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

BI STELLA CHE ¹, NGUM HELEN NTONIFOR ^2*, KATAMSSADAN HAMAN TOFEL ³, VANESSA TITA JUGHA ⁴, BERTRAND YUWONG WANYU ⁴, GERMAIN SOTOING TAIWE ⁴ 

¹Department of Microbiology and Parasitology, Faculty of Science, The University of Bamenda, P.O. Box 39, Bamenda, Cameroon. 

²Department of Zoology, Faculty of Science, The University of Bamenda, P.O. Box 39, Bamenda, Cameroon. 

³Department of Phytosanitary Protection, Higher Institute of Agriculture, Wood, Water Resources and Environment, The University of Bertoua, P.O. Box 416, Bertoua, Cameroon. 

⁴Department of Animal Biology and Conservation, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon. 

*Corresponding Author: ngumnto@yahoo.com, +237 675 21 31 56.

Received: 03 Jun 2025, Reviewed: 02 Jul 2025, Revised: 22 Jul 2025, Accepted: 05 Aug 2025, Published: 22 Oct 2025.

https://doi.org/10.63342/cjbbs2025.33.022.fr

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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.

RÉSUMÉ

Le Cameroun est l’un des pays d’Afrique subsaharienne où le paludisme et les helminthes intestinaux sont endémiques. L’étude a évalué l’influence du paludisme et des helminthes intestinaux sur les paramètres hépatiques au sein des forces armées des régions du Nord-Ouest et du Sud-Ouest du Cameroun. Il s’agissait d’une étude transversale menée entre mai 2022 et avril 2023. Un total de 812 échantillons de selles et de sang veineux ont été prélevés chez des hommes âgés de 18 à 52 ans afin d’identifier le paludisme et les parasites intestinaux et d’évaluer les paramètres hépatiques. La coloration au Giemsa et les méthodes microscopiques de Kato-Katz ont été utilisées pour l’identification des parasites, tandis que le test immuno-enzymatique (ELISA) a été utilisé pour l’évaluation des paramètres hépatiques. Les comparaisons statistiques ont été effectuées à l’aide du logiciel SPSS (Statistical Package for Social Sciences). Les résultats obtenus ont identifié Plasmodium falciparum (11,9 %) et Plasmodium vivax (1,7 %). Cinq espèces différentes d’helminthes intestinaux ont été identifiées, parmi lesquelles Ascaris lumbricoides était la plus répandue (4,7 %) et l’espèce la moins répandue était Schistosoma intercalatum (1,2 %). Le taux global de co-infection était de 3,2 %. Les parasites du paludisme ont affecté de manière significative les valeurs de tous les paramètres hépatiques (aspartate transaminase : p = 0,003 ; alanine transaminase : p = 0,002 ; phosphatase alcaline : p = 0,000 ; bilirubine totale : p = 0,001) ; tandis que l’infection par Trichuris trichiura et Schistosoma mansoni a influencé de manière significative la phosphatase alcaline (p = 0,000) et (p = 0,007) respectivement. Schistosoma mansoni a également affecté de manière significative la valeur de l’aspartate transaminase (p = 0,018). La co-infection par le paludisme et les helminthes intestinaux a eu une influence significative sur les valeurs de tous les paramètres hépatiques à p = 0,000. Les densités de parasites Plasmodium étaient positivement corrélées aux paramètres hépatiques et étaient statistiquement significatives à p = 0,0008 avec l’AST et à p = 0,0004 avec l’ALT. Ascaris lumbricoide, les ankylostomes, S. mansoni et S. intercalatum étaient négativement corrélés aux paramètres hépatiques tandis que T. trichiura était positivement corrélé à ces paramètres. Pour améliorer la prise en charge des complications hépatiques, nous recommandons d’ajouter des évaluations de la fonction hépatique aux évaluations de routine du paludisme et des helminthes intestinaux dans les zones d’endémie.

Mots-clés: Paludisme, Helminthes intestinaux, Paramètres hépatiques, Forces armées.

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