In order to estimate the potential benefits of interventions
against multiple geohelminth species in endemic areas, an
improved understanding of the population biology of multiple infections
is required. This paper presents a detailed
analysis of the associations among Ascaris lumbricoides,
Trichuris trichiura and hookworm infections in 1539 schoolchildren
on Pemba Island, Tanzania, where 58% of the sampled children
carried infections of all 3 parasites at the time of the
study. Infection intensities of different species were
positively correlated, and individuals with single-species infections
had generally lower species-specific egg counts than individuals
with multiple-species infections. There was no age- or
sex-related clustering of infections. A weak clustering of
intense infections among individuals with multiple-species
infections was observed, which became more pronounced as the
threshold defining an intense infection increased for each
species. The results suggest that individuals with multiple species
infections are likely to be at highest risk of geohelminth-related
morbidity, not only because of the number of infections they harbour,
but also because they generally carry heavier
infections of each species.