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Rodgers ML, Bolnick DI. Opening a can of worms: a test of the co-infection facilitation hypothesis. Oecologia 2024; 204:317-325. [PMID: 37386196 PMCID: PMC10756930 DOI: 10.1007/s00442-023-05409-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/12/2023] [Indexed: 07/01/2023]
Abstract
Parasitic infections are a global occurrence and impact the health of many species. Coinfections, where two or more species of parasite are present in a host, are a common phenomenon across species. Coinfecting parasites can interact directly or indirectly via their manipulation of (and susceptibility to) the immune system of their shared host. Helminths, such as the cestode Schistocephalus solidus, are well known to suppress immunity of their host (threespine stickleback, Gasterosteus aculeatus), potentially facilitating other parasite species. Yet, hosts can evolve a more robust immune response (as seen in some stickleback populations), potentially turning facilitation into inhibition. Using wild-caught stickleback from 20 populations with non-zero S. solidus prevalence, we tested an a priori hypothesis that S. solidus infection facilitates infection by other parasites. Consistent with this hypothesis, individuals with S. solidus infections have 18.6% higher richness of other parasites compared to S. solidus-uninfected individuals from the same lakes. This facilitation-like trend is stronger in lakes where S. solidus is particularly successful but is reversed in lakes with sparse and smaller cestodes (indicative of stronger host immunity). These results suggest that a geographic mosaic of host-parasite co-evolution might lead to a mosaic of between-parasite facilitation/inhibition effects.
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Affiliation(s)
- Maria L Rodgers
- Department of Ecology and Evolutionary Biology, University of Connecticut, Storrs, CT, 06269, USA.
- Department of Biological Sciences, North Carolina State University, Morehead City, NC, 28557, USA.
| | - Daniel I Bolnick
- Department of Ecology and Evolutionary Biology, University of Connecticut, Storrs, CT, 06269, USA
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Rodgers ML, Bolnick DI. Opening a can of worms: a test of the coinfection facilitation hypothesis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.18.541347. [PMID: 37292793 PMCID: PMC10245757 DOI: 10.1101/2023.05.18.541347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Parasitic infections are a global occurrence and impact the health of many species. Coinfections, where two or more species of parasite are present in a host, are a common phenomenon across species. Coinfecting parasites can interact directly, or indirectly via their manipulation of (and susceptibility to) the immune system of their shared host. Helminths, such as the cestode Schistocephalus solidus , are well known to suppress immunity of their host (threespine stickleback, Gasterosteus aculeatus ), potentially facilitating other parasite species. Yet, hosts can evolve a more robust immune response (as seen in some stickleback populations), potentially turning facilitation into inhibition. Using wild-caught stickleback from 21 populations with non-zero S. solidus prevalence, we tested an a priori hypothesis that S. solidus infection facilitates infection by other parasites. Consistent with this hypothesis, individuals with S. solidus infections have 18.6% higher richness of other parasites, compared to S. solidus -uninfected individuals from the same lakes. This facilitation-like trend is stronger in lakes where S. solidus is particularly successful but is reversed in lakes with sparse and smaller cestodes (indicative of stronger host immunity). These results suggest that a geographic mosaic of host-parasite coevolution might lead to a mosaic of between-parasite facilitation/inhibition effects.
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Schluth CG, Standley CJ, Bansal S, Carlson CJ. Spatial parasitology and the unmapped human helminthiases. Parasitology 2023; 150:1-9. [PMID: 36632014 PMCID: PMC10090474 DOI: 10.1017/s0031182023000045] [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: 08/28/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023]
Abstract
Helminthiases are a class of neglected tropical diseases that affect at least 1 billion people worldwide, with a disproportionate impact on resource-poor areas with limited disease surveillance. Geospatial methods can offer valuable insights into the burden of these infections, particularly given that many are subject to strong ecological influences on the environmental, vector-borne or zoonotic stages of their life cycle. In this study, we screened 6829 abstracts and analysed 485 studies that use maps to document, infer or predict transmission patterns for over 200 species of parasitic worms. We found that quantitative mapping methods are increasingly used in medical parasitology, drawing on One Health surveillance data from the community scale to model geographic distributions and burdens up to the regional or global scale. However, we found that the vast majority of the human helminthiases may be entirely unmapped, with research effort focused disproportionately on a half-dozen infections that are targeted by mass drug administration programmes. Entire regions were also surprisingly under-represented in the literature, particularly southern Asia and the Neotropics. We conclude by proposing a shortlist of possible priorities for future research, including several neglected helminthiases with a burden that may be underestimated.
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Affiliation(s)
| | - Claire J. Standley
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Colin J. Carlson
- Department of Biology, Georgetown University, Washington, DC, USA
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA
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Perry MA, Gowland RL. Compounding vulnerabilities: Syndemics and the social determinants of disease in the past. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2022; 39:35-49. [PMID: 36215930 DOI: 10.1016/j.ijpp.2022.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This article explores the theory and utility of a syndemic approach for the study of disease in the past. Syndemic principles are examined alongside other theoretical developments within bioarchaeology. Two case studies are provided to illustrate the efficacy of this approach: Tuberculosis and vitamin D deficiency in 18th and 19th century England, and malaria and helminth infections in Early Medieval England. MATERIALS Public health studies of present syndemics, in addition to published bioarchaeological, clinical and social information relating to the chosen case studies. METHODS The data from these two historical examples are revisited within a syndemic framework to draw deeper conclusions about disease clustering and heterogeneity in the past. RESULTS A syndemic framework can be applied to past contexts using clinical studies of diseases in a modern context and relevant paleopathological, archaeological, and historical data. CONCLUSIONS This approach provides a means for providing a deeper, contextualised understanding ancient diseases, and integrates well with extant theoretical tools in bioarchaeology SIGNIFICANCE: Syndemics provides scholars a deep-time perspective on diseases that still impact modern populations. LIMITATIONS Many of the variables essential for a truly syndemic approach cannot be obtained from current archaeological, bioarchaeological, or historical methods. SUGGESTIONS FOR FURTHER RESEARCH More detailed and in-depth analysis of specific disease clusters within the past and the present, which draws on a comprehensive analysis of the social determinants of health.
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Affiliation(s)
- Megan A Perry
- Department of Anthropology MS 568, East Carolina University, Greenville, NC 27858, USA.
| | - Rebecca L Gowland
- Department of Archaeology, Durham University, South Road, Durham DH1 3LE, UK.
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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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Corbacho-Loarte MD, Crespillo-Andújar C, Chamorro-Tojeiro S, Norman F, Pérez-Molina JA, Martín O, Rubio JM, Gullón-Peña B, López-Vélez R, Monge-Maillo B. Screening of imported malaria infection in asymptomatic migrants from Sub-Saharan Africa: A retrospective analysis of a 2010-2019 cohort. Travel Med Infect Dis 2022; 49:102411. [PMID: 35933089 DOI: 10.1016/j.tmaid.2022.102411] [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: 06/17/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Up to 40% of cases of imported malaria in Europe are diagnosed in recently arrived migrants, who generally exhibit asymptomatic or mild symptoms and show low parasitaemia (submicroscopic). The study describes the prevalence of malaria infection among asymptomatic Sub-Saharan African migrants (ASSAM) and compares asymptomatic malaria-infected (AMI) vs non-malaria infected patients. METHODS An observational, comparative, retrospective study was carried out in ASSAM who underwent a medical examination, between 2010 and 2019 at the National Reference Unit for Tropical Diseases (NRU-Trop) in Madrid, Spain. Medical examination and systematic screening protocol for infectious diseases, including screening for malaria infection by Polymerase Chain Reaction (PCR) was performed. RESULTS During the study period, 632 out of 1061 ASSAM were screened for malaria, median age: 24 years (IQR:1-5); median time from arrival to diagnosis: 2 months (IQR:1-5). P. falciparum was the most frequent species: 61 patients (67.8%). Compared to non-malaria infected, AMI subjects had: higher rate of co-infection with S. stercoralis (41.1%VS 22.9%;p < 0.001) and filariae (8.9% VS 2.4%;p = 0.006), lower erythrocyte corpuscular volume (83.6 VS 84.4;p = 0.008) and lower levels of cholesterol (151.0 VS 167.3;p < 0.001). CONCLUSIONS We observed a high prevalence of AMI among ASSAM. This highlights the need to consider routing screening of migrants from endemic areas and to study if such screening could avoid the potential morbidities associated with chronic infection, reduce morbi-mortality of acute malaria and the risk of transmission in host communities.
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Affiliation(s)
- María Dolores Corbacho-Loarte
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Clara Crespillo-Andújar
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Sandra Chamorro-Tojeiro
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Francesca Norman
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - José Antonio Pérez-Molina
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Oihane Martín
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain; Microbiology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - José Miguel Rubio
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Gullón-Peña
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Hospital Ramon y Cajal, IRYCIS, Madrid, Spain.
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Makenga G, Baraka V, Francis F, Minja DTR, Gesase S, Kyaruzi E, Mtove G, Nakato S, Madebe R, Søeborg SR, Langhoff KH, Hansson HS, Alifrangis M, Lusingu JPA, Van geertruyden JP. Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania. PLoS One 2022; 17:e0268654. [PMID: 35617296 PMCID: PMC9135275 DOI: 10.1371/journal.pone.0268654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 04/01/2022] [Indexed: 11/18/2022] Open
Abstract
In Africa, children aged 5 to 15 years (school age) comprises more than 50% (>339 million) of the under 19 years population, and are highly burdened by malaria and anaemia that impair cognitive development. For the prospects of improving health in African citizens, understanding malaria and its relation to anaemia in school-aged children, it is crucial to inform targeted interventions for malaria control and accelerate elimination efforts as part of improved school health policy. We conducted a study to determine the risk factors for asymptomatic malaria and their association to anaemia. We explored the prevalence of antimalarial drug resistance as well as the association of asymptomatic malaria infection and anaemia on cognitive and psychomotor functions in school-aged children living in high endemic areas. This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial on the effectiveness and safety of antimalarial drugs in preventing malaria and its related morbidity in schoolchildren. We enrolled 1,587 schoolchildren from 7 primary schools located in Muheza, north-eastern Tanzania. Finger-pricked blood samples were collected for estimation of malaria parasitaemia using a microscope, haemoglobin concentration using a haemoglobinometer, and markers of drug resistance processed from dried blood spots (DBS). Psychomotor and Cognitive functions were assessed using a ‘20 metre Shuttle run’ and a test of everyday attention for children (TEA-Ch), respectively. The prevalence of asymptomatic malaria parasitaemia, anaemia and stunting was 26.4%, 49.8%, and 21.0%, respectively with marked variation across schools. In multivariate models, asymptomatic malaria parasitaemia attributed to 61% of anaemia with a respective population attribution fraction of 16%. Stunting, not sleeping under a bednet and illiterate parent or guardian were other factors attributing to 7%, 9%, and 5% of anaemia in the study population, respectively. Factors such as age group (10–15 years), not sleeping under a bednet, low socioeconomic status, parents’ or guardians’ with a low level of education, children overcrowding in a household, and fewer rooms in a household were significantly attributed to higher malaria infection. There was no significant association between malaria infection or anaemia and performance on tests of cognitive function (sustained attention) or psychomotor function (VO2 max). However, a history of malaria in the past one month was significantly associated with decreased cognitive scores (aOR = -4.1, 95% CI -7.7–0.6, p = 0.02). Furthermore, stunted children had significantly lower VO2max scores (aOR = -1.9, 95% CI -3.0–0.8, p = 0.001). Regarding the antimalarial drug resistance markers, the most prevalent Pfmdr1 86-184-1034-1042-1246 haplotypes were the NFSND in 47% (n = 88) and the NYSND in 52% (n = 98). The wild type Pfcrt haplotypes (codons 72–76, CVMNK) were found in 99.1% (n = 219) of the samples. Malaria, stunting and parents’ or guardians’ illiteracy were the key attributable factors for anaemia in schoolchildren. Given malaria infection in schoolchildren is mostly asymptomatic; an addition of interventional programmes such as intermittent preventive treatment of malaria in schoolchildren (IPTsc) would probably act as a potential solution while calling for an improvement in the current tools such as bednet use, school food programme, and community-based (customised) health education with an emphasis on nutrition and malaria control.
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Affiliation(s)
- Geofrey Makenga
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
- Global Health Institute, University of Antwerp, Antwerp, Belgium
- * E-mail:
| | - Vito Baraka
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Filbert Francis
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | | | - Samwel Gesase
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Edna Kyaruzi
- College of Education (DUCE), University of Dar es Salaam, Dar es Salaam, Tanzania
| | - George Mtove
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Swabra Nakato
- Global Health Institute, University of Antwerp, Antwerp, Belgium
| | - Rashid Madebe
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Sif R. Søeborg
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Kathrine H. Langhoff
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Helle S. Hansson
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Alifrangis
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
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Pousibet-Puerto J, Lozano-Serrano AB, Soriano-Pérez MJ, Vázquez-Villegas J, Giménez-López MJ, Cabeza-Barrera MI, Cuenca-Gómez JÁ, Palanca-Giménez M, Luzón-García MP, Castillo-Fernández N, Cabezas-Fernández MT, Salas-Coronas J. Migration-associated malaria from Africa in southern Spain. Parasit Vectors 2021; 14:240. [PMID: 33962647 PMCID: PMC8103587 DOI: 10.1186/s13071-021-04727-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background The western area of the province of Almeria, sited in southern Spain, has one of the highest immigrant population rates in Spain, mainly dedicated to agricultural work. In recent years, there has been a significant increase in the number of cases of imported malaria associated with migrants from countries belonging to sub-Saharan Africa. The objective of our study is to describe the epidemiological, clinical and analytical characteristics of malaria patients treated in a specialized tropical unit, paying special attention to the differences between VFR and non-VFR migrants and also to the peculiarities of microscopic malaria cases compared to submicroscopic ones. Methods Retrospective observational study of migrants over 14 years of age with imported malaria treated from October 2004 to May 2019. Characteristics of VFR and non-VFR migrants were compared. Malaria cases were divided into microscopic malaria (MM) and submicroscopic malaria (SMM). SMM was defined as the presence of a positive malaria PCR test together with a negative direct microscopic examination and a negative rapid diagnostic test (RDT). Microscopic malaria was defined as the presence of a positive RDT and/or a positive smear examination. Results Three hundred thirty-six cases of malaria were diagnosed, 329 in sub-Saharan immigrants. Of these, 78.1% were VFR migrants, in whom MM predominated (85.2% of cases). In non-VFR migrants, SMM represented 72.2% of the cases. Overall, 239 (72.6%) patients presented MM and 90 (27.4%) SMM. Fever was the most frequent clinical manifestation (64.4%), mainly in the MM group (MM: 81.1% vs SMM: 20.0%; p < 0.01). The most frequent species was P. falciparum. Patients with SMM presented fewer cytopenias and a greater number of coinfections due to soil-transmitted helminths, filarial and intestinal protozoa compared to patients with MM. Conclusions Imported malaria in our area is closely related to sub-Saharan migration. VFR migrants are the main risk group, highlighting the need for actions aimed at improving disease prevention measures. On the other hand, almost a third of the cases are due to SMM. This fact could justify its systematic screening, at least for those travelers at greater risk. Graphic Abstract ![]()
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Joaquín Salas-Coronas
- Tropical Medicine Unit. Hospital de Poniente, El Ejido, Almería, Spain. .,CEMyRI (Center for the Study of Migration and Intercultural Relations) of the University of Almeria, Almería, Spain.
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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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Dejon-Agobé JC, Adegnika AA, Grobusch MP. Haematological changes in Schistosoma haematobium infections in school children in Gabon. Infection 2021; 49:645-651. [PMID: 33486713 PMCID: PMC8316219 DOI: 10.1007/s15010-020-01575-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/30/2020] [Indexed: 01/03/2023]
Abstract
Background Schistosomiasis is a parasitic disease affecting the blood cell. As a chronic disease, schistosomiasis particularly impacts on the human host’s haematological profile. We assessed here the impact of urogenital schistosomiasis on the full blood counts (FBC) as proxy diagnostic tool for schistosomiasis. Methods A cross-sectional study was conducted among school children living in Lambaréné, Gabon. Schistosomiasis status was determined using urine filtration technique. EDTA blood samples were analysed using a Pentra ABX 60® analyzer. Results Compared to their infection-free counterparts, school children infected with Schistosoma haematobium displayed an altered FBC profile, with changes in all three blood cell lines. Adjusted for praziquantel intake, soil-transmitted helminthic infections and Plasmodium falciparum infection status, schistosomiasis was independently associated with a decreasing trend of mean haemoglobin (β = − 0.20 g/dL, p-value = 0.08) and hematocrit (β = − 0.61%, p-value = 0.06) levels, a lower mean MCV (β = − 1.50µm3, p-value = 0.02) and MCH (β = − 0.54 pg, p-value = 0.04), and higher platelet (β = 28.2 103/mm3, p-value = 0.002) and leukocyte (β = 1.13 103/mm3, p-value = 0.0003) counts, respectively. Conclusions Schistosomiasis is associated with a characteristic FBC profile of schoolchildren living in Lambaréné, indicating the necessity to consider schistosomiasis as a single cause of disease, or a co-morbidity, when interpreting FBC in endemic areas.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, BP 242, Lambaréné, Gabon.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Ayôla A Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, BP 242, Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands.,Institut Für Tropenmedizin, Eberhard Karls University Tübingen, 72074, Tübingen, Germany.,German Center for Infection Research, Partner Site Tübingen, 72074, Tübingen, Germany.,Fondation Pour la Recherche Scientifique, 72 BP 045, Cotonou, Benin
| | - Martin P Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, BP 242, Lambaréné, Gabon. .,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands. .,Institut Für Tropenmedizin, Eberhard Karls University Tübingen, 72074, Tübingen, Germany. .,Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone. .,Institute of Infectious Diseases and Molecular Medicine (IIDMM), Cape Town, Republic of South Africa.
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11
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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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12
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Syndemic anemia in British Malaya: An early global health encounter with hookworm and malaria co-infections in plantation workers. Soc Sci Med 2020; 295:113555. [PMID: 33261905 DOI: 10.1016/j.socscimed.2020.113555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/22/2020] [Accepted: 11/23/2020] [Indexed: 11/23/2022]
Abstract
With the establishment of the International Health Commission in 1913, the Rockefeller Foundation sought governmental partnerships overseas to combat hookworm disease and improve feces disposal practices. In the Madras Presidency in British India, the India Research Fund Association carried out hookworm surveys but failed in its educational efforts to improve feces disposal practices. In British Malaya, the Uncinariasis [Hookworm] Commission to the Orient discovered a syndemic of anemia among Tamil plantation laborers from the Madras Presidency and Chinese laborers from southern China who suffered from hookworm and malarial co-infections. Confronted with the apparent infeasibility of improving feces disposal practices and the obdurate fact of re-infection with hookworm after purgative treatment, the Rockefeller Foundation ended its hookworm initiative in British Malaya without advocating for programmatic intervention against syndemic anemia. The essay concludes with a reflection on the engagement of historians with the syndemic paradigm.
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13
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Vengesai A, Marume A, Midzi H, Kasambala M, Naicker T, Mduluza T. Association of TNF (rs1800629) promoter polymorphism and schistosomiasis with sub-microscopic asymptomatic Plasmodium falciparum infections in a schistosomiasis-endemic area in Zimbabwe. Trop Med Int Health 2020; 26:366-373. [PMID: 33191564 DOI: 10.1111/tmi.13527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Infection with Plasmodium falciparum parasites may result in a wide spectrum of symptoms ranging from asymptomatic to mild or severe. A number of factors are associated with this heterogeneous response to P. falciparum infection. In the present study, associations of sub-microscopic asymptomatic P. falciparum with Schistosoma species and TNF (rs1800629) polymorphism were investigated. METHODS 361 clinically healthy primary school children were microscopically screened for S. haematobium, S. mansoni and P. falciparum. Sub-microscopic asymptomatic P. falciparum infections were determined by PCR. Genotypic profiles were identified using ARMS-PCR. Logistic regression was used to assess the association of sub-microscopic asymptomatic P. falciparum with Schistosoma species and TNF (rs1800629) polymorphism. RESULTS 17.2% of the children were infected with S. mansoni, and 27.4% were infected with S. haematobium. Microscopic examination of thick smears detected only one child infected with P. falciparum. Based on PCR results, 46.1% were infected with sub-microscopic asymptomatic P. falciparum. Children carrying heterozygous AG (OR: 16.964, 95% CI: 0.496-586.547) and homozygous GG (OR: 2.280, 95% CI: 0.111-46.796) genotypes of rs1800629 were associated with an increased likelihood of sub-microscopic asymptomatic P. falciparum infections compared with those carrying homozygous AA genotype. Children without S. haematobium infections (OR: 1.051, 95% CI: 0.146-8.985) and S. mansoni (OR: 2.658, 95% CI: 0.498-14.184) also had an increased likelihood (risk) of being infected with sub-microscopic asymptomatic P. falciparum compared with the Schistosoma-infected groups. However, all the associations observed were not statistical significant. CONCLUSION No associations were observed between rs1800629 and schistosomiasis with sub-microscopic asymptomatic P. falciparum infections. This study also reports a high prevalence of sub-microscopic asymptomatic P. falciparum infection concomitant with low malaria transmission.
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Affiliation(s)
- Arthur Vengesai
- Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe.,School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Amos Marume
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Herald Midzi
- Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe
| | - Maritha Kasambala
- Department of Biology, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Thajasvarie Naicker
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Takafira Mduluza
- Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe
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14
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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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15
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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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16
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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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17
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Valice EM, Wiegand RE, Mwinzi PNM, Karanja DMS, Williamson JM, Ochola E, Samuels A, Verani JR, Leon JS, Secor WE, Montgomery SP. Relative Contribution of Schistosomiasis and Malaria to Anemia in Western Kenya. Am J Trop Med Hyg 2018; 99:713-715. [PMID: 29988002 PMCID: PMC6169184 DOI: 10.4269/ajtmh.18-0069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/04/2018] [Indexed: 02/04/2023] Open
Abstract
Because anemia is one of the markers of morbidity associated with schistosomiasis, it has been proposed as a potential measure to evaluate the impact of control programs. However, anemia is also a common consequence of malaria, and schistosomiasis and malaria are often co-endemic. To estimate the attributable fraction of anemia due to Schistosoma mansoni and Plasmodium falciparum infections, we applied a log-binomial model to four studies measuring these parameters of a combined 5,849 children in western Kenya. In our studies, malaria contributed 23.3%, schistosomiasis contributed 6.6%, and co-infection contributed 27.6% of the anemia. We conclude that in areas where S. mansoni and P. falciparum are co-endemic, the contribution of schistosomiasis to anemia is masked by anemia resulting from malaria, thus limiting anemia as a useful measure for schistosomiasis control programs in these settings.
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Affiliation(s)
- Emily M. Valice
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ryan E. Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pauline N. M. Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Diana M. S. Karanja
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - John M. Williamson
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth Ochola
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Aaron Samuels
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer R. Verani
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Juan S. Leon
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - W. Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan P. Montgomery
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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18
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Dejon-Agobé JC, Zinsou JF, Honkpehedji YJ, Ateba-Ngoa U, Edoa JR, Adegbite BR, Mombo-Ngoma G, Agnandji ST, Ramharter M, Kremsner PG, Lell B, Grobusch MP, Adegnika AA. Schistosoma haematobium effects on Plasmodium falciparum infection modified by soil-transmitted helminths in school-age children living in rural areas of Gabon. PLoS Negl Trop Dis 2018; 12:e0006663. [PMID: 30080853 PMCID: PMC6095623 DOI: 10.1371/journal.pntd.0006663] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/16/2018] [Accepted: 07/05/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Malaria burden remains high in the sub-Saharan region where helminths are prevalent and where children are often infected with both types of parasites. Although the effect of helminths on malaria infection is evident, the impact of these co-infections is not clearly elucidated yet and the scarce findings are conflicting. In this study, we investigated the effect of schistosomiasis, considering soil-transmitted helminths (STH), on prevalence and incidence of Plasmodium falciparum infection. METHODOLOGY This longitudinal survey was conducted in school-age children living in two rural communities in the vicinity of Lambaréné, Gabon. Thick blood smear light microscopy, urine filtration and the Kato-Katz technique were performed to detect malaria parasites, S. haematobium eggs and, STH eggs, respectively. P. falciparum carriage was assessed at inclusion, and incidence of malaria and time to the first malaria event were recorded in correlation with Schistosoma carriage status. Stratified multivariate analysis using generalized linear model was used to assess the risk of plasmodium infection considering interaction with STH, and survival analysis to assess time to malaria. MAIN FINDINGS The overall prevalence on subject enrolment was 30%, 23% and 9% for S. haematobium, P. falciparum infections and co-infection with both parasites, respectively. Our results showed that schistosomiasis in children tends to increase the risk of plasmodium infection but a combined effect with Trichuris trichiura or hookworm infection clearly increase the risk (aOR = 3.9 [95%CI: 1.7-9.2]). The incidence of malaria over time was 0.51[95%CI: 0.45-0.57] per person-year and was higher in the Schistosoma-infected group compared to the non-infected group (0.61 vs 0.43, p = 0.02), with a significant delay of time-to first-malaria event only in children aged from 6 to 10-years-old infected with Schistosoma haematobium. CONCLUSIONS Our results suggest that STH enhance the risk for P. falciparum infection in schistosomiasis-positive children, and when infected, that schistosomiasis enhances susceptibility to developing malaria in young children but not in older children.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Yabo Josiane Honkpehedji
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ulysse Ateba-Ngoa
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jean-Ronald Edoa
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Bayodé Roméo Adegbite
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Ghyslain Mombo-Ngoma
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Departement de Parasitologie-Mycologie, Faculté de Médecine, Université des Sciences de la Santé, Owendo, Gabon
| | - Selidji Todagbe Agnandji
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Michael Ramharter
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I, Department of Medicine, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Gottfried Kremsner
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
- * E-mail:
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Adu-Gyasi D, Asante KP, Frempong MT, Gyasi DK, Iddrisu LF, Ankrah L, Dosoo D, Adeniji E, Agyei O, Gyaase S, Amenga-Etego S, Gyan B, Owusu-Agyei S. Epidemiology of soil transmitted Helminth infections in the middle-belt of Ghana, Africa. Parasite Epidemiol Control 2018; 3:e00071. [PMID: 29988303 PMCID: PMC6020085 DOI: 10.1016/j.parepi.2018.e00071] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 02/19/2018] [Accepted: 04/22/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Helminths are among the most widespread infectious agents prevalent in tropical and sub-tropical regions of the developing world defined by inadequate sanitation, poverty and unsafe water sources. This study was carried out to describe the distribution of helminth and malaria parasite infections in the middle-belt of Ghana in sub-Saharan Africa where disease burden, including anaemia is rife and helminths are perceived to be significant contributors of the burden. METHODS A cross-sectional survey involving 1826 residents located in the middle belt of Ghana where no or very little previous community-based helminth work had been carried out. The participants randomly recruited at household level provided biological samples collected over a 12-month period following a rigorous consenting process and these were analysed to describe the different types and seasonal distribution of helminths. FINDINGS Overall, 19.3% intestinal helminth infection prevalence was documented. Also based on parasites targeted for elimination, 12.1% Hookworm, 4.0% Hymenolepis nana/Hymenolepis dimunita, 1.5% Ascaris lumbricoides, 1.5% Taenia species, 0.9% Strongyloides stercoralis and 0.8% Trichuris trichiura, with about 1.0% polyphelminthiasis were recorded in the survey. About 55.4% and 44.4% of the participants had heavy hookworm and Trichuris infections respectively. Most of the Ascariasis (83.3%) infections were light in intensity. Hookworm infection was identified with significant odds considering decreasing age (OR = 2.09, p = 0.03), inappropriate footwear use (OR = 1.88, p = 0.021), malaria parasite co-infection (OR = 1.62, p = 0.018), not scrubbing nails during hand washing (OR = 0.68, p = 0.048), source of drinking water (OR = 2.51, p = 0.027) and religion (OR = 4.36, p = 0.002). CONCLUSIONS Hookworm infection was significantly higher in younger age groups and among those who did not have safe drinking water. Proper sanitation, protective footwear, religion and good personal hygiene practices were found to influence helminth and hookworm prevalence in the area. Malaria parasite coinfection with helminths, especially hookworm infections increased 2-fold.
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Affiliation(s)
- Dennis Adu-Gyasi
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - Margaret T. Frempong
- Kwame Nkrumah University of Science and Technology (KNUST), Department of Molecular Medicine, PMB, Kumasi, Ghana
| | | | | | - Love Ankrah
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - David Dosoo
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - Elisha Adeniji
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - Oscar Agyei
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - Stephaney Gyaase
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - Seeba Amenga-Etego
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
| | - Ben Gyan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, P O Box 200, Kintampo, Brong Ahafo, Ghana
- Institute of Health Research, University of Health & Allied Sciences, Ho. Ghana
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20
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Lo AC, Faye B, Gyan BA, Amoah LE. Plasmodium and intestinal parasite perturbations of the infected host's inflammatory responses: a systematic review. Parasit Vectors 2018; 11:387. [PMID: 29970128 PMCID: PMC6031113 DOI: 10.1186/s13071-018-2948-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/12/2018] [Indexed: 01/03/2023] Open
Abstract
Co-infection of malaria and intestinal parasites is widespread in sub-Saharan Africa and causes severe disease especially among the poorest populations. It has been shown that an intestinal parasite (helminth), mixed intestinal helminth or Plasmodium parasite infection in a human induces a wide range of cytokine responses, including anti-inflammatory, pro-inflammatory as well as regulatory cytokines. Although immunological interactions have been suggested to occur during a concurrent infection of helminths and Plasmodium parasites, different conclusions have been drawn on the influence this co-infection has on cytokine production. This review briefly discusses patterns of selected cytokine (IL-6, IL-8, IL-10, TNF-α and INF-γ) responses associated with infections caused by Plasmodium, intestinal parasites as well as a Plasmodium-helminth co-infection.
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Affiliation(s)
- Aminata Colle Lo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,University Cheikh Anta DIOP, Dakar, Senegal
| | | | - Ben Adu Gyan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Linda Eva Amoah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
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21
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Abbate JL, Ezenwa VO, Guégan JF, Choisy M, Nacher M, Roche B. Disentangling complex parasite interactions: Protection against cerebral malaria by one helminth species is jeopardized by co-infection with another. PLoS Negl Trop Dis 2018; 12:e0006483. [PMID: 29746467 PMCID: PMC5963812 DOI: 10.1371/journal.pntd.0006483] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/22/2018] [Accepted: 04/30/2018] [Indexed: 12/24/2022] Open
Abstract
Multi-species interactions can often have non-intuitive consequences. However, the study of parasite interactions has rarely gone beyond the effects of pairwise combinations of species, and the outcomes of multi-parasite interactions are poorly understood. We investigated the effects of co-infection by four gastrointestinal helminth species on the development of cerebral malaria among Plasmodium falciparum-infected patients. We characterized associations among the helminth parasite infra-community, and then tested for independent (direct) and co-infection dependent (indirect) effects of helminths on cerebral malaria risk. We found that infection by Ascaris lumbricoides and Trichuris trichiura were both associated with direct reductions in cerebral malaria risk. However, the benefit of T. trichiura infection was halved in the presence of hookworm, revealing a strong indirect effect. Our study suggests that the outcome of interactions between two parasite species can be significantly modified by a third, emphasizing the critical role that parasite community interactions play in shaping infection outcomes.
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Affiliation(s)
- Jessica L Abbate
- UMMISCO, IRD / Sorbonne Université, Bondy, France.,MIVEGEC, IRD, CNRS, Université Montpellier, Montpellier, France
| | - Vanessa O Ezenwa
- Odum School of Ecology and Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States of America
| | | | - Marc Choisy
- MIVEGEC, IRD, CNRS, Université Montpellier, Montpellier, France.,Oxford University Clinical Research Unit, Hanoi, Vietnam
| | - Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana.,EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, French Guiana
| | - Benjamin Roche
- UMMISCO, IRD / Sorbonne Université, Bondy, France.,MIVEGEC, IRD, CNRS, Université Montpellier, Montpellier, France.,Departamento de Etología, Fauna Silvestre y Animales de Laboratorio, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, México
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22
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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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23
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M’bondoukwé NP, Kendjo E, Mawili-Mboumba DP, Koumba Lengongo JV, Offouga Mbouoronde C, Nkoghe D, Touré F, Bouyou-Akotet MK. Prevalence of and risk factors for malaria, filariasis, and intestinal parasites as single infections or co-infections in different settlements of Gabon, Central Africa. Infect Dis Poverty 2018; 7:6. [PMID: 29378644 PMCID: PMC5789590 DOI: 10.1186/s40249-017-0381-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 12/13/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Malaria, filariasis, and intestinal parasitic infections (IPIs) are common and frequently overlap in developing countries. The prevalence and predictors of these infections were investigated in three different settlements (rural, semi-urban, and urban) of Gabon. METHODS During cross-sectional surveys performed from September 2013 to June 2014, 451 individuals were interviewed. In addition, blood and stool samples were analysed for the presence of Plasmodium, filarial roundworm, intestinal protozoan, and helminth infections. RESULTS Intestinal parasitic infections (61.1%), including intestinal protozoa (56.7%) and soil-transmitted helminths (STHs) (22.2%), predominated, whereas Plasmodium falciparum (18.8%), Loa loa (4.7%), and Mansonella perstans (1.1%) were less prevalent. Filariasis and STHs were mainly found in rural settlements, whereas a higher plasmodial infection prevalence rate was observed in the periurban area. The most common IPI was blastocystosis (48.6%), followed by ascaridiasis (13.7%), trichuriasis (11.8%), amoebiasis (9.3%), giardiasis (4.8%), and strongyloidiasis (3.7%). Hookworm was detected in one adult from rural Dienga. Adults had a higher prevalence of Blastocystis hominis and STHs, whereas Giardia duodenalis was more frequently observed among children aged below 5 years (P < 0.01). The polyparasitism rate was 41.5%, with 7.0% Plasmodium-IPIs and 1.8% Plasmodium-STH co-infections. The multivariate analysis showed that living in a suburban area, belonging to the age group of 5-15 years, having none or a secondary education, or having an open body water close to home were significant risk factors for malaria (P ≤ 0.01). For STH infections, identified risk factors were drinking untreated water and living in a rural area (P ≤ 0.04). No significant predictors were identified for IPIs and malaria-IPI co-infection. CONCLUSIONS This study reports a high prevalence of IPIs and intestinal protozoa, but a low rate of malaria-IPI co-infections in the study sites. Improvements in the living conditions of the population such as adequate water supply and proper health education and sanitation should be integrated into control strategies for malaria, STHs, and IPIs.
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Affiliation(s)
- Noé Patrick M’bondoukwé
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Eric Kendjo
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Jeanne Vanessa Koumba Lengongo
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Christelle Offouga Mbouoronde
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Dieudonné Nkoghe
- International Center for Medical Research of Franceville, Franceville, Gabon
| | - Fousseyni Touré
- International Center for Medical Research of Franceville, Franceville, Gabon
| | - Marielle Karine Bouyou-Akotet
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
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24
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Abstract
Systemic inflammation mediated by Plasmodium parasites is central to malaria disease and its complications. Plasmodium parasites reside in erythrocytes and can theoretically reach all host tissues via the circulation. However, actual interactions between parasitized erythrocytes and host tissues, along with the consequent damage and pathological changes, are limited locally to specific tissue sites. Such tissue specificity of the parasite can alter the outcome of malaria disease, determining whether acute or chronic complications occur. Here, we give an overview of the recent progress that has been made in understanding tissue-specific immunopathology during Plasmodium infection. As knowledge on tissue-specific host-parasite interactions accumulates, better treatment modalities and targets may emerge for intervention in malaria disease.
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25
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Menezes RADO, Gomes MDSM, Mendes AM, Couto ÁARDA, Nacher M, Pimenta TS, de Sousa ACP, Baptista ARDS, de Jesus MI, Enk MJ, Cunha MG, Machado RLD. Enteroparasite and vivax malaria co-infection on the Brazil-French Guiana border: Epidemiological, haematological and immunological aspects. PLoS One 2018; 13:e0189958. [PMID: 29293589 PMCID: PMC5749708 DOI: 10.1371/journal.pone.0189958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/05/2017] [Indexed: 11/30/2022] Open
Abstract
Malaria-enteroparasitic co-infections are known for their endemicity. Although they are prevalent, little is known about their epidemiology and effect on the immune response. This study evaluated the effect of enteroparasite co-infections with malaria caused by Plasmodium vivax in a border area between Brazil and French Guiana. The cross sectional study took place in Oiapoque, a municipality of Amapá, on the Amazon border. Malaria was diagnosed using thick blood smears, haemoglobin dosage by an automated method and coproparasitology by the Hoffman and Faust methods. The anti-PvMSP-119 IgG antibodies in the plasma were evaluated using ELISA and Th1 (IFN-γ, TNF-α and IL-2), and Th2 (IL-4, IL-5 and IL-10) cytokine counts were performed by flow cytometry. The participants were grouped into those that were monoinfected with vivax malaria (M), vivax malaria-enteroparasite co-infected (CI), monoinfected with enteroparasite (E) and endemic controls (EC), who were negative for both diseases. 441 individuals were included and grouped according to their infection status: [M 6.9% (30/441)], [Cl 26.5% (117/441)], [E 32.4% (143/441)] and [EC 34.2% (151/441)]. Males prevailed among the (M) 77% (23/30) and (CI) 60% (70/117) groups. There was a difference in haemoglobin levels among the different groups under study for [EC-E], [EC-Cl], [E-M] and [Cl-M], with (p < 0.01). Anaemia was expressed as a percentage between individuals [CI-EC (p < 0.05)]. In terms of parasitaemia, there were differences for the groups [CI-M (p < 0.05)]. Anti-PvMSP-119 antibodies were detected in 51.2% (226/441) of the population. The level of cytokines evaluation revealed a large variation in TNF-α and IL-10 concentrations in the co-infected group. In this study we did not observe any influence of coinfection on the acquisition of IgG antibodies against PvMSP119, as well as on the profile of the cytokines that characterize the Th1 and Th2 patterns. However, co-infection increased TNF-α and IL-10 levels.
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Affiliation(s)
- Rubens Alex de Oliveira Menezes
- Postgraduate Program in the Biology of Infectious and Parasitic Agents, Federal University of Pará (UFPA), Belém, Pará State, Brazil
- Laboratory of morphofunctional and parasitic studies with impact on health (LEMPIS), Federal University of Amapá (UNIFAP), Macapa, Amapá State, Brazil
- * E-mail:
| | | | - Anapaula Martins Mendes
- UNIFAP/Oiapoque Binational Campus, Federal University of Amapá, Oiapoque, Amapá State, Brazil
| | | | - Mathieu Nacher
- Centre d’Investigation Clinique, CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Tamirys Simão Pimenta
- Postgraduate Program in Neuroscience and Cell Biology, UFPA, Belém, Pará State, Brazil
- Evandro Chagas Institute/Brazilian Secretariat of Health Surveillance (SVS)/Brazilian Ministry of Health (MS), Ananindeua, Pará State, Brazil
| | - Aline Collares Pinheiro de Sousa
- Evandro Chagas Institute/Brazilian Secretariat of Health Surveillance (SVS)/Brazilian Ministry of Health (MS), Ananindeua, Pará State, Brazil
| | | | - Maria Izabel de Jesus
- Evandro Chagas Institute/Brazilian Secretariat of Health Surveillance (SVS)/Brazilian Ministry of Health (MS), Ananindeua, Pará State, Brazil
| | - Martin Johannes Enk
- Evandro Chagas Institute/Brazilian Secretariat of Health Surveillance (SVS)/Brazilian Ministry of Health (MS), Ananindeua, Pará State, Brazil
| | - Maristela Gomes Cunha
- Postgraduate Program in the Biology of Infectious and Parasitic Agents, Federal University of Pará (UFPA), Belém, Pará State, Brazil
- Laboratory of Microbiology and Immunology, Federal University of Pará (UFPA), Belém, Pará State, Brazil
| | - Ricardo Luiz Dantas Machado
- Postgraduate Program in the Biology of Infectious and Parasitic Agents, Federal University of Pará (UFPA), Belém, Pará State, Brazil
- Evandro Chagas Institute/Brazilian Secretariat of Health Surveillance (SVS)/Brazilian Ministry of Health (MS), Ananindeua, Pará State, Brazil
- Fluminense Federal University, Niterói, Rio de Janeiro State, Brazil
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26
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Craig JM, Scott AL. Antecedent Nippostrongylus infection alters the lung immune response to Plasmodium berghei. Parasite Immunol 2017; 39. [PMID: 28475238 DOI: 10.1111/pim.12441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 04/25/2017] [Indexed: 12/13/2022]
Abstract
In endemic regions, it is not uncommon for patients to be co-infected with soil-transmitted helminths and malaria. Although both malaria and many helminth species use the lungs as a site of development, little attention has been paid to the impact that pulmonary immunity induced by one parasite has on the lung response to the other. To model the consequences of a prior hookworm exposure on the development of immunity to malaria in the lungs, mice were infected with Nippostrongylus brasiliensis and 2 weeks later challenged with Plasmodium berghei. We found that a pre-existing hookworm-induced type 2 immune environment had a measurable but modest impact on the nature of the malaria-driven type 1 cytokine response in the lungs that was associated with a transient effect on parasite development and no significant changes in morbidity and mortality after malaria infection. However, prior hookworm infection did have a lasting effect on lung macrophages, where the malaria-induced M1-like response was blunted by previous M2 polarization. These results demonstrate that, although helminth parasites confer robust changes to the immunological status of the pulmonary microenvironment, lung immunity is plastic and capable of rapidly adapting to consecutive heterologous infections.
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Affiliation(s)
- J M Craig
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - A L Scott
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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27
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Coinfection with Schistosoma haematobium and Plasmodium falciparum and Anaemia Severity among Pregnant Women in Munyenge, Mount Cameroon Area: A Cross-Sectional Study. J Parasitol Res 2017; 2017:6173465. [PMID: 28168042 PMCID: PMC5266839 DOI: 10.1155/2017/6173465] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/24/2016] [Accepted: 11/30/2016] [Indexed: 01/06/2023] Open
Abstract
Background. Malaria and urogenital schistosomiasis are coendemic in Mount Cameroon Area. This study investigated the prevalence of S. haematobium, P. falciparum, and coinfections and their effect on anaemia in pregnancy. Methods. Pregnant women reporting for antenatal care (ANC) clinic visit in Munyenge were enrolled. S. haematobium and P. falciparum infections were determined by urine filtration and microscopy, respectively. Haemoglobin (Hb) levels were measured using haemoglobinometer. Of 250 women, 46.8%, 39.2%, and 15.2% had S. haematobium, P. falciparum, and coinfections, respectively. Schistosomes infection was higher in younger women (≤25 years) and those who bathe in and had domestic contact with stream compared with older age (>25 years) women and those who had only domestic contact with stream. Lower infection rate was associated with less water contact (≤2 times/day) compared with more water contact (>2 times/day). Compared with no sulphadoxine-pyrimethamine (SP) usage, malaria parasitaemia was less among women who used SP. Stream usage increased risk of coinfection while less water contact and SP usage decreased its risk. All coinfected cases were anaemic and coinfection accounted for 93.8% of severe anaemia. Conclusion. Coinfection contributes to anaemia severity. Less water contact and SP usage will reduce coinfection in pregnancy in Munyenge.
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Degarege A, Degarege D, Veledar E, Erko B, Nacher M, Beck-Sague CM, Madhivanan P. Plasmodium falciparum Infection Status among Children with Schistosoma in Sub-Saharan Africa: A Systematic Review and Meta-analysis. PLoS Negl Trop Dis 2016; 10:e0005193. [PMID: 27926919 PMCID: PMC5142807 DOI: 10.1371/journal.pntd.0005193] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 11/17/2016] [Indexed: 12/29/2022] Open
Abstract
Background It has been suggested that Schistosoma infection may be associated with Plasmodium falciparum infection or related reduction in haemoglobin level, but the nature of this interaction remains unclear. This systematic review synthesized evidence on the relationship of S. haematobium or S. mansoni infection with the occurrence of P. falciparum malaria, Plasmodium density and related reduction in haemoglobin level among children in sub-Saharan Africa (SSA). Methodology/Principal findings A systematic review in according with PRISMA guidelines was conducted. All published articles available in PubMed, Embase, Cochrane library and CINAHL databases before May 20, 2015 were searched without any limits. Two reviewers independently screened, reviewed and assessed all the studies. Cochrane Q and Moran’s I2 were used to assess heterogeneity and the Egger test was used to examine publication bias. The summary odds ratio (OR), summary regression co-efficient (β) and 95% confidence intervals (CI) were estimated using a random-effects model. Out of 2,920 citations screened, 12 articles (five cross-sectional, seven prospective cohort) were eligible to be included in the systematic review and 11 in the meta-analysis. The 12 studies involved 9,337 children in eight SSA countries. Eight studies compared the odds of asymptomatic/uncomplicated P. falciparum infection, two studies compared the incidence of uncomplicated P. falciparum infection, six studies compared P. falciparum density and four studies compared mean haemoglobin level between children infected and uninfected with S. haematobium or S. mansoni. Summary estimates of the eight studies based on 6,018 children showed a higher odds of asymptomatic/uncomplicated P. falciparum infection in children infected with S. mansoni or S. haematobium compared to those uninfected with Schistosoma (summary OR: 1.82; 95%CI: 1.41, 2.35; I2: 52.3%). The increase in odds of asymptomatic/uncomplicated P. falciparum infection among children infected with Schistosoma remained significant when subgroup analysis was conducted for S. haematobium (summary OR: 1.68; 95%CI: 1.18, 2.41; I2: 53.2%) and S. mansoni (summary OR: 2.15; 95%CI: 1.89, 2.46: I2: 0.0%) infection. However, the density of P. falciparum infection was lower in children co-infected with S. haematobium compared to those uninfected with Schistosoma (summary-β: -0.14; 95% CI: -0.24, -0.01; I2: 39.7%). The mean haemoglobin level was higher among children co-infected with S. haematobium and P. falciparum than those infected with only P. falciparum (summary-mean haemoglobin difference: 0.49; 95% CI: 0.04, 0.95; I2: 66.4%) Conclusions/Significance The current review suggests S. mansoni or S. haematobium co-infection may be associated with increased prevalence of asymptomatic/uncomplicated P. falciparum infection in children, but may protect against high density P. falciparum infection and related reduction in haemoglobin level. A clear understanding of the epidemiology of malaria during Schistosoma co-infection is essential to inform decisions on appropriate control strategies for schistosomiasis and malaria in SSA. In this systematic review and meta-analysis, we synthesized evidence on the nature of relationship of S. haematobium and S. mansoni infection with the prevalence/incidence of P. falciparum infection, density of the parasite and related reduction in haemoglobin level among children in SSA. We searched all published articles available in PubMed, Embase, Cochrane library and CINAHL databases before May 20, 2015 without any language restriction. We found five cross-sectional and seven prospective cohort studies eligible to be included in the systematic review, and 11 of these studies were included in the meta-analysis. A summarized analysis of the study findings showed that S. haematobium and S. mansoni infection is associated with an increased odds of asymptomatic/uncomplicated P. falciparum infection. However, density of P. falciparum infection decreased and haemoglobin level increased during S. haematobium co-infection.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Dawit Degarege
- Ethiopian Ministry of Health Office, Addis Ababa, Ethiopia
| | - Emir Veledar
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mathieu Nacher
- Ecosystemes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, French Guiana
- Centre d’Investigation Clinique, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Consuelo M. Beck-Sague
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, United States of America
- Public Health Research Institute of India, Mysore, India
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Weinberg JB, Volkheimer AD, Rubach MP, Florence SM, Mukemba JP, Kalingonji AR, Langelier C, Chen Y, Bush M, Yeo TW, Granger DL, Anstey NM, Mwaikambo ED. Monocyte polarization in children with falciparum malaria: relationship to nitric oxide insufficiency and disease severity. Sci Rep 2016; 6:29151. [PMID: 27385484 PMCID: PMC4935839 DOI: 10.1038/srep29151] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/15/2016] [Indexed: 12/23/2022] Open
Abstract
We earlier established that nitric oxide (NO) is protective against severe malaria and that arginine and NO levels are reduced in malaria patients. We now show that an M2-like blood monocyte phenotype is significantly associated with hypoargininemia, NO insufficiency, and disease severity in Tanzanian children with falciparum malaria. Compared to control children (n = 106), children with moderately severe (n = 77) and severe falciparum malaria (n = 129) had significantly higher mononuclear cell arginase 1 mRNA, protein, and enzyme activity; lower NOS2 mRNA; lower plasma arginine; and higher plasma IL-10, IL-13, and IL-4. In addition, monocyte CD206 and CD163 and plasma soluble CD163 were elevated. Multivariate logistic regression analysis revealed a significant correlation of risk of severe malaria with both plasma IL-10 and soluble CD163 levels. Monocyte M2 skewing likely contributes to NO bioinsufficiency in falciparum malaria in children. Treatments that reverse the M2 polarization may have potential as adjunctive treatment for malaria.
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Affiliation(s)
- J Brice Weinberg
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | | | - Matthew P Rubach
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | | | | | | | | | - Youwei Chen
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | - Margaret Bush
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | - Tsin W Yeo
- Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Donald L Granger
- University of Utah and V.A. Medical Centers, Salt Lake City, Utah, USA
| | - Nicholas M Anstey
- Menzies School of Health Research and Charles Darwin University, Darwin, Australia
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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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31
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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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Mendonça VRD, Barral-Netto M. Immunoregulation in human malaria: the challenge of understanding asymptomatic infection. Mem Inst Oswaldo Cruz 2015; 110:945-55. [PMID: 26676319 PMCID: PMC4708013 DOI: 10.1590/0074-02760150241] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/23/2015] [Indexed: 12/21/2022] Open
Abstract
Asymptomatic Plasmodium infection carriers represent a major threat
to malaria control worldwide as they are silent natural reservoirs and do not seek
medical care. There are no standard criteria for
asymptomaticPlasmodium infection; therefore, its diagnosis relies
on the presence of the parasite during a specific period of symptomless infection.
The antiparasitic immune response can result in reducedPlasmodium
sp. load with control of disease manifestations, which leads to asymptomatic
infection. Both the innate and adaptive immune responses seem to play major roles in
asymptomatic Plasmodiuminfection; T regulatory cell activity
(through the production of interleukin-10 and transforming growth factor-β) and
B-cells (with a broad antibody response) both play prominent roles. Furthermore,
molecules involved in the haem detoxification pathway (such as haptoglobin and haeme
oxygenase-1) and iron metabolism (ferritin and activated c-Jun N-terminal kinase)
have emerged in recent years as potential biomarkers and thus are helping to unravel
the immune response underlying asymptomatic Plasmodium infection.
The acquisition of large data sets and the use of robust statistical tools, including
network analysis, associated with well-designed malaria studies will likely help
elucidate the immune mechanisms responsible for asymptomatic infection.
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Affiliation(s)
- Vitor R de Mendonça
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil
| | - Manoel Barral-Netto
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil
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33
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Simon GG. Impacts of neglected tropical disease on incidence and progression of HIV/AIDS, tuberculosis, and malaria: scientific links. Int J Infect Dis 2015; 42:54-57. [PMID: 26594012 DOI: 10.1016/j.ijid.2015.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/19/2015] [Accepted: 11/07/2015] [Indexed: 01/15/2023] Open
Abstract
The neglected tropical diseases (NTDs) are the most common infections of humans in Sub-Saharan Africa. Virtually all of the population living below the World Bank poverty figure is affected by one or more NTDs. New evidence indicates a high degree of geographic overlap between the highest-prevalence NTDs (soil-transmitted helminths, schistosomiasis, onchocerciasis, lymphatic filariasis, and trachoma) and malaria and HIV, exhibiting a high degree of co-infection. Recent research suggests that NTDs can affect HIV and AIDS, tuberculosis (TB), and malaria disease progression. A combination of immunological, epidemiological, and clinical factors can contribute to these interactions and add to a worsening prognosis for people affected by HIV/AIDS, TB, and malaria. Together these results point to the impacts of the highest-prevalence NTDs on the health outcomes of malaria, HIV/AIDS, and TB and present new opportunities to design innovative public health interventions and strategies for these 'big three' diseases. This analysis describes the current findings of research and what research is still needed to strengthen the knowledge base of the impacts NTDs have on the big three.
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Affiliation(s)
- G G Simon
- Management Sciences for Health, Arlington VA, USA.
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34
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Taniguchi T, Miyauchi E, Nakamura S, Hirai M, Suzue K, Imai T, Nomura T, Handa T, Okada H, Shimokawa C, Onishi R, Olia A, Hirata J, Tomita H, Ohno H, Horii T, Hisaeda H. Plasmodium berghei ANKA causes intestinal malaria associated with dysbiosis. Sci Rep 2015; 5:15699. [PMID: 26503461 PMCID: PMC4621605 DOI: 10.1038/srep15699] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 09/14/2015] [Indexed: 12/22/2022] Open
Abstract
Gastrointestinal symptoms, such as abdominal pain and diarrhea, are frequently observed in patients with Plasmodium falciparum malaria. However, the correlation between malaria intestinal pathology and intestinal microbiota has not been investigated. In the present study, infection of C57BL/6 mice with P. berghei ANKA (PbA) caused intestinal pathological changes, such as detachment of epithelia in the small intestines and increased intestinal permeability, which correlated with development with experimental cerebral malaria (ECM). Notably, an apparent dysbiosis occurred, characterized by a reduction of Firmicutes and an increase in Proteobacteria. Furthermore, some genera of microbiota correlated with parasite growth and/or ECM development. By contrast, BALB/c mice are resistant to ECM and exhibit milder intestinal pathology and dysbiosis. These results indicate that the severity of cerebral and intestinal pathology coincides with the degree of alteration in microbiota. This is the first report demonstrating that malaria affects intestinal microbiota and causes dysbiosis.
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Affiliation(s)
- Tomoyo Taniguchi
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan.,Center for Medical Education, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Eiji Miyauchi
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Kanagawa 230-0045, Japan
| | - Shota Nakamura
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Makoto Hirai
- Department of Molecular and Cellular Parasitology, Juntendo University School of Medicine, Hongo, Bunkyo, Tokyo 113-8421, Japan
| | - Kazutomo Suzue
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Takashi Imai
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Takahiro Nomura
- Department of Bacteriology and Laboratory of Bacterial Drug Resistance, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Tadashi Handa
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, 3-19-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Hiroko Okada
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Chikako Shimokawa
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Risa Onishi
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Alex Olia
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Jun Hirata
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Haruyoshi Tomita
- Department of Bacteriology and Laboratory of Bacterial Drug Resistance, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Hiroshi Ohno
- Laboratory for Intestinal Ecosystem, RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Kanagawa 230-0045, Japan
| | - Toshihiro Horii
- Department of Molecular Protozoology, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Hajime Hisaeda
- Department of Parasitology, Graduate School of Medicine, Gunma University, 3-39-22, Showa-machi, Maebashi, Gunma 371-8511, Japan
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Vaumourin E, Vourc'h G, Gasqui P, Vayssier-Taussat M. The importance of multiparasitism: examining the consequences of co-infections for human and animal health. Parasit Vectors 2015; 8:545. [PMID: 26482351 PMCID: PMC4617890 DOI: 10.1186/s13071-015-1167-9] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/14/2015] [Indexed: 11/23/2022] Open
Abstract
Most parasites co-occur with other parasites, although the importance of such multiparasitism has only recently been recognised. Co-infections may result when hosts are independently infected by different parasites at the same time or when interactions among parasite species facilitate co-occurrence. Such interactions can have important repercussions on human or animal health because they can alter host susceptibility, infection duration, transmission risks, and clinical symptoms. These interactions may be synergistic or antagonistic and thus produce diverse effects in infected humans and animals. Interactions among parasites strongly influence parasite dynamics and therefore play a major role in structuring parasite populations (both within and among hosts) as well as host populations. However, several methodological challenges remain when it comes to detecting parasite interactions. The goal of this review is to summarise current knowledge on the causes and consequences of multiparasitism and to discuss the different methods and tools that researchers have developed to study the factors that lead to multiparasitism. It also identifies new research directions to pursue.
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Affiliation(s)
- Elise Vaumourin
- UR346 Animal Epidemiology Research Unit, INRA, Saint Genès Champanelle, France. .,USC BIPAR, INRA-ANSES-ENVA, Maisons-Alfort, France.
| | - Gwenaël Vourc'h
- UR346 Animal Epidemiology Research Unit, INRA, Saint Genès Champanelle, France.
| | - Patrick Gasqui
- UR346 Animal Epidemiology Research Unit, INRA, Saint Genès Champanelle, France.
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Tritten L, Keiser J, Karwa T, Utzinger J, Holmes E, Saric J. Comparing systemic metabolic responses in mice to single or dual infection with Plasmodium berghei and Heligmosomoides bakeri. MOLECULAR BIOSYSTEMS 2015; 10:2358-67. [PMID: 24960299 DOI: 10.1039/c4mb00097h] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Concomitant infections with Plasmodium and gastrointestinal nematodes are frequently observed in humans. At the metabolic level, the cross-talk between the host and multiple coexisting pathogens is poorly characterized. The purpose of this study was to give a comprehensive insight into the systemic metabolic phenotype of mice with a single or dual infection with Plasmodium berghei and Heligmosomoides bakeri. Four groups of eight NMRI female mice were infected with P. berghei or H. bakeri, or with both species concurrently. An additional group remained uninfected, and served as control. Mice were sacrificed at day 19 of the experiment. We collected samples from the liver, spleen, kidney, three intestinal regions, and four brain regions. All biological samples were subjected to (1)H nuclear magnetic resonance spectroscopy, combined with multivariate data analysis, to establish metabolic fingerprints of each tissue from the various infection groups. Compared to uninfected mice, single and dual species infection models showed unique metabolic profiles. P. berghei exerted major effects on glycolysis, tricarboxylic acid cycle, and nucleotide and amino acid metabolism in all studied tissues with the exception of the gut. H. bakeri was characterized by a dysregulation of choline and lipid metabolism in most tissues examined with a particularly strong imprint in the jejunum. Simultaneous co-infection with P. berghei and H. bakeri induced the strongest and most diverse effects in the liver and spleen but led to only minor changes in the intestinal and cerebral parts assessed. Infection with P. berghei showed more pronounced and systemic alterations in the mice metabolic profile than H. bakeri infection. The metabolic fingerprints in the co-infection models were driven by P. berghei infection, whilst the presence of H. bakeri in co-infections had little effect. However, simultaneous co-infection showed indeed the least metabolic disruptions in the peripheral tissues, namely the gut and brain.
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Affiliation(s)
- Lucienne Tritten
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
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37
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Fang Y, Wu C, Chen Q, Wu J, Yang Y, Guo X, Chen G, Wang Z. SjE16.7 activates macrophages and promotes Schistosoma japonicum egg-induced granuloma development. Acta Trop 2015; 149:49-58. [PMID: 25997882 DOI: 10.1016/j.actatropica.2015.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 05/11/2015] [Accepted: 05/16/2015] [Indexed: 12/13/2022]
Abstract
SjE16.7 is an egg-specific protein from Schistosoma japonicum that recruits neutrophils and initiates an inflammatory granuloma response in host tissue. However, since macrophages are known to be important regulators of egg granuloma formation we investigated the effect of SjE16.7 on this cell type. Here we report that SjE16.7 is a potent macrophage activator, inducing macrophage chemotaxis and stimulating cytokine production. Treatment of murine primary macrophages with SjE16.7 resulted in upregulation of both pro- and anti-inflammatory cytokines (IL-10, IL-12, IL-6 and TNF-α), as well as phosphorylation of mitogen-activated protein kinases (MAPKs). Moreover, SjE16.7 treatment increased MHC Class II expression on the surface of macrophages. Importantly, in vivo blockade of SjE16.7 significantly reduced egg-induced pathology, as a result of decreased leucocyte infiltration and reduced granuloma size. Our results suggest that SjE16.7 is an important pathogenic factor and a potential treatment target for this disease.
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Affiliation(s)
- Yan Fang
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenyun Wu
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Chen
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianhua Wu
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Yang
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaokui Guo
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangjie Chen
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Zhaojun Wang
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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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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Kepha S, Nuwaha F, Nikolay B, Gichuki P, Edwards T, Allen E, Njenga SM, Mwandawiro CS, Brooker SJ. Epidemiology of coinfection with soil transmitted helminths and Plasmodium falciparum among school children in Bumula District in western Kenya. Parasit Vectors 2015; 8:314. [PMID: 26063324 PMCID: PMC4486705 DOI: 10.1186/s13071-015-0891-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/07/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Many school children living in Africa are infected with plasmodia and helminth species and are consequently at risk of coinfection. However, the epidemiology of such coinfection and the implications of coinfection for children's health remain poorly understood. This study describes the epidemiology of Ascaris lumbricoides-Plasmodium and hookworm-Plasmodium coinfection among school children living in western Kenya and investigates the associated risk factors. METHODS As part of a randomized trial, a baseline cross-sectional survey was conducted among school children aged 5-18 years in 23 schools in Bumula District. Single stool samples were collected to screen for helminth infections using the Kato-Katz technique and malaria parasitaemia was determined from a finger prick blood sample. Demographic and anthropometric data were also collected. RESULTS Overall, 46.4% of the children were infected with Plasmodium falciparum while 27.6% of the children were infected with at least one soil transmitted helminth (STH) species, with hookworm being the most common (16.8%) followed by A. lumbricoides (15.3%). Overall 14.3% of the children had STH-Plasmodium coinfection, with hookworm-Plasmodium (9.0%) coinfection being the most common. Geographical variation in the prevalence of coinfection occurred between schools. In multivariable logistic regression analysis, hookworm was positively associated with P. falciparum infection. In stratified analysis, hookworm infection was associated with increased odds of P. falciparum infection among both boys (P < 0.001) and girls (P = 0.01), whereas there was no association between A. lumbricoides and P. falciparum. CONCLUSION These findings demonstrate STH infections are still prevalent, despite the ongoing national deworming programme in Kenya, and that malaria parasitaemia is widespread, such that coinfection occurs among a proportion of children. A subsequent trial will allow us to investigate the implications of coinfection for the risk of clinical malaria.
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Affiliation(s)
- Stella Kepha
- College of Health Sciences, Makerere University, Kampala, Uganda. .,Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
| | - Fred Nuwaha
- College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Birgit Nikolay
- London School of Hygiene & Tropical Medicine, London, UK.
| | - Paul Gichuki
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
| | - Tansy Edwards
- London School of Hygiene & Tropical Medicine, London, UK.
| | | | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
| | - Charles S Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
| | - Simon J Brooker
- London School of Hygiene & Tropical Medicine, London, UK. .,KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
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Jolles AE, Beechler BR, Dolan BP. Beyond mice and men: environmental change, immunity and infections in wild ungulates. Parasite Immunol 2015; 37:255-66. [PMID: 25354672 PMCID: PMC4414670 DOI: 10.1111/pim.12153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 10/16/2014] [Indexed: 02/06/2023]
Abstract
In the face of rapid environmental change, anticipating shifts in microparasite and macroparasite dynamics, including emergence events, is an enormous challenge. We argue that immunological studies in natural populations are pivotal to meeting this challenge: many components of environmental change--shifts in biotic assemblages, altered climate patterns and reduced environmental predictability--may affect host immunity. We suggest that wild ungulates can serve as model systems aiding the discovery of immunological mechanisms that link environmental change with parasite transmission dynamics. Our review of eco-immunological studies in wild ungulates reveals progress in understanding how co-infections affect immunity and parasite transmission and how environmental and genetic factors interact to shape immunity. Changes in bioavailability of micronutrients have been linked to immunity and health in wild ungulates. Although physiological stress in response to environmental change has been assessed, downstream effects on immunity have not been studied. Moreover, the taxonomic range of ungulates studied is limited to bovids (bighorn sheep, Soay sheep, chamois, musk oxen, bison, African buffalo) and a few cervids (red deer, black-tailed deer). We discuss areas where future studies in ungulates could lead to significant contributions in understanding the patterns of immunity and infection in natural populations and across species.
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Affiliation(s)
- Anna E. Jolles
- Department of Biomedical Sciences, Oregon State University, Corvallis, OR 97331
- Department of Integrative Biology, Oregon State University, Corvallis, OR 97331
| | - Brianna R. Beechler
- Department of Biomedical Sciences, Oregon State University, Corvallis, OR 97331
| | - Brian P. Dolan
- Department of Biomedical Sciences, Oregon State University, Corvallis, OR 97331
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Deribew K, Tekeste Z, Petros B, Huat LB. Urinary schistosomiasis and malaria associated anemia in Ethiopia. Asian Pac J Trop Biomed 2015; 3:307-10. [PMID: 23620856 DOI: 10.1016/s2221-1691(13)60068-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/12/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the prevalence of anemia in children with urinary schistosomiasis, malaria and concurrent infections by the two diseases. METHODS Urine and blood samples were collected from 387 children (216 males and 171 females) to examine urinary schistosomiasis and malaria and to determine hemoglobin concentration at Hassoba and Hassoba Buri village in Amibara woreda, Afar region, Ethiopia. RESULTS The overall prevalence of urinary schistosomiasis and Plasmodium falciparum malaria was 24.54% and 6.20% respectively. Only 2.84% of children carried concurrent infections of both parasites. There was high percentage of anemic patients (81.81%) in the coinfected cases than in either malaria (33.3%) or schistosomiasis (38.94%) cases. There was significantly low mean hemoglobin concentration in concurrently infected children than non-infected and single infected (P<0.05). The mean hemoglobin concentration between Plasmodium falciparum and S. haematobium infected children showed no significant difference (P>0.05). The level of hemoglobin was negatively correlated with the number of S. haematobium eggs/10 mL urine (r=-0.6) and malaria parasitemia (r=-0.53). CONCLUSIONS The study showed that anemia is higher in concurrently infected children than non-infected and single infected. Furthermore, level of hemoglobin was negatively correlated with the number of S. haematobium eggs and malaria parsitemia. Therefore, examination of hemoglobin status in patients co-infected with malaria and schistosomiasis is important to reduce the risk of anemia and to improve health of the community.
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Affiliation(s)
- Ketema Deribew
- Department of Biology, Bonga Teacher Education College, P.O. Box 91, Bonga, Ethiopia
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Naing C, Whittaker MA, Nyunt-Wai V, Reid SA, Wong SF, Mak JW, Tanner M. Malaria and soil-transmitted intestinal helminth co-infection and its effect on anemia: a meta-analysis. Trans R Soc Trop Med Hyg 2015; 107:672-83. [PMID: 24123127 DOI: 10.1093/trstmh/trt086] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study aimed to synthesize available evidence on the extent of malaria and soil-transmitted intestinal helminth (STH) co-infections in people living in endemic countries and to explore the effect of interactions between malaria and STHs on anemia. We searched relevant studies in electronic databases up to March 2013. Studies comparing malaria and STH co-infected patients with those not co-infected were included and the effect estimates were pooled using a random-effects model. We identified 30 studies for meta-analyses of which 17 were cross-sectional design. The majority of included studies (80%) were carried out in African countries. Among pregnant women, those infected with hookworm were found to have higher association with malaria infection compared with those without (summary OR: 1.36; 95% CI: 1.17-1.59; I(2): 0%). Among non-pregnant adults, the summary OR of the association between anemia and the combined malaria and STH was 2.91 (1.38-6.14). The summary OR of the association between anemia and malaria alone was 1.53 (0.97-2.42), while the association between anemia and STH alone was 0.28 (0.04-1.95). There is no good evidence to support a different effect of malaria and STH on anemia. A subgroup analysis showed a higher risk of malaria infection in the primigravidae (summary OR: 1.61; 95% CI: 1.3-1.99; I(2): 0%). In conclusion, the malaria-STH co-infection was variable with complex outcomes on anemia.
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Affiliation(s)
- Cho Naing
- School of Population Health, University of Queensland, Queensland 4006, Australia
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Ateba-Ngoa U, Adegnika AA, Zinsou JF, Kassa Kassa RF, Smits H, Massinga-Loembe M, Mordmüller B, Kremsner PG, Yazdanbakhsh M. Cytokine and chemokine profile of the innate and adaptive immune response of Schistosoma haematobium and Plasmodium falciparum single and co-infected school-aged children from an endemic area of Lambaréné, Gabon. Malar J 2015; 14:94. [PMID: 25890010 PMCID: PMC4365807 DOI: 10.1186/s12936-015-0608-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 02/09/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Helminths and malaria are among the most prevalent infectious diseases in the world. They both occur in tropical area where they often affect the same populations. There are studies suggesting an effect of helminths on malariometric indices. For example, malaria attacks as well as disease severity has been shown to be influenced by a concurrent chronic helminth infection. However, there are also studies that show no effect of concurrent helminth infections on malarial outcomes. To start addressing this issue, the effect of chronic Schistosoma haematobium infection on both the innate and adaptive immune response of Plasmodium falciparum-infected subjects was assessed in an area endemic for both these infections in Gabon. METHOD Subjects infected with S. haematobium and or P. falciparum, as well as a control group with neither of these infections, were recruited. For innate immune response, heparinized blood was obtained and cultured for 24 hours with a panel of TLR ligands. For adaptive immune response, PBMC was isolated and stimulated with SEB for 72 hours. Cytokines and chemokines were measured in supernatants using a multiplex beads array immunoassay. Principal Component analysis was used to assess pattern of cytokine and chemokine responses representing the innate and adaptive components of the immune system. RESULTS Overall it was observed that the presence of P. falciparum infection was marked by an increase in innate and adaptive immune responsiveness while S. haematobium infection was characterized by an increased chemokine profile, with at the same time, lower pro inflammatory markers. When the study subjects were split into single infected and co-infected groups no effect of S. haematobium on the immune response of P. falciparum infected subjects was observed, neither for the innate nor for the adaptive component of the immune response. CONCLUSION This study provides original information on the cellular immune response of S. haematobium and/or P. falciparum in infected subjects. It rules out an effect of S. haematobium on the cytokine profile of subjects co-infected with P. falciparum.
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Affiliation(s)
- Ulysse Ateba-Ngoa
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands. .,Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Ayola Akim Adegnika
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands. .,Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Jeannot F Zinsou
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | | | - Hermelijn Smits
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands.
| | - Marguerite Massinga-Loembe
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Peter G Kremsner
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
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Ateba-Ngoa U, Mombo-Ngoma G, Zettlmeissl E, van der Vlugt LEPM, de Jong S, Matsiegui PB, Ramharter M, Kremsner PG, Yazdanbakhsh M, Adegnika AA. CD4+CD25hiFOXP3+ cells in cord blood of neonates born from filaria infected mother are negatively associated with CD4+Tbet+ and CD4+RORγt+ T cells. PLoS One 2014; 9:e114630. [PMID: 25531674 PMCID: PMC4273973 DOI: 10.1371/journal.pone.0114630] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/11/2014] [Indexed: 11/18/2022] Open
Abstract
Background Children who have been exposed in utero to maternal filarial infection are immunologically less responsive to filarial antigens, have less pathology, and are more susceptible to acquire infection than offspring of uninfected mothers. Moreover children from filaria infected mothers have been shown to be less responsive to vaccination as a consequence of an impairment of their immune response. However, it is not well known how in utero exposure to parasite antigens affects cellular immune responses. Methodology Here, 30 pregnant women were examined for the presence of microfilaria of Loa loa and Mansonella perstans in peripheral blood. At delivery, cord blood mononuclear cells (CBMC) were obtained and the CD4+T cells were phenotyped by expression of the transcription factors Tbet, RORγt, and FOXP3. Results No significant difference was observed between newborns from infected versus uninfected mothers in the frequencies of total CD4+T cells and CD4+T cells subsets including CD4+Tbet+, CD4+RORγt+ T and CD4+CD25hiFOXP3+ T cells. However, there was a negative association between CD4+CD25hiFOXP3+T cells and CD4+Tbet+ as well as CD4+RORγt+ T cells in the infected group only (B = −0.242, P = 0.002; B = −0.178, P = 0.013 respectively). Conclusion Our results suggest that filarial infection during pregnancy leads to an expansion of functionally active regulatory T cells that keep TH1 and TH17 in check.
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Affiliation(s)
- Ulysse Ateba-Ngoa
- Centre de Recherches Médicales de Lambaréné, BP 118, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2 2333 ZA Leiden, The Netherlands
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27 D-72074 Tübingen, Germany
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, BP 118, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2 2333 ZA Leiden, The Netherlands
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27 D-72074 Tübingen, Germany
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
| | - Eva Zettlmeissl
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27 D-72074 Tübingen, Germany
| | | | - Sanne de Jong
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2 2333 ZA Leiden, The Netherlands
| | - Pierre-Blaise Matsiegui
- Centre de Recherches Médicales de Lambaréné, BP 118, Lambaréné, Gabon
- Centre de Recherches Médicales de la Ngounié, Fougamou, Gabon
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné, BP 118, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27 D-72074 Tübingen, Germany
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
| | - Peter G. Kremsner
- Centre de Recherches Médicales de Lambaréné, BP 118, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27 D-72074 Tübingen, Germany
| | - Maria Yazdanbakhsh
- Centre de Recherches Médicales de Lambaréné, BP 118, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2 2333 ZA Leiden, The Netherlands
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, BP 118, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2 2333 ZA Leiden, The Netherlands
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27 D-72074 Tübingen, Germany
- * E-mail:
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Campbell OMR, Benova L, Gon G, Afsana K, Cumming O. Getting the basic rights - the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework. Trop Med Int Health 2014; 20:252-67. [PMID: 25430609 PMCID: PMC4681319 DOI: 10.1111/tmi.12439] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To explore linkages between water, sanitation and hygiene (WASH) and maternal and perinatal health via a conceptual approach and a scoping review. METHODS We developed a conceptual framework iteratively, amalgamating three literature-based lenses. We then searched literature and identified risk factors potentially linked to maternal and perinatal health. We conducted a systematic scoping review for all chemical and biological WASH risk factors identified using text and MeSH terms, limiting results to systematic reviews or meta-analyses. The remaining 10 complex behavioural associations were not reviewed systematically. RESULTS The main ways poor WASH could lead to adverse outcomes are via two non-exclusive categories: 1. 'In-water' associations: (a) Inorganic contaminants, and (b) 'water-system' related infections, (c) 'water-based' infections, and (d) 'water borne' infections. 2. 'Behaviour' associations: (e) Behaviours leading to water-washed infections, (f) Water-related insect-vector infections, and (g-i) Behaviours leading to non-infectious diseases/conditions. We added a gender inequality and a life course lens to the above framework to identify whether WASH affected health of mothers in particular, and acted beyond the immediate effects. This framework led us to identifying 77 risk mechanisms (67 chemical or biological factors and 10 complex behavioural factors) linking WASH to maternal and perinatal health outcomes. CONCLUSION WASH affects the risk of adverse maternal and perinatal health outcomes; these exposures are multiple and overlapping and may be distant from the immediate health outcome. Much of the evidence is weak, based on observational studies and anecdotal evidence, with relatively few systematic reviews. New systematic reviews are required to assess the quality of existing evidence more rigorously, and primary research is required to investigate the magnitude of effects of particular WASH exposures on specific maternal and perinatal outcomes. Whilst major gaps exist, the evidence strongly suggests that poor WASH influences maternal and reproductive health outcomes to the extent that it should be considered in global and national strategies.
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Affiliation(s)
- Oona M R Campbell
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Salim N, Schindler T, Abdul U, Rothen J, Genton B, Lweno O, Mohammed AS, Masimba J, Kwaba D, Abdulla S, Tanner M, Daubenberger C, Knopp S. Enterobiasis and strongyloidiasis and associated co-infections and morbidity markers in infants, preschool- and school-aged children from rural coastal Tanzania: a cross-sectional study. BMC Infect Dis 2014; 14:644. [PMID: 25486986 PMCID: PMC4271451 DOI: 10.1186/s12879-014-0644-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/20/2014] [Indexed: 11/24/2022] Open
Abstract
Background There is a paucity of data pertaining to the epidemiology and public health impact of Enterobius vermicularis and Strongyloides stercoralis infections. We aimed to determine the extent of enterobiasis, strongyloidiasis, and other helminth infections and their association with asymptomatic Plasmodium parasitaemia, anaemia, nutritional status, and blood cell counts in infants, preschool-aged (PSAC), and school-aged children (SAC) from rural coastal Tanzania. Methods A total of 1,033 children were included in a cross-sectional study implemented in the Bagamoyo district in 2011/2012. Faecal samples were examined for intestinal helminth infections using a broad set of quality controlled methods. Finger-prick blood samples were subjected to filariasis and Plasmodium parasitaemia testing and full blood cell count examination. Weight, length/height, and/or mid-upper arm circumference were measured and the nutritional status determined in accordance with age. Results E. vermicularis infections were found in 4.2% of infants, 16.7%, of PSAC, and 26.3% of SAC. S. stercoralis infections were detected in 5.8%, 7.5%, and 7.1% of infants, PSAC, and SAC, respectively. Multivariable regression analyses revealed higher odds of enterobiasis in children of all age-groups with a reported anthelminthic treatment history over the past six months (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.22 - 3.79) and in SAC with a higher temperature (OR: 2.21; CI: 1.13 - 4.33). Strongyloidiasis was associated with eosinophilia (OR: 2.04; CI: 1.20-3.48) and with Trichuris trichiura infections (OR: 4.13; CI: 1.04-16.52) in children of all age-groups, and with asymptomatic Plasmodium parasitaemia (OR: 13.03; CI: 1.34 - 127.23) in infants. None of the investigated helminthiases impacted significantly on the nutritional status and anaemia, but moderate asymptomatic Plasmodium parasitaemia was a strong predictor for anaemia in children aged older than two years (OR: 2.69; 95% CI: 1.23 – 5.86). Conclusions E. vermicularis and S. stercoralis infections were moderately prevalent in children from rural coastal Tanzania. Our data can contribute to inform yet missing global burden of disease and prevalence estimates for strongyloidiasis and enterobiasis. The association between S stercoralis and asymptomatic Plasmodium parasitaemia found here warrants further comprehensive investigations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0644-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nahya Salim
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,Department of Pediatrics and Child Health, Muhimbili University Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania. .,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Tobias Schindler
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Ummi Abdul
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Julian Rothen
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania. .,University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Blaise Genton
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Ambulatory Care and Community Medicine, Infectious Disease Service, Lausanne University Hospital, Lausanne, Switzerland.
| | - Omar Lweno
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Alisa S Mohammed
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - John Masimba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Denis Kwaba
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Salim Abdulla
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, United Republic of Tanzania.
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Claudia Daubenberger
- University of Basel, Basel, Switzerland. .,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom.
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Faure E. Malarial pathocoenosis: beneficial and deleterious interactions between malaria and other human diseases. Front Physiol 2014; 5:441. [PMID: 25484866 PMCID: PMC4240042 DOI: 10.3389/fphys.2014.00441] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/28/2014] [Indexed: 11/28/2022] Open
Abstract
In nature, organisms are commonly infected by an assemblage of different parasite species or by genetically distinct parasite strains that interact in complex ways. Linked to co-infections, pathocoenosis, a term proposed by M. Grmek in 1969, refers to a pathological state arising from the interactions of diseases within a population and to the temporal and spatial dynamics of all of the diseases. In the long run, malaria was certainly one of the most important component of past pathocoenoses. Today this disease, which affects hundreds of millions of individuals and results in approximately one million deaths each year, is always highly endemic in over 20% of the world and is thus co-endemic with many other diseases. Therefore, the incidences of co-infections and possible direct and indirect interactions with Plasmodium parasites are very high. Both positive and negative interactions between malaria and other diseases caused by parasites belonging to numerous taxa have been described and in some cases, malaria may modify the process of another disease without being affected itself. Interactions include those observed during voluntary malarial infections intended to cure neuro-syphilis or during the enhanced activations of bacterial gastro-intestinal diseases and HIV infections. Complex relationships with multiple effects should also be considered, such as those observed during helminth infections. Moreover, reports dating back over 2000 years suggested that co- and multiple infections have generally deleterious consequences and analyses of historical texts indicated that malaria might exacerbate both plague and cholera, among other diseases. Possible biases affecting the research of etiological agents caused by the protean manifestations of malaria are discussed. A better understanding of the manner by which pathogens, particularly Plasmodium, modulate immune responses is particularly important for the diagnosis, cure, and control of diseases in human populations.
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Affiliation(s)
- Eric Faure
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Centrale Marseille, I2M, UMR 7373Marseille, France
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Ndeffo Mbah ML, Skrip L, Greenhalgh S, Hotez P, Galvani AP. Impact of Schistosoma mansoni on malaria transmission in Sub-Saharan Africa. PLoS Negl Trop Dis 2014; 8:e3234. [PMID: 25329403 PMCID: PMC4199517 DOI: 10.1371/journal.pntd.0003234] [Citation(s) in RCA: 20] [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: 01/07/2014] [Accepted: 09/02/2014] [Indexed: 01/22/2023] Open
Abstract
Background Sub-Saharan Africa harbors the majority of the global burden of malaria and schistosomiasis infections. The co-endemicity of these two tropical diseases has prompted investigation into the mechanisms of coinfection, particularly the competing immunological responses associated with each disease. Epidemiological studies have shown that infection with Schistosoma mansoni is associated with a greater malaria incidence among school-age children. Methodology We developed a co-epidemic model of malaria and S. mansoni transmission dynamics which takes into account key epidemiological interaction between the two diseases in terms of elevated malaria incidence among individuals with S. mansoni high egg output. The model was parameterized for S. mansoni high-risk endemic communities, using epidemiological and clinical data of the interaction between S. mansoni and malaria among children in sub-Saharan Africa. We evaluated the potential impact of the S. mansoni–malaria interaction and mass treatment of schistosomiasis on malaria prevalence in co-endemic communities. Principal Findings Our results suggest that in the absence of mass drug administration of praziquantel, the interaction between S. mansoni and malaria may reduce the effectiveness of malaria treatment for curtailing malaria transmission, in S. mansoni high-risk endemic communities. However, when malaria treatment is used in combination with praziquantel, mass praziquantel administration may increase the effectiveness of malaria control intervention strategy for reducing malaria prevalence in malaria- S. mansoni co-endemic communities. Conclusions/Significance Schistosomiasis treatment and control programmes in regions where S. mansoni and malaria are highly prevalent may have indirect benefits on reducing malaria transmission as a result of disease interactions. In particular, mass praziquantel administration may not only have the direct benefit of reducing schistosomiasis infection, it may also reduce malaria transmission and disease burden. Malaria and Schistosoma mansoni are co-endemic in many regions of sub-Saharan Africa. Evidence from clinical and epidemiological studies support the hypothesis that concurrent infection with S. mansoni is associated with greater malaria incidence among school-age children. We use mathematical modeling to evaluate the epidemiological impact of S. mansoni infection on malaria transmission in sub-Saharan Africa. Using epidemiological data on the increased risk of malaria incidence in S. mansoni endemic communities from Senegal, we developed a co-epidemic model of malaria and S. mansoni transmission dynamics to address key epidemiological interactions between the two diseases. Parameterizing our model for S. mansoni high-risk endemic communities, we show that the interaction between S. mansoni and malaria may reduce the effectiveness of malaria treatment for curtailing malaria transmission. Moreover, we show that in addition to reducing schistosomiasis health burden, mass praziquantel administration will generate indirect benefit in terms of reducing malaria transmission and disease burden in S. mansoni–malaria co-endemic communities. Our findings indicate the possible benefit of scaling up schistosomiasis control efforts in sub-Saharan Africa, and especially in areas were S. mansoni and malaria are highly prevalent.
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Affiliation(s)
- Martial L. Ndeffo Mbah
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
- * E-mail:
| | - Laura Skrip
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Scott Greenhalgh
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Peter Hotez
- National School of Tropical Medicine, and Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, United States of America
| | - Alison P. Galvani
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
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Ateba Ngoa U, Zinsou JF, Kassa RFK, Ngoune Feugap E, Honkpehedji YJ, Massinga-Loembe M, Kenguele Moundounga H, Nkoma Mouima AM, Mbenkep LH, Wammes LJ, Mbow M, Kruize Y, Mombo-Ngoma G, Bouyoukou Hounkpatin AL, Dejon Agobe JC, Saadou I, Lell B, Smits H, Kremsner PG, Yazdanbakhsh M, Adegnika AA. Assessment of the effect of Schistosoma haematobium co infection on malaria parasites and immune responses in rural populations in Gabon: study protocol. SPRINGERPLUS 2014; 3:388. [PMID: 25120947 PMCID: PMC4128953 DOI: 10.1186/2193-1801-3-388] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/15/2014] [Indexed: 02/05/2023]
Abstract
Background Malaria and helminth co infection are common in tropical and subtropical areas where they affect the life of millions of people. While both helminth and malaria parasites have immunomodulatory activities, little is known about the consequence of co-infections on malaria antigen specific immune responses. Method/Design This study will be conducted in two rural areas of the Moyen Ogooué province in Gabon, endemic for both Plasmodium falciparum and Schistosoma haematobium infections. Participants, 5 to 50 years old, will be enrolled and grouped according to their infection status. S. haematobium and malaria parasites will be detected, demographic and clinical data will be recorded and blood will be collected for hematological as well as for immunological assays. The level of antibody specific to Plasmodium falciparum blood stage and gametocyte antigens will be measured using ELISA. PBMC will be isolated for phenotyping of different T cell subsets ex vivo by flow cytometry and for culture and cytokine response assessment. Discussion We will provide a comprehensive picture of the interaction between schistosomes and malaria parasites which co-localize in peripheral blood. We will test the hypothesis that schistosome infection has an impact on specific humoral as well as on cellular immune responses to malaria antigens.
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Affiliation(s)
- Ulysse Ateba Ngoa
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Roland Fabrice Kassa Kassa
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Eliane Ngoune Feugap
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Marguerite Massinga-Loembe
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Faculté de Médecine, Université des Sciences de la Santé de Libreville, BP: 4009, Libreville, Gabon
| | - Hilaire Kenguele Moundounga
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Anne Marie Nkoma Mouima
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Lima Honorine Mbenkep
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Linda Judith Wammes
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Moustapha Mbow
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec Teaching Hospital, 30 Avenue Pasteur, BP 7325, Dakar, Senegal ; Institute of Tropical Medicine of Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Yvonne Kruize
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Faculté de Médecine, Université des Sciences de la Santé de Libreville, BP: 4009, Libreville, Gabon
| | - Aurore Larissa Bouyoukou Hounkpatin
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Jean Claude Dejon Agobe
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Issifou Saadou
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Hermelijn Smits
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Peter Gottfried Kremsner
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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van der Vlugt LEPM, Zinsou JF, Ozir-Fazalalikhan A, Kremsner PG, Yazdanbakhsh M, Adegnika AA, Smits HH. Interleukin 10 (IL-10)–Producing CD1dhi Regulatory B Cells From Schistosoma Haematobium–Infected Individuals Induce IL-10–Positive T Cells and Suppress Effector T-Cell Cytokines. J Infect Dis 2014; 210:1207-16. [DOI: 10.1093/infdis/jiu257] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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