Schistosome and Intestinal Worm Infections and Malaria Morbidity Among School and Pre-school Children in, Tanzania
Condition: Anaemia; Malaria; Hepatosplenomegaly
MeSH terms: Infections; Malaria
Study type: Interventional

Summary: 
      The proposed study has as the main objective to investigate the effect of schistosome and STH
      infections and the effect of an anthelminthic intervention on P. falciparum malaria, related
      anaemia and malaria antibody responses among school and pre-school children in Mwanza,
      Tanzania. The study will include a cross-sectional baseline survey followed by an
      anthelminthic intervention trial of two years duration. At baseline, prevalence and intensity
      of malaria, schistosome and STH infections and the prevalence of anaemia will be determined
      by examination of blood, faecal and urine samples. Spleen and liver size and consistency will
      be determined by palpation. P. falciparum specific antibodies will be determined by ELISA.
      All children will be treated with a single dose of praziquantel 40mg/kg and albendazole
      400mg. Children selected to participate in the intervention trial will be randomized into two
      groups, an intervention group of 258 children which will be followed up with albendazole
      400mg and praziquantel 40mg/kg at three months interval and a control group of 258 children
      which will be followed up with praziquantel 40mg/kg and albendazole 400mg once a year in
      accordance with the National Schistosomiasis and Soil-transmitted Helminths Control
      Programme. At 12 months and 24 months follow-up, all examinations conducted at baseline
      survey will be repeated.
    

Detailed description: 
      alaria is a major public health problem in tropical and subtropical countries particularly
      sub-Saharan Africa. Studies have shown that in Tanzania malaria, schistosome and
      soil-transmitted helminth infections (STH) (Hookworms, Ascaris lumbricoides and Trichuris
      trichiura) are co-endemic and that they share the human hosts. It has been hypothesized that
      co-infection with schistosomes and STH may modulate the immune response to Plasmodium
      falciparum leading to increased susceptibility to clinical malaria and severity of cases. The
      proposed study has as the main objective to investigate the effect of schistosome and STH
      infections and the effect of an anthelminthic intervention on P. falciparum malaria, related
      anaemia and malaria antibody responses among school and pre-school children in Mwanza,
      Tanzania. The study will include a cross-sectional baseline survey followed by an
      anthelminthic intervention trial of two years duration. At baseline, prevalence and intensity
      of malaria, schistosome and STH infections and the prevalence of anaemia will be determined
      by examination of blood, faecal and urine samples. Spleen and liver size and consistency will
      be determined by palpation. P. falciparum specific antibodies will be determined by ELISA.
      All children will be treated with a single dose of praziquantel 40mg/kg and albendazole
      400mg. Children selected to participate in the intervention trial will be randomized into two
      groups, an intervention group of 258 children which will be followed up with albendazole
      400mg and praziquantel 40mg/kg at three months interval and a control group of 258 children
      which will be followed up with praziquantel 40mg/kg and albendazole 400mg once a year in
      accordance with the National Schistosomiasis and Soil-transmitted Helminths Control
      Programme. At 12 months and 24 months follow-up, all examinations conducted at baseline
      survey will be repeated. If an effect of schistosome and STH infections on malaria infection
      and morbidity is demonstrated, control of these diseases could provide another feasible and
      affordable way of reducing malaria morbidity. Results of the proposed study will contribute
      to the understanding of the epidemiology and control of malaria in the context of other
      co-endemic diseases and may be important in the planning of integrated disease control
      strategies.

      Keywords: P. falciparum, malaria, schistosome infections, soil-transmitted helminths
      infection, anaemia, immune response, Tanzania
    

Intervention name(s): Albendazole and praziquantel
Intervention type(s): Drug
Intervention MeSH terms: Albendazole; Praziquantel
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: P. falciparum; malaria; schistosome infections; soil-transmitted helminths infection; anaemia; immune response; Tanzania