Schistosoma haematobium and nutritional status among primary school children in Bertoua, Cameroon: Effect of praziquantel on hemoglobin levels, anthropometric measures, liver and spleen size
Description
The impact of S. haematobium infection on nutritional and health status with regards to hemoglobin levels, anthropometric measures, hepatomegaly and splenomegaly, and the effect of praziquantel treatment on these parameters six months after intervention were studied in primary school children in Bertoua, Cameroon. The prevalence of schistosomiasis in the study sample was 23.9%, 10% of whom had heavy infection (egg count $>$ 499 per 10 ml of urine). Malaria and hookworm infection affected 42.6% and 23.2% respectively. The mean hemoglobin level of the study population with and without S. haematobium infection was 12.1 g/dl. There was no difference in mean hemoglobin levels per intensity of infection. Mean hemoglobin levels were significantly lower in children with malaria, splenomegaly or hepatomegaly. The percent median weight for age, height for age and weight for height of the study sample were 83.7%, 94.3% and 97.5% respectively. Mean height for age and weight for age indices were significantly greater in the uninfected than the infected (p $<$ 0.001). Subjects with light-moderate S. haematobium infection (1-499 eggs/10 ml urine) were randomly allocated to either praziquantel treatment (PZQ, n = 238) or placebo (PLB, n = 198) groups. The uninfected controls (NON, n = 174) were randomly selected from the study population. Children were examined before and six months after praziquantel treatment. Hemoglobin levels and height for age indices decreased significantly (p $<$ 0.05) in all three groups but anthropometric measures increased significantly between the two exams. Increase in mid arm circumference was significantly different between the PZQ and NON (p = 0.036) and marginally significant between the PZQ and PLB (p = 0.056). Praziquantel had no significant effect on hepatomegaly or splenomegaly. There was an interaction between changes in hemoglobin levels and malaria (p = 0.0015). Neither iron nor folic acid was responsible for the increase in hemoglobin levels observed one month after deworming and iron/folic acid intervention. Praziquantel treatment did not have a significant effect on the nutritional status of these children after six months despite the impact of S. haematobium infection on growth