 40.0%. Age limit of 5-6 years recorded the
highest prevalence for S. haematobium, A. lumbricoides, and hookworm infections.
Key words: Helminthias, Schistosomiasis, co-infection, School aged, children

INTRODUCTION of their major complications include reduction

Schistosomiasis and soil transmitted of nutritional status, physical and mental
helminthiasis are part of the neglected tropical ability impairment and lessen cognitive
diseases that affect the population that are development especially in school-aged children
relatively of resource poor settings, mostly (Montresor, 2011).
overwhelmed by poverty, poor sanitary The preventive measures as the first line of
conditions, unsafe drinking water and general approaches to be taken to reduce occurrence
lack of hygiene. and subsequent repercussion of their
Schistosomiasis (SCH) and helminthiasis are morbidities include health education and
poverty‐related in which school-aged children improvement of environmental hygiene. This
are at highest risk, Schistosoma mansoni goes in line with WHO which put forward
infection for example, may lead to recommendations and tools for preventive
consequences such as nutritional deficiencies, chemotherapy (PC) in cases of human
anaemia, and impaired cognitive abilities of the schistosomiasis and helminthiasis. the 54th
affected person also Schistosoma haematobium World Health Assembly, published the
on the other hand is an important agent for Resolution WHA54.19 on SCH and STH which
urinary tract infection leading to poor urge Member States to implement but not only
reproductive and in some cases sexual that to also sustain successful control activities
dysfunction and ultimately infertility with regards to these important parasitic
(Montresor, 2011). The disease is also notably a diseases, with minimum target to be achieved
risk of bladder cancer and in children may lead by 2010 (WHO, 2013).
to anaemia and stunted growth (Hotez and Unfortunately, the goal was not realized., with
Kamath 2009). progress in expanding preventive
Helminthic infections belongs to the major chemotherapy, for that reason, new Resolution
groups of parasitic infections that affect the WHA65.21 was endorsed to intensify control
less privilege communities in the developing measures to eliminate SCH, targeting majorly
countries worldwide, with the main species school‐aged children (5-14 years), with a new
causing the disease such as Whipworm timeline set to treat at least 75% of school‐aged
(Trichuris trichiura), roundworm (Ascaris children in all endemic regions by the year 2020
lumbricoides), and hookworms (Necator and hoped to reach elimination status of SCH
americanus and Ancylostoma duodenale). Some

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 UJMR, Volume 5 Number 1, June, 2020, pp 82 - 85 ISSN: 2616 – 0668
and STH as a public health problem (WHO 2016).
According to WHO) more than 2 billion people Sample collection and processing
are affected with these groups parasites SCH Two separate clean and dry universal and wide
and STH which are regarded as Neglected mouth bottles were given to each participant,
Tropical Disease (NTD) and is found that for urine and stool samples respectively they
schistosome alone had up to 240 million people were instructed on how to provide the
infected yearly, leading to the disease abnormal part of the stool when produced
schistosomiasis and 700 million are at risk in 74 while for the urine last drops were collected.
different countries. Macroscopic examination of the collected
MATERIALS AND METHODS Urine: Colour, turbidity and blood were
Study area checked and recorded.
The study was carried out in some selected Stool: Colour, consistency and constituents
villages (Bauren Tanko, Fegi, and Butalawa) of were observed and recorded.
Kura local government area, Kano state, Urine Microscopy
Nigeria. The local government has an area of Ten (10ml) of urine was poured in a clean
206km2 and a population of 144,601 at the 2006 centrifuge tube. It was spun at 2500rpm for 5
census. It lies on latitude of 11o 46’ 17N and minutes. The supernatant was discarded and
longitude of 8o 25’ 49E (Ado, 2009). the deposit was taped and a drop transferred
Study design onto a clean grease free glass slide and covered
The research was prospective cross sectional gently with coverslip. It was examined under
study. microscope with 10x and 40x objectives (Ochie,
Sample size determination 2005).
The sample size of this study was determined Stool Microscopy
using the formula as follows About a half teaspoon of faecal mass were
n= z2p (1-p) (Cochran, 1963) thouroghly mixed in 10ml of water and strained
________ through 2 layers of gauze in a funnel. The
d2 filterate was centrifuged at 2000rpm for 2
Where; minutes. The supernatant was discarded and
n= number of samples the sediment was re-suspended in 10ml of
z= statistic for level of confidence 95% (1.96) physiological saline. It was again centrifuged
p= prevalence 11% (0.11) (Aribodor et al., and the supernatant was discarded. The
2018) sediment was re-suspended in 7ml of 10%
d= allowable error of 5% (0.05) formal saline and allowed to stand for at least
n= 3.8416×0.11×0.89 10 minutes for fixation. To this, 3ml of ether
0.0025 was added. The tube was stoppered and shaken
Sample size approximately = 150 vigorously to mix. Then the stopper was
Using 10% attrition rate, the sample size removed and the tube was centrifuged at 2000
becomes 165 rpm for 2 minutes. The tube was allowed to
Study population rest in a stand. Four layers became visible, and
This includes school aged children of 3 selected the upper three layers were discarded. The
villages in Kura local government, Kano state plug of debris was detached from the side of
(Bauren Tanko, Fegi, and Butalawa) in which the tube with the aid of a glass rod for the
165 participants were recruited for the study. supernatant to be easily out of the tube. The
Ethical approval sediment was poured on a clean glass slide,
Ethical approval to carry out the study was covered with a cover slip and examined using
received from Kano state ministry of health 10 and 40 X objectives (Cheesebrough, 2009).
Reference Number: MOH/OFF/797/T.1/1416. Data analysis
Inclusion criteria The result was analyzed using statistical
Primary school children who were not under package for the social science (SPSS) version
any antihelminthic drugs but willing to 20.0 software and presented in tables p value
participate in the study were included in the ≤0.005 was considered significant.
study.
Exclusion criteria RESULTS
Primary school children not willing to During the study, a total of 165 primary school
participate in the study and or under aged children in the selected villages, of Kura
anthelminthic treatment within a period of one Local Government Area were enrolled in the
month before the study were excluded from study and overall prevalence of co-infection of
the study. 15 (9.0%) was recorded.

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 UJMR, Volume 5 Number 1, June, 2020, pp 82 - 85 ISSN: 2616 – 0668

The parasites identified in the study area were (6.7%). There was also no significant difference
S. hematobium 44 (26.7%), followed by A. in infection rates among different age groups
lumbricoides with 12 (7.27%), S. mansoni 11 examine X2=10.756, P=0.293. According to the
(6.7%) and hookworm 5 (3.03%). The co- results also, the age groups of 11-12 had the
infection according to gender revealed that, infection rate of 26.7%, age range of 13-14 had
males had higher prevalence rate 9(60%) 13.3% while the age limit of 15-16 do not have
compared to females 6(40%), (Table 2). The age any infection, meaning, they have 0.0%
group with highest prevalence was 7-8 (40%) infection rate.
and that with the least co-infection was the 5-6
Table 1: The different agents of schistosomiasis and helminthiasis identified
Variable Number Positive Prevalence % χ2 P-value
the parasite (eggs) examined
(165)
Schistosomes 36.667 0.000
S. hematobium 44 26.7
S. mansoni 11 6.7
Both 6 3.6
Sub total 61 37
STH
A. lumbricoides 12 7.27 144.228 0.000
H. worms 5 3.03
Sub total 17 10.3
Total 165 78 47.3
χ2= chi square, %= percentage, P-value= probability value (≤0.05) was significant

Table 2: Distribution of co-infection of schistosome and soil transmitted helminth based on gender
Variable Number No. Prevalence% X2 P-value
examined coinfected
Gender 1.408 0.235
Male 75 9 60
Female 90 6 40
TOTAL 165 15 100
X2= chi square, %= percentage, P-value= probability value (≤0.05) was significant
Table 3: (Co-infection of schistosomes and soil transmitted helminthes based on age-groups)
Variable Number Positive Prevalence % χ2 P-value
examined
Age 10.756 0.293
3-4 1 0 0
5-6 20 1 6.7
7-8 52 6 40
9-10 32 2 13.3
11-12 24 4 26.7
13-14 22 2 13.3
15-16 14 0 0
Total 165 15 100
Note: χ2= chi square, %= percentage, P-value= probability value (≤0.05) was significant
DISCUSSION schistosomes and two soil transmitted helminth
Soil transmitted helminths are among the while Trichuris triciura replaces Hookworm in
neglected tropical diseases affecting less their study; The parasites and their respective
privilege across the globe. In this study, the frequencies were 47(17.%), 11(4.2%) and
following organisms were identified, 49(18.7%) for Schistosoma mansonii, Tichuris
Schistosoma mansonii 11(6.7), Schistosoma Trichiura and Ascaris lumbricoides
haematobium 44(26.7), Ascaris lumbricoides 84 respectively. Agersew et al. (2016), in a work
12(7.3) and Hook worm 5(3.0). Inocencio et al. on Schistosomes and soil-transmitted helminths
(2017), was also able to identify different among school-aged children in Chuahit, Dembia
parasitic species which includes; two district, Northwest Ethiopia, concerning
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 UJMR, Volume 5 Number 1, June, 2020, pp 82 - 85 ISSN: 2616 – 0668
prevalence, intensity of infection and age group. Oluwale et al. (2018), however, in
associated risk factors, was able to identify Ogun state, Nigeria, reported almost same
Schistosoma mansonii, Hookworm, Trichuris identification frequencies for three different
trichiura and Ascaris lumbricoides in their age groups but with slightly higher rate in the
research, with Ascaris lumbricoides the age range of 10-12 with (39.5%) followed
dominant parasite having 77(19.2) as closely by 13-15 and 8-10 that had (38.9%) and
prevalence rate, while 45(11.2), 9(22), 7(1.7) (38.33%) as their identification frequencies
were the identification rates for Schistosoma respectively.
mansonii, Hook worm and Trichuris trichiura
respectively. CONCLUSION
The distribution of the parasite according to It can be concluded therefore that school aged
gender showed that males were more affected children are prone not only to schistosomiasis
than the females participants with 9 (60%) and but also the soil transmitted helminth in the
6(40%) for females participants respectively. study area.
This is in agreement with the work of
Oluwarotimi et al. (2019) who also identified ACKNOWLEDGEMENT:
males subjects as the participants with highest We appreciate the contributions of everyone
infection rate, although with higher involved in making the research a success,
percentages 33(18.0%) and 29(13.6%) including Kano state ministry of education,
respectively. With respect to age groups, the district head of Dawakin Kudu and all staff of
age bracket of 7-8 was found to have higher the primary schools involved.
infection rate 6(40.0%) compared to the rest of Conflicts of interest:
the groups, followed by 11-12 with 4(26.7%) There is no conflict of interest among the
while 5-6 had only 1(6.6%) as the least infected authors.
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