Schistosomiasis, soil-transmitted helminthiasis, and sociodemographic factors influence quality of life of adults in Côte d'Ivoire

Abstract

Background: Burden of disease estimates are widely used for priority setting in public health and disability-adjusted life years are a powerful "currency" nowadays. However, disability weights, which capture the disability incurred by a typical patient of a certain condition, are fundamental to such burden calculation and their determination remains a widely debated issue.

Methodology: A cross-sectional epidemiological survey was conducted in the recently established Taabo health demographic surveillance system (HDSS) in south-central Côte d'Ivoire, to provide new, population-based evidence on the disability caused by schistosomiasis and soil-transmitted helminthiasis. Parasitological results from stool, urine, and blood examinations were juxtaposed to quality of life (QoL) questionnaire results from 187 adults. A multivariable linear regression model with stepwise backward elimination was used to identify significant associations, considering also sociodemographic characteristics obtained from the Taabo HDSS database.

Principal findings: Prevalences for hookworm, Plasmodium spp., Trichuris trichiura, Schistosoma haematobium and Schistosoma mansoni were 39.0%, 18.2%, 2.7%, 2.1% and 2.1%, respectively. S. mansoni and T. trichiura infections of any intensity reduced the participants' self-rated QoL by 16 points (95% confidence interval (CI): 4-29 points) and 13 points (95% CI: 1-24 points), respectively, on a scale from 0 (worst QoL) to 100 points (best QoL). The only other statistically significant effect was a 1-point (95% CI: 0.1-2 points) increase on the QoL scale per one unit increase in a calculated wealth index.

Conclusions/significance: We found consistent and significant results on the negative effects of schistosomiasis and soil-transmitted helminthiasis on adults' self-rated QoL, also when taking sociodemographic characteristics into account. Our results warrant further investigation on the disability incurred by helmintic infections and the usefulness of generic QoL questionnaires in this endeavor.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1. Map of the Taabo health demographic surveillance system (HDSS) and predefined survey locations.

The study was carried out in June 2010, readily embedded in the second annual cross-sectional epidemiological survey of the Taabo HDSS.

Figure 2. Flow chart of the study procedure in the field.

The study was carried out in June 2010, readily embedded in the second annual cross-sectional epidemiological survey of the Taabo health demographic surveillance system (HDSS). In the frame of this second annual cross-sectional epidemiological survey, the whole population of the Taabo HDSS was offered anthelmintic treatment with albendazole and ivermectin. At the same time, people selected for an in-depth clinical and parasitological examination were invited to visit a series of different posts, including a quality of life (QoL) questionnaire for heads of households and a second adult household member of the opposing sex.

Figure 3. Flow chart of the participation and compliance in the present study.

The study was carried out in June 2010, readily embedded in the second annual cross-sectional epidemiological survey of the Taabo health demographic surveillance system.

Figure 4. Box plots illustrating the different domain and overall quality of life scores as revealed in the present study.

The study was carried out in June 2010, readily embedded in the second annual cross-sectional epidemiological survey of the Taabo health demographic surveillance system. The different domain and overall quality of life (QoL) scores were obtained through questionnaire-based QoL interviews with the study participants. The participants' scores were measured on a scale from 0 to 100, as detailed on the y-axis of the figure, with higher scores indicating higher wellbeing. Domain 1, environmental wellbeing; domain 2, psychological wellbeing; domain 3, physical wellbeing; domain 4, social wellbeing. Box plot: the ends of the box represent the 25th and 75th percentile of the scores; the middle line represents the median; the lower whisker represents the lowest value between the lower quartile and the lower quartile−1.5*(interquartile range); the upper whisker represents the highest value between the upper quartile and the upper quartile+1.5*(interquartile range); the small squares, triangles, and crosses indicate outliers.