Comparative Analysis of Haematological Parameters in Hookworm and Plasmodium falciparum Co-Infected Individuals in Kintampo North Municipality, Ghana

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.