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Aung PP, Han KT, Groot W, Biesma R, Thein ZW, Htay T, Lin Z, Aye KH, Adams M, Pavlova M. Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study. Trop Med Health 2024; 52:22. [PMID: 38459581 PMCID: PMC10921590 DOI: 10.1186/s41182-024-00577-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/05/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection. METHODS A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis. RESULTS The prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman's age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy. CONCLUSIONS A comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.
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Affiliation(s)
- Poe Poe Aung
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
- Malaria Consortium, Bangkok, Thailand.
| | - Kay Thwe Han
- Department of Medical Research, Ministry of Health, Yangon, Myanmar
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Regien Biesma
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Zaw Win Thein
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Thura Htay
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Zaw Lin
- National Malaria Control Program, Ministry of Health, Mandalay, Myanmar
| | - Kyin Hla Aye
- Department of Medical Research, Ministry of Health, Yangon, Myanmar
| | - Matthew Adams
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Hauser M, Kabuya JBB, Mantus M, Kamavu LK, Sichivula JL, Matende WM, Fritschi N, Shields T, Curriero F, Kvit A, Chongwe G, Moss WJ, Ritz N, Ippolito MM. Malaria in Refugee Children Resettled to a Holoendemic Area of Sub-Saharan Africa. Clin Infect Dis 2023; 76:e1104-e1113. [PMID: 35640824 PMCID: PMC10169438 DOI: 10.1093/cid/ciac417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/06/2022] [Accepted: 05/20/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Malaria is a leading cause of morbidity and mortality in refugee children in high-transmission parts of Africa. Characterizing the clinical features of malaria in refugees can inform approaches to reduce its burden. METHODS The study was conducted in a high-transmission region of northern Zambia hosting Congolese refugees. We analyzed surveillance data and hospital records of children with severe malaria from refugee and local sites using multivariable regression models and geospatial visualization. RESULTS Malaria prevalence in the refugee settlement was similar to the highest burden areas in the district, consistent with the local ecology and leading to frequent rapid diagnostic test stockouts. We identified 2197 children hospitalized for severe malaria during the refugee crisis in 2017 and 2018. Refugee children referred from a refugee transit center (n = 63) experienced similar in-hospital mortality to local children and presented with less advanced infection. However, refugee children from a permanent refugee settlement (n = 110) had more than double the mortality of local children (P < .001), had lower referral rates, and presented more frequently with advanced infection and malnutrition. Distance from the hospital was an important mediator of the association between refugee status and mortality but did not account for all of the increased risk. CONCLUSIONS Malaria outcomes were more favorable in refugee children referred from a highly outfitted refugee transit center than those referred later from a permanent refugee settlement. Refugee children experienced higher in-hospital malaria mortality due in part to delayed presentation and higher rates of malnutrition. Interventions tailored to the refugee context are required to ensure capacity for rapid diagnosis and referral to reduce malaria mortality.
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Affiliation(s)
- Manuela Hauser
- Faculty of Medicine, University of Basel, Basel, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Jean-Bertin B Kabuya
- Department of Clinical Sciences, Tropical Diseases Research Centre, Ndola, Zambia
| | - Molly Mantus
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Luc K Kamavu
- Office of Hospital Administration, Saint Paul's General Hospital, Nchelenge, Zambia
| | - James L Sichivula
- Department of Clinical Sciences, Tropical Diseases Research Centre, Ndola, Zambia
| | - Wycliffe M Matende
- United Nations High Commissioner for Refugees, Country Representation Office, Lusaka, Zambia
| | - Nora Fritschi
- Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital, Basel, Switzerland.,Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Timothy Shields
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Frank Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anton Kvit
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gershom Chongwe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - William J Moss
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicole Ritz
- Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital, Basel, Switzerland.,Infectious Disease and Vaccinology Unit, University Children's Hospital Basel, University of Basel, Basel, Switzerland.,Department of Pediatrics, The Royal Children's Hospital Melbourne, The University of Melbourne, Melbourne, Australia.,Department of Paediatrics and Paediatric Infectious Diseases, Children's Hospital, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Matthew M Ippolito
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Division of Clinical Pharmacology and Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abdoli A. Can helminth and malaria infections affect sex ratio at birth in sub-Saharan Africa? Ideas and hypothesis. Trans R Soc Trop Med Hyg 2022; 116:1223-1225. [PMID: 35947958 DOI: 10.1093/trstmh/trac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 01/19/2023] Open
Abstract
The sex ratio (ratio of boys to girls) at birth (SRB) is about 1.05 (about 105 males to 100 females) under normal conditions and could be an indicator for monitoring demographic changes. Generally, in comparison with female fetuses, the male fetus is biologically weaker and more vulnerable to prenatal events. SRB is influenced by various factors, such as maternal malnourishment. Remarkably, maternal malnourishment and less energy intake are pivotal factors for declining SRB in humans. As estimates, the SRB is below the normal range in sub-Saharan Africa (1.03) than the normal range (1.05). On the other hand, both malaria and helminth infections are hyperendemic in sub-Saharan Africa and both diseases are associated with maternal malnourishment. Hence, an important question arises, could declining SRB in sub-Saharan Africa be influenced by malaria and helminth infections? Cumulative evidence suggests that malaria and helminth infections could influence SRB by induction of maternal malnourishment. This hypothesis provides new ideas about the variation of SRB in some regions of the world where helminths and malaria are endemic.
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Affiliation(s)
- Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, PO Box 74148-46199, Jahrom, Iran.,Department of Parasitology and Mycology, Jahrom University of Medical Sciences, PO Box 74148-46199, Jahrom, Iran
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Adukpo S, Adedoja A, Esen M, Theisen M, Ntoumi F, Ojurongbe O. Humoral antimalaria immune response in Nigerian children exposed to helminth and malaria parasites. Front Immunol 2022; 13:979727. [PMID: 36159869 PMCID: PMC9494551 DOI: 10.3389/fimmu.2022.979727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/16/2022] [Indexed: 11/14/2022] Open
Abstract
Background Malaria and helminthic parasites are endemic in tropical countries, and co-infections might influence host-parasite interactions. In this community-based cross-sectional study, the effect that the presence of soil-transmitted helminths (STH) (Hookworm, Hymenolepis nana) and Schistosoma haematobium infections could have on the immunoglobulin (Ig) candidate protein of the malaria vaccine GMZ2 levels was evaluated. Methods Blood, stool, and urine samples were collected from 5-15-year-old children to diagnose P. falciparum (Pf), STH, and Schistosoma haematobium, respectively. Identification and quantification of the parasite load of STH and S. haematobium were achieved by light microscopy. A polymerase chain reaction was carried out to detect submicroscopic infections of P. falciparum. Plasma levels of GMZ2 specific IgG and its subclasses were quantified by ELISA. Results The median level of total IgG in individuals with co-infection with Pf/H. nana was significantly lower in the mono-infected group with Pf (p = 0.0121) or study participants without infection (p=0.0217). Similarly, the median level of IgG1 was statistically lower in Pf/H. nana group compared to Pf-group (p=0.0137). Equally, the Pf/H. nana infected individuals posted a lower level of IgG1 compared to Pf-group (p=0.0137) and IgG4 compared to the Pf-group (p=0.0144). Spearman rank correlation analyses indicated positive relationships between the densities of H. nana (ρ=0.25, p=0.015) and S. haematobium (ρ=0.36, p<0.0001). Conclusions Hookworm and H. nana infections are associated with reduced GMZ2 specific IgG levels. This study shows the possible manipulation of immune responses by helminths for their survival and transmission, which may have serious implications for vaccine development and deployment in helminth-endemic regions.
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Affiliation(s)
- Selorme Adukpo
- Department of Pharmaceutics and Microbiology, School of Pharmacy, University of Ghana, Accra, Ghana
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Ayodele Adedoja
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
- Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Meral Esen
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Michael Theisen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Centre for Medical Parasitology at the Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Francine Ntoumi
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Infectious Disease Department, Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
| | - Olusola Ojurongbe
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
- Centre for Emerging and Re-emerging Infectious Disease, Humboldt-Bayer Foundations Research Hub, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- *Correspondence: Olusola Ojurongbe,
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Afolabi MO, Adebiyi A, Cano J, Sartorius B, Greenwood B, Johnson O, Wariri O. Prevalence and distribution pattern of malaria and soil-transmitted helminth co-endemicity in sub-Saharan Africa, 2000-2018: A geospatial analysis. PLoS Negl Trop Dis 2022; 16:e0010321. [PMID: 36178964 PMCID: PMC9555675 DOI: 10.1371/journal.pntd.0010321] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 10/12/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Limited understanding exists about the interactions between malaria and soil-transmitted helminths (STH), their potential geographical overlap and the factors driving it. This study characterised the geographical and co-clustered distribution patterns of malaria and STH infections among vulnerable populations in sub-Saharan Africa (SSA). METHODOLOGY/PRINCIPAL FINDINGS We obtained continuous estimates of malaria prevalence from the Malaria Atlas Project (MAP) and STH prevalence surveys from the WHO-driven Expanded Special Project for the Elimination of NTDs (ESPEN) from Jan 1, 2000, to Dec 31, 2018. Although, MAP provides datasets on the estimated prevalence of Plasmodium falciparum at 5km x 5km fine-scale resolution, we calculated the population-weighted prevalence of malaria for each implementation unit to ensure that both malaria and STH datasets were on the same spatial resolution. We incorporated survey data from 5,935 implementation units for STH prevalence and conducted the prevalence point estimates before and after 2003. We used the bivariate local indicator of spatial association (LISA analysis) to explore potential co-clustering of both diseases at the implementation unit levels among children aged 2-10 years for P. falciparum and 5-14 years for STH, living in SSA. Our analysis shows that prior to 2003, a greater number of SSA countries had a high prevalence of co-endemicity with P.falciparium and any STH species than during the period from 2003-2018. Similar prevalence and distribution patterns were observed for the co-endemicity involving P.falciparum-hookworm, P.falciparum-Ascaris lumbricoides and P.falciparum-Trichuris trichiura, before and after 2003. We also observed spatial variations in the estimates of the prevalence of P. falciparum-STH co-endemicity and identified hotspots across many countries in SSA with inter-and intra-country variations. High P. falciparum and high hookworm co-endemicity was more prevalent in West and Central Africa, whereas high P. falciparum with high A. lumbricoides and high P. falciparum with high T. trichiura co-endemicity were more predominant in Central Africa, compared to other sub-regions in SSA. CONCLUSIONS/SIGNIFICANCE Wide spatial heterogeneity exists in the prevalence of malaria and STH co-endemicity within the regions and within countries in SSA. The geographical overlap and spatial co-existence of malaria and STH could be exploited to achieve effective control and elimination agendas through the integration of the vertical control programmes designed for malaria and STH into a more comprehensive and sustainable community-based paradigm.
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Affiliation(s)
- Muhammed O. Afolabi
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Adekola Adebiyi
- College of Agriculture, Engineering and Environmental Design, Legacy University, Banjul, The Gambia
| | - Jorge Cano
- Expanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Benn Sartorius
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Department of Health Metric Sciences, University of Washington, Seattle, Washington, United States of America
| | - Brian Greenwood
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Olatunji Johnson
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - Oghenebrume Wariri
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia
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Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095444. [PMID: 35564842 PMCID: PMC9101176 DOI: 10.3390/ijerph19095444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/22/2022]
Abstract
Malaria and helminthic co-infection during pregnancy causes fetomaternal haemorrhage and foetal growth retardation. This study determined the pooled burden of pregnancy malaria and helminthic co-infection in sub-Saharan Africa. CINAHL, EMBASE, Google Scholar, Scopus, PubMed, and Web of Science databases were used to retrieve data from the literature, without restricting language and publication year. The Joanna Briggs Institute’s critical appraisal tool for prevalence studies was used for quality assessment. STATA Version 14.0 was used to conduct the meta-analysis. The I2 statistics and Egger’s test were used to test heterogeneity and publication bias. The random-effects model was used to estimate the pooled prevalence at a 95% confidence interval (CI). The review protocol has been registered in PROSPERO, with the number CRD42019144812. In total, 24 studies (n = 14,087 participants) were identified in this study. The pooled analysis revealed that 20% of pregnant women were co-infected by malaria and helminths in sub-Saharan Africa. The pooled prevalence of malaria and helminths were 33% and 35%, respectively. The most prevalent helminths were Hookworm (48%), Ascaris lumbricoides (37%), and Trichuris trichiura (15%). Significantly higher malaria and helminthic co-infection during pregnancy were observed. Health systems in sub-Saharan Africa must implement home-grown innovative solutions to underpin context-specific policies for the early initiation of effective intermittent preventive therapy.
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Alnaz ARM, Darlan DM, Andriyani Y, Lubis RR. Hemoglobin Level and Risk of Anemia in Soil-Transmitted Helminths Infections among Children: A Systematic Review and Meta-analysis. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction. Soil Transmitted Helminthiasis (STH) is a Neglected Tropical Disease with almost 25% world population infected. Children were vulnerable to infection with morbidities affecting growth. STH infection alters children nutritional status which potentially causing anemia. Meta-analysis relating STH infections to hemoglobin (Hb) level and risk of anemia in children is limited.
Aim. To compare hemoglobin levels and risk of anemia in children infected and uninfected with STH.
Methods. Meta-analysis conducted from journals obtained from Pubmed, ScienceDirect, WileyLibrary, Cochrane, EBSCO, Proquest, DOAJ, and GoogleScholar from 2011-2021. Full text cross sectional studies on children with relevant topic is included, while unclear, inaccessible, or post interventional studies were excluded. Articles were analyzed in Review Manager 5.4 in mean difference (MD) and odds ratio (OR) with Confidence Interval (CI) of 95%.
Result. Out of 25,683 articles in literature search, 29 were eligible for systematic review and meta-analysis. STH infection significantly decreases hemoglobin level (MD -0.2g/dL; p=0.02) and increases risk of anemia (OR 1.83; p<0.00001). Species analysis presented parallel result on Trichuris trichiura (MD -0.31g/dL; p=0.001 and OR 1.66; p=0.009), Hookworm (MD -0.56g/dL; p=0.02 and OR 3.3; p<0.00001), and multiple infection (MD -0.25g/dL; p=0.03 and OR 4.49; p=0.005). Ascaris lumbricoides didn’t show significance on hemoglobin level but comparable for risk of anemia (MD -0.16g/dL; p=0.17 and OR 1.57; p=0.001).
Discussion. All STH infections exhibits lower hemoglobin level and higher risk of anemia caused by lower nutrition absorption and occult bleeding in gastrointestinal tract. Hookworm and multiple infections has the highest risk of anemia. Proportion of anemia may vary in studies and influenced by sociodemographic characteristics, but higher proportions occur in STH infected.
Conclusion. Children infected with STH has lower hemoglobin level and in risk of anemia compared to uninfected children, hence further study is still needed to be conducted.
Keywords: Anemia, Children, Hemoglobin, Infection, Soil Transmitted Helminths
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Dila KAS, Reda A, Elhady MT, Linh LK, Minh-Duc NT, El-Qushayri AE, Han NL, Mehta V, Hamad WMA, Eskarous H, Samsom M, Hirayama K, Huy NT. Association of anthelmintic treatment with malaria prevalence, incidence, and parasitemia: A systematic review and meta-analysis. Acta Trop 2022; 225:106213. [PMID: 34687649 DOI: 10.1016/j.actatropica.2021.106213] [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: 09/01/2020] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 11/29/2022]
Abstract
A chronic helminth infection can alter host immune response and affect malaria infection. We conducted a systematic review and meta-analysis to find the impact of anthelmintic treatment on malaria prevalence, incidence, and parasitemia. Nine and 12 electronic databases were searched on 28th July 2015 and 26th June 2020 for relevant studies. We performed meta-analysis for malaria prevalence, incidence, parasitemia, and a qualitative synthesis for other effects of anthelmintic treatment. Seventeen relevant papers were included. There was no association between anthelmintic treatment and malaria prevalence or change of parasitemia at the end of follow up period (pooled OR 0.93, 95% CI: 0.62, 1.38, p-value=0.71 and SMD -0.08, 95%CI: -0.24, 0.07, p-value=0.30 respectively) or at any defined time points in analysis. Pooled analysis of three studies demonstrated no association between malaria incidence and anthelmintic treatment (rate ratio 0.93, 95%CI: 0.80, 1.08, p-value=0.33). Our study encourages anthelmintic treatment in countries with high burden of co-infections as anthelmintic treatment is not associated with change in malaria prevalence, incidence, or parasitemia.
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Affiliation(s)
- Kadek Agus Surya Dila
- Pratama Giri Emas Hospital, Singaraja City, 81171 Buleleng, Bali, Indonesia; Online Research Club: http://www.onlineresearchclub.org/
| | - Ahmed Reda
- Online Research Club: http://www.onlineresearchclub.org/; Faculty of Pharmacy, Tanta University, Gharbia 31511, Egypt
| | - Mohamed Tamer Elhady
- Online Research Club: http://www.onlineresearchclub.org/; Department of Pediatrics, Zagazig University Hospital, Sharkia 44511, Egypt
| | - Le Khac Linh
- Online Research Club: http://www.onlineresearchclub.org/; College of Health Sciences, Vin University, Hanoi 100000, Vietnam
| | - Nguyen Tran Minh-Duc
- Online Research Club: http://www.onlineresearchclub.org/; University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam
| | - Amr Ehab El-Qushayri
- Online Research Club: http://www.onlineresearchclub.org/; Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Nguyen Lac Han
- Online Research Club: http://www.onlineresearchclub.org/; University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam
| | - Varshil Mehta
- Online Research Club: http://www.onlineresearchclub.org/; Internal Medicine Trainee, Department of Cardiology, Lister Hospital, Stevenage, United Kingdom
| | - Walid Mohamed Attiah Hamad
- Online Research Club: http://www.onlineresearchclub.org/; Departement of Internal Medicine, Zagazig University, Zagazig 44511, Egypt
| | - Hany Eskarous
- Online Research Club: http://www.onlineresearchclub.org/; Minya University, Faculty of Medicine, Egypt, Internal Medicine Resident, Easton Hospital, Easton City 18042, Pennsylvania
| | - Maryan Samsom
- Online Research Club: http://www.onlineresearchclub.org/; Internal Medicine Department, Faculty of Medicine, Egypt, Internal Medicine Resident, Jersey Shore University Medical Center, 07753 New Jersey, United States
| | - Kenji Hirayama
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
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Byrne A, Manalo G, Clarke NE, Vaz Nery S. Impact of hookworm infection and preventive chemotherapy on haemoglobin in non-pregnant populations. Trop Med Int Health 2021; 26:1568-1592. [PMID: 34587315 DOI: 10.1111/tmi.13681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the impact of hookworm infection and preventive chemotherapy on haemoglobin levels in non-pregnant populations in endemic areas. METHOD Systematic review and meta-analysis searching PubMed and Web of Science for articles published since 2010 reporting either hookworm prevalence and Hb concentration (cross-sectional studies) or Hb concentration before and after the implementation of preventive chemotherapy (before-after studies and randomised controlled trials [RCTs]). For papers published before 2010, data were extracted from a previously published systematic review. Random effects meta-analyses were conducted to examine the relationship between Hb concentration and hookworm infection intensity (from cross-sectional studies) and the effect of preventive chemotherapy on Hb concentration (from before-after studies and RCTs). Sensitivity analyses investigated the impact of malaria endemicity and combined interventions for schistosomiasis and nutrition status on Hb concentration. RESULTS Among cross-sectional studies, both light- and heavy-intensity hookworm infections were associated with lower Hb in school-aged children. School-aged children with heavy hookworm infection in settings of high malaria endemicity had lower mean Hb than those in settings of low malaria endemicity. In non-pregnant populations, deworming with albendazole was associated with an increase in Hb of 3.02 g/L (95% CI 0.1, 6.0 g/L). No additional benefit was seen with deworming using albendazole co-administered with praziquantel for schistosomiasis infection or iron supplementation for nutrition status. CONCLUSION Our findings confirm the benefits of preventive chemotherapy as a public health intervention.
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Affiliation(s)
- Aisling Byrne
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Giselle Manalo
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Naomi E Clarke
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Susana Vaz Nery
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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10
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Taghipour A, Ghodsian S, Jabbari M, Olfatifar M, Abdoli A, Ghaffarifar F. Global prevalence of intestinal parasitic infections and associated risk factors in pregnant women: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2021; 115:457-470. [PMID: 33007067 DOI: 10.1093/trstmh/traa101] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/04/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited information is available about the global status of IPIs in pregnant women. Here we undertook a meta-analysis to estimate the global prevalence of IPIs and associated risk factors in pregnant women. METHODS We searched the PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases for relevant studies that were published between 1 January 1987 and 30 December 2019. A random effects meta-analysis model was used to estimate the pooled prevalence, odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 114 studies comprising 98 342 pregnant women across 35 countries were included in the systematic review and meta-analysis. Among IPIs identified from pregnant women, three helminth infections (hookworm 19% [95% CI 15 to 23], Ascaris lumbricoides 17% [95% CI 13 to 21] and Trichuris trichiura 11% [95% CI 7 to 16]) and three protozoan infections (Blastocystis sp. 21% [95% CI 4 to 46], Entamoeba histolytica/dispar 9% [95% CI 3 to 19] and Giardia sp. 8% [95% CI 4 to 13]) were identified as the most prevalent intestinal parasites. Moreover, we found that there was a significant association between IPIs with increased risk of anaemia in pregnant women (OR 2.65 [95% CI 2.08 to 3.37]). The prevalence of IPIs was slightly higher in geophagic pregnant women compared with controls, but this was not significant (OR 1.22 [95% CI 0.87 to 1.71]). According to species, the pooled OR of A. lumbricoides infection had a significantly higher risk in geophagic pregnant women compared with controls (OR 2.66 [95% CI 1.37 to 5.16]). There was a positive relationship between the high prevalence of IPIs in pregnant women living in rural areas compared with urban residents (OR 3.36 [95% CI 1.57 to 7.19]). CONCLUSIONS The current review revealed a relatively high prevalence of IPIs in pregnant women, especially in some low- and middle-income countries. These results suggest a need for improved prevention and control efforts to reduce the health risks to pregnant women.
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Affiliation(s)
- Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
| | - Sahar Ghodsian
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Jabbari
- Department of Microbiology, Faculty of Basic Science, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
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11
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Bathla S, Arora S. Prevalence and approaches to manage iron deficiency anemia (IDA). Crit Rev Food Sci Nutr 2021; 62:8815-8828. [PMID: 34096415 DOI: 10.1080/10408398.2021.1935442] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Iron is a vital micronutrient required for growth and development at all stages of human life. Its deficiency is the primary cause of anemia that poses a significant global health problem and challenge for developing countries. Various risks are involved during iron deficiency anemia (IDA), such as premature delivery, low birth weight, etc. Further, it affects children's cognitive functioning, delays motor development, hampers physical performance and quality of life. It also speeds up the morbidity and mortality rate among women. The major reasons accountable are elevated iron demand in diet, socio-economic status, and disease condition. Various strategies have been adopted to reduce the IDA occurrence, such as iron supplementation, iron fortificants salts, agronomic practices, dietary diversification, biofortification, disease control measures, and nutritional education. Usually, the staple food groups for fortification are considered, but the selection of food fortificants and their combination must be safe for the consumers and not alter the finished product's stability and acceptability. Genetically modified breeding practices also increase the micronutrient levels of cereal crops. Therefore, multiple strategies could be relied on to combat IDA.
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Affiliation(s)
- Shikha Bathla
- Krishi Vigyan Kendra, Punjab Agricultural University, Ludhiana, Punjab, 144516, India
| | - Shalini Arora
- Department of Dairy Technology, College of Dairy Science and Technology, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, 125001, India
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12
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Afolabi MO, Ale BM, Dabira ED, Agbla SC, Bustinduy AL, Ndiaye JLA, Greenwood B. Malaria and helminth co-infections in children living in endemic countries: A systematic review with meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009138. [PMID: 33600494 PMCID: PMC7924789 DOI: 10.1371/journal.pntd.0009138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/02/2021] [Accepted: 01/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background Current knowledge on the burden of, and interactions between malaria and helminth co-infections, as well as the impact of the dual infections on anaemia, remains inconclusive. We have conducted a systematic review with meta-analysis to update current knowledge as a first step towards developing and deploying coordinated approaches to the control and, ultimately, elimination of malaria-helminth co-infections among children living in endemic countries. Methodology/Principal findings We searched Medline, Embase, Global Health and Web of Science from each database inception until 16 March 2020, for peer-reviewed articles reporting malaria-helminth co-infections in children living in endemic countries. No language restriction was applied. Following removal of duplicates, two reviewers independently screened the studies for eligibility. We used the summary odds ratio (OR) and 95% confidence intervals (CI) as a measure of association (random-effects model). We also performed Chi-square heterogeneity test based on Cochrane’s Q and evaluated the severity of heterogeneity using I2 statistics. The included studies were examined for publication bias using a funnel plot and statistical significance was assessed using Egger’s test (bias if p<0.1). Fifty-five of the 3,507 citations screened were eligible, 28 of which had sufficient data for meta-analysis. The 28 studies enrolled 22, 114 children in 13 countries across sub-Saharan Africa, Southeast Asia and South America. Overall, the pooled estimates showed a prevalence of Plasmodium-helminth co-infections of 17.7% (95% CI 12.7–23.2%). Summary estimates from 14 studies showed a lower odds of P. falciparum infection in children co-infected with Schistosoma spp (OR: 0.65; 95%CI: 0.37–1.16). Similar lower odds of P. falciparum infection were observed from the summary estimates of 24 studies in children co-infected with soil transmitted helminths (STH) (OR: 0.42; 95%CI: 0.28–0.64). When adjusted for age, gender, socio-economic status, nutritional status and geographic location of the children, the risk of P. falciparum infection in children co-infected with STH was higher compared with children who did not have STH infection (OR = 1.3; 95% CI 1.03–1.65). A subset of 16 studies showed that the odds of anaemia were higher in children co-infected with Plasmodium and STH than in children with Plasmodium infection alone (OR = 1.20; 95% CI: 0.59–2.45), and were almost equal in children co-infected with Plasmodium-Schistosoma spp or Plasmodium infection alone (OR = 0.97, 95% CI: 0.30–3.14). Conclusions/Significance The current review suggests that prevalence of malaria-helminth co-infection is high in children living in endemic countries. The nature of the interactions between malaria and helminth infection and the impact of the co-infection on anaemia remain inconclusive and may be modulated by the immune responses of the affected children. Updated evidence is needed to guide the planning and implementation of appropriate interventions for control of mixed infections involving malaria and worms affecting children living in endemic countries. We performed a systematic review and meta-analysis to update current knowledge on the magnitude of the burden of dual infections with malaria and worms in children in the developing world. We searched all published articles available in Medline, Embase, Global Health and Web of Science from the database inception until 16 March 2020, without any language restriction. We found 55 eligible studies, and 28 of these studies were included in the meta-analysis. A summary of the evidence synthesis showed that the burden of dual infections involving malaria and worm parasites is high in children and varies significantly across endemic countries. There was a lower risk of P. falciparum infection in children infected with soil transmitted helminths (STH) or S. haematobium or S.mansoni. Conversely, the odds of anaemia were higher in children who had dual infections with Plasmodium and STH parasites than in children with a Plasmodium infection alone while the odds of anaemia were almost equal in children who were co-infected with Plasmodium-Schistosoma compared to those with a Plasmodium infection alone. These findings underscore the need to further understand the epidemiology of malaria-helminth co-infections in order to support implementation of appropriate interventions for control and, ultimately, elimination of the dual infections in children living in endemic countries, especially low and middle-income countries (LMIC).
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Affiliation(s)
- Muhammed O. Afolabi
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Edgard D. Dabira
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Schadrac C. Agbla
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
| | - Amaya L. Bustinduy
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jean Louis A. Ndiaye
- Department of Parasitology, University of Thies, Thies, Senegal
- Département de Parasitologie-Mycologie, Université Cheikh Anta Diop, Dakar, Senegal
| | - Brian Greenwood
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
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13
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Ness TE, Agrawal V, Bedard K, Ouellette L, Erickson TA, Hotez P, Weatherhead JE. Maternal Hookworm Infection and Its Effects on Maternal Health: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2020; 103:1958-1968. [PMID: 32840198 DOI: 10.4269/ajtmh.20-0503] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently fetal health. A systematic review and meta-analysis was conducted. The meta-analysis was performed on the association between maternal hookworm and maternal anemia, as well as maternal hookworm coinfection with malaria. The prevalence of hookworm ranged from 1% to 78% in pregnant women, whereas malaria prevalence ranged from 11% to 81%. Pregnant women with hookworm infection were more likely to have anemia (combined odds ratio [cOR] 2.55 [2.20, 2.96], P < 0.001). In addition, pregnant woman with hookworm were more likely to have malaria coinfection (cOR 1.60 [1.38, 1.86], P < 0.001). Other effects on maternal and child health were investigated and summarized without systematic review or meta-analysis because of the limited study numbers. Despite current deworming recommendations in pregnant women, heavy hookworm burden, coinfection with malaria, and subsequent anemia persist. Although this is likely due, in part, to a lack of implementation of preventive chemotherapy, additional interventions such as health education, proper waste management, or linking malaria and soil-transmitted helminth treatment and prevention programs may also be needed. Further investigations on maternal-child outcomes as a result of hookworm infection during pregnancy will highlight public health interventional targets to reduce morbidity in pregnant women and children globally.
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Affiliation(s)
- Tara E Ness
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Vedika Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn Bedard
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Timothy A Erickson
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Peter Hotez
- Department of Biology, Baylor University, Waco, Texas.,Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas.,National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jill E Weatherhead
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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14
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Zeleke AJ, Bayih AG, Afework S, Gilleard JS. Treatment efficacy and re-infection rates of soil-transmitted helminths following mebendazole treatment in schoolchildren, Northwest Ethiopia. Trop Med Health 2020; 48:90. [PMID: 33292853 PMCID: PMC7659054 DOI: 10.1186/s41182-020-00282-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transmission of soil-transmitted helminth (STH) infection remains high in Ethiopia. This study aimed at assessing the therapeutic efficacy of mebendazole against soil-transmitted helminths and determining the re-infection rates of the parasites among schoolchildren in Northwest Ethiopia. METHODS A school-based cross-sectional study was conducted. Data was collected using a structured questionnaire. Stool specimens were examined using direct wet mount microscopy and Kato-Katz methods. Schoolchildren who tested positive for soil-transmitted helminths were treated with 500 mg single-dose of mebendazole. Cure and egg reduction rates were evaluated 2 to 3 weeks post treatment. Moreover, the re-infection rate of these parasites among those who were cured was determined 1 year after treatment. Data were analyzed using SPSS version 20. P value < 0.05 was considered as statistically significant. RESULT A drug efficacy study was conducted on 62, 52, and 14 children infected by Ascaris lumbricoides (A. lumbricoides), hookworm, and Trichuris trichiura (T. trichiura), respectively. The cure rates (CR) of mebendazole against A. lumbricoides, hookworm, and T. trichiura were found to be 96.9%, 23.1%, and, 28.6%, respectively. The egg reduction rate (ERR) of A. lumbricoides was found to be 99.6% whereas 49.6% and 56.3% were reported for hookworm and T. trichiura, respectively. Eighty schoolchildren who were treated and cured from any STH infections were included for the determination of re-infection rate. Out of 80 children, 36.3% (29/80) were found to be re-infected after 1 year: 22 (75.9%), 6 (20.7%), and 1 (1.3%) of study participants were re-infected with A. lumbricoides, hookworm, and both infections, respectively. All re-infections were grouped under the "light infection" category. CONCLUSION Mebendazole was found to be highly effective against A. lumbricoides, but had relatively low efficacy against hookworms and T. trichiura. These results bring into question the use of mebendazole in STH mass drug administration (MDA) programs in this region if albendazole, a drug with higher efficacy against hookworms, is available. Moreover, a significant number of treated children were re-infected with either or both of A. lumbricoides or hookworms 1 year after treatment emphasizing the need for better integrated intestinal helminthiasis control measures.
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Affiliation(s)
- Ayalew Jejaw Zeleke
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Genetu Bayih
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Solomon Afework
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
| | - John S. Gilleard
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, Host-Parasite Interactions Program, University of Calgary, Calgary, Canada
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15
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Ngasala B, Matata F, Mwaiswelo R, Mmbando BP. Anemia among Schoolchildren with Malaria and Soil-Transmitted Helminth Coinfections after Repeated Rounds of Mass Drug Administration in Muheza District, Tanzania. Am J Trop Med Hyg 2020; 101:1148-1155. [PMID: 31516116 DOI: 10.4269/ajtmh.19-0362] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Coinfections with malaria and soil-transmitted helminths (STHs) has been common among school-aged children in Tanzania. However, after a countrywide scaling up of interventions for malaria and STHs, there are limited data on the prevalence of malaria-STH coinfections and its effect on anemia in schoolchildren in Tanzania. We assessed the distribution and risk factors for malaria, STHs, and malaria-STH coinfections, and its relation to anemia among 445 primary schoolchildren in Muheza district. A semi-structured questionnaire was used to collect demographic characteristics of the children. Malaria rapid diagnostic test (mRDT) was used to diagnose malaria infection. Soil-transmitted helminths were diagnosed using the Kato-Katz technique. Primary outcome was anemia, defined as hemoglobin concentration < 11 g/dL. Chi-square (χ2) or Fisher's exact tests, Kruskal-Wallis or t-test, and logistic models were used as appropriate. Overall, the prevalence of malaria, STHs, malaria-STH coinfection, and anemia were 18.4%, 6.1%, 1.6%, and 19.8%, respectively. Anemic children were more likely to have malaria (adjusted odds ratio [aOR] = 4.538, 95% CI: 2.189-9.409), whereas frequent use of bed nets was associated with reduced risk of malaria (aOR = 0.234, 95% CI: 0.130-0.42). On the other hand, not always using latrines and eating raw uncooked food increased the risk of STH infection. The prevalence of anemia was high and was associated with both malaria and malaria-STH infections, therefore calling for more integrated malaria-STH control approaches to target school-aged children.
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Affiliation(s)
- Billy Ngasala
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden
| | - Ferdinand Matata
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Richard Mwaiswelo
- Department of Microbiology, Immunology, and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.,Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno P Mmbando
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
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16
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Zeng W, Malla P, Xu X, Pi L, Zhao L, He X, He Y, Menezes LJ, Cui L, Yang Z. Associations among Soil-Transmitted Helminths, G6PD Deficiency and Asymptomatic Malaria Parasitemia, and Anemia in Schoolchildren from a Conflict Zone of Northeast Myanmar. Am J Trop Med Hyg 2020; 102:851-856. [PMID: 32043453 DOI: 10.4269/ajtmh.19-0828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In tropical areas of developing countries, the interactions among parasitic diseases such as soil-transmitted helminths (STHs) and malaria, and glucose-6-phosphate dehydrogenase deficiency (G6PDd), are complex. Here, we investigated their interactions and impact on anemia in school students residing in a conflict zone of northeast Myanmar. A cross-sectional survey was conducted between July and December 2015 in two schools located along the China-Myanmar border. Stool samples from the schoolchildren were analyzed for STH infections, whereas finger-prick blood samples were analyzed for G6PDd, hemoglobin concentrations, and Plasmodium infections. Among 988 enrolled children, Plasmodium vivax, Plasmodium falciparum, hookworm, Ascaris lumbricoides, and Trichuris trichiura infections occurred in 3.3%, 0.8%, 31.5%, 1.2%, and 0.3%, respectively. Glucose-6-phosphate dehydrogenase deficiency was present in 16.9% of the children, and there was a very high prevalence of anemia (73%). Anthropometric measures performed on all children showed that 50% of the children were stunted and 25% wasted. Moderate to severe anemia was associated with STH infections, stunting, and wasting. In addition, children had increasing odds of anemia with increasing burden of infections. This study revealed a high prevalence of G6PDd, STHs, and anemia in schools located in a conflict zone. In areas where malnutrition and STH infections are rampant, testing for both glucose-6-phosphate dehydrogenase and anemia should be considered before treating vivax malaria with 8-aminoquinolines.
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Affiliation(s)
- Weilin Zeng
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
| | - Pallavi Malla
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Xin Xu
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
| | - Liang Pi
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
| | - Luyi Zhao
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
| | - Xi He
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
| | - Yongshu He
- Department of Cell Biology and Medical Genetics, Kunming Medical University, Kunming, China
| | - Lynette J Menezes
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Liwang Cui
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Zhaoqing Yang
- Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China
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17
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Malaria Parasitemia in Febrile Patients Mono- and Coinfected with Soil-Transmitted Helminthiasis Attending Sanja Hospital, Northwest Ethiopia. J Parasitol Res 2020; 2020:9891870. [PMID: 32089868 PMCID: PMC7024094 DOI: 10.1155/2020/9891870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/20/2019] [Accepted: 01/13/2020] [Indexed: 11/18/2022] Open
Abstract
Background Malaria is a life-threatening disease associated with high morbidity and mortality. Helminths are among the most widespread infectious agents prevalent in tropical and subtropical regions of the developing world. Malaria and soil-transmitted helminthiasis (STHs) are coendemic and major public health problems in Ethiopia. The effects of helminth coinfection on malaria parasitemia remained poorly understood. Therefore, the objective of this study was to assess malaria parasitemia among malaria-monoinfected and malaria-soil-transmitted helminthiasis-coinfected febrile patients attending Sanja Hospital, Northwest Ethiopia. Methods A cross-sectional study with parallel groups was conducted to assess malaria parasitemia among malaria-monoinfected and malaria-soil-transmitted helminthiasis-coinfected febrile patients in Sanja Hospital from January to March 2019. Double population proportion formula was used for sample size calculation, and convenient sampling technique was used to select 134 study participants. Data were entered and analyzed by using the Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics, independent t-test, and one-way analysis of variance (ANOVA) were performed. A P value of <0.05 was considered as statistically significant. Results From 134 malaria-positive study participants, 67 were malaria-monoinfected and 67 were malaria-STHs-coinfected patients. Out of 67 malaria STHs-coinfected patients, 54 (80.6%) were infected with hookworm followed by Ascaris lumbricoides 11 (16.4%) and Strongyloides stercoralis 2 (3%). The mean Plasmodium parasite density was significantly higher in malaria-STHs-coinfected patients than in patients infected with only Plasmodium parasite density was significantly higher in malaria-STHs-coinfected patients than in patients infected with only P value of <0.05 was considered as statistically significant. Plasmodium parasite density was significantly higher in malaria-STHs-coinfected patients than in patients infected with only F = 6.953, P value of <0.05 was considered as statistically significant. Conclusions Infections with STHs, especially hookworm, were positively associated with Plasmodium parasite density. The current study finding also revealed that increased worm burden of hookworm as expressed by egg intensity had significantly increased Plasmodium parasite density.Plasmodium parasite density was significantly higher in malaria-STHs-coinfected patients than in patients infected with only Plasmodium parasite density was significantly higher in malaria-STHs-coinfected patients than in patients infected with only.
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18
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Abdoli A, Ardakani HM. Helminth infections and immunosenescence: The friend of my enemy. Exp Gerontol 2020; 133:110852. [PMID: 32007545 DOI: 10.1016/j.exger.2020.110852] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/13/2019] [Accepted: 01/21/2020] [Indexed: 12/14/2022]
Abstract
Age-associated alterations of the immune system, which known as "immunosenescence", is characterized by a decline in innate and adaptive immunity, which leading to increased susceptibility to age-associated diseases, such as infectious diseases, rheumatic disease and malignancies. On the other hand, helminth infections are among the most prevalent infections in older individuals, especially in the nursing homes. Most of helminth infections have minor clinical symptoms and usually causing chronic infections without treatment. Nevertheless, chronic helminthiasis alters immune responses somewhat similar to the immunosenescence. Some similarities also exist between helminth infections and immunosenescence: 1) both of them led to declining the immune responses; 2) undernutrition is a consequence of immunosenescence and helminthiasis; 3) vaccine efficacy declines in aging and individuals with helminth infections; 4) increase incidence and prevalence of infectious diseases in the elder individuals and patients with helminth infections; and 5) both of them promote tumorigenesis. Hence, it is probable that helminth infections in the elderly population can intensify the immunosenescence outcomes due to the synergistic immunoregulatory effects of each of them. It would be suggested that, diagnosis, treatment and prevention of helminth infections should be more considered in older individuals. Also, it would be suggested that helminths or their antigens can be used for investigation of immunosenescence because both of them possess some similarities in immune alterations. Taken together, this review offers new insights into the immunology of aging and helminth infections.
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Affiliation(s)
- Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran; Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran; Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Hoda Mirzaian Ardakani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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19
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Kamdem SD, Konhawa F, Kuemkon EM, Meyo Kamguia L, Tchanana GK, Nche F, Oumarou A, Hamza M, Ouratou Y, Tcheutchoua MN, Ghislain Essomba R, Ngogang MP, Kengne M, Netongo PM, Ondigui BE, Okomo Assoumou MC, Brombacher F, Nono JK. Negative Association of Interleukin-33 Plasma Levels and Schistosomiasis Infection in a Site of Polyparasitism in Rural Cameroon. Front Immunol 2019; 10:2827. [PMID: 31849991 PMCID: PMC6901687 DOI: 10.3389/fimmu.2019.02827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022] Open
Abstract
Background: This study aimed to investigate the association of plasma levels of IL-33, a mucosal alarmin known to elicit type-2 immunity, with infection and liver fibrosis profiles of school children from an endemic area for Schistosoma mansoni, malaria and hepatitis (B & C) in rural Cameroon. Methods: A cross-sectional study enrolling schoolchildren from 5 public schools was conducted. Single schistosomiasis, malaria and hepatitis infections or co-infections were assessed by kato katz, microscopy, and rapid diagnostic tests, respectively. Hepatic fibrosis was assessed by ultrasound according to WHO Niamey guidelines and plasma levels of Interleukin 33 were determined by ELISA. All statistics were performed using R studio software. Principal findings: We found a prevalence of 13.5% (37/275), 18.2% (50/275), and 8% (22/275), respectively for schistosomiasis, malaria and hepatitis (B or C) single infections. Only 7.6% (21/275) of co-infections were reported. Although Plasma IL-33 showed a minimal negative risk for schistosomiasis infection (AOR 0.99; 95% CI 0.97–1.01), S. mansoni infected participants had lower levels of plasma IL-33 (p = 0.003) which decreased significantly as eggs burdens increased (p = 0.01) with a negative Pearson coefficient of r = −0.22. Hepatic fibrosis occurred in 47.3% (130/275) of our study population independently from plasma levels of IL-33 (AOR 1.00; 95% CI 0.99–1.01). Conclusion/Significance: Our data failed to show an association between plasma IL-33 levels and liver disease but convincingly report on a negative association between plasma IL-33 levels and schistosomiasis infection and egg burden in school children from a polyparasitic schistosomiasis endemic area.
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Affiliation(s)
- Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
| | - Francis Konhawa
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Erve Martial Kuemkon
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Leonel Meyo Kamguia
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Gladys K Tchanana
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,CIAB EXACT Medical Laboratory, Yaoundé, Cameroon
| | - Frungwa Nche
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Yasmine Ouratou
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - René Ghislain Essomba
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | | | - Michel Kengne
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Palmer Masumbe Netongo
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon.,Department of Biochemistry, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Justin Komguep Nono
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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20
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Donohue RE, Cross ZK, Michael E. The extent, nature, and pathogenic consequences of helminth polyparasitism in humans: A meta-analysis. PLoS Negl Trop Dis 2019; 13:e0007455. [PMID: 31211774 PMCID: PMC6599140 DOI: 10.1371/journal.pntd.0007455] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/28/2019] [Accepted: 05/09/2019] [Indexed: 02/07/2023] Open
Abstract
Background Individual helminth infections are ubiquitous in the tropics; geographical overlaps in endemicity and epidemiological reports suggest areas endemic for multiple helminthiases are also burdened with high prevalences of intestinal protozoan infections, malaria, tuberculosis (TB), and human immunodeficiency virus (HIV). Despite this, pathogens tend to be studied in isolation, and there remains a need for a better understanding of the community ecology and health consequences of helminth polyparasitism to inform the design of effective parasite control programs. Methodology We performed meta-analyses to (i) evaluate the commonality of polyparasitism for helminth-helminth, helminth-intestinal protozoa, helminth-malaria, helminth-TB, and helminth-HIV co-infections, (ii) assess the potential for interspecies interactions among helminth-helminth and helminth-intestinal protozoan infections, and (iii) determine the presence and magnitude of association between specific parasite pairs. Additionally, we conducted a review of reported health consequences of multiply-infected individuals compared to singly- or not multiply-infected individuals. Principal findings We found that helminth-helminth and helminth-intestinal protozoan multiple infections were significantly more common than single infections, while individuals with malaria, TB, and HIV were more likely to be singly-infected with these infections than co-infected with at least one helminth. Most observed species density distributions significantly differed from the expected distributions, suggesting the potential presence of interspecies interactions. All significant associations between parasite pairs were positive in direction, irrespective of the combination of pathogens. Polyparasitized individuals largely exhibited lower hemoglobin levels and higher anemia prevalence, while the differences in growth-related variables were mostly statistically insignificant. Conclusions Our findings confirm that helminth polyparasitism and co-infection with major diseases is common in the tropics. A multitude of factors acting at various hierarchical levels, such as interspecies interactions at the within-host infra-parasite community level and environmental variables at the higher host community level, could explain the observed positive associations between pathogens; there remains a need to develop new frameworks which can consider these multilevel factors to better understand the processes structuring parasite communities to accomplish their control. Helminth infections are a highly prevalent global health problem. These parasitic worm infections occur in areas also burdened with intestinal protozoan infections, malaria, tuberculosis, and human immunodeficiency virus. While these pathogens tend to be studied in isolation, there remains a need to better understand the nature, extent, and health consequences of helminth polyparasitism and co-infection with major diseases. Here, we reviewed the literature and performed meta-analyses to evaluate the commonality of helminth polyparasitism and co-infection, the potential for interspecies interactions between parasites, the association between parasite pairs, and the health consequences among multiply-infected individuals. We confirmed that polyparasitism and co-infection with major diseases are common in the global South and found that multiply-infected individuals experienced worse health consequences when compared to singly or not-multiply infected individuals. Our analysis suggested the potential presence of interspecies interactions and we identified the existence of positive associations between parasite pairs. These findings support the call for integrating deworming into malaria, TB, and HIV treatment protocols and suggest there remains a need to improve our understanding of the factors influencing co-transmission to achieve sustainable parasite control.
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Affiliation(s)
- Rose E. Donohue
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Zoë K. Cross
- University of Utah, Salt Lake City, Utah, United States of America
| | - Edwin Michael
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
- * E-mail:
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21
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Shen SS, Qu XY, Zhang WZ, Li J, Lv ZY. Infection against infection: parasite antagonism against parasites, viruses and bacteria. Infect Dis Poverty 2019; 8:49. [PMID: 31200765 PMCID: PMC6570864 DOI: 10.1186/s40249-019-0560-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 05/28/2019] [Indexed: 12/21/2022] Open
Abstract
Background Infectious diseases encompass a large spectrum of diseases that threaten human health, and coinfection is of particular importance because pathogen species can interact within the host. Currently, the antagonistic relationship between different pathogens during concurrent coinfections is defined as one in which one pathogen either manages to inhibit the invasion, development and reproduction of the other pathogen or biologically modulates the vector density. In this review, we provide an overview of the phenomenon and mechanisms of antagonism of coinfecting pathogens involving parasites. Main body This review summarizes the antagonistic interaction between parasites and parasites, parasites and viruses, and parasites and bacteria. At present, relatively clear mechanisms explaining polyparasitism include apparent competition, exploitation competition, interference competition, biological control of intermediate hosts or vectors and suppressive effect on transmission. In particular, immunomodulation, including the suppression of dendritic cell (DC) responses, activation of basophils and mononuclear macrophages and adjuvant effects of the complement system, is described in detail. Conclusions In this review, we summarize antagonistic concurrent infections involving parasites and provide a functional framework for in-depth studies of the underlying mechanisms of coinfection with different microorganisms, which will hasten the development of promising antimicrobial alternatives, such as novel antibacterial vaccines or biological methods of controlling infectious diseases, thus relieving the overwhelming burden of ever-increasing antimicrobial resistance. Electronic supplementary material The online version of this article (10.1186/s40249-019-0560-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shi-Shi Shen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China.,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, China
| | - Xiao-Yan Qu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China.,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, China
| | - Wei-Zhe Zhang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China.,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, China
| | - Jian Li
- Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, ZhuHai, Guangdong, China
| | - Zhi-Yue Lv
- Fifth Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, ZhuHai, Guangdong, China. .,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China. .,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, China.
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22
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Geus D, Sifft KC, Habarugira F, Mugisha JC, Mukampunga C, Ndoli J, Bayingana C, Sendegeya A, Martus P, Fraundorfer K, Samson‐Himmelstjerna G, Gahutu JB, Klotz C, Aebischer A, Mockenhaupt FP. Co‐infections with
Plasmodium
,
Ascaris
and
Giardia
among Rwandan schoolchildren. Trop Med Int Health 2019; 24:409-420. [DOI: 10.1111/tmi.13206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Dominik Geus
- Charité – Universitätsmedizin Institute of Tropical Medicine and International Health Berlin Germany
| | - Kevin C. Sifft
- Charité – Universitätsmedizin Institute of Tropical Medicine and International Health Berlin Germany
| | - Felix Habarugira
- University Teaching Hospital of Butare University of Rwanda Butare Rwanda
| | | | - Caritas Mukampunga
- University Teaching Hospital of Butare University of Rwanda Butare Rwanda
| | - Jules Ndoli
- University Teaching Hospital of Butare University of Rwanda Butare Rwanda
| | - Claude Bayingana
- University Teaching Hospital of Butare University of Rwanda Butare Rwanda
| | - Augustin Sendegeya
- University Teaching Hospital of Butare University of Rwanda Butare Rwanda
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry University Hospital Tübingen Germany
| | - Kira Fraundorfer
- Institute for Parasitology and Tropical Veterinary Medicine Freie Universität Berlin Berlin Germany
| | | | - Jean Bosco Gahutu
- University Teaching Hospital of Butare University of Rwanda Butare Rwanda
| | - Christian Klotz
- Unit for Mycotic and Parasitic Agents and Mycobacteria Robert Koch‐Institute Berlin Germany
| | - Anton Aebischer
- Unit for Mycotic and Parasitic Agents and Mycobacteria Robert Koch‐Institute Berlin Germany
| | - Frank P. Mockenhaupt
- Charité – Universitätsmedizin Institute of Tropical Medicine and International Health Berlin Germany
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23
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Hürlimann E, Houngbedji CA, Yapi RB, N’Dri PB, Silué KD, Ouattara M, Utzinger J, N’Goran EK, Raso G. Antagonistic effects of Plasmodium-helminth co-infections on malaria pathology in different population groups in Côte d'Ivoire. PLoS Negl Trop Dis 2019; 13:e0007086. [PMID: 30629580 PMCID: PMC6343929 DOI: 10.1371/journal.pntd.0007086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 01/23/2019] [Accepted: 12/17/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction Plasmodium spp. and helminths are co-endemic in many parts of the tropics; hence, co-infection is a common phenomenon. Interactions between Plasmodium and helminth infections may alter the host’s immune response and susceptibility and thus impact on morbidity. There is little information on the direction and magnitude of such interactions and results are conflicting. This study aimed at shedding new light on the potential interactions of Plasmodium and helminth co-infections on anemia and splenomegaly in different population groups in Côte d’Ivoire. Methodology Parasitologic and clinical data were obtained from four cross-sectional community-based studies and a national school-based survey conducted between 2011 and 2013 in Côte d’Ivoire. Six scenarios of co-infection pairs defined as Plasmodium infection or high parasitemia, combined with one of three common helminth infections (i.e., Schistosoma mansoni, S. haematobium, and hookworm) served for analysis. Adjusted logistic regression models were built for each scenario and interaction measures on additive scale calculated according to Rothman et al., while an interaction term in the model served as multiplicative scale measure. Principal findings All identified significant interactions were of antagonistic nature but varied in magnitude and species combination. In study participants aged 5–18 years from community-based studies, Plasmodium-hookworm co-infection showed an antagonistic interaction on additive scale on splenomegaly, while Plasmodium-Schistosoma co-infection scenarios showed protective effects on multiplicative scale for anemia and splenomegaly in participants aged 5–16 years from a school-based study. Conclusions/Significance No exacerbation from co-infection with Plasmodium and helminths was observed, neither in participants aged 5–18 years nor in adults from the community-based studies. Future studies should unravel underlying mechanisms of the observed interactions, as this knowledge might help shaping control efforts against these diseases of poverty. Malaria (due to infection with Plasmodium spp.) and parasitic worms (for example soil-transmitted helminths and Schistosoma spp.) are common in the tropics. Hence, people are often co-infected, depending on various factors. Interactions between Plasmodium and helminth infections may alter immune response and susceptibility of the infected host, and thus impact on morbidity by either making it worse (synergism) or by reducing it (antagonism). Although these co-infections are common, little is known about the direction and magnitude of such interactions. To deepen the understanding of how co-infection could affect morbidity in infected people, we looked at clinical data (i.e., anemia and splenomegaly) in different population groups in Côte d’Ivoire. We did not observe any exacerbation from co-infection with Plasmodium and helminths; all identified significant interactions were of antagonistic nature but varied in magnitude and parasite combination. In the light of enhanced control efforts targeting helminthiases, a better understanding about potential effects on susceptibility to malaria in co-endemic areas should be gained and intervention strategies against the two type of diseases be planned in a more integrative manner.
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Affiliation(s)
- Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Clarisse A. Houngbedji
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Centre d’Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, Bouaké, Côte d’Ivoire
| | - Richard B. Yapi
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Prisca B. N’Dri
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Kigbafori D. Silué
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Hophouët-Boigny, Abidjan, Côte d’Ivoire
| | - Mamadou Ouattara
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Hophouët-Boigny, Abidjan, Côte d’Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Eliézer K. N’Goran
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Hophouët-Boigny, Abidjan, Côte d’Ivoire
| | - Giovanna Raso
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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24
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Hernandez HW, Soeung M, Zorn KM, Ashoura N, Mottin M, Andrade CH, Caffrey CR, de Siqueira-Neto JL, Ekins S. High Throughput and Computational Repurposing for Neglected Diseases. Pharm Res 2018; 36:27. [PMID: 30560386 PMCID: PMC6792295 DOI: 10.1007/s11095-018-2558-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/09/2018] [Indexed: 12/21/2022]
Abstract
Purpose Neglected tropical diseases (NTDs) represent are a heterogeneous group of communicable diseases that are found within the poorest populations of the world. There are 23 NTDs that have been prioritized by the World Health Organization, which are endemic in 149 countries and affect more than 1.4 billion people, costing these developing economies billions of dollars annually. The NTDs result from four different causative pathogens: protozoa, bacteria, helminth and virus. The majority of the diseases lack effective treatments. Therefore, new therapeutics for NTDs are desperately needed. Methods We describe various high throughput screening and computational approaches that have been performed in recent years. We have collated the molecules identified in these studies and calculated molecular properties. Results Numerous global repurposing efforts have yielded some promising compounds for various neglected tropical diseases. These compounds when analyzed as one would expect appear drug-like. Several large datasets are also now in the public domain and this enables machine learning models to be constructed that then facilitate the discovery of new molecules for these pathogens. Conclusions In the space of a few years many groups have either performed experimental or computational repurposing high throughput screens against neglected diseases. These have identified compounds which in many cases are already approved drugs. Such approaches perhaps offer a more efficient way to develop treatments which are generally not a focus for global pharmaceutical companies because of the economics or the lack of a viable market. Other diseases could perhaps benefit from these repurposing approaches. Electronic supplementary material The online version of this article (10.1007/s11095-018-2558-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Melinda Soeung
- MD Anderson Cancer Center, University of Texas, Houston, Texas, USA
| | - Kimberley M Zorn
- Collaborations Pharmaceuticals Inc., 840 Main Campus Drive, Lab 3510, Raleigh, North Carolina, 27606, USA
| | | | - Melina Mottin
- LabMol - Laboratory for Molecular Modeling and Drug Design Faculdade de Farmacia, Universidade Federal de Goias - UFG, Goiânia, GO, 74605-170, Brazil
| | - Carolina Horta Andrade
- LabMol - Laboratory for Molecular Modeling and Drug Design Faculdade de Farmacia, Universidade Federal de Goias - UFG, Goiânia, GO, 74605-170, Brazil
| | - Conor R Caffrey
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, California, 92093, USA
| | - Jair Lage de Siqueira-Neto
- Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, California, 92093, USA
| | - Sean Ekins
- Collaborations Pharmaceuticals Inc., 840 Main Campus Drive, Lab 3510, Raleigh, North Carolina, 27606, USA.
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25
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Budischak SA, Wiria AE, Hamid F, Wammes LJ, Kaisar MMM, van Lieshout L, Sartono E, Supali T, Yazdanbakhsh M, Graham AL. Competing for blood: the ecology of parasite resource competition in human malaria-helminth co-infections. Ecol Lett 2018; 21:536-545. [DOI: 10.1111/ele.12919] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/14/2017] [Accepted: 01/03/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Sarah A. Budischak
- Department of Ecology and Evolutionary Biology; Princeton University; Princeton NJ USA
| | - Aprilianto E. Wiria
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
- Department of Parasitology; Faculty of Medicine; Universitas Indonesia; Jakarta Indonesia
| | - Firdaus Hamid
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
- Department of Microbiology; Faculty of Medicine; Hasanuddin University; Makassar Indonesia
| | - Linda J. Wammes
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
- Department of Medical Microbiology; Erasmus MC; Rotterdam The Netherlands
| | - Maria M. M. Kaisar
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
- Department of Parasitology; Faculty of Medicine; Universitas Indonesia; Jakarta Indonesia
| | - Lisette van Lieshout
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
| | - Erliyani Sartono
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
| | - Taniawati Supali
- Department of Parasitology; Faculty of Medicine; Universitas Indonesia; Jakarta Indonesia
| | - Maria Yazdanbakhsh
- Department of Parasitology; Leiden University Medical Center; Leiden The Netherlands
| | - Andrea L. Graham
- Department of Ecology and Evolutionary Biology; Princeton University; Princeton NJ USA
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26
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Dieme C, Rotureau B, Mitri C. Microbial Pre-exposure and Vectorial Competence of Anopheles Mosquitoes. Front Cell Infect Microbiol 2017; 7:508. [PMID: 29376030 PMCID: PMC5770632 DOI: 10.3389/fcimb.2017.00508] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/23/2017] [Indexed: 11/16/2022] Open
Abstract
Anopheles female mosquitoes can transmit Plasmodium, the malaria parasite. During their aquatic life, wild Anopheles mosquito larvae are exposed to a huge diversity of microbes present in their breeding sites. Later, adult females often take successive blood meals that might also carry different micro-organisms, including parasites, bacteria, and viruses. Therefore, prior to Plasmodium ingestion, the mosquito biology could be modulated at different life stages by a suite of microbes present in larval breeding sites, as well as in the adult environment. In this article, we highlight several naturally relevant scenarios of Anopheles microbial pre-exposure that we assume might impact mosquito vectorial competence for the malaria parasite: (i) larval microbial exposures; (ii) protist co-infections; (iii) virus co-infections; and (iv) pathogenic bacteria co-infections. In addition, significant behavioral changes in African Anopheles vectors have been associated with increasing insecticide resistance. We discuss how these ethological modifications may also increase the repertoire of microbes to which mosquitoes could be exposed, and that might also influence their vectorial competence. Studying Plasmodium–Anopheles interactions in natural microbial environments would efficiently contribute to refining the transmission risks.
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Affiliation(s)
- Constentin Dieme
- Genetics and Genomics of Insect Vectors Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique Unit of Hosts, Vectors and Pathogens (URA3012), Paris, France
| | - Brice Rotureau
- Trypanosome Transmission Group, Trypanosome Cell Biology Unit, Institut National de la Santé et de la Recherche Médicale U1201 and Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Christian Mitri
- Genetics and Genomics of Insect Vectors Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France.,Centre National de la Recherche Scientifique Unit of Hosts, Vectors and Pathogens (URA3012), Paris, France
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27
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Kinung'hi SM, Mazigo HD, Dunne DW, Kepha S, Kaatano G, Kishamawe C, Ndokeji S, Angelo T, Nuwaha F. Coinfection of intestinal schistosomiasis and malaria and association with haemoglobin levels and nutritional status in school children in Mara region, Northwestern Tanzania: a cross-sectional exploratory study. BMC Res Notes 2017; 10:583. [PMID: 29121978 PMCID: PMC5679344 DOI: 10.1186/s13104-017-2904-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/01/2017] [Indexed: 11/27/2022] Open
Abstract
Background Schistosomiasis represents a major public health problem in Tanzania despite ongoing national control efforts. This study examined whether intestinal schistosomiasis is associated with malaria and assessed the contribution of intestinal schistosomiasis and malaria on anaemia and undernutrition in school children in Mara region, North-western Tanzania. Methods Stool samples were collected from each of 928 school children randomly selected from 5 schools and examined for intestinal schistosomiasis using the Kato Katz method. Finger prick blood samples were collected and examined for malaria parasites and haemoglobin concentrations using the Giemsa stain and Haemocue methods, respectively. Nutritional status was assessed by taking anthropometric measurements. Results The overall prevalence and infection intensity of S. mansoni was 85.6% (794/928) and 192 (100–278), respectively. The prevalence of malaria was 27.4% (254/928) with significant differences among villages (χ2 = 96.11, p < 0.001). The prevalence of anaemia was 42.3% (392/928) with significant differences among villages (χ2 = 39.61, p < 0.001). The prevalence of stunting, thinness and underweight was 21, 6.8 and 1.3%, respectively. Stunting varied significantly by sex (χ2 = 267.8, p < 0.001), age group (χ2 = 96.4, p < 0.001) and by village (χ2 = 20.5, p < 0.001). Out of the 825 infected children, 217 (26.4%) had multiple parasite infections (two to three parasites). The prevalence of co-infections occurred more frequently in boys than in girls (χ2 = 21.65, p = 0.010). Mean haemoglobin concentrations for co-infected children was significantly lower than that of children not co-infected (115.2 vs 119.6; t = 0.01, p = 0.002). Co-infected children were more likely to be stunted than children who were not co-infected (χ2 = 11.6, p = 0.003). On multivariate analysis, age group, village of residence and severe anaemia were significant predictors of stunting after adjusting for sex and infection status. Conclusions Intestinal schistosomiasis and malaria are prevalent in Mara region. Coinfections of these parasites as well as chronic undernutrition were also common. We recommend Mara region to be included in national schistosomiasis control programmes.
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Affiliation(s)
- Safari M Kinung'hi
- National Institute for Medical Research, Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania.
| | - Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
| | - David W Dunne
- Department of Pathology, Cambridge University, Tennis Court Road, Cambridge, UK
| | - Stella Kepha
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Godfrey Kaatano
- National Institute for Medical Research, Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Coleman Kishamawe
- National Institute for Medical Research, Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Samuel Ndokeji
- National Institute for Medical Research, Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Teckla Angelo
- National Institute for Medical Research, Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, P. O. Box 7072, Kampala, Uganda
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[Profiles of intestinal polyparasitism in a community of the Colombian Amazon region]. BIOMEDICA 2017; 37:368-377. [PMID: 28968014 DOI: 10.7705/biomedica.v37i3.3395] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Intestinal parasite infections and polyparasitism are highly prevalent in the most vulnerable populations of developing countries due to environmental, biological and social determinants common in the transmission of parasites. Children between 1 and 15 years of age are the most affected population. OBJECTIVE To describe the prevalence and profiles of intestinal polyparasitism in 1 to 15 year-old children from native communities in the Colombian Amazon region. MATERIALS AND METHODS We used a non-probability sampling of 300 children between 1 and 15 years of age from several rural settlements and the main urban area of Puerto Nariño, Amazonas, Colombia, who participated voluntarily in the study. We obtained fecal samples that were analyzed by the direct method (0.85% saline solution-lugol) and the Kato-Katz technique. The most prevalent polyparasitism profiles were identified using Cohen's kappa coefficient with a 95% confidence interval. RESULTS The prevalence of polyparasitism, defined as the presence of at least two intestinal pathogenic parasites, was 84% (95 % CI: 79.35-87.96). Polyparasitism by two or three of the following parasites: Ascaris lumbricoides, Trichuris trichiura, Blastocystis sp., Ancylostoma duodenale and Necator americanus from the Ancylostomatidae family, and Entamoeba histolytica, E. dispar and E. moshkovskii of the Entamoeba complex, had the highest prevalence. CONCLUSION Several intestinal polyparasitism profiles were found, although in most cases fewer than six parasites were involved. Better prevalence estimations and identification of determinant factors will allow to priorize and direct resources to control these infections.
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Madinga J, Polman K, Kanobana K, van Lieshout L, Brienen E, Praet N, Kabwe C, Gabriël S, Dorny P, Lutumba P, Speybroeck N. Epidemiology of polyparasitism with Taenia solium, schistosomes and soil-transmitted helminths in the co-endemic village of Malanga, Democratic Republic of Congo. Acta Trop 2017; 171:186-193. [PMID: 28336269 DOI: 10.1016/j.actatropica.2017.03.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 03/10/2017] [Accepted: 03/18/2017] [Indexed: 11/27/2022]
Abstract
Helminth co-infections are common in sub-Saharan Africa. However, little is known about the distribution and determinants of co-infections with Taenia solium taeniasis/cysticercosis. Building on a previous community-based study on human cysticercosis in Malanga village, we investigated co-infections with Taenia solium, soil-transmitted helminths (STHs) and Schistosoma spp and associated risk factors in a random subsample of 330 participants. Real time PCR assays were used to detect DNA of soil-transmitted helminths (STHs), T. solium and Schistosoma in stool samples and Schistosoma DNA in urine samples. Serum samples were tested for T. solium cysticercosis using the B158/B60 monoclonal antibody-based antigen ELISA. Bivariate analysis and logistic regression were applied to assess associations of single and co-infections with common risk factors (age, sex, area, hygiene) as well as pair wise associations between helminth species. Overall, 240 (72.7%) participants were infected with at least one helminth species; 128 (38.8%) harbored at least two helminth species (16.1% with STHs-Schistosoma, 14.5% with STHs-T. solium taeniasis/cysticercosis and 8.2% with Schistosoma-T. solium taeniasis/cysticercosis co-infections). No significant associations were found between Schistosoma-T. solium taeniasis/cysticercosis co-infection and any of the risk factors studied. Males (OR=2 (95%CI=1.1-5), p=0.03) and open defecation behavior (OR=3.8 (95%CI=1.1-6.5), p=0.04) were associated with higher odds of STHs-T. solium taeniasis/cysticercosis co-infection. Village districts that were found at high risk of T. solium taeniasis/cysticercosis were also at high risk of co-infection with STHs and T. solium taeniasis/cysticercosis (OR=3.2 (95%CI=1.1-7.8), p=0.03). Significant pair-wise associations were found between T. solium cysticerci and Necator americanus (OR=2.2 (95%CI=1.2-3.8), p<0.01) as well as Strongyloides stercoralis (OR=2.7 (95%CI=1.1-6.5), p=0.02). These findings show that co-infections with T. solium are common in this polyparasitic community in DRC. Our results on risk factors of helminth co-infections and specific associations between helminths may contribute to a better integration of control within programmes that target more than one NTD.
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Knoblauch AM, Divall MJ, Owuor M, Archer C, Nduna K, Ng'uni H, Musunka G, Pascall A, Utzinger J, Winkler MS. Monitoring of Selected Health Indicators in Children Living in a Copper Mine Development Area in Northwestern Zambia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030315. [PMID: 28335490 PMCID: PMC5369151 DOI: 10.3390/ijerph14030315] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 12/19/2022]
Abstract
The epidemiology of malaria, anaemia and malnutrition in children is potentially altered in mining development areas. In a copper extraction project in northwestern Zambia, a health impact assessment (HIA) was commissioned to predict, manage and monitor health impacts. Two cross-sectional surveys were conducted: at baseline prior to project development (2011) and at four years into development (2015). Prevalence of Plasmodium falciparum, anaemia and stunting were assessed in under-five-year-old children, while hookworm infection was assessed in children aged 9–14 years in communities impacted and comparison communities not impacted by the project. P. falciparum prevalence was significantly higher in 2015 compared to 2011 in both impacted and comparison communities (odds ratio (OR) = 2.51 and OR = 6.97, respectively). Stunting was significantly lower in 2015 in impacted communities only (OR = 0.63). Anaemia was slightly lower in 2015 compared to baseline in both impacted and comparison communities. Resettlement due to the project and migration background (i.e., moving into the area within the past five years) were generally associated with better health outcomes in 2015. We conclude that repeated cross-sectional surveys to monitor health in communities impacted by projects should become an integral part of HIA to deepen the understanding of changing patterns of health and support implementation of setting-specific public health measures.
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Affiliation(s)
- Astrid M Knoblauch
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
| | - Mark J Divall
- SHAPE Consulting Ltd., GY1 2 St Peter Port, P.O. Box 602, Channel Islands.
| | - Milka Owuor
- SHAPE Consulting Ltd., GY1 2 St Peter Port, P.O. Box 602, Channel Islands.
| | - Colleen Archer
- University of Kwa Zulu Natal, Durban 4041, South Africa.
| | - Kennedy Nduna
- Solwezi District Health Management Team, Solwezi 40100, Zambia.
| | - Harrison Ng'uni
- Solwezi District Health Management Team, Solwezi 40100, Zambia.
| | | | - Anna Pascall
- First Quantum Minerals Limited, Lusaka 10100, Zambia.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
| | - Mirko S Winkler
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
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Abstract
Soil-transmitted helminth (STH) infections are widely distributed in tropical and subtropical areas, including Brazil. We performed a nationwide population-based study including all deaths in Brazil from 2000 to 2011, in which STHs (ascariasis, trichuriasis and/or hookworm infection) were mentioned on death certificates, either as underlying or as associated causes of death. Epidemiological characteristics, time trends and spatial analysis of STH-related mortality were analysed. STHs was identified on 853/12 491 280 death certificates: 827 (97·0%) deaths related to ascariasis, 25 (2·9%) to hookworm infections, and 1 (0·1%) to trichuriasis. The average annual age-adjusted mortality rate was 0·34/1 000 000 inhabitants (95% confidence interval: 0·27-0·44). Females, children <10 years of age, indigenous ethnic groups and residents in the Northeast region had highest STH-related mortality rates. Nationwide mortality decreased significantly over time (annual percent change: -5·7%; 95% CI: -6·9 to -4·4), with regional differences. We identified spatial high-risk clusters for STH-related mortality mainly in the North, Northeast and South regions. Diseases of the digestive system and infectious/parasitic diseases were the most commonly associated causes of death mentioned in the STH-related deaths. Despite decreasing mortality in Brazil, a considerable number of deaths is caused by STHs, with ascariasis responsible for the vast majority. There were marked regional differences, affecting mainly children and vulnerable populations.
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Abstract
Helminths are parasitic nematodes and trematodes, grouped together because of morphological similarities and commonalities in the effects infections have on hosts. These include complications such as anemia and biasing of immune responses, which can alter susceptibility for other diseases. For pregnant women, these complications might have implications for pregnancy outcomes or neonatal health. Here, I review studies of helminth infections during pregnancy, and ask the following questions: Do helminths affect maternal health or pregnancy outcomes? Are there consequences of maternal infection for infants? What are the effects of antihelminth treatment during pregnancy? The evidence suggests that the answers to these questions depend on the particular helminth species in question, maternal nutritional status, and the presence or absence of comorbid infection with other species, such as malaria. Moreover, there may also be unexpected consequences of treatment, as maternal infections can affect the priming of infant immune systems, with potential effects on infants later in life. These complex interactions suggest that a consideration of the evolutionary history of human–helminth interactions, as well as the ecological context of infections, can help to clarify an understanding of these host–parasite interactions and provide direction for future investigations.
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Affiliation(s)
- Aaron D Blackwell
- Department of Anthropology, University of California, Santa Barbara, Santa Barbara, CA, USA
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Food science and technology for management of iron deficiency in humans: A review. Trends Food Sci Technol 2016. [DOI: 10.1016/j.tifs.2016.05.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Degarege A, Veledar E, Degarege D, Erko B, Nacher M, Madhivanan P. Plasmodium falciparum and soil-transmitted helminth co-infections among children in sub-Saharan Africa: a systematic review and meta-analysis. Parasit Vectors 2016; 9:344. [PMID: 27306987 PMCID: PMC4908807 DOI: 10.1186/s13071-016-1594-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/17/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The epidemiology of soil-transmitted helminth (STH) and Plasmodium co-infections need better understanding. The findings of the individual studies are inconclusive. A systematic review was conducted to synthesize evidence on the association of STH infection with the prevalence and density of Plasmodium falciparum infection, and its effect on anaemia among children in sub-Saharan Africa (SSA). METHODS Relevant studies published before March 6, 2015 were identified by searching Medline (via Pubmed), Embase, Cochrane Library and CINAHL without any language restriction. Studies on P. falciparum and STH co-infection among children in SSA except for case studies were included in this study. Studies were screened for eligibility and data extracted independently by two authors. The primary outcome assessed was the prevalence of P. falciparum infection and the secondary outcomes included P. falciparum density and prevalence of anaemia. Heterogeneity was assessed using Cochrane Q and Moran's I (2) and publication bias was evaluated using Egger test. A random-effects model was used to estimate the summary odds ratio (OR) and the corresponding 95 % confidence intervals (CI). RESULTS Out of 2985 articles screened, 11 articles were included in the systematic review; of these seven were considered in the meta-analysis. Of the 11 studies with 7458 study participants, seven were cross-sectional, one prospective cohort and three were randomized controlled trials. Four studies examined the outcome for hookworms, one for Ascaris lumbricoides and six for pooled (at least one) STH species. Eight studies measured prevalence/incidence of uncomplicated P. falciparum infection, two calculated prevalence of asymptomatic P. falciparum infection, three evaluated P. falciparum density and four considered prevalence of P. falciparum infection related anaemia/mean haemoglobin reduction. The odds of asymptomatic/uncomplicated P. falciparum infection were higher among children infected with STH than those uninfected with intestinal helminths (summary Odds Ratio [OR]: 1.4; 95 % Confidence Interval [CI]: 1.05-1.87; I (2) = 36.8 %). Plasmodium falciparum density tended to be higher among children infected with STH than those uninfected with intestinal helminths. However, STH infection was associated with lower odds of P. falciparum infection related anaemia (summary OR: 0.5; 95 % CI: 0.21-0.78; I (2) = 43.3 %). CONCLUSIONS The findings suggest that STH infection may increase susceptibility to asymptomatic/uncomplicated P. falciparum infection but may protect malaria-related anaemia in children. Future studies should investigate the effect of STH infection upon the incidence of severe P. falciparum infection among children in SSA.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, Robert Stemple College of Public Health, Florida International University, Miami, USA.
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Emir Veledar
- Department of Epidemiology, Robert Stemple College of Public Health, Florida International University, Miami, USA
| | - Dawit Degarege
- Ethiopian Ministry of Health Office, Addis Ababa, Ethiopia
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Purnima Madhivanan
- Department of Epidemiology, Robert Stemple College of Public Health, Florida International University, Miami, USA
- Public Health Research Institute of India, Mysore, India
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Babamale OA, Shittu O, Danladi YK, Abdulraheem JY, Ugbomoiko US. Pattern of Plasmodium-intestinal helminth co-infection among pregnant women in a high transmission zone of malaria in Nigeria. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2016. [DOI: 10.1016/s2222-1808(16)61060-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Effect of single-dose albendazole and vitamin A supplementation on the iron status of pre-school children in Sichuan, China. Br J Nutr 2016; 115:1415-23. [PMID: 26902307 DOI: 10.1017/s0007114516000350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to explore the effect of single-dose albendazole and vitamin A intervention on the anaemic status and Fe metabolism of pre-school children. This study was a randomised, placebo-controlled and double-blinded intervention trial. All eligible anaemic pre-school children were randomly divided into three groups: group 1 received no intervention, which served as the control group, group 2 received 400 mg single-dose albendazole administration and group 3 received a 60000 μg vitamin A capsule combined with 400 mg single-dose albendazole at the beginning of the study. The follow-up period was for 6 months. Anthropometry and biochemical index about Fe metabolism were measured before and after intervention. A total of 209 pre-school anaemic children were randomly divided into three intervention groups (sixty-four, sixty-two and sixty for groups 1, 2 and 3, respectively). The mean age of the children in the study was 4·4 (sd 0·7) years and 50·5 % of the children were female (94/186). After a follow-up period of 6 months, the levels of serum retinol, ferritin, transferrin receptor-ferritin index and body total Fe content of children in group 3 were significantly higher compared with children in groups 1 and 2 (P<0·05). Moreover, the proportion of vitamin A deficiency, marginal vitamin A deficiency and Fe deficiency among children in group 3 were markedly lower compared with children in groups 1 and 2 (P<0·05). Albendazole plus vitamin A administration showed more efficacy on the improvement of serum retinol and Fe metabolic status.
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Njua-Yafi C, Achidi EA, Anchang-Kimbi JK, Apinjoh TO, Mugri RN, Chi HF, Tata RB, Njumkeng C, Nkock EN, Nkuo-Akenji T. Malaria, helminths, co-infection and anaemia in a cohort of children from Mutengene, south western Cameroon. Malar J 2016; 15:69. [PMID: 26852392 PMCID: PMC4744422 DOI: 10.1186/s12936-016-1111-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 01/18/2016] [Indexed: 12/20/2022] Open
Abstract
Background Malaria and helminthiases frequently co-infect the same individuals in endemic zones. Plasmodium falciparum and helminth infections have long been recognized as major contributors to anaemia in endemic countries. Several studies have explored the influence of helminth infections on the course of malaria in humans but how these parasites interact within co-infected individuals remains controversial. Methods In a community-based longitudinal study from March 2011 to February 2012, the clinical and malaria parasitaemia status of a cohort of 357 children aged 6 months to 10 years living in Mutengene, south-western region of Cameroon, was monitored. Following the determination of baseline malaria/helminths status and haemoglobin levels, the incidence of malaria and anaemia status was determined in a 12 months longitudinal study by both active and passive case detection. Results Among all the children who completed the study, 32.5 % (116/357) of them had at least one malaria episode. The mean (±SEM) number of malaria attacks per year was 1.44 ± 0.062 (range: 1–4 episodes) with the highest incidence of episodes occuring during the rainy season months of March–October. Children <5 years old were exposed to more malaria attacks [OR = 2.34, 95 % CI (1.15–4.75), p = 0.019] and were also more susceptible to anaemia [OR = 2.24, 95 % CI (1.85–4.23), p = 0.013] compared to older children (5–10 years old). Likewise children with malaria episodes [OR = 4.45, 95 % CI (1.66–11.94), p = 0.003] as well as those with asymptomatic parasitaemia [OR = 2.41, 95 % CI (1.58–3.69) p < 0.001] were susceptible to anaemia compared to their malaria parasitaemia negative counterparts. Considering children infected with Plasmodium alone as the reference, children infected with helminths alone were associated with protection from anaemia [OR = 0.357, 95 % CI (0.141–0.901), p = 0.029]. The mean haemoglobin level (g/dl) of participants co-infected with Plasmodium and helminths was higher (p = 0.006) compared to participants infected with Plasmodium or helminths alone. Conclusion Children below 5 years of age were more susceptible to malaria and anaemia. The high prevalence of anaemia in this community was largely due to malaria parasitaemia. Malaria and helminths co-infection was protective against anaemia. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1111-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Clarisse Njua-Yafi
- Department of Animal Biology and Physiology, University of Yaounde I, Yaounde, Cameroon. .,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
| | - Eric A Achidi
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon.
| | | | - Tobias O Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon.
| | - Regina N Mugri
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
| | - Hanesh F Chi
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
| | - Rolland B Tata
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
| | - Charles Njumkeng
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
| | - Emmanuel N Nkock
- Department of Medical Laboratory Science, University of Buea, Buea, Cameroon.
| | - Theresa Nkuo-Akenji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
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Kaewpitoon SJ, Namwichaisirikul N, Loyd RA, Churproong S, Ueng-Arporn N, Matrakool L, Tongtawee T, Rujirakul R, Nimkhuntod P, Wakhuwathapong P, Kaewpitoon N. Nutritional Status among Rural Community Elderly in the Risk Area of Liver Fluke, Surin Province, Thailand. Asian Pac J Cancer Prev 2016; 16:8391-6. [DOI: 10.7314/apjcp.2015.16.18.8391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Adedoja A, Tijani BD, Akanbi AA, Ojurongbe TA, Adeyeba OA, Ojurongbe O. Co-endemicity of Plasmodium falciparum and Intestinal Helminths Infection in School Age Children in Rural Communities of Kwara State Nigeria. PLoS Negl Trop Dis 2015; 9:e0003940. [PMID: 26222743 PMCID: PMC4519155 DOI: 10.1371/journal.pntd.0003940] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/29/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Malaria and intestinal helminths co-infection are major public health problems particularly among school age children in Nigeria. However the magnitude and possible interactions of these infections remain poorly understood. This study determined the prevalence, impact and possible interaction of Plasmodium falciparum and intestinal helminths co-infection among school children in rural communities of Kwara State, Nigeria. METHODS Blood, urine and stool samples were collected from 1017 primary school pupils of ages 4-15 years. Stool samples were processed using both Kato-Katz and formol-ether concentration techniques and microscopically examined for intestinal helminths infection. Urine samples were analyzed using sedimentation method for Schistosoma haematobium. Plasmodium falciparum was confirmed by microscopy using thick and thin blood films methods and packed cell volume (PCV) was determined using hematocrit reader. Univariate analysis and chi-square statistical tests were used to analyze the data. RESULTS Overall, 61.2% of all school children had at least an infection of either P. falciparum, S. haematobium, or intestinal helminth. S. haematobium accounted for the largest proportion (44.4%) of a single infection followed by P. falciparum (20.6%). The prevalence of malaria and helminth co-infection in the study was 14.4%. Four species of intestinal helminths were recovered from the stool samples and these were hookworm (22.5%), Hymenolepis species (9.8%), Schistosoma mansoni (2.9%) and Enterobius vermicularis (0.6%). The mean densities of P. falciparum in children co-infected with S. haematobium and hookworm were higher compared to those infected with P. falciparum only though not statistically significant (p = 0.062). The age distribution of both S. haematobium (p = 0.049) and hookworm (p = 0.034) infected children were statistically significant with the older age group (10-15 years) recording the highest prevalence of 47.2% and 25% respectively. Children who were infected with S. haematobium (RR = 1.3) and hookworm (RR = 1.4) have equal chances of being infected with P. falciparum as children with no worm infection. On the other hand children infected with Hymenolepis spp. (p<0.0001) are more likely to be infected with P. falciparum than Hymenolepis spp. uninfected children (RR = 2.0). CONCLUSIONS These findings suggest that multiple parasitic infections are common in school age children in rural communities of Kwara State Nigeria. The Hymenolepis spp. induced increase susceptibility to P. falciparum could have important consequences on how concurrent infections affect the expression or pathogenesis of these infections.
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Affiliation(s)
- Ayodele Adedoja
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
- Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Bukola Deborah Tijani
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
- Department of Medical Microbiology and Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Ajibola A. Akanbi
- Department of Medical Microbiology and Parasitology, University of Ilorin, Ilorin, Nigeria
| | - Taiwo A. Ojurongbe
- Department of Mathematical and Physical Sciences, Osun State University, Osogbo, Nigeria
| | - Oluwaseyi A. Adeyeba
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
| | - Olusola Ojurongbe
- Department of Medical Microbiology and Parasitology, Ladoke Akintola University of Technology, Osogbo, Nigeria
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40
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Kobylinski KC, Alout H, Foy BD, Clements A, Adisakwattana P, Swierczewski BE, Richardson JH. Rationale for the coadministration of albendazole and ivermectin to humans for malaria parasite transmission control. Am J Trop Med Hyg 2014; 91:655-62. [PMID: 25070998 PMCID: PMC4183382 DOI: 10.4269/ajtmh.14-0187] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/04/2014] [Indexed: 10/25/2022] Open
Abstract
Recently there have been calls for the eradication of malaria and the elimination of soil-transmitted helminths (STHs). Malaria and STHs overlap in distribution, and STH infections are associated with increased risk for malaria. Indeed, there is evidence that suggests that STH infection may facilitate malaria transmission. Malaria and STH coinfection may exacerbate anemia, especially in pregnant women, leading to worsened child development and more adverse pregnancy outcomes than these diseases would cause on their own. Ivermectin mass drug administration (MDA) to humans for malaria parasite transmission suppression is being investigated as a potential malaria elimination tool. Adding albendazole to ivermectin MDAs would maximize effects against STHs. A proactive, integrated control platform that targets malaria and STHs would be extremely cost-effective and simultaneously reduce human suffering caused by multiple diseases. This paper outlines the benefits of adding albendazole to ivermectin MDAs for malaria parasite transmission suppression.
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Affiliation(s)
- Kevin C Kobylinski
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Haoues Alout
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Brian D Foy
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Archie Clements
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Poom Adisakwattana
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Brett E Swierczewski
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
| | - Jason H Richardson
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Arthropod-Borne and Infectious Diseases Laboratory, Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado; Research School of Population Health, The Australian National University, Canberra, Australian Capitol Territory, Australia; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland; Deployed Warfighter Protection Program, Armed Forces Pest Management Board, Silver Spring, Maryland
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Brickley EB, Wood AM, Kabyemela E, Morrison R, Kurtis JD, Fried M, Duffy PE. Fetal origins of malarial disease: cord blood cytokines as risk markers for pediatric severe malarial anemia. J Infect Dis 2014; 211:436-44. [PMID: 25139023 DOI: 10.1093/infdis/jiu454] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Severe malarial anemia (SMA) remains a major cause of pediatric illness and mortality in Sub-Saharan Africa. Here we test the hypothesis that prenatal exposures, reflected by soluble inflammatory mediators in cord blood, can condition an individual's susceptibility to SMA. METHODS In a Tanzanian birth cohort (n = 743), we measured cord blood concentrations of tumor necrosis factor (TNF), TNF receptors I and II (TNF-RI and TNF-RII), interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-10, and interferon gamma (IFN-γ). After adjusting for conventional covariates, we calculated the hazard ratios (HR) for time to first SMA event with log(e) cytokine concentrations dichotomized at the median, by quartile, and per standard deviation (SD) increase. RESULTS Low levels of TNF, TNF-RI, IL-1β, and IL-5 and high levels of TNF-RII were associated statistically significantly and respectively with approximately 3-fold, 2-fold, 8-fold, 4-fold, and 3-fold increased risks of SMA (Hb < 50 g/L). TNF, TNF-RI, and IL-1β concentrations were inversely and log-linearly associated with SMA risk; the HR (95% confidence interval [CI]) per 1-SD increase were respectively 0.81 (.65, 1.02), 0.76 (.62, .92), and 0.50 (.40, .62). CONCLUSIONS These data suggest that proinflammatory cytokine levels at birth are inversely associated with SMA risk and support the hypothesis that pediatric malarial disease has fetal origins.
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Affiliation(s)
- Elizabeth B Brickley
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland Department of Public Health and Primary Care, Strangeways Research Laboratories, University of Cambridge, United Kingdom
| | - Angela M Wood
- Department of Public Health and Primary Care, Strangeways Research Laboratories, University of Cambridge, United Kingdom
| | - Edward Kabyemela
- MOMS Project, Seattle Biomedical Research Institute, Washington Muheza Designated District Hospital, Tanzania
| | - Robert Morrison
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland MOMS Project, Seattle Biomedical Research Institute, Washington
| | - Jonathan D Kurtis
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Brown University Medical School, Providence
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
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The epidemiology of malaria and anaemia in the Bonikro mining area, central Côte d'Ivoire. Malar J 2014; 13:194. [PMID: 24884607 PMCID: PMC4047267 DOI: 10.1186/1475-2875-13-194] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 05/20/2014] [Indexed: 12/03/2022] Open
Abstract
Background The epidemiology of malaria and anaemia is characterized by small-scale spatial and temporal heterogeneity, which might be influenced by human activities, such as mining and related disturbance of the environment. Private sector involvement holds promise to foster public health, including the prevention and control of malaria and anaemia. Here, results from a cross-sectional epidemiological survey, conducted in communities that might potentially be affected by the Bonikro Gold Mine (BGM) in Côte d’Ivoire, are reported. Methods In December 2012, a cross-sectional survey was carried out in seven communities situated within a 20-km radius of the BGM in central Côte d’Ivoire. Capillary blood samples were obtained from children aged six to 59 months. Samples were subjected to a rapid diagnostic test (RDT) for Plasmodium falciparum detection, whilst haemoglobin (Hb) was measured to determine anaemia. Additionally, mothers were interviewed with a malaria-related knowledge, attitudes and practices questionnaire. Results A total of 339 children and 235 mothers participated in the surveys. A positive RDT for P. falciparum was found in 69% of the children, whilst 72% of the children were anaemic (Hb <11 g/dl). Plasmodium falciparum infection was significantly associated with anaemia (odds ratio (OR) 7.43, 95% confidence interval (CI) 3.97-13.89), access to a health facility (OR 5.59, 95% CI 1.81-17.32) and age (OR 0.04, 95% CI 0.01-0.12; youngest (six to 11 months) versus oldest (48-59 months) age group). Less than a quarter of mothers knew that malaria is uniquely transmitted by mosquitoes (22.3%, 95% CI 16.8-27.7%). Misconceptions were common; most of the mothers believe that working in the sun can cause malaria. Conclusions Malaria and anaemia are highly endemic in the surveyed communities around the BGM project area in Côte d’Ivoire. The data presented here provide a rationale for designing setting-specific interventions and can be utilized as a benchmark for longitudinal monitoring of potential project-related impacts due to changes in the social-ecological and health systems.
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Hürlimann E, Yapi RB, Houngbedji CA, Schmidlin T, Kouadio BA, Silué KD, Ouattara M, N'Goran EK, Utzinger J, Raso G. The epidemiology of polyparasitism and implications for morbidity in two rural communities of Côte d'Ivoire. Parasit Vectors 2014; 7:81. [PMID: 24568206 PMCID: PMC3942297 DOI: 10.1186/1756-3305-7-81] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 02/17/2014] [Indexed: 12/31/2022] Open
Abstract
Background Polyparasitism is still widespread in rural communities of the developing world. However, the epidemiology of polyparasitism and implications for morbidity are poorly understood. We studied patterns of multiple species parasite infection in two rural communities of Côte d’Ivoire, including associations and interactions between infection, clinical indicators and self-reported morbidity. Methods Between August and September 2011, two purposely selected rural communities in southern Côte d’Ivoire were screened for helminth, intestinal protozoa and Plasmodium infection, using a suite of quality-controlled diagnostic methods. Additionally, participants were examined clinically and we measured haemoglobin level, height, weight and mid-upper arm circumference to determine nutritional status. An anamnestic questionnaire was administered to assess people’s recent history of diseases and symptoms, while a household questionnaire was administered to heads of household to collect socioeconomic data. Multivariate logistic regression models were applied for assessment of possible associations between parasitic (co-)infections and morbidity outcomes. Results 912/1,095 (83.3%) study participants had complete parasitological data and 852 individuals were considered for in-depth analysis. The rate of polyparasitism was high, with Plasmodium falciparum diagnosed as the predominant species, followed by Schistosoma haematobium, Schistosoma mansoni and hookworm. There were considerable differences in polyparasitic infection profiles among the two settings. Clinical morbidity such as anaemia, splenomegaly and malnutrition was mainly found in young age groups, while in adults, self-reported morbidity dominated. High parasitaemia of P. falciparum was significantly associated with several clinical manifestations such as anaemia, splenomegaly and fever, while light-intensity helminth infections seemed to have beneficial effects, particularly for co-infected individuals. Conclusions Clinical morbidity is disturbingly high in young age groups in rural communities of Côte d’Ivoire and mainly related to very high P. falciparum endemicity. Interactions between helminth infections and P. falciparum burden (parasitaemia and clinical morbidity) are evident and must be taken into account to design future interventions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P,O, Box, CH-4002, Basel, Switzerland.
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Abdoli A, Pirestani M. Are pregnant women with chronic helminth infections more susceptible to congenital infections? Front Immunol 2014; 5:53. [PMID: 24575099 PMCID: PMC3921675 DOI: 10.3389/fimmu.2014.00053] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 01/29/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amir Abdoli
- Department of Parasitology, Faculty of Medical Sciences, Kashan University of Medical Science , Kashan , Iran ; Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University , Tehran , Iran
| | - Majid Pirestani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University , Tehran , Iran
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Castelli F, Sulis G, Caligaris S. The relationship between anaemia and malaria: apparently simple, yet controversial. Trans R Soc Trop Med Hyg 2014; 108:181-2. [PMID: 24488980 DOI: 10.1093/trstmh/tru012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Among many other factors, malaria plays a major causative role of anaemia globally. The mechanisms leading to anaemia in the course of malaria are extremely diverse, involving immunological factors that act differently according to age and malaria epidemiology. The malaria-attributable fraction of anaemia may then differ in different settings. While tremendous efforts are being made to control malaria, the availability of a simple and reliable biomarker of impact is of the upmost importance. Promising data are accumulating that Hb levels could be used as a proxy of malaria even in hypo-endemic areas, even if many grey areas still deserve research efforts.
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Affiliation(s)
- Francesco Castelli
- University Division of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy
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