Association between Intestinal Helminthiasis and Serum Ferritin Levels Among School Children


Background: Significant iron deficiency anaemia is a major concern in children with helminthiasis, because it may eventually contribute to the growing health challenges of severe anaemia This descriptive cross sectional study was carried out to determine the association between serum ferritin levels and intestinal helminthiasis among school children. Methods: A structured questionnaire was used to collect the study population data. Stool specimens were obtained and examined on the same day using the sedimentation method for identification of the parasite. Blood samples were also obtained for full blood count and serum ferritin measurement. Results: A total of 246 school children were studied with a response rate of 82%. The prevalence of intestinal helminthiasis was 29.7%. The different helminthes identified included Ascaris lumbricoides, Necator americanus, Trichuris trichiura, Strongyloides stercoralis. Of the population studied, 36.2% were anaemic, 15.9% had microcytosis, and 47.6% had hypochromia. The prevalence of ex-hausted iron stores was 3.7%. Serum ferritin levels were significantly lower in children with intestinal helminthiasis compared with controls. Conclusions: The findings in this study demonstrate an inverse re-lationship between intestinal helminthiasis and serum ferritin levels and this is more marked in pupils with hookworm infections. The control of intestinal hel-minthiasis and prevention of iron deficiency anaemia should be given high priority in the implementation of the school health programme.

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Adebara, O. , Ernest, S. and Ojuawo, I. (2011) Association between Intestinal Helminthiasis and Serum Ferritin Levels Among School Children. Open Journal of Pediatrics, 1, 12-16. doi: 10.4236/ojped.2011.12004.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Schwartz E. Iron Deficiency Anaemia. In: Behrman RE, Kliegman RM, Jenson HB (Eds). Nelson textbook of Paediatrics, Philadelphia: W.B. Saunders Company, 2000; 1469-1471.
[2] Olsen A, Magnussen P, Ouma JH, Friis H. The contribution of hookworm and other parasitic infections to haemoglobin and iron status among children and adults in western Kenya. Trans Roy Soc Trop Med Hyg. 1998; 92:643-649.
[3] Stoltzfus RJ, Chwaya HM, Tielsch JM, Schulze KJ. Epidemiology of iron deficiency anaemia in Zanzibar schoolchildren: the importance of hookworms. Am J Clin Nutr 1997; 65:153-159.
[4] Maziya-Dixon B, Sanusi RA, Akinyele IO, Oguntona EB. Iron status in under-5 in Nigeria: Results of the Nigeria food consumption and nutrition survey. In: Proceedings of iron deficiency in early life and challenges and progress. Lima, Peru. Abstract Tb. 98, 43.
[5] Hendrickse RG. Disorders of the blood. .In: Hendrickse RG, Barr DGD, Matthews TS, (Eds). Paediatrics in the Tropics. London: Blackwell Scientific Publications, 1991:336-372.
[6] Adedoyin MA, Awogun IA, Juergensen T. Prevalence of intestinal parasitoses in relationship to diarrhea among children in Ilorin. West Afr J Med 1990;9:83-88.
[7] Montressor A, Cromptom DWT, Gyorkos TW, Savioli L. Helminthic Control in school aged children. A guide for managers of control programme. WHO. Geneva. 2002;1.
[8] Ikpeme E, Anochie K. Intestinal helminthic infestations. In: Azubuike JC, Nkanginieme KEO (Eds). Pediatrics and Child health in a tropical region. Port Harcourt: African Educational Services.1999; 438-444.
[9] Bundy DAP, Hall A, Adjei S, Kihama C, Khoi HH. Better health, Nutrition and education for the school aged child. Trans Roy Soc Trop Med Hyg .1997; 91:1-2.
[10] Hass JD, Fairchild MW.Summary and conclusions of the International Conference on Iron Deficiency and Behavioural Development. Ann Clin Nutr.1989; 50:703- 705.
[11] Stephenson LS, Latham MC, Adams EJ Kinoti SN, Pertet A. Physical fitness, growth and appetite of Kenyan school boys with hookworm, Tricuris trichiura and Ascaris lumbricoides infections are improved four months after a single dose of Albendazole. J Nutr 1993; 123:1036-1046.
[12] Savioli L, Bundy DAP, Tomkins A. Intestinal parasitic infections: a soluble public health problem. Trans Roy Soc Trop Med Hyg. 1992; 86:353-354.
[13] Jimoh LAK. Present day Ilorin. In: Ilorin: The journey so far. Ilorin. Atoto Press Limited. 1994:8-11.
[14] Cheesbrough M. District Laboratory practice in tropical countries. Part 1.Tropical health technology. 1998: 192-196, 220.
[15] Markell EK, Examination of stool specimen In: Medical Parasitology Markell EK, Voge M, John DT eds. Philadelphia. W. B. Saunders Company. 1992 ; 406-428
[16] Adewuyi JO. Current prevalence and some clinical associations of childhood anaemia in urban communities in central Nigeria. Central Afr J Med 1992; 38:66-72.
[17] Fairbanks VF, Klee GG. Biochemical aspects of haematology. In: Tietz textbook of clinical chemistry. Philadelphia. W.B. Saunders Company.1999; 1703-1704.
[18] Dean AG, Dean JA, Coulombier D et al. Epi info version 6.0. A word processing data base and statistics programme for public health on IBM – compatible micro computers. Atlanta: Center for disease control and prevention.1995.
[19] Ighogboja IS, Ikeh EI. Parasitic agents in childhood diarrhea and malnutrition. West Afr J Med 1997; 16:21-25.
[20] Okafor CN, Azubike CN. Studies in intestinal parasitic disease agents in stools of people in a rural area in Nigeria. West Afr J Med 1992; 11:106-111.
[21] Agi IP. Comparative helminth infection of man in two rural communities of the Niger delta, Nigeria. West Afr J Med 1997; 16:232-236.
[22] Fashuyi SA. The pattern of human intestinal helminth infection in farming communities in different parts of Ondo State, Nigeria. West Afr J Med 1992; 16:102-105.
[23] Curtale F, Pezzotti P, Saad YS, Aloi A. An analysis of individual, household and environmental risk factors for intestinal helminth infection among children in Qena Governate, Upper Egypt. J Trop Paediatr 1999; 45:14-17.
[24] Ibrahim M, Odoemena DI, Ibrahim MT. Intestinal helminthic infections among primary school children in Sokoto. Sahel Med J .2000; 3:62-68.
[25] Omoigberale AI, Airauhi L, Ibadin MT. Intestinal helminthiasis amongst school children in Benin City, Nigeria. Nig J Med 1996; 30:118-122.
[26] Meremikwu MM, Anita-Obong OE Asindi AA, Ejezie GC. Nutritional status of pre-school children: relationship with intestinal helminthiasis. Nig J Med 1995; 4:40-44.
[27] Runsewe-Abiodun TI, Olowu AO, Akosode FA, Odetunde OS. Prevalence of helminthic infestation in pre-school children. Nig J Paediatr 1995; 22:81-82.
[28] Kabatereine NB, Tukahebwa EM, Brooker S, Alderman H, Hall A. Epidemiology of intestinal helminth infestations among school children in Southern Uganda. East Afr Med J 2001; 76:283-286.
[29] de Carneri I, Di Matteo L, Tedla S. A comparism of helminth infection in urban and rural areas of Addis Ababa. Trans Roy Soc Trop Med Hyg 1992; 86:540-541.
[30] Albonico M, deCarneri I, DiMatteo L, Ghiglietti R, Toscano P, Uledi MK, et al. Intestinal parasitic infections of urban and rural children on Pemba Island: implications for control. Ann Trop Med Parasitol 1993; 87:579-583.
[31] Flores A, Esteban J, Angles R, Mas-Coma S. Soil transmitted helminthic infections at very high altitude in Bolivia. Trans Roy Soc Trop Med Hyg. 2001; 95:272-277.
[32] Gbakima AA, Sherpard M, White PT. Intestinal helminth infections in rural school children in Njala, Sierra Loene. East Afr Med J 1994; 71:792-796.
[33] Phiri K, Whitty CJM, Graham SM, Ssembatya-lule G. Urban/rural differences in prevalence and risk factors for intestinal helminth infections in Southern Malawi. Ann Trop Med Parasitol 2000; 94:381-387.
[34] Musa OI. Intestinal Helminthiasis among students seen during school entrance medical examination in Ilorin .J comm. Med Pri Hlth 1997; 9:35-41.
[35] Elekwa DE, Ikeh EI,. A survey of the incidence of intestinal parasites amongst primary school children in relation to socio-economic factors in Jos, Nigeria. Nig Med Pract 1996; 31:60-62.
[36] Azubike JC, Izuora GI, Obi GO. Anaemia in nonsickling children around Enugu. Trop Geogr Med 1977; 29:365-268.
[37] Fleming AF, Werbinska B.Anaemia in childhood in the guinea savanna of Nigeria. Annals Trop Paed 1982; 2:161-173.
[38] Akenzua GI, Ihongbe JC, Imasuen VI, Mwobi BC. Anaemia on children: a survey in Obadan, a rural community in the rain forest zone of Nigeria. J Trop Paed 1985; 31: 20-24.
[39] Akinkugbe FM. Prevalence of anaemia in an urban population (University College Hospital GOPD). J Trop Paediatr Env Child Hlth 1977; 23: 271-275.
[40] Islek I, Kucukoduk S, Cetinkaya F, Gurses N. Effects of Ascaris infection on iron absorption in children. Annals Trop Med Parasitol.1983; 87:477-481.
[41] Bundy DAP, Cooper ES. Trichuris and trichuriasis in humans. Advances in Parasitology.1989; 28:107-173.
[42] Warren KS, Bundy DAP, Anderson RM. Helminth infection. In: Jamison DT, Mosley WH, Measham AR, Bobadilla JL (Eds). Disease control priorities in developing countries. New York: University Press. 1993:131-160.

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