Concurrent infections and socioeconomic determinants of geohelminth infection: a community study of schoolchildren in periurban Guinea-Bissau

We explored the association between subclinical intestinal helminth infections and other gastrointestinal pathogens in 706 schoolchildren from a poor semirural area while adjusting for socioeconomic risk factors. The study was carried out in two neighbouring areas in the capital of Guinea-Bissau in West Africa. Children aged 4-12 years were visited and one child per mother was invited to participate in the study. Among the 706 children included in the study, helminths were detected in 44.2%, enteropathogenic bacteria in 13.7%, protozoans in 51.1% and rotavirus in 5.9%. A total of 76.1% had an infection of some sort and 41.8% were concomitantly infected with more than one and up to five gastrointestinal pathogens. After adjustment for possible confounding factors, infection with helminths and Entamoeba histolytica/E. dispar remained associated. Other risk factors for helminths included increasing age, male gender, small mid-upper arm circumference and chicken husbandry. Maternal school attendance and belonging to a Muslim family were associated with a lower prevalence of helminths. Investigations of concomitant infections are valuable as they may have implications for control and treatment strategies.