Liver Function Alterations in Armed Forces Infected with Malaria and Intestinal Helminths in Cameroon’s North West and South West Regions

Abstract

Cameroon is one of the sub-Saharan countries where malaria and intestinal helminths are endemic. The study evaluated the influence of malaria and intestinal helminths on liver parameters among armed forces in the North West and South West regions of Cameroon. This was a cross-sectional study conducted between May 2022 and April 2023. A total of 812 stool and venous blood samples were collected from males aged 18 to 52 years to identify malaria and intestinal parasites and to evaluate liver parameters. Giemsa staining and Kato-Katz microscopic methods were used for parasite identification, while the enzyme-linked immunosorbent assay (ELISA) was used for liver parameters evaluation. Statistical comparisons were performed using the Statistical Package for Social Sciences (SPSS). Results obtained showed that Plasmodium falciparum (11.9%) and Plasmodium vivax (1.7%) were identified. Five different species of intestinal helminths were identified out of which Ascaris lumbricoides was the most prevalent (4.7%), and the least prevalent species was Schistosoma intercalatum (1.2%). The overall co-infection rate was 3.2%. Plasmodium sp significantly affected the values of all the liver parameters (Aspartate transaminase: p = 0.003; Alanine transaminase: p = 0.002; Alkaline phosphatase: p = 0.000; Total Bilirubin: p = 0.001) while Trichuris trichiura and Schistosoma mansoni infection significantly influenced Alkaline phosphatase (p = 0.000) and (p = 0.007) respectively. Schistosoma mansoni equally significantly affected the value of Aspartate transaminase (p = 0.018). Malaria and intestinal helminths co-infection significantly influenced the values of all liver parameters at p = 0.000. Plasmodium parasite densities positively correlated with liver parameters and were statistically significant at p = 0.0008 with AST and at p = 0.0004 with Alanine transaminase. Ascaris lumbricoide, Hookworms, S. mansoni, and S. intercalatum negatively correlated with liver parameters, while T. trichiura positively correlated with these parameters. To improve management of liver-related complications, we recommend adding hepatic function assessments to routine evaluations of malaria and intestinal helminths in endemic areas. Keywords: Malaria, Intestinal helminths, Liver parameters, Armed forces.