The Effect of Intestinal Parasitic Infection on the Clinical Outcome of Malaria in Coinfected Children in Cameroon

Background The interaction between intestinal parasites and malaria is still not clear. Data in published literature are conflicting. We studied the effect of intestinal parasitic infection (IPI) on the clinical outcome of malaria in coinfected children. Methods In a cross sectional study performed between October 2014 and September 2015, children infected with malaria, as demonstrated by the presence of asexual parasites in Giemsa stained blood films, were enrolled. Stool samples were obtained from participants and subjected to the formol-ether concentration technique for the detection of intestinal parasites. The Complete blood count was performed using an automated haematology analyser (Mindray, BC-2800). The risk ratio, Pearson's chi-square and the student T test were all performed as part of the statistical analyses. Statistical significance was set at p<0.05. Results In all, 405 children successfully took part in the study. The children were between 1 week and 120 months of age (mean +/- SD=41.5 +/- 33.5). Coinfection with intestinal parasites was observed in 11.6%. The rate of severe malaria (SM) attack in this study was 10.9%. SM was not observed to be associated with age (p=0.377) or gender (p=0.387), meanwhile co-infection with intestinal parasites was associated with age (p=0.003). Among SM cases, IPI prevalence was higher in children with mild (WHO group 3) severe malaria (p=0.027). Overall, IPI was not observed to be associated with SM (p=0.656) or malaria parasite density (p=0.185) or haemoglobin concentration (p=0.205). The main clinical features of SM observed were hyperpyrexia (68.2%), severe malarial anaemia (61.4%), and multiple convulsion (52.3%). Conclusion IPI was not observed to be associated with the severity of malaria, the malaria parasite density, and the haemoglobin concentration in coinfected children in Cameroon. The clinical outcome of malaria in children coinfected with intestinal parasites may depend on the geographical setting after all.