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Kim ES, Adriko M, Oseku KC, Lokure D, Webb EL, Sabapathy K. Factors associated with hookworm and Schistosoma mansoni infections among school-aged children in Mayuge district, Uganda. BMC Public Health 2024; 24:1620. [PMID: 38886749 PMCID: PMC11184691 DOI: 10.1186/s12889-024-19092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Hookworm infection and schistosomiasis are two of sub-Saharan Africa's most common neglected tropical diseases. An annual mass drug administration (MDA) program against schistosomiasis and soil-transmitted helminths (STHs), including hookworm, has been implemented in Mayuge district, Uganda, since 2003 to date. However, hookworm and schistosomiasis remain prevalent in Mayuge district. Understanding the factors that predispose children to these infections in the context of MDA could inform interventions to reduce prevalence in Uganda and similar settings. METHOD This cross-sectional study took place in 33 randomly selected primary schools in the Mayuge district from January to February 2022. Children in primary classes 4 or 5, in the selected schools provided single stool samples and completed questionnaires. Stool specimens were examined using the Kato-Katz method to determine the prevalence of hookworm and schistosomiasis. We performed univariable and multivariable logistic regression to assess the associations of each infection with potential risk factors. RESULT A total of 1,617 students (mean age 12.1 years, 50.1% male) were enrolled. The prevalence of hookworm infection and schistosomiasis was 21.8% (95% confidence interval (CI): 19.8-23.9%) and 18.7% (95% CI: 16.8-20.7%), respectively. In multivariable analysis, longer water fetching time (over 30 min versus less than 30 min) and working daily in the soil were associated with increased odds of hookworm infection (adjusted odds ratio (AOR): 1.49, 95% CI: 1.13-1.96 and 1.37, 95% CI: 1.03-1.82, respectively). Higher odds of schistosomiasis were linked to proximity to water bodies within a one-hour walking distance (AOR: 1.84, 95% CI: 1.35-2.50), and not always washing hands before eating (AOR: 2.00, 95% CI: 1.50-2.67). Swimming, bathing, or washing in water bodies twice a week, compared to never, also increased schistosomiasis odds (AOR: 2.91, 95% CI: 1.66-5.13). CONCLUSION Consistent with the mechanisms of acquisition, hookworm infection increased with exposure to soil, and schistosomiasis increased with exposure to unclean water. Our findings highlight the importance of Water, Sanitation, and Hygiene programs and strategies aimed at reducing exposure within the framework of Neglected Tropical Disease elimination programs.
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Affiliation(s)
- Eun Seok Kim
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
- World Vision Korea, Seoul, Korea.
| | - Moses Adriko
- Vector-Borne and NTDs Control Division, Ministry of Health, Kampala, Uganda
| | | | - David Lokure
- Information and Technology Sector, Kotido District Local Government, Kotido, Uganda
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Kalpana Sabapathy
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Njambe Priso GD, Lissom A, Ngu LN, Nji NN, Tchadji JC, Tchouangueu TF, Ambada GE, Ngane CSS, Dafeu BL, Djukouo L, Nyebe I, Magagoum S, Ngoh AA, Herve OF, Garcia R, Gutiérrez A, Okoli AS, Esimone CO, Njiokou F, Park CG, Waffo AB, Nchinda GW. Filaria specific antibody response profiling in plasma from anti-retroviral naïve Loa loa microfilaraemic HIV-1 infected people. BMC Infect Dis 2018; 18:160. [PMID: 29618330 PMCID: PMC5885382 DOI: 10.1186/s12879-018-3072-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/26/2018] [Indexed: 12/14/2022] Open
Abstract
Background In West and Central Africa areas of endemic Loa loa infections overlap with regions of high prevalence of human immunodeficiency virus type 1 (HIV-1) infections. Because individuals in this region are exposed to filarial parasites from birth, most HIV-1 infected individuals invariably also have a history of filarial parasite infection. Since HIV-1 infection both depletes immune system and maintains it in perpetual inflammation, this can hamper Loa loa filarial parasite mediated immune modulation, leading to enhanced loaisis. Methods In this study we have assessed in plasma from asymptomatic anti-retroviral (ARV) naïve Loa loa microfilaraemic HIV-1 infected people the filarial antibody responses specific to a filariasis composite antigen consisting of Wbgp29-BmR1-BmM14-WbSXP. The antibody responses specific to the filariasis composite antigen was determined by enzyme linked immunosorbent assay (ELISA) in plasma from ARV naïve Loa loa microfilaraemic HIV-1 infected participants. In addition the filarial antigen specific IgG antibody subclass profiles were also determined for both HIV-1 positive and negative people. Results Both Loa loa microfilaraemic HIV-1 positive and negative individuals showed significantly higher plasma levels of IgG1 (P < 0.0001), IgG2 (P < 0.0001) and IgM (P < 0.0001) relative to amicrofilaraemic participants. A significant increase in IgE (P < 0.0001) was observed exclusively in Loa loa microfilaraemic HIV-1 infected people. In contrast there was a significant reduction in the level of IgG4 (p < 0.0001) and IgG3 (P < 0.0001) in Loa loa microfilaraemic HIV-1 infected individuals. Conclusions Loa loa microfilaraemia in ARV naïve HIV-1 infected people through differential reduction of plasma levels of filarial antigen specific IgG3, IgG4 and a significant increase in plasma levels of filarial antigen specific IgE could diminish Loa loa mediated immune-regulation. This in effect can result to increase loaisis mediated immunopathology in antiretroviral naive HIV-1 infected people.
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Affiliation(s)
- Ghislain Donald Njambe Priso
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Abel Lissom
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Loveline N Ngu
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biochemistry, University of Yaounde I, Yaounde, Cameroon
| | - Nadesh N Nji
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon
| | - Jules Colince Tchadji
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Thibau Flaurant Tchouangueu
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biochemistry, University of Dschang, Yaounde, Cameroon
| | - Georgia E Ambada
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Carole Stéphanie Sake Ngane
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of Microbiology, University of Yaounde I, Yaounde, Cameroon.,Department of biochemistry, University of Yaounde I, Yaounde, Cameroon
| | - Brigitte Laure Dafeu
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Larissa Djukouo
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biochemistry, University of Yaounde I, Yaounde, Cameroon
| | - Inès Nyebe
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of Microbiology, University of Yaounde I, Yaounde, Cameroon
| | - Suzanne Magagoum
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Apeh Alfred Ngoh
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biomedical sciences, University of Dschang, Dschang, Cameroon
| | - Ouambo Fotso Herve
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of medical laboratory sciences, University of Buea, Buea, Cameroon
| | - Rosario Garcia
- CSCB (Centre de santé catholique de Bikop), Bikop, Cameroon
| | - Anna Gutiérrez
- CSCB (Centre de santé catholique de Bikop), Bikop, Cameroon
| | | | - Charles O Esimone
- Department of Pharmaceutical Microbiology & Biotechnology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Flobert Njiokou
- Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Chae Gyu Park
- Laboratory of Immunology, Brain Korea 21 PLUS Project for Medical Science, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Alain Bopda Waffo
- Department of Biological Sciences, College STEM, 1627 Hall Street, Montgomery, AL, 36101, USA.,Center for NanoBiotechnology Research, 1627 Harris Way, Montgomery, AL, 36104, USA
| | - Godwin W Nchinda
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.
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Dickson BFR, Graves PM, McBride WJ. Lymphatic Filariasis in Mainland Southeast Asia: A Systematic Review and Meta-Analysis of Prevalence and Disease Burden. Trop Med Infect Dis 2017; 2:E32. [PMID: 30270890 PMCID: PMC6082107 DOI: 10.3390/tropicalmed2030032] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/17/2017] [Accepted: 07/17/2017] [Indexed: 01/15/2023] Open
Abstract
Accurate prevalence data are essential for the elimination of lymphatic filariasis (LF) as a public health problem. Despite it bearing one of the highest burdens of disease globally, there remains limited reliable information on the current epidemiology of filariasis in mainland Southeast Asia. We conducted a systematic review and meta-analysis of available literature to assess the recent and current prevalence of infection and morbidity in the region. Fifty-seven journal articles and reports containing original prevalence data were identified, including over 512,010 participants. Data were summarised using percentage prevalence estimates and a subset combined using a random effects meta-analysis by country and year. Pooled estimates for microfilaraemia, immunochromatographic card positivity and combined morbidity were 2.64%, 4.48% and 1.34% respectively. Taking into account pooled country estimates, grey literature and the quality of available data, we conclude that Lao People's Democratic Republic (PDR), Myanmar and Northeast India demonstrate ongoing evidence of LF transmission that will require multiple further rounds of mass drug administration. Bangladesh, Malaysia, Thailand and Vietnam appear close to having eliminated LF, whilst Cambodia has already achieved elimination status. We estimate that the burden of morbidity is likely high in Thailand; moderate in Cambodia, Myanmar, and Northeast India; and low in Bangladesh. There was insufficient evidence to accurately estimate the disease burden in Lao PDR, Malaysia or Vietnam. The results of this study indicate that whilst considerable progress toward LF elimination has been made, there remains a significant filariasis burden in the region. The results of this study will assist policy makers to advocate and budget for future control programs.
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Affiliation(s)
- Benjamin F R Dickson
- College of Medicine & Dentistry, James Cook University, Cairns, QLD 4870, Australia.
| | - Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD 4870, Australia.
| | - William J McBride
- College of Medicine & Dentistry, James Cook University, Cairns, QLD 4870, Australia.
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Adjobimey T, Hoerauf A. Induction of immunoglobulin G4 in human filariasis: an indicator of immunoregulation. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2011; 104:455-64. [PMID: 20863434 PMCID: PMC3065634 DOI: 10.1179/136485910x12786389891407] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Filarial parasites are known to induce a large range of immunoregulatory mechanisms, including the induction of alternatively activated macrophages and regulatory T cells. These mechanisms are used to evade and down-modulate the host's immune system, to support parasite survival. Several reports have focused on some of these mechanisms, in humans and murine models, but the complex immunoregulatory networks associated with filarial infections remain unclear. Recent publications have conferred a role for regulatory T cells in the ability of helminth parasites to modulate human immune responses, such cells promoting the induction of the non-complement-fixing immunoglobulin G4 (IgG4). High plasma concentrations of IgG4 have been reported in hypo-responsive and asymptomatic cases of helminth infection. In both human lymphatic filariasis and onchocerciasis, the asymptomatic infections are characterised by high plasma concentrations of IgG4 (compared with those of IgE) and of the complement-fixing antibodies IgG1, IgG2 and IgG3. In asymptomatic filarial infection, elevations in IgG4 are also often associated with high worm loads and with high plasma levels of the immunomodulatory interleukin-10. Here, various aspects of the induction of IgG4 in humans and it roles in the immunomodulation of the human responses to filarial parasites are reviewed.
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Affiliation(s)
- T Adjobimey
- Institute for Medical Microbiology, Immunology and Parasitology, University Clinic Bonn, Germany
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