Abstract:
Background: Hookworm and Plasmodium falciparum are endemic in Ghana, especially in the
north-east and middle belt areas. Haematological parameters have been shown to predict the
presence of these infections in patients. This study investigated the effect of hookworm-P.
falciparum co-infection on haematological parameters among the patients.
Methodology: Stool and blood samples from 984 participants in a cross-sectional study conducted in the Kintampo North Municipality of Ghana were examined for hookworm and Plasmodium
falciparum parasites. Malaria parasitaemia was estimated by microscopy and Plasmodium
falciparum-specific 18S rRNA gene by polymerase chain reaction. Hookworm eggs in faecal
samples were analyzed using Kato-Katz and formol-ether concentration methods. Hookworm
speciation was done by PCR. Estimation of haematological parameters was done by automated
haematology analyzer. Tukey multiple comparisons test was used to compare continuous variables
among the infected groups and Spearman’s rank correlation test determined the relationships
between variables.
Results: The overall mean (SD) age of the study participants was 22.8 (17.4). Mean lymphocytes
and eosinophils counts were higher while mean neutrophil and monocytes counts were lower in the
co-infected individuals compared to the single infections. The mean red blood cell (RBC) count and
haemoglobin (Hb) levels were higher in the co-infected individuals than in those with malaria only
infection. However, white blood cell count and platelet counts were not statistically significant
among the groups. There was a significant negative correlation between malaria parasite density
and Hb level (r = - 0.239, p = 0.001)
Conclusion: Hookworm and Plasmodium falciparum co-infections showed an increased in
lymphocyte, eosinophil count and Haemoglobin levels, but a decrease in neutrophil and monocyte
levels compared to malaria only infection. The possible mechanisms accounting for the variations in
haematological levels remain to be elucidated.
