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Berry SPDG, Honkpèhedji YJ, Ludwig E, Mahmoudou S, Prodjinotho UF, Adamou R, Nouatin OP, Adégbitè BR, Dejon-Agobe JC, Mba RB, Maloum M, Nkoma AMM, Zinsou JF, Luty AJF, Esen M, Adégnika AA, Prazeres da Costa C. Impact of helminth infections during pregnancy on maternal and newborn Vitamin D and on birth outcomes. Sci Rep 2024; 14:14845. [PMID: 38937587 PMCID: PMC11211496 DOI: 10.1038/s41598-024-65232-9] [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: 02/27/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024] Open
Abstract
Poor birth outcomes in low- and middle income countries are associated with maternal vitamin D deficiency and chronic helminth infections. Here, we investigated whether maternal Schistosoma haematobium affects maternal or cord vitamin D status as well as birth outcomes. In a prospective cross-sectional study of pregnant women conducted in Lambaréné, Gabon, we diagnosed maternal parasitic infections in blood, urine and stool. At delivery we measured vitamin D in maternal and cord blood. S. haematobium, soil-transmitted helminths, and microfilariae were found at prevalences of 30.2%, 13.0%, and 8.8%, respectively. Insufficient vitamin D and calcium levels were found in 28% and 15% of mothers, and in 11.5% and 1.5% of newborns. Mothers with adequate vitamin D had lower risk of low birthweight babies (aOR = 0.11, 95% CI 0.02-0.52, p = 0.01), whilst offspring of primipars had low cord vitamin D levels, and low vitamin D levels increased the risk of maternal inflammation. Maternal filariasis was associated with low calcium levels, but other helminth infections affected neither vitamin D nor calcium levels in either mothers or newborns. Healthy birth outcomes require maintenance of adequate vitamin D and calcium levels. Chronic maternal helminth infections do not disrupt those levels in a semi-rural setting in sub-Saharan Africa.
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Affiliation(s)
- Sèyigbéna P Déo-Gracias Berry
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine and Health, Technical University of Munich (TUM), Trogerstrasse 30, 81675, Munich, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Center for Global Health, TUM School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany
| | - Yabo Josiane Honkpèhedji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
- Institut Für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Fondation Pour La Recherche Scientifique (FORS), Cotonou, Benin
| | - Esther Ludwig
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine and Health, Technical University of Munich (TUM), Trogerstrasse 30, 81675, Munich, Germany
- Center for Global Health, TUM School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany
| | | | - Ulrich Fabien Prodjinotho
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine and Health, Technical University of Munich (TUM), Trogerstrasse 30, 81675, Munich, Germany
- Center for Global Health, TUM School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany
| | - Rafiou Adamou
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Odilon P Nouatin
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
| | - Bayode R Adégbitè
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut Für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Jean Claude Dejon-Agobe
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut Für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Romuald Beh Mba
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | | | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut Für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Fondation Pour La Recherche Scientifique (FORS), Cotonou, Benin
| | | | - Meral Esen
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut Für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Partner site Tübingen, Tübingen, Germany
| | - Ayôla Akim Adégnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut Für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Fondation Pour La Recherche Scientifique (FORS), Cotonou, Benin
- German Center for Infection Research (DZIF), Partner site Tübingen, Tübingen, Germany
| | - Clarissa Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine and Health, Technical University of Munich (TUM), Trogerstrasse 30, 81675, Munich, Germany.
- Center for Global Health, TUM School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany.
- German Center for Infection Research (DZIF), Partner site Munich, Munich, Germany.
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van Dorst MMAR, Pyuza JJ, Nkurunungi G, Kullaya VI, Smits HH, Hogendoorn PCW, Wammes LJ, Everts B, Elliott AM, Jochems SP, Yazdanbakhsh M. Immunological factors linked to geographical variation in vaccine responses. Nat Rev Immunol 2024; 24:250-263. [PMID: 37770632 DOI: 10.1038/s41577-023-00941-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/30/2023]
Abstract
Vaccination is one of medicine's greatest achievements; however, its full potential is hampered by considerable variation in efficacy across populations and geographical regions. For example, attenuated malaria vaccines in high-income countries confer almost 100% protection, whereas in low-income regions these same vaccines achieve only 20-50% protection. This trend is also observed for other vaccines, such as bacillus Calmette-Guérin (BCG), rotavirus and yellow fever vaccines, in terms of either immunogenicity or efficacy. Multiple environmental factors affect vaccine responses, including pathogen exposure, microbiota composition and dietary nutrients. However, there has been variable success with interventions that target these individual factors, highlighting the need for a better understanding of their downstream immunological mechanisms to develop new ways of modulating vaccine responses. Here, we review the immunological factors that underlie geographical variation in vaccine responses. Through the identification of causal pathways that link environmental influences to vaccine responsiveness, it might become possible to devise modulatory compounds that can complement vaccines for better outcomes in regions where they are needed most.
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Affiliation(s)
- Marloes M A R van Dorst
- Department of Parasitology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Jeremia J Pyuza
- Department of Parasitology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Gyaviira Nkurunungi
- Immunomodulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Vesla I Kullaya
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Hermelijn H Smits
- Department of Parasitology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | | | - Linda J Wammes
- Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Bart Everts
- Department of Parasitology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Alison M Elliott
- Immunomodulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Simon P Jochems
- Department of Parasitology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands.
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Gaidhane S, Gaidhane A, Khatib MN, Telrandhe S, Patil M, Saxena D, Bhardwaj P, Choudhari S, Zahiruddin QS. Estimation of the Parasitic Burden of Soil-Transmitted Helminths Among Pregnant Women in the Maharashtra State of India Using qPCR: A Community-Based Study. Indian J Community Med 2024; 49:157-164. [PMID: 38425985 PMCID: PMC10900441 DOI: 10.4103/ijcm.ijcm_249_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/01/2023] [Indexed: 03/02/2024] Open
Abstract
Background Soil-transmitted helminth (STH) infections are widespread in developing countries with inadequate sanitation facilities. These infections can lead to malnutrition, anemia, and other complications that can negatively impact both the mother's and fetus's health during pregnancy. This study aimed to estimate the burden of STH by Kato-Katz microscopy and quantitative polymerase chain reaction (qPCR) in pregnant women from rural India. The diagnostic accuracy of these two methods was also compared. Material and Methods A community-based cross-sectional study was conducted in rural areas of Wardha district of Maharashtra state. We randomly selected and interviewed 688 pregnant women. A total of 534 (77.61%) participants gave stool samples. Two containers (60 mL) labeled with a unique identification number were given to pregnant women to collect stool samples for Kato-Katz microscopy and qPCR. Stool specimens were transported to an accredited lab and examined within 24 hours. Suitable examinations were conducted to compare sensitivity between two tests. Results The results are presented for 534 participants who gave stool samples. The prevalence of any STH by Kato-Katz stool microscopy was 6.55% (95%CI 4.46-12.19), and that by qPCR was 20.41 (95%CI 17.53-29.40). The sensitivity of Kato-Katz microscopy was 29.17% compared to sensitivity of 90.83% by qPCR (P = 0.001). Pregnant women with STH infection have a significantly lower weight gain during pregnancy, and the majority were either mild or moderate anemic compared to those without STH. Conclusion The study highlighted significant differences in prevalence of STH among pregnant women by Kato-Katz microscopy and qPCR. The sensitivity of qPCR for detecting STH was higher than that of Kato-Katz microscopy.
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Affiliation(s)
- Shilpa Gaidhane
- Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Abhay Gaidhane
- Centre of One Health, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Mahalaqua Nazli Khatib
- Global Evidence Synthesis Initiative, Division of Evidence Synthesis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Shital Telrandhe
- Global Health Academy, Centre of Early Childhood Development - Stepping Stones Project, Wardha, Maharashtra, India
| | - Manoj Patil
- Global Health Consortium Public Health and Research, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Deepak Saxena
- i Health Consortium, Department of Epidemiology, Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | - Pankaj Bhardwaj
- School of Public Health (SPH), Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Sonali Choudhari
- School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Quazi S. Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
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Gebreegziabher T, Sidibe S. Prevalence and contributing factors of anaemia among children aged 6-24 months and 25-59 months in Mali. J Nutr Sci 2023; 12:e112. [PMID: 37964977 PMCID: PMC10641697 DOI: 10.1017/jns.2023.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/18/2023] [Accepted: 10/06/2023] [Indexed: 11/16/2023] Open
Abstract
Although considerable global initiatives have been undertaken to tackle anaemia, its prevalence continues to be high in sub-Saharan African nations. In Mali specifically, anaemia represents a significant and pressing public health issue. The purpose of the present study was to examine the key risk factors related to anaemia among children aged 6-24 months (younger age group) and 25-59 months (older age group). We used the Mali 2018 Demographic and Health Survey data, collected from 8861 mothers with children under five. Logistic regression was used to assess the risk factors for childhood anaemia. The results suggest that the prevalence of anaemia was 88 % in the younger and 76 % in the older age groups. The risk factors unique to the younger age group were malaria (OR 4⋅05; CI 0⋅95, 11⋅3) and place of residence (OR 0⋅55; CI 0⋅32, 0⋅94), while for the older age group, they were morbidity (OR 1⋅91; CI 1⋅12, 3⋅24), drinking from a bottle (OR 1⋅52; CI 1⋅04, 2⋅22), and micronutrient intake (OR 0⋅61; CI 0⋅40, 0⋅91). Risk factors that significantly contributed to both age groups include breastfeeding, deworming, maternal anaemia, maternal education, and wealth index. Anaemia also varied by region. The widespread prevalence of anaemia can be attributed to a multitude of factors. In addressing this issue, it is imperative to acknowledge the unique characteristics of specific regions and rural areas, where the incidence of anaemia surpasses the national average. Therefore, any intervention efforts should be tailored to the specific needs and challenges of these areas.
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Affiliation(s)
- Tafere Gebreegziabher
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA 98926-7571, USA
| | - Saran Sidibe
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA 98926-7571, USA
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Traore SS, Bo Y, Kou G, Lyu Q. Iron supplementation and deworming during pregnancy reduces the risk of anemia and stunting in infants less than 2 years of age: a study from Sub-Saharan Africa. BMC Pregnancy Childbirth 2023; 23:63. [PMID: 36698082 PMCID: PMC9875517 DOI: 10.1186/s12884-023-05399-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In sub-Saharan Africa, infant anemia, stunting and low birth weight remains major public health problems. It is unclear whether prenatal iron supplementation and/or deworming can reduce the risk of infant stunting, anemia and low birth weight. The aim of this study was to investigate the relationship between iron supplementation and/or deworming and stunting, anemia, and low birth weight in infants under two years of age in sub-Saharan Africa. METHODS Our studies examined pooled data from Demographic and Health Surveys (DHS) in twenty-three African countries collected between 2014 and 2020. childhood anemia and stunting in infants under the age of two were the primary outcomes. Iron supplementation and deworming during prenatal visits were the main exposure variables. A multivariate logistic regression model was used to investigate these relationships. RESULTS The prevalence of stunting was 29.9%, severe stunting was 10.6%, childhood anemia was 74.3%, childhood severe anemia was 3.2%, and low birth weight was 16.4%, respectively. The use of prenatal iron supplementation alone was associated with a significant reduction of childhood anemia [aOR (95% CI) = 0.9 (0.8-1.0)]. Prenatal deworming alone was associated with a significantly reduced risk of stunting [aOR (95% CI) = 0.7 (0.8-1.0)], childhood anemia [aOR (95% CI) = 0.7 (0.8-0.9)], and low birth weight [aOR (95% CI) = 0.7 (0.8-1.0)]. Prenatal iron supplementation plus deworming or iron supplementation (with or without deworming) were not associated with childhood anemia, infant stunting and low birth weight. CONCLUSIONS In Sub-Saharan Africa, prenatal deworming alone has the potential to improve infants' outcomes. Childhood anemia was improved with prenatal iron supplementation alone. Our recent findings indicate the necessity for prospective studies on the association between prenatal iron supplementation plus deworming and childhood anemia, stunting and low birth weight.
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Affiliation(s)
- Stanislav Seydou Traore
- grid.207374.50000 0001 2189 3846Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China
| | - Yacong Bo
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, 999077 China
| | - Guangning Kou
- grid.207374.50000 0001 2189 3846Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China ,grid.207374.50000 0001 2189 3846Centre of Sport Nutrition and Health, School of Physical Education, Zhengzhou University, Zhengzhou, 450001 China
| | - Quanjun Lyu
- grid.207374.50000 0001 2189 3846Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001 China ,grid.412633.10000 0004 1799 0733Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
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Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095444. [PMID: 35564842 PMCID: PMC9101176 DOI: 10.3390/ijerph19095444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/22/2022]
Abstract
Malaria and helminthic co-infection during pregnancy causes fetomaternal haemorrhage and foetal growth retardation. This study determined the pooled burden of pregnancy malaria and helminthic co-infection in sub-Saharan Africa. CINAHL, EMBASE, Google Scholar, Scopus, PubMed, and Web of Science databases were used to retrieve data from the literature, without restricting language and publication year. The Joanna Briggs Institute’s critical appraisal tool for prevalence studies was used for quality assessment. STATA Version 14.0 was used to conduct the meta-analysis. The I2 statistics and Egger’s test were used to test heterogeneity and publication bias. The random-effects model was used to estimate the pooled prevalence at a 95% confidence interval (CI). The review protocol has been registered in PROSPERO, with the number CRD42019144812. In total, 24 studies (n = 14,087 participants) were identified in this study. The pooled analysis revealed that 20% of pregnant women were co-infected by malaria and helminths in sub-Saharan Africa. The pooled prevalence of malaria and helminths were 33% and 35%, respectively. The most prevalent helminths were Hookworm (48%), Ascaris lumbricoides (37%), and Trichuris trichiura (15%). Significantly higher malaria and helminthic co-infection during pregnancy were observed. Health systems in sub-Saharan Africa must implement home-grown innovative solutions to underpin context-specific policies for the early initiation of effective intermittent preventive therapy.
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Raj E, Calvo-Urbano B, Heffernan C, Halder J, Webster JP. Systematic review to evaluate a potential association between helminth infection and physical stunting in children. Parasit Vectors 2022; 15:135. [PMID: 35443698 PMCID: PMC9022337 DOI: 10.1186/s13071-022-05235-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/10/2022] [Indexed: 01/02/2023] Open
Abstract
Background Despite considerable public health efforts over the past 20 years, childhood stunting (physical and/or cognitive) levels globally remain unacceptably high—at 22% amongst children under 5 years old in 2020. The aetiology of stunting is complex and still largely unknown. Helminths can cause significant mortality and morbidity and have often been cited as major causative agents for stunting, although their actual role in childhood stunting remains unclear. Our aim was to systematically review the current evidence to help support or refute the hypothesis that helminths cause physical stunting in children. Methods Inclusion criteria were as follows: infected with (and/or exposed to) helminths (soil-transmitted helminths, schistosomes or food-borne trematodes), children, pregnant or breastfeeding women as study participants (children included infants 0–1 year old, preschool-age children 1–5 years and school-age children > 5 years old), anthelmintic treatment intervention, stunting-related variables reported (e.g. height, height-for-age z-score, birth weight), helminth infection reported in relation to stunting, any geographic location, any date, peer-reviewed literature only. Exclusion criteria were: non-primary research, study protocols, studies with no new data, non-English language papers and animal (non-human) helminth studies. Seven databases were searched on 28 May 2021. Risk of bias was assessed for included studies and GRADE was used for studies included in RCT subgroup meta-analyses (in preschool-age children and pregnant women). This systematic review was registered with PROSPERO (CRD42021256201). Results Eighty studies were included in the analyses. No significant overall evidence was found in support of the hypothesis that helminths cause physical stunting in children, although there was some association with wasting. Conclusions Whilst analyses of the available literature to date failed to support a direct association between helminth infection and childhood stunting, there was significant heterogeneity between studies, and many had follow-up periods which may have been too short to detect impacts on growth. Most apparent was a lack of available data from key demographic groups wherein one may predict the greatest association of helminth infection with stunting—notably that of infants, preschool-age children, and pregnant or nursing women. Thus this review highlights the urgent need for further targeted empirical research amongst these potentially most vulnerable demographic groups. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05235-5.
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Affiliation(s)
- E Raj
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.
| | - B Calvo-Urbano
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.,London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, W2 1PG, London, UK
| | - C Heffernan
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.,London International Development Centre, London, WC1A 2NS, UK
| | - J Halder
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.,London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, W2 1PG, London, UK
| | - J P Webster
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK. .,London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, W2 1PG, London, UK.
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Dey AR, Begum N, Anisuzzaman, Islam MT, Alam MZ. A large-scale epidemiological investigation on trematode infections in small ruminants in Bangladesh. Vet Med Sci 2022; 8:1219-1228. [PMID: 35113500 PMCID: PMC9122409 DOI: 10.1002/vms3.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The important trematode species in small ruminants: Paramphistomum sp., Fasciola spp. and Schistosoma spp. seriously affect the productivity of domestic ruminants in endemic areas. Methods In the present study, we identified the potential risk factors associated with trematodes infections in small ruminants in seven topographic zones of Bangladesh using simple sedimentation and modified Stoll’ ova counting technique. Results A total of 2440 samples were examined, where 965 were found positive with one or more trematode species with an overall prevalence of 39.5% (95% CI, 37.6%–41.5%) and intensity of infection was 264.77 ± 9.86 egg per gram of faeces. Three trematode species were identified namely Paramphistomum sp. (34.1%, 32.2%–36.0%), Fasciola spp. (7.5%, 6.5%–8.6%) and Schistosoma spp. (2.7%, 2.1%–3.5%). Prevalence of co‐infection was 4.8%. The spatial distribution of trematode infections varied from 29.5% to 53.6%. Univariate analysis revealed that physiological condition of females, body condition, farming system, deworming and season were significantly (p < 0.05) associated with trematodes infections in small ruminants. By multiple logistic regression model, three factors such as physiological condition of females (pregnant and lactating), poor body condition and animals without deworming were identified as potential risk factors for trematodes infection in small ruminants. Conclusion Trematode infections are prevalent in the study areas and Paramphistomum sp. is most common in different areas among the identified trematodes species. Government should take necessary action to appraise an effective control strategy of trematode infections in small ruminants.
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Affiliation(s)
- Anita Rani Dey
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Nurjahan Begum
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Anisuzzaman
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Md Taohidul Islam
- Department of Medicine, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Mohammad Zahangir Alam
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Alvarado-Gonzalez JC, Alvis-Zakzuk NR, Castillo-Saavedra DE, Lozada-Martinez ID, Picón-Jaimes YA, Narvaez-Rojas AR, Zakzuk J. Impact of helminthiasis on gestational anemia in low- and middle-income countries: a systematic review and meta-analysis of more than 19,000 women. LE INFEZIONI IN MEDICINA 2022; 31:36-48. [PMID: 36908393 PMCID: PMC9994832 DOI: 10.53854/liim-3101-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/25/2023] [Indexed: 03/07/2023]
Abstract
Intestinal helminthiasis are a common public health problem in developed and developing countries. It is thought that they can influence pregnancy by causing gestational anemia. The aim of this study was to determine if there is a relationship between helminth infection and gestational anemia. A structured review of scientific literature was conducted through active search in the electronic databases MEDLINE® and LILACS® until December 2021, following 2020 PRISMA statement. The studies were reviewed independently by two authors, extracting the most relevant information from each study. Cross-sectional studies, case-control and ecological studies were included, with no date or language limit. Randomized clinical trials were excluded. A total of 38 studies were included in the systematic review. The study populations of all studies belonged to low- and middle-income countries: 28 studies from Africa, 6 from Asia, 3 from Latin America and 1 from Oceania. Overall, the average prevalence of gestational anemia among the included studies was 40% (95% CI 34-46%). Hookworm was the predominant species detected in most studies (19/38; 50%), followed by Ascaris lumbricoides (15/38; 39.5%). Gestational anemia was positively associated with A. lumbricoides (OR 1.86, 95% CI 1.12-3.08) and hookworms (OR 3.09, 95% CI 1.99-4.78). Prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk during meta-regression (p=0.5182). The results of this review indicate that there is a statistically significant association between helminthiasis and gestational anemia. Although hookworm is the main species associated with the outcome, prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk. The impact of other species needs to be defined given the expected bias that arises from polyparasitism when defining comparison groups.
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Affiliation(s)
- Juan Carlos Alvarado-Gonzalez
- Institute of Immunological Research, Universidad de Cartagena, Cartagena de Indias, Colombia.,ALZAK Foundation, Cartagena de Indias, Colombia
| | | | | | - Ivan David Lozada-Martinez
- Fac Ciències Salut Blanquerna, Univ Ramon Llul, Barcelona, Spain.,Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia
| | | | - Alexis Rafael Narvaez-Rojas
- Division of Breast Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine - Jackson Health System, Miami, FL, USA
| | - Josefina Zakzuk
- Institute of Immunological Research, Universidad de Cartagena, Cartagena de Indias, Colombia.,ALZAK Foundation, Cartagena de Indias, Colombia
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Taylor M, Pillaye J, Horsnell WGC. Inherent maternal type 2 immunity: Consequences for maternal and offspring health. Semin Immunol 2021; 53:101527. [PMID: 34838445 DOI: 10.1016/j.smim.2021.101527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 02/08/2023]
Abstract
An inherent elevation in type 2 immunity is a feature of maternal and offspring immune systems. This has diverse implications for maternal and offspring biology including influencing success of pregnancy, offspring immune development and maternal and offspring ability to control infection and diseases such as allergies. In this review we provide a broad insight into how this immunological feature of pregnancy and early life impacts both maternal and offspring biology. We also suggest how understanding of this axis of immune influence is and may be utilised to improve maternal and offspring health.
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Affiliation(s)
- Matthew Taylor
- Institute of Immunology and Infection Research, Ashworth Laboratories, The Kings Buildings, University of Edinburgh, West Mains Road, Edinburgh, EH9 3JT, UK.
| | - Jamie Pillaye
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - William Gordon Charles Horsnell
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK; Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine (IDM), Department of Pathology, Division of Immunology, Faculty of Health Science, University of Cape Town, Cape Town, 7925, South Africa.
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11
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Avokpaho EFGA, Houngbégnon P, Accrombessi M, Atindégla E, Yard E, Rubin Means A, Kennedy DS, Littlewood DTJ, Garcia A, Massougbodji A, Galagan SR, Walson JL, Cottrell G, Ibikounlé M, Ásbjörnsdóttir KH, Luty AJF. Factors associated with soil-transmitted helminths infection in Benin: Findings from the DeWorm3 study. PLoS Negl Trop Dis 2021; 15:e0009646. [PMID: 34403424 PMCID: PMC8396766 DOI: 10.1371/journal.pntd.0009646] [Citation(s) in RCA: 2] [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: 12/30/2020] [Revised: 08/27/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Despite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt the transmission of STH, through a series of cluster-randomized trials in Benin, India and Malawi. We used the pre-treatment baseline survey data to describe and analyze the factors associated with STH infection in Comé, the study site of the DeWorm3 project in Benin. These data will improve understanding of the challenges that need to be addressed in order to eliminate STH as a public health problem in Benin. Methods Between March and April 2018, the prevalence of STH (hookworm spp., Ascaris and Trichuris trichiura) was assessed by Kato-Katz in stool samples collected from 6,153 residents in the community of Comé, Benin using a stratified random sampling procedure. A standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of STH infections in pre-school (PSAC, aged 1–4), school-aged children (SAC, aged 5–14) and adults (aged 15 and above). Multilevel mixed-effects models were used to assess associations between these factors and STH infection. Results The overall prevalence of STH infection was 5.3%; 3.2% hookworm spp., 2.1% Ascaris lumbricoides and 0.1% Trichuris. Hookworm spp. were more prevalent in adults than in SAC (4.4% versus 2.0%, respectively; p = 0.0001) and PSAC (4.4% versus 1.0%, respectively; p<0.0001), whilst Ascaris lumbricoides was more prevalent in SAC than in adults (3.0% versus 1.7%, respectively; p = 0.004). Being PSAC (adjusted Odds Ratio (aOR) = 0.2, p< 0.001; adjusted Infection Intensity Ratio (aIIR) = 0.1, p<0.001) or SAC (aOR = 0.5, p = 0.008; aIIR = 0.3, p = 0.01), being a female (aOR = 0.6, p = 0.004; aIIR = 0.3, p = 0.001), and having received deworming treatment the previous year (aOR = 0.4, p< 0.002; aIIR = 0.2, p<0.001) were associated with a lower prevalence and intensity of hookworm infection. Lower income (lowest quintile: aOR = 5.0, p<0.001, 2nd quintile aOR = 3.6, p = 0.001 and 3rd quintile aOR = 2.5, p = 0.02), being a farmer (aOR = 1.8, p = 0.02), medium population density (aOR = 2.6, p = 0.01), and open defecation (aOR = 0.5, p = 0.04) were associated with a higher prevalence of hookworm infection. Lower education—no education, primary or secondary school- (aIIR = 40.1, p = 0.01; aIIR = 30.9, p = 0.02; aIIR = 19.3, p = 0.04, respectively), farming (aIIR = 3.9, p = 0.002), natural flooring (aIIR = 0.2, p = 0.06), peri-urban settings (aIIR = 6.2, 95%CI 1.82–20.90, p = 0.003), and unimproved water source more than 30 minutes from the household (aIIR = 13.5, p = 0.02) were associated with a higher intensity of hookworm infection. Improved and unshared toilet was associated with lower intensity of hookworm infections (aIIR = 0.2, p = 0.01). SAC had a higher odds of Ascaris lumbricoides infection than adults (aOR = 2.0, p = 0.01) and females had a lower odds of infection (aOR = 0.5, p = 0.02). Conclusion Hookworm spp. are the most prevalent STH in Comé, with a persistent reservoir in adults that is not addressed by current control measures based on school MDA. Expanding MDA to target adults and PSAC is necessary to substantially impact population prevalence, particularly for hookworm. Trial registration ClinicalTrials.gov NCT03014167. Despite several years of deworming campaigns targeting school-aged children, soil-transmitted helminths (STH) remains a public health problem in most developing countries, including Benin. The burden is mostly on children and pregnant women, but also on the whole society. Soil-transmitted helminths are responsible for malnutrition, anemia, low birth weight, cognitive impairment, decrease of school performance, and subsequently economic loss. The current strategy of the Benin National Neglected Tropical Diseases (NTD) Program is to achieve STH control through mass drug administration campaigns targeting school-aged children (SAC). The baseline data of Deworm3 study, implemented in Comé, southern Benin, as part of a multicountry (Benin, Malawi and India) STH elimination trial, shows that previous school deworming campaigns decreased STH prevalence; however there is a persistent reservoir of STH infection in adults and pre-school aged children that should be targeted for a better impact. In order to eliminate STH as a public health problem, Benin National NTD Program would need to increase its target population, from the SAC to the whole community. The future results of Deworm3 trial would demonstrate whether the STH elimination goal STH using community wide mass drug administration would be achievable.
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Affiliation(s)
- Euripide F. G. A. Avokpaho
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
- Université de Paris, ED 393 Pierre Louis de Santé Publique, Paris, France
- * E-mail:
| | | | - Manfred Accrombessi
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Eloïc Atindégla
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
| | - Elodie Yard
- DeWorm3, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Arianna Rubin Means
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - David S. Kennedy
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- DeWorm3, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | | | | | | | - Sean R. Galagan
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Judd L. Walson
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | | | - Moudachirou Ibikounlé
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
- Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales (CReMIT/TIDRC), Université d’Abomey-Calavi, Abomey-Calavi, Bénin
| | - Kristjana Hrönn Ásbjörnsdóttir
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Centre for Public Health Sciences, University of Iceland, Reykjavík, Iceland
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Animaw Z, Melese A, Demelash H, Seyoum G, Abebe A. Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2021; 21:474. [PMID: 34210260 PMCID: PMC8252203 DOI: 10.1186/s12884-021-03908-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/28/2021] [Indexed: 11/24/2022] Open
Abstract
Background Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia. Methods Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software. Results Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia. Conclusions Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.
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Affiliation(s)
- Zelalem Animaw
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Addisu Melese
- Department of Medical Microbiology, College of Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habtamu Demelash
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Girma Seyoum
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiy Abebe
- Traditional and Modern Medicine Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Keller L, Welsche S, Patel C, Sayasone S, Ali SM, Ame SM, Hattendorf J, Hürlimann E, Keiser J. Long-term outcomes of ivermectin-albendazole versus albendazole alone against soil-transmitted helminths: Results from randomized controlled trials in Lao PDR and Pemba Island, Tanzania. PLoS Negl Trop Dis 2021; 15:e0009561. [PMID: 34191812 PMCID: PMC8277064 DOI: 10.1371/journal.pntd.0009561] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/13/2021] [Accepted: 06/14/2021] [Indexed: 12/13/2022] Open
Abstract
Background Preventive chemotherapy is the cornerstone of soil-transmitted helminth (STH) control. Long-term outcomes and adequate treatment frequency of the recently recommended albendazole-ivermectin have not been studied to date. Methodology/principal findings Double-blind randomized controlled trials were conducted in Lao PDR, Pemba Island, Tanzania and Côte d’Ivoire between 2018 and 2020 to evaluate the efficacy and safety of ivermectin-albendazole versus albendazole-placebo in Trichuris trichiura-infected individuals aged 6 to 60. In the framework of this study, in Lao PDR 466 and 413 participants and on Pemba Island, 558 and 515 participants were followed-up six and 12 months post-treatment, respectively. From each participant at least one stool sample was processed for Kato-Katz diagnosis and cure rates (CRs), egg reduction rates (ERRs) and apparent reinfection rates were calculated. If found helminth-positive at six months, participants were re-treated according to their allocated treatment. Long-term outcomes against T. trichiura based on CRs and ERRs of ivermectin-albendazole compared to albendazole were significantly higher at six months in Lao PDR (CR, 65.8 vs 13.4%, difference; 52.4; 95% CI 45.0–60.0; ERRs, 99.0 vs 79.6, difference 19.4; 95% CI 14.4–24.4) and Pemba Island (CR, 17.8 vs 1.4%, difference; 16.4; 95% CI 11.6–21.0; ERRs, 84.9 vs 21.2, difference 63.8; 95% CI 50.6–76.9) and also at 12 months in Lao PDR (CR, 74.0 vs 23.4%, difference; 50.6; 95% CI 42.6–61.0; ERRs, 99.6 vs 91.3, difference 8.3; 95% CI 5.7–10.8) and Pemba Island (CR, 19.5 vs 3.4%, difference; 16.1; 95% CI 10.7–21.5; ERRs, 92.9 vs 53.6, difference 39.3; 95% CI 31.2–47.4) respectively. Apparent reinfection rates with T. trichiura were considerably higher on Pemba Island (100.0%, 95% CI, 29.2–100.0) than in Lao PDR (10.0%, 95% CI, 0.2–44.5) at 12 months post-treatment for participants treated with albendazole alone. Conclusions/significance The long-term outcomes against T. trichiura of ivermectin-albendazole are superior to albendazole in terms of CRs and ERRs and in reducing infection intensities. Our results will help to guide decisions on how to best use ivermectin-albendazole in the context of large-scale PC programs tailored to the local context to sustainably control STH infections. Trial registration ClinicalTrials.gov registered with clinicaltrials.gov, reference: NCT03527732, date assigned: 17 May 2018. Around 1.5 billion people are infected with the gastrointestinal dwelling nematodes, the so-called soil-transmitted helminths (STHs). Especially chronic high-intensity infections with these parasites can cause substantial morbidity in endemic regions. Preventive chemotherapy, which is the regular administration of a single dose of an anthelmintic drug to at-risk populations, aims to reduce morbidity by lowering the prevalence and intensity of STH infections. Due to the suboptimal efficacy of these recommended single dose monotherapies, particularly against Trichuris trichiura, the use of drug combinations with dissimilar modes of action may enhance treatment efficacy. In double-blind randomized controlled trials in Lao PDR and on Pemba Island, Tanzania, we examined the long-term outcomes of ivermectin-albendazole versus albendazole alone, against T. trichiura. We assessed the infection status, apparent reinfections, new infections and the change of infection intensity for the three major STH species six and 12 months post-treatment. The long-term outcomes (in terms of cure and egg-reduction rates) of the ivermectin-albendazole combination therapy against T. trichiura were significantly higher than that of albendazole alone at all-time points and in both countries. Bi-annual treatment intervals using the ivermectin-albendazole combination might be necessary to sustainably decrease transmission of STH infections.
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Affiliation(s)
- Ladina Keller
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sophie Welsche
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Chandni Patel
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Somphou Sayasone
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | - Said M. Ali
- Public Health Laboratory Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Shaali M. Ame
- Public Health Laboratory Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Jan Hattendorf
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Eveline Hürlimann
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Taghipour A, Ghodsian S, Jabbari M, Olfatifar M, Abdoli A, Ghaffarifar F. Global prevalence of intestinal parasitic infections and associated risk factors in pregnant women: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2021; 115:457-470. [PMID: 33007067 DOI: 10.1093/trstmh/traa101] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/04/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited information is available about the global status of IPIs in pregnant women. Here we undertook a meta-analysis to estimate the global prevalence of IPIs and associated risk factors in pregnant women. METHODS We searched the PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases for relevant studies that were published between 1 January 1987 and 30 December 2019. A random effects meta-analysis model was used to estimate the pooled prevalence, odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 114 studies comprising 98 342 pregnant women across 35 countries were included in the systematic review and meta-analysis. Among IPIs identified from pregnant women, three helminth infections (hookworm 19% [95% CI 15 to 23], Ascaris lumbricoides 17% [95% CI 13 to 21] and Trichuris trichiura 11% [95% CI 7 to 16]) and three protozoan infections (Blastocystis sp. 21% [95% CI 4 to 46], Entamoeba histolytica/dispar 9% [95% CI 3 to 19] and Giardia sp. 8% [95% CI 4 to 13]) were identified as the most prevalent intestinal parasites. Moreover, we found that there was a significant association between IPIs with increased risk of anaemia in pregnant women (OR 2.65 [95% CI 2.08 to 3.37]). The prevalence of IPIs was slightly higher in geophagic pregnant women compared with controls, but this was not significant (OR 1.22 [95% CI 0.87 to 1.71]). According to species, the pooled OR of A. lumbricoides infection had a significantly higher risk in geophagic pregnant women compared with controls (OR 2.66 [95% CI 1.37 to 5.16]). There was a positive relationship between the high prevalence of IPIs in pregnant women living in rural areas compared with urban residents (OR 3.36 [95% CI 1.57 to 7.19]). CONCLUSIONS The current review revealed a relatively high prevalence of IPIs in pregnant women, especially in some low- and middle-income countries. These results suggest a need for improved prevention and control efforts to reduce the health risks to pregnant women.
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Affiliation(s)
- Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
| | - Sahar Ghodsian
- Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Jabbari
- Department of Microbiology, Faculty of Basic Science, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran
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15
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Campillo JT, Chabot EB, Awaca-Uvon NP, Tambwe JP, Kuyangisa-Simuna G, Boussinesq M, Chesnais CB, Pion SD. Effect of Lymphatic Filariasis and Hookworm Infection on Pregnancy Course and Outcome in Women Living in the Democratic Republic of the Congo. Am J Trop Med Hyg 2021; 104:2074-2081. [PMID: 33939636 PMCID: PMC8176502 DOI: 10.4269/ajtmh.20-1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/29/2021] [Indexed: 11/26/2022] Open
Abstract
Little is known about the effect of helminth infections on the natural gynecological and pregnancy course. Our goal was to assess the relationship between Wuchereria bancrofti and hookworm (HW) infections with pregnancy course and outcome in a group of 82 women living in a rural area of the Democratic Republic of the Congo. Demographics and information on gynecological and obstetrical histories were collected retrospectively with standardized questionnaires. Wuchereria bancrofti and HW infections were diagnosed using a filarial antigen-detection test and the Kato-Katz method, respectively. Analyses consisted of multivariable logistic regressions adjusting for age, number of deliveries, and history of anthelmintic treatment (HAHT). The median age of study participants was 35 (interquartile range [IQR]: 30-44) years, and the median number of deliveries was five (IQR: 3-7). Wuchereria bancrofti and HW infection rates were 44.5% and 43.3%, respectively. Filarial antigenemia and HW infection were not significantly associated with the number of deliveries. The proportions of women with a history of pregnancy resulting in neonatal death, miscarriage, premature birth, and postpartum hemorrhage were 56%, 44%, 23%, and 36%, respectively. History of pregnancy associated with neonatal death was less frequent in women with HAHT, tended to be more frequent in women with filarial antigenemia, and was not associated with HW infection. None of the three other pregnancy events studied (miscarriage, premature birth, and postpartum hemorrhage) were associated with filarial antigenemia or HW infection. The positive association found between HAHT and lower risk of neonatal death warrants investigation in larger groups of women.
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Affiliation(s)
- Jérémy T Campillo
- 1UMI 233, Institut de Recherche pour le Développement (IRD), INSERM Unité 1175 and University of Montpellier, Montpellier, France
| | - Emmanuel B Chabot
- 1UMI 233, Institut de Recherche pour le Développement (IRD), INSERM Unité 1175 and University of Montpellier, Montpellier, France
- 2UMR1027, Institut National de la Santé et de la Recherche Nationale (Inserm) and University of Toulouse, Toulouse, France
| | - Naomi-Pitchouna Awaca-Uvon
- 3Programme National de Lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo
| | - Jean-Paul Tambwe
- 3Programme National de Lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo
| | - Godefroy Kuyangisa-Simuna
- 3Programme National de Lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo
| | - Michel Boussinesq
- 1UMI 233, Institut de Recherche pour le Développement (IRD), INSERM Unité 1175 and University of Montpellier, Montpellier, France
| | - Cédric B Chesnais
- 1UMI 233, Institut de Recherche pour le Développement (IRD), INSERM Unité 1175 and University of Montpellier, Montpellier, France
| | - Sébastien D Pion
- 1UMI 233, Institut de Recherche pour le Développement (IRD), INSERM Unité 1175 and University of Montpellier, Montpellier, France
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16
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Routine deworming during antenatal care decreases risk of neonatal mortality and low birthweight: A retrospective cohort of survey data. PLoS Negl Trop Dis 2021; 15:e0009282. [PMID: 33914732 PMCID: PMC8084140 DOI: 10.1371/journal.pntd.0009282] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 03/02/2021] [Indexed: 01/09/2023] Open
Abstract
Background Soil transmitted helminths (STH) are a common infection among pregnant women in areas with poor access to sanitation. Deworming medications are cheap and safe; however, the health benefit of deworming during pregnancy is not clear. Methods / Principal findings We created a retrospective cohort of more than 800,000 births from 95 Demographic and Health Survey datasets to estimate the impact of deworming medicine during routine antenatal care (ANC) on neonatal mortality and low birthweight. We first matched births on the probability of receiving deworming during ANC. We then modeled the birth outcomes with the matched group as a random intercept to estimate the effect of deworming during antenatal care after accounting for various risk factors. We also tested for effect modification of soil transmitted helminth prevalence on the impact of deworming during ANC. Receipt of deworming medication during ANC was associated with a 14% reduction in the risk of neonatal mortality (95% confidence interval = 10–17%, n = 797,772 births), with no difference between high and low transmission countries. In low transmission countries, we found an 11% reduction in the odds of low birth weight (95% confidence interval = 8–13%) for women receiving deworming medicine, and in high transmission countries, we found a 2% reduction in the odds of low birthweight (95% confidence interval = 0–5%). Conclusions / Significance These results suggest a substantial health benefit for deworming during ANC that may be even greater in countries with low STH transmission. Soil-transmitted helminths cause a significant burden of disease throughout the world, particularly in communities with limited access to sanitation facilities and clean drinking water. Deworming medicines effectively clear these parasites, are inexpensive, and are well tolerated. However the effectiveness of deworming medicines, particularly for pregnant women, has not been clearly demonstrated. In this paper we analyze more than 800,000 births to measure the effect that deworming medicine during pregnancy has on birth outcomes. When women receive deworming medicine during pregnancy we saw two specific benefits for the baby: first the risk of neonatal mortality (a baby’s death within first 4 weeks of life) decreases by an estimated 14%, and second, the odds of low birthweight were 11% lower in countries with lower transmission of soil-transmitted helminths. In countries with higher transmission of soil-transmitted helminths we saw no effect of deworming medicine on the odds of low birthweight. Given the results, resources leading to widescale distribution of deworming during pregnancy would have a positive effect on child survival and health.
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Brummaier T, Tun NW, Min AM, Gilder ME, Archasuksan L, Proux S, Kiestra D, Charunwatthana P, Utzinger J, Paris DH, Nacher M, Simpson JA, Nosten F, McGready R. Burden of soil-transmitted helminth infection in pregnant refugees and migrants on the Thailand-Myanmar border: Results from a retrospective cohort. PLoS Negl Trop Dis 2021; 15:e0009219. [PMID: 33647061 PMCID: PMC7951971 DOI: 10.1371/journal.pntd.0009219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/11/2021] [Accepted: 02/08/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infections are widespread in tropical and subtropical regions. While many STH infections are asymptomatic, vulnerable populations such as pregnant women face repercussions such as aggravation of maternal anaemia. However, data on prevalence and the effect of STH infections in pregnancy are limited. The aim of this analysis was to describe the burden of STH infections within and between populations of pregnant women from a local refugee camp to a mobile migrant population, and to explore possible associations between STH infection and pregnancy outcomes. METHODOLOGY This is a retrospective review of records from pregnant refugee and migrant women who attended Shoklo Malaria Research Unit antenatal care (ANC) clinics along the Thailand-Myanmar border between July 2013 and December 2017. Inclusion was based on provision of a stool sample during routine antenatal screening. A semi-quantitative formalin concentration method was employed for examination of faecal samples. The associations between STH mono-infections and maternal anaemia and pregnancy outcomes (i.e., miscarriage, stillbirth, preterm birth, and small for gestational age) were estimated using regression analysis. PRINCIPAL FINDINGS Overall, 12,742 pregnant women were included, of whom 2,702 (21.2%) had a confirmed infection with either Ascaris lumbricoides, hookworm, Trichuris trichiura, or a combination of these. The occurrence of STH infections in the refugee population (30.8%; 1,246/4,041) was higher than in the migrant population (16.7%; 1,456/8,701). A. lumbricoides was the predominant STH species in refugees and hookworm in migrants. A. lumbricoides and hookworm infection were associated with maternal anaemia at the first ANC consultation with adjusted odds ratios of 1.37 (95% confidence interval (CI) 1.08-1.72) and 1.65 (95% CI 1.19-2.24), respectively. Pregnant women with A. lumbricoides infection were less likely to miscarry when compared to women with negative stool samples (adjusted hazard ratio 0.63, 95% CI 0.48-0.84). STH infections were not significantly associated with stillbirth, preterm birth or being born too small for gestational age. One in five pregnant women in this cohort had STH infection. Association of STH infection with maternal anaemia, in particular in the event of late ANC enrolment, underlines the importance of early detection and treatment of STH infection. A potential protective effect of A. lumbricoides infection on miscarriage needs confirmation in prospective studies.
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Affiliation(s)
- Tobias Brummaier
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nay Win Tun
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Aung Myat Min
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mary Ellen Gilder
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Laypaw Archasuksan
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Stephane Proux
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Douwe Kiestra
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Prakaykaew Charunwatthana
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel H. Paris
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles Guyane, Centre Hospitalier Andree Rosemon Cayenne, French Guiana
- Département Formation Recherche Santé, Université de Guyane, Cayenne, French Guiana
| | - Julie A. Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Francois Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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18
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Naim N, Amrit FRG, McClendon TB, Yanowitz JL, Ghazi A. The molecular tug of war between immunity and fertility: Emergence of conserved signaling pathways and regulatory mechanisms. Bioessays 2020; 42:e2000103. [PMID: 33169418 DOI: 10.1002/bies.202000103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/11/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022]
Abstract
Reproduction and immunity are energy intensive, intimately linked processes in most organisms. In women, pregnancy is associated with widespread immunological adaptations that alter immunity to many diseases, whereas, immune dysfunction has emerged as a major cause for infertility in both men and women. Deciphering the molecular bases of this dynamic association is inherently challenging in mammals. This relationship has been traditionally studied in fast-living, invertebrate species, often in the context of resource allocation between life history traits. More recently, these studies have advanced our understanding of the mechanistic underpinnings of the immunity-fertility dialogue. Here, we review the molecular connections between reproduction and immunity from the perspective of human pregnancy to mechanistic discoveries in laboratory organisms. We focus particularly on recent invertebrate studies identifying conserved signaling pathways and transcription factors that regulate resource allocation and shape the balance between reproductive status and immune health.
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Affiliation(s)
- Nikki Naim
- Departments of Pediatrics, Developmental Biology and Cell Biology and Physiology, John, G. Rangos Sr. Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Francis R G Amrit
- Departments of Pediatrics, Developmental Biology and Cell Biology and Physiology, John, G. Rangos Sr. Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - T Brooke McClendon
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Judith L Yanowitz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Arjumand Ghazi
- Departments of Pediatrics, Developmental Biology and Cell Biology and Physiology, John, G. Rangos Sr. Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Hassan NA, Thodsapol A, Lim YAL, Wan Sulaiman WY, Sidi Omar SFN, Umsakul K, Ngui R. Copro-molecular identification of intestinal nematode infections in a rural community in East Malaysia. Parasitol Int 2020; 80:102237. [PMID: 33144195 DOI: 10.1016/j.parint.2020.102237] [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] [Received: 01/13/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022]
Abstract
Soil-transmitted helminth (STH) infections are the most common intestinal parasitic infections of medical importance in humans. The infections are widely distributed throughout tropical and subtropical countries, particularly among disadvantaged and underprivileged communities. In Malaysia, STH infections is highly prevalent, especially among the indigenous groups. However, species identification through molecular studies is still lacking. Using molecular techniques, this study was conducted to identify STH species that infect humans. Faecal samples were collected from three Iban tribal longhouses in the rural area of Sarikei Division, Sarawak. Positive faecal samples by microscopy were subjected to PCR and sequenced for species identification. Based on the microscopy examination, the most prevalent STH infection was Ascaris, followed by hookworm and Trichuris. All microscopy-positive samples were then PCR-amplified. The amplicons were sequenced, aligned, and compared with other sequences in the GenBank database. The results showed that Ascaris lumbricoides was the predominant STH species, followed by Trichuris trichiura, Ancylostoma duodenale, and Necator americanus. Our findings were contradictory to past studies, as we showed that A. duodenale was more abundant than N. americanus. Socioeconomic improvement and health education programs should be included in the management and prevention of public health strategies against STH.
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Affiliation(s)
- Nur-Amirah Hassan
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Autchariya Thodsapol
- Department of Microbiology, Faculty of Science, Prince of Songkla University, 90112, Hat Yai, Thailand
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Wan Yusoff Wan Sulaiman
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | | | - Kamontam Umsakul
- Department of Microbiology, Faculty of Science, Prince of Songkla University, 90112, Hat Yai, Thailand
| | - Romano Ngui
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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20
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Keller L, Patel C, Welsche S, Schindler T, Hürlimann E, Keiser J. Performance of the Kato-Katz method and real time polymerase chain reaction for the diagnosis of soil-transmitted helminthiasis in the framework of a randomised controlled trial: treatment efficacy and day-to-day variation. Parasit Vectors 2020; 13:517. [PMID: 33059756 PMCID: PMC7558729 DOI: 10.1186/s13071-020-04401-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/09/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Accurate, scalable and sensitive diagnostic tools are crucial in determining prevalence of soil-transmitted helminths (STH), assessing infection intensities and monitoring treatment efficacy. However, assessments on treatment efficacy comparing traditional microscopic to newly emerging molecular approaches such as quantitative Polymerase Chain Reaction (qPCR) are scarce and hampered partly by lack of an established diagnostic gold standard. METHODS We compared the performance of the copromicroscopic Kato-Katz method to qPCR in the framework of a randomized controlled trial on Pemba Island, Tanzania, evaluating treatment efficacy based on cure rates of albendazole monotherapy versus ivermectin-albendazole against Trichuris trichiura and concomitant STH infections. Day-to-day variability of both diagnostic methods was assessed to elucidate reproducibility of test results by analysing two stool samples before and two stool samples after treatment of 160 T. trichiura Kato-Katz positive participants, partially co-infected with Ascaris lumbricoides and hookworm, per treatment arm (n = 320). As negative controls, two faecal samples of 180 Kato-Katz helminth negative participants were analysed. RESULTS Fair to moderate correlation between microscopic egg count and DNA copy number for the different STH species was observed at baseline and follow-up. Results indicated higher sensitivity of qPCR for all three STH species across all time points; however, we found lower test result reproducibility compared to Kato-Katz. When assessed with two samples from consecutive days by qPCR, cure rates were significantly lower for T. trichiura (23.2 vs 46.8%), A. lumbricoides (75.3 vs 100%) and hookworm (52.4 vs 78.3%) in the ivermectin-albendazole treatment arm, when compared to Kato-Katz. CONCLUSIONS qPCR diagnosis showed lower reproducibility of test results compared to Kato-Katz, hence multiple samples per participant should be analysed to achieve a reliable diagnosis of STH infection. Our study confirms that cure rates are overestimated using Kato-Katz alone. Our findings emphasize that standardized and accurate molecular diagnostic tools are urgently needed for future monitoring within STH control and/or elimination programmes.
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Affiliation(s)
- Ladina Keller
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Chandni Patel
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Sophie Welsche
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
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21
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Ssetaala A, Nabawanuka J, Matovu G, Nakiragga N, Namugga J, Nalubega P, Kaluuma HL, Chinyenze K, Perehudoff K, Michielsen K, Bagaya B, Price M, Kiwanuka N, Degomme O. Components of antenatal care received by women in fishing communities on Lake Victoria, Uganda; a cross sectional survey. BMC Health Serv Res 2020; 20:901. [PMID: 32993644 PMCID: PMC7526094 DOI: 10.1186/s12913-020-05739-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 09/16/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women's reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district. METHODS A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components. RESULTS Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P < 0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR = 1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR = 3.2; 95% CI:1.1-9.1). CONCLUSIONS We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities. TRIAL REGISTRATION PACTR201903906459874 (Retrospectively registered).
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Affiliation(s)
- Ali Ssetaala
- UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda. .,Ghent University International Centre for Reproductive Health, Ghent, Belgium.
| | | | | | | | | | | | | | | | - Katrina Perehudoff
- Ghent University International Centre for Reproductive Health, Ghent, Belgium
| | - Kristien Michielsen
- Ghent University International Centre for Reproductive Health, Ghent, Belgium
| | - Bernard Bagaya
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Matt Price
- IAVI, New York, NY, USA.,Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - Noah Kiwanuka
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Olivier Degomme
- Ghent University International Centre for Reproductive Health, Ghent, Belgium
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22
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Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol 2020; 254:59-63. [PMID: 32942076 DOI: 10.1016/j.ejogrb.2020.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 11/17/2022]
Abstract
Intestinal parasitic infections are widespread worldwide and with increased global travel and transport of food, these are not entirely limited to traditionally endemic areas. The prevalence of parasitic infections in endemic areas among pregnant women ranges from 24 to 70 % with approximately 10 % of women having multiple parasites. Pregnancy with its increased nutritional demands and altered immunological defenses is an especially vulnerable time for acquiring parasitic infections, which may be associated with adverse outcomes such as anaemia, which in some cases may even contribute to mortality. The presence of a helminthic infections during pregnancy may also cause immunological effects that can contribute to maternal morbidity and mortality as well as affecting the maternal immune response and immune system function in the baby after birth. Mass administration of anthelminthic drug therapy has been applied in endemic areas but there is inconclusive evidence of its benefit in improving pregnancy outcomes, however, no safety concerns have been highlighted with the use of the recommended drugs for parasitic infections.
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Affiliation(s)
- Suruchi Mohan
- Department of Obstetrics, Sidra Medicine, PO Box 26999, Doha, Qatar.
| | - Gregory Halle-Ekane
- Department of Obstetrics/Gynaecology, Faculty of Health Sciences, University of Buea, Cameroon.
| | - Justin C Konje
- Department of Obstetrics, Sidra Medicine, PO Box 26999, Doha, Qatar.
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23
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Lynsdale CL, Mon NO, Franco Dos Santos DJ, Aung HH, Nyein UK, Htut W, Childs D, Lummaa V. Demographic and reproductive associations with nematode infection in a long-lived mammal. Sci Rep 2020; 10:9214. [PMID: 32513991 PMCID: PMC7280280 DOI: 10.1038/s41598-020-66075-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 05/14/2020] [Indexed: 11/19/2022] Open
Abstract
Infection by macroparasites, such as nematodes, varies within vertebrate host systems; elevated infection is commonly observed in juveniles and males, and, for females, with different reproductive states. However, while such patterns are widely recognized in short-lived model systems, how they apply to long-lived hosts is comparatively understudied. Here, we investigated how infection varies with host age, sex, and female reproduction in a semi-captive population of individually marked Asian elephants Elephas maximus. We carried out 1,977 faecal egg counts (FECs) across five years to estimate nematode loads for 324 hosts. Infection patterns followed an established age-infection curve, whereby calves (5 years) exhibited the highest FECs and adults (45 years) the lowest. However, males and females had similar FECs across their long lifespan, despite distinct differences in life-history strategy and clear sexual dimorphism. Additionally, although mothers invest two years in pregnancy and a further three to five years into lactation, nematode load did not vary with four different measures of female reproduction. Our results provide a much-needed insight into the host-parasite dynamics of a long-lived host; determining host-specific associations with infection in such systems is important for broadening our knowledge of parasite ecology and provides practical applications for wildlife medicine and management.
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Affiliation(s)
| | - Nay Oo Mon
- Department of Animal Science, University of Veterinary Science, Yezin, Myanmar
| | | | - Htoo Htoo Aung
- Myanma Timber Enterprise, Ministry of Natural Resources and Environmental Conservation, Yangon, Myanmar
| | - U Kyaw Nyein
- Myanma Timber Enterprise, Ministry of Natural Resources and Environmental Conservation, Yangon, Myanmar
| | - Win Htut
- Myanma Timber Enterprise, Ministry of Natural Resources and Environmental Conservation, Yangon, Myanmar
| | - Dylan Childs
- Department of Animal and Plant Sciences, University of Sheffield, Sheffield, UK
| | - Virpi Lummaa
- Department of Biology, University of Turku, Turku, Finland
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24
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Ortiz-Martínez S, Ramos-Rincón JM, Vásquez-Chasnamote ME, Alarcón-Baldeón JJ, Parraguez-de-la-Cruz J, Gamboa-Paredes ON, Schillyk-Guerra P, Espinoza-Venegas LA, Pinedo-Cancino VV, Perez-Tanoira R, Górgolas-Hernández-Mora M, Casapía-Morales M. A Cross-Sectional Study of Seroprevalence of Strongyloidiasis in Pregnant Women (Peruvian Amazon Basin). Pathogens 2020; 9:pathogens9050348. [PMID: 32375325 PMCID: PMC7281748 DOI: 10.3390/pathogens9050348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 01/01/2023] Open
Abstract
Strongyloidiasis is a soil-transmitted helminthiasis with a high global prevalence. Objectives: We aimed to evaluate the prevalence of Strongyloides stercoralis infection and assess strongyloidiasis serology as a screening technique in the Peruvian Amazon. Material and Methods: We performed a cross-sectional study of strongyloidiasis in 300 pregnant women in Iquitos (Peru) from 1 May 2019 to 15 June 2019. Women were tested using serology (Strongyloides IgG IVD-ELISA kit) as an index test and the modified Baermann technique and/or charcoal fecal culture as the parasitological reference standard. Results: The reference tests showed S. stercoralis in the stool of 30 women (prevalence: 10%; 95% confidence interval [CI] 7.1% to 13.9%), while 101 women tested positive on the blood test (prevalence: 33.7%; 95% CI 28.6% to 39.4%). Fourteen of the 15 women (93.3%) with positive results according to the modified Baermann technique, and 14 of the 23 women (56.5%) with positive charcoal cultures also had positive serological results. Serology showed a sensitivity of 63.3% and a negative predictive value of 94.4%. Conclusion: In Iquitos, pregnant women have a high prevalence of S stercoralis. S. stercoralis ELISA could be an excellent tool for population-based screening, as it has a high negative predictive value that can help to rule out the presence of active infection.
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Affiliation(s)
- Sonia Ortiz-Martínez
- Consultorio El Ballestero, Servicio de Salud Castellano Manchego, 2614 Albacete, Spain;
| | - José-Manuel Ramos-Rincón
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, 03550 Alicante, Spain
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, 03010 Alicante, Spain
- Correspondence:
| | | | - Jhonatan J. Alarcón-Baldeón
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | - Jorge Parraguez-de-la-Cruz
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | | | - Patricia Schillyk-Guerra
- Laboratorio Clínico. Asociación Civil Selva Amazónica, 16001 Iquitos, Peru; (J.J.A.-B.); (J.P.-d.-l.-C.); (P.S.-G.)
| | | | - Viviana-Vanessa Pinedo-Cancino
- Laboratorio de Biología Molecular e Inmunología, Unidad Especializada del LIPNAA-CIRNA, Universidad Nacional de la Amazonia Peruana, 16001 Iquitos, Peru;
| | - Ramón Perez-Tanoira
- Servicio de Microbiologia, Hospital Universitario Príncipe de Asturias, 28802 Alcalá de Henares, Spain;
| | - Miguel Górgolas-Hernández-Mora
- División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain;
- Departamento de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Martin Casapía-Morales
- Servicio de Enfermedades Infecciosas y Medicina Tropical, Hospital Regional de Loreto, 16001 Iquitos, Peru;
- Departamento Médico, Asociación Cívica Selva Amazónica, 16001 Iquitos, Peru;
- Facultad de Medicina, Universidad Nacional de la Amazonia Peruana, 496 Iquitos, Peru
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Ikotun K, Sowemimo O, Chou CM, Ajenifuja K, Chuang TW, Asaolu S, Akinwale O, Gyang V, Nwafor T, Henry E, Fan CK. High seroprevalence of Toxocara antibodies in pregnant women attending an antenatal clinic at a university hospital in Ile-Ife, Nigeria. Trans R Soc Trop Med Hyg 2020; 114:301-307. [PMID: 31925444 DOI: 10.1093/trstmh/trz116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/09/2019] [Accepted: 05/11/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Human toxocariasis is a neglected zoonotic disease and its impact on human health is underestimated. Studies investigating the occurrence of toxocariasis in pregnancy are very scarce in Nigeria. This study investigated the seroprevalence of Toxocara spp. antibodies as well as the possible risk factors in pregnant women who routinely attended an antenatal clinic in a university hospital in Ile-Ife, Osun state. METHODS Blood samples were collected from 413 participating pregnant women between October 2017 and February 2018. Epidemiological data were obtained through a structured questionnaire. The sera were screened for anti-Toxocara IgG antibodies by western blot technique based on Toxocara canis larval excretory-secretory antigens, targeting low molecular weight bands of 24-35 kDa, specifically for T. canis infection. RESULTS The overall seroprevalence was 92.49% (382/413). There was no significant difference in the seroprevalence rate of Toxocara spp. infection between pregnant women aged ≤30 y and those aged >30 y (91.63 vs 93.33%; OR 1.28, 95% CI 0.61 to 2.67, p=0.511). The seroprevalence rate increased with the number of miscarriages but there was no statistical significance (p>0.05). Moreover, no significant associations were found between Toxocara spp. seropositivity and other studied risk factors (p>0.05). CONCLUSION The high seroprevalence of Toxocara spp. in pregnant Nigerian women needs comprehensive health education regarding personal hygiene and how to avoid exposure to this parasite infection.
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Affiliation(s)
- Kemisola Ikotun
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Oluyomi Sowemimo
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Chia-Mei Chou
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan
| | - Kayode Ajenifuja
- Department of Obstetrics, Gynaecology And Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Osun State, Nigeria
| | - Ting-Wu Chuang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.,Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Samuel Asaolu
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Olaoluwa Akinwale
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Vincent Gyang
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Timothy Nwafor
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Emmanuel Henry
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Chia-Kwung Fan
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.,Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
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Maizels RM. Regulation of immunity and allergy by helminth parasites. Allergy 2020; 75:524-534. [PMID: 31187881 DOI: 10.1111/all.13944] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 12/26/2022]
Abstract
There is increasing interest in helminth parasite modulation of the immune system, both from the fundamental perspective of the "arms race" between host and parasite, and equally importantly, to understand if parasites offer new pathways to abate and control untoward immune responses in humans. This article reviews the epidemiological and experimental evidence for parasite down-regulation of host immunity and immunopathology, in allergy and other immune disorders, and recent progress towards defining the mechanisms and molecular mediators which parasites exploit in order to modulate their host. Among these are novel products that interfere with epithelial cell alarmins, dendritic cell activation, macrophage function and T-cell responsiveness through the promotion of an immunoregulatory environment. These modulatory effects assist parasites to establish and survive, while dampening immune reactivity to allergens, autoantigens and microbiome determinants.
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Affiliation(s)
- Rick M. Maizels
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunology and Inflammation University of Glasgow Glasgow UK
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Placental gene expression and antibody levels of mother-neonate pairs reveal an enhanced risk for inflammation in a helminth endemic country. Sci Rep 2019; 9:15776. [PMID: 31673046 PMCID: PMC6823435 DOI: 10.1038/s41598-019-52074-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/11/2019] [Indexed: 02/06/2023] Open
Abstract
In utero exposure to environmental factors can modify the development of allergies later in life whereby the mechanisms of the feto-maternal crosstalk still remain largely unknown. Murine studies revealed that inflammatory maternal signals elicited by chronic helminth infection within the placenta imprint a distinct gene expression profile related to the Vitamin-D-receptor (VDR)-inflammation-axis. We thus investigated whether pro- or anti- inflammatory immune responses as well as VDR and related gene expression within the placenta differ between women from helminth-endemic and non-endemic areas. A prospective pilot study was conducted in Munich, Germany (helminth non-endemic) and Lambaréné, Gabon (helminth-endemic). At delivery, clinical information alongside placenta tissue samples and maternal and cord blood were obtained for further laboratory analysis. Schistosoma haematobium infection was detected in 13/54 (23%) Gabonese women. RT PCR revealed significantly lower gene expression of VDR, Cyp27b1, Foxp3 and IL10 in Gabonese compared to German placentae as well as significantly lower levels of plasma IgG4 in newborns resulting in a significantly higher IgE/IgG4 ratio. These findings demonstrate that exposure in utero to different environments alters placental gene expression and thus possibly plays a role in the development and modulation of the immune system of the offspring.
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Anderson AS, Trumble BC, Hové C, Kraft TS, Kaplan H, Gurven M, Blackwell AD. Old friends and friendly fire: Pregnancy, hookworm infection, and anemia among tropical horticulturalists. Am J Hum Biol 2019; 32:e23337. [PMID: 31642576 DOI: 10.1002/ajhb.23337] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/02/2019] [Accepted: 09/14/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Despite public health concerns about hookworm infection in pregnancy, little is known about immune profiles associated with hookworm (Necator americanus and Ancylostoma duodenale) infection during pregnancy. Fetal tolerance requirements may constrain maternal immune response to hookworm, thereby increasing susceptibility to new infections or increasing hemoglobin loss. To explore this possibility, we study systemic immune response and hemoglobin levels in a natural fertility population with endemic helminthic infection. METHODS We used Bayesian multilevel models to analyze mixed longitudinal data on hemoglobin, hookworm infection, reproductive state, eosinophils, and erythrocyte sedimentation rate (ESR) to examine the effects of pregnancy and hookworm infection on nonspecific inflammation, cellular parasite response, and hemoglobin among 612 Tsimane women aged 15-45 (1016 observations). RESULTS Pregnancy is associated with lower eosinophil counts and lower eosinophil response to hookworm, particularly during the second and third trimesters. Both hookworm and pregnancy are associated with higher ESR, with evidence for an interaction between the two causing further increases in the first trimester. Pregnancy is moderately associated with higher odds of hookworm infection (OR: 1.23, 95% CI: 0.83 to 1.83). Pregnancy and hookworm both decrease hemoglobin and may interact to accentuate this effect in the first-trimester of pregnancy (Interaction: β: -0.30 g/dL; CI: -0.870 to 0.24). CONCLUSIONS Our findings are consistent with a possible trade-off between hookworm immunity and successful pregnancy, and with the suggestion that hookworm and pregnancy may have synergistic effects, particularly in the first trimester.
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Affiliation(s)
- Amy S Anderson
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Benjamin C Trumble
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Arizona State University, Tempe, Arizona
| | - Carmen Hové
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Thomas S Kraft
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Hillard Kaplan
- Economic Science Institute, Chapman University, Orange, California
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara
| | - Aaron D Blackwell
- Department of Anthropology, University of California Santa Barbara, California, Santa Barbara.,Department of Anthropology, Washington State University, Pullman, Washington
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Avokpaho E, d'Almeida TC, Sadissou I, Tokplonou L, Adamou R, Sonon P, Milet J, Cottrell G, Mondière A, Massougbodji A, Moutairou K, Donadi EA, Teixeira Mendes Junior C, Favier B, Carosella E, Moreau P, Rouas-Freiss N, Garcia A, Courtin D. HLA-G expression during hookworm infection in pregnant women. Acta Trop 2019; 196:52-59. [PMID: 31078470 DOI: 10.1016/j.actatropica.2019.04.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 01/25/2023]
Abstract
INTRODUCTION HLA-G plays a key role on immune tolerance. Pathogens can induce soluble HLA-G (sHLA-G) production to down-regulate the host immune response, creating a tolerogenic environment favorable for their dissemination. To our knowledge, no study has yet been conducted to assess the relationship between sHLA-G and geohelminth infections. METHODS The study was conducted in Allada, Southeastern Benin, from 2011-2014. The study population encompassed 400 pregnant women, included before the end of the 28th week of gestation and followed-up until delivery. At two antenatal care visits and at delivery, stool and blood samples were collected. Helminths were diagnosed by means of the Kato-Katz concentration technique. We used quantile regression to analyze the association between helminth infections and sHLA-G levels during pregnancy. RESULTS sHLA-G levels gradually increased during pregnancy and reached maximal levels at delivery. Prevalence of helminth infections was low, with a majority of hookworm infections. We found significantly more hookworm-infected women above the 80th quantile (Q80) of the distribution of the mean sHLA-G level (p < 0.03, multivariate quantile regression). Considering only women above the Q80 percentile, the mean sHLA-G level was significantly higher in hookworm-infected compared to uninfected women (p = 0.04). CONCLUSION High levels of sHLA-G were associated with hookworm infection in pregnant women. This result is consistent with the potential involvement of sHLA-G in immune tolerance induced by helminths during pregnancy.
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Affiliation(s)
- Euripide Avokpaho
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Tania C d'Almeida
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Ibrahim Sadissou
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin; Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Léonidas Tokplonou
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin
| | - Rafiou Adamou
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin
| | - Paulin Sonon
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin; Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Jacqueline Milet
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Gilles Cottrell
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Amandine Mondière
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | | | | | - Eduardo A Donadi
- Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Celso Teixeira Mendes Junior
- Department of Chemistry, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Brazil
| | - Benoit Favier
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - Edgardo Carosella
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - Philippe Moreau
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - Nathalie Rouas-Freiss
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - André Garcia
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - David Courtin
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.
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Human schistosomiasis in Benin: Countrywide evidence of Schistosoma haematobium predominance. Acta Trop 2019; 191:185-197. [PMID: 30633895 DOI: 10.1016/j.actatropica.2019.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 12/28/2018] [Accepted: 01/07/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND A national mapping of human schistosomiasis was conducted in Benin to provide the baseline epidemiological data required to implement the national strategy for schistosomiasis control and elimination to achieve the WHO's goal of reaching at least 75% of school-age children in endemic areas by 2020. METHODS Parasitological surveys were conducted from 2013 to 2015, among 19,250 children aged 8-14 years randomly sampled in 385 units (schools/villages) across all districts. Urine and stool samples were examined using parasite-egg filtration for urine samples and the Kato-Katz technique for stool specimens. RESULTS Human schistosome eggs from two major species (S. haematobium and S. mansoni) were detected in the surveyed population with variable prevalence and parasite intensity. Urinary schistosomiasis due to S. haematobium was widely distributed and detected in 76/77 districts with a national average prevalence of 17.56% (95 °CI:16.80%- 18.32%), compared to S. mansoni detected in 28/77 districts with a national prevalence of 2.45% (95 °CI:2.14%-2.76%). The combined national prevalence of schistosomiasis, defined by infections with either or both schistosome species was 19.78% (95% CI:18.90% -20.49%), and was detected in 76/77 districts. Based on our findings, 31 districts were classified as low-risk (>0% and <10%); 37 as moderate-risk (≥10% and <50%); and 8 as high-risk (≥50%) of schistosome infection. No infection was detected in Kpomassè district in this study. In several districts where the two species were endemic with prevalence ≥10%, S. haematobium was the most prevalent schistosome species. Boys were relatively more infected than girls (18.29% v 16.82%, p = 0.007). Of note, heavy infections with S. haematobium (>50 eggs/10 mL) were detected in several districts of Atacora, Donga, Borgou, Collines, Ouémé and Atlantique departments. CONCLUSIONS The schistosomiasis mapping reported here clearly present a nationwide view of the epidemiological pattern of Schistosoma infections and the baseline data for implementing an effective control strategy by preventive chemotherapy (PCT). Although PCT might not be required in 32/77 districts, a yearly and bi-annual deworming is needed in 2 and 43 districts, respectively. If no environmental change occurs, and no mass treatment is delivered, prevalence is likely to remain stable for many years owing to poor hygiene and sanitation.
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Kandi V, Koka SS, Bhoomigari MR. Hymenolepiasis in a Pregnant Woman: A Case Report of Hymenolepis nana Infection. Cureus 2019; 11:e3810. [PMID: 30868024 PMCID: PMC6402731 DOI: 10.7759/cureus.3810] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hymenolepiasis is an infection caused by Hymenolepis nana (H. nana) and H. diminuta (H. diminuta). Hymenolepiasis is prevalent throughout the world with human infections with H. nana being frequently reported in the literature as compared to H. diminuta. Hymenolepiasis is more frequent among children, and most human infections remain asymptomatic and self-limited. Symptoms including abdominal pain, diarrhea, and vomiting are frequently noted in the cases of heavy infections. We report a case of hymenolepiasis caused by H. nana in a pregnant woman.
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Affiliation(s)
| | - Sri Sandhya Koka
- Microbiology, Prathima Institute of Medical Sciences, Karimnagar, IND
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Filarial infection during pregnancy has profound consequences on immune response and disease outcome in children: A birth cohort study. PLoS Negl Trop Dis 2018; 12:e0006824. [PMID: 30252839 PMCID: PMC6173457 DOI: 10.1371/journal.pntd.0006824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 10/05/2018] [Accepted: 09/09/2018] [Indexed: 11/19/2022] Open
Abstract
Background Current Global Program to Eliminate Lymphatic Filariasis (GPELF) that prohibits pregnant mothers and children below two years of age from coverage targeted interruption of transmission after 5–6 rounds of annual mass drug administration (MDA). However, after more than 10 rounds of MDA in India the target has not been achieved, which poses challenge to the researchers and policy makers. Several studies have shown that in utero exposure to maternal filarial infections plays certain role in determining the susceptibility and disease outcome in children. But the mechanism of which has not been studied extensively. Therefore the present study was undertaken to understand the mechanism of immune modulation in children born to filarial infected mother in a MDA ongoing area. Methodology and principal finding To our knowledge this is the first study to conduct both cellular and humoral immunological assays and follow up the children until older age in a W bancrofti endemic area,where the microfilariae (Mf) rate has come down to <1% after 10 rounds of MDA. A total 57 (32: born to infected, 25: born to uninfected mother) children were followed up. The infection status of children was measured by presence of Mf and circulating filarial antigen (CFA) assay. Filaria specific IgG1, IgG2, IgG3 and IgG4 responses were measured by ELISA. Plasma level of IL-10 and IFN-γ were evaluated by using commercially available ELISA kit. The study reveals a high rate of acquisition of filarial infection among the children born to infected mother compared to uninfected mothers. A significantly high level of IgG1 and IgG4 was observed in children born to infected mother, whereas high level of IgG3 was marked in children born to uninfected mother. Significantly high level of IL-10 positively correlated with IgG4 have been observed in infected children born to infected mother, while high level of IFN-γ positively correlated with IgG3 was found in infection free children born to mother free from infection at the time of pregnancy. Moreover a negative correlation between IL-10 and IFN-γ has been observed only among the infected children born to infected mother. Significance conclusion The study shows a causal association between maternal filarial infection and impaired or altered immune response in children more susceptible to filarial infection during early childhood. As lymphatic damage that commences in childhood during asymptomatic stage has major implications from public health point of view, understanding maternal programming of the newborn immune system could provide a basis for interventions promoting child health by implementing MDA campaigns towards all women of childbearing age and young children in achieving the target of global elimination of LF. Lymphatic filariasis (LF) has been targeted for elimination by 2020 through a major global initiative. The elimination strategy mainly aims to interrupt the transmission, or spread of infection, through annual mass drug administration (MDA) to entire at-risk population except the pregnant women and children below two years of age. Nevertheless, evidence exists that maternal W bancrofti infection during pregnancy can increase the susceptibility of the offspring to such infection during early childhood, the precise mechanism of which is not clear. Therefore in this study we have made an attempt to elucidate the mechanism of alteration of the foetal immunity due to maternal filarial infection, which may help developing strategy to strengthen the elimination programme. It is known that regulatory T cells are responsible for development of hyporesponsiveness, a condition that supports parasite growth and maternal filarial infection influences the development of T-regulatory cells from infancy to early childhood. Since T-reg cell can induce the production of regulatory cytokine IL-10 that often implicated in induction of IgG4 and we have observed an increased level of IL-10 / IgG4 and decreased levels of IFN- γ/ IgG3 in cord blood of infected mothers, we have thought that the modulation that takes place in utero affects the immune response and eventually disease outcome in early childhood. In order to prove our hypothesis, we have followed up a cohort of 57 children born to infected and uninfected mother in a MDA ongoing area of Odisha, India, where we have found a high rate of acquisition of filarial infection by children born to infected mother. Moreover a significantly high as well as a positive correlation between IgG4 and IL-10 levels in children born to infected mother during early childhood indicates that IL-10 and IgG4 contribute to immune modulation that starts during the period of gestation and continues till the early childhood helping the filarial parasites to evade destruction by their host’s immune system. In contrast a high level of IFN-γ and IgG3 in infection free children irrespective of infection status of mother shows the protective mechanism against the parasite. Additionally the correlation between antibodies and cytokines indicates that susceptibility to filarial infection during early childhood is due to the in utero modulation of T and B responses. Our findings highlights that every effort should be made to advance implementation policies and continue the focus to use the currently available anti-filarial drugs to prevent filarial infection before pregnancy as well as early childhood to achieve the target on time.
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Seroprevalence of Malaria and Hepatitis B Coinfection among Pregnant Women in Tamale Metropolis of Ghana: A Cross-Sectional Study. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2018; 2018:5610981. [PMID: 30344800 PMCID: PMC6174787 DOI: 10.1155/2018/5610981] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/29/2018] [Accepted: 07/22/2018] [Indexed: 01/21/2023]
Abstract
Background Coinfections are becoming common risk factors that may contribute to the increased burden of morbidity in pregnancy. The aim of this study was to assess the seroprevalence of coinfections of malaria, hepatitis B (HBV), human immunodeficiency virus (HIV), and syphilis among pregnant women attending antenatal clinics (ANC) in the Tamale Metropolis. Methods By means of rapid diagnostic tests (RDTs), pregnant women attending the Tamale Teaching Hospital (TTH) were screened for malaria, HBV infection, HIV infection, and syphilis from March 2013 to February 2015. Haemoglobin (Hb) values, sickling, and glucose-6-phosphate dehydrogenase deficiency (G6PDd) statuses were also assessed using full blood count (FBC), sodium metabisulphite, and methaemoglobin reduction tests, respectively. Logistic regression analysis was performed to estimate the risks/odds ratios (ORs) for the coinfections and other variables (age, gravidity, and time of the first ANC visit) with 95% confidence intervals (CIs) and set p values for accepting any differences at <0.05. Results Within the two-year study period, data were collected from 3,127 pregnant women. The mean age (SD) of the pregnant women was 28.5 (±5.0) years. Of the total number, seroprevalence was high for malaria (11.6%) and HBV infection (4.2%) and low for HIV infection (1.0%) and syphilis (0.4%) monoinfections. Mal/HBV coinfection was higher (0.7%) when compared with Mal/HIV (0.1%), Mal/syphilis (0.0%), HBV/HIV (0.0%), HBV/syphilis (0.1%), and HIV/syphilis (0.0%) coinfections. The mean Hb (g/dl) for the women with the four monoinfections was significantly different from one another (p=0.009). Pregnant women with malaria infection were about 2 times more likely to be coinfected with HBV even after adjusting for potential confounders (adjusted odds ratio (AOR) = 1.66, 95% CI = 1.04-2.65, p=0.031). Those in their third trimester and visiting the ANC for the first time were significantly less likely to be infected with HBV (AOR = 0.45, 95% CI = 0.28-0.73, p=0.001), with malaria/HBV coinfection (AOR = 0.09, 95% CI = 0.01-0.68, p=0.020), and with any coinfection (AOR = 0.19, 95% CI = 0.06-0.63, p=0.007). Conclusion A comparatively high seroprevalence of malaria and its coinfection with HBV in pregnant women was observed in this study. Considering the effects that both malaria and HBV have on the liver, it would be expedient to conduct further studies to assess liver function among malaria/HBV-infected individuals, while interventions to prevent coinfections among pregnant women are intensified.
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McSorley HJ, Chayé MAM, Smits HH. Worms: Pernicious parasites or allies against allergies? Parasite Immunol 2018; 41:e12574. [PMID: 30043455 PMCID: PMC6585781 DOI: 10.1111/pim.12574] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/13/2018] [Accepted: 07/18/2018] [Indexed: 12/14/2022]
Abstract
Type 2 immune responses are most commonly associated with allergy and helminth parasite infections. Since the discovery of Th1 and Th2 immune responses more than 30 years ago, models of both allergic disease and helminth infections have been useful in characterizing the development, effector mechanisms and pathological consequences of type 2 immune responses. The observation that some helminth infections negatively correlate with allergic and inflammatory disease led to a large field of research into parasite immunomodulation. However, it is worth noting that helminth parasites are not always benign infections, and that helminth immunomodulation can have stimulatory as well as suppressive effects on allergic responses. In this review, we will discuss how parasitic infections change host responses, the consequences for bystander immunity and how this interaction influences clinical symptoms of allergy.
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Affiliation(s)
- Henry J McSorley
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Mathilde A M Chayé
- Department of Parasitology, Leiden Immunology of Parasitic Infections Group, Leiden University Medical Centre, ZA Leiden, The Netherlands
| | - Hermelijn H Smits
- Department of Parasitology, Leiden Immunology of Parasitic Infections Group, Leiden University Medical Centre, ZA Leiden, The Netherlands
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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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Freer JB, Bourke CD, Durhuus GH, Kjetland EF, Prendergast AJ. Schistosomiasis in the first 1000 days. THE LANCET. INFECTIOUS DISEASES 2018; 18:e193-e203. [PMID: 29170089 DOI: 10.1016/s1473-3099(17)30490-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 07/02/2017] [Accepted: 07/13/2017] [Indexed: 12/29/2022]
Abstract
Infections during the first 1000 days-the period from conception to a child's second birthday-can have lifelong effects on health, because this is a crucial phase of growth and development. There is increasing recognition of the burden and potential effects of schistosomiasis in women of reproductive age and young children. Exposure to schistosomes during pregnancy can modulate infant immune development and schistosomiasis can occur from early infancy, such that the high disease burden found in adolescents is often due to accumulation of infections with long-lived schistosomes from early life. Women of reproductive age and young children are largely neglected in mass drug administration programmes, but early treatment could avert subsequent disease. We evaluate the evidence that early schistosomiasis has adverse effects on birth, growth, and development. We also discuss the case for expanding public health interventions for schistosomiasis in women of reproductive age and preschool-age children, and the need for further research to evaluate the potential of treating women pre-conception to maximise health across the life course.
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Affiliation(s)
- Joseph B Freer
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Blizard Institute, Queen Mary University of London, London, UK.
| | - Claire D Bourke
- Blizard Institute, Queen Mary University of London, London, UK
| | - Gunn H Durhuus
- Department of Internal Medicine, Sorlandet Hospital, Kristiansand, Norway
| | - Eyrun F Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Oslo, Norway; Discipline of Public Health Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Blizard Institute, Queen Mary University of London, London, UK
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Sanya RE, Nkurunungi G, Andia Biraro I, Mpairwe H, Elliott AM. A life without worms. Trans R Soc Trop Med Hyg 2018; 111:3-11. [PMID: 28340138 PMCID: PMC5412073 DOI: 10.1093/trstmh/trx010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/27/2017] [Indexed: 12/14/2022] Open
Abstract
Worms have co-evolved with humans over millions of years. To survive, they manipulate host systems by modulating immune responses so that they cause (in the majority of hosts) relatively subtle harm. Anthelminthic treatment has been promoted as a measure for averting worm specific pathology and to mitigate subtle morbidities which may include effects on anaemia, growth, cognitive function and economic activity. With our changing environment marked by rapid population growth, urbanisation, better hygiene practices and anthelminthic treatment, there has been a decline in worm infections and other infectious diseases and a rise in non-communicable diseases such as allergy, diabetes and cardiovascular disease. This review reflects upon our age-old interaction with worms, and the broader ramifications of life without worms for vaccine responses and susceptibility to other infections, and for allergy-related and metabolic disease. We touch upon the controversy around the benefits of mass drug administration for the more-subtle morbidities that have been associated with worm infections and then focus our attention on broader, additional aspects of life without worms, which may be either beneficial or detrimental.
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Affiliation(s)
- Richard E Sanya
- MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.,College of Health Sciences, Makerere University, Kampala, Uganda
| | - Gyaviira Nkurunungi
- MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | | | - Harriet Mpairwe
- MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda
| | - Alison M Elliott
- MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.,Department of Clinical Research, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Ibikounlé M, Onzo-Aboki A, Doritchamou J, Tougoué JJ, Boko PM, Savassi BS, Siko EJ, Daré A, Batcho W, Massougbodji A, Kindé-Gazard DA, Kaboré A. Results of the first mapping of soil-transmitted helminths in Benin: Evidence of countrywide hookworm predominance. PLoS Negl Trop Dis 2018; 12:e0006241. [PMID: 29494579 PMCID: PMC5849360 DOI: 10.1371/journal.pntd.0006241] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 03/13/2018] [Accepted: 01/17/2018] [Indexed: 11/19/2022] Open
Abstract
Background National mapping of soil-transmitted helminth infections (STH) was conducted for the first time in all of the 77 districts of Benin (West Africa) from 2013 to 2015. This mapping aimed to provide basic epidemiological data essential for the implementation of the national strategy against the neglected tropical diseases (NTDs) in the context of achieving the WHO target of controlling these infections by 2020. Methods In each district, 5 schools were purposively selected in 5 villages and 50 school-children (25 girls and 25 boys) from ages 8 to 14 years were randomly enrolled in each school. In total, 19,250 stool samples of school children (9,625 girls and 9,625 boys) from 385 schools were examined by Kato-Katz technique. Results The three major species of STH (hookworm, Ascaris lumbricoides and Trichuris trichiura) were observed with intra- and inter-specific variations in the prevalence and the intensity of these parasites. Hookworm infection was present in all of the surveyed districts with an average prevalence of 17.14% (95% CI 16.6%-17.6%). Among the infected schoolchildren, at national level, 90.82%, 6.73% and 2.45% of infections were of light, moderate and heavy parasite intensities respectively. A. lumbricoides infection, with a national average prevalence of 5.35% (95% CI 5.00%-5.60%),was the second most prevalent STH, and 84.37%, 14.27% and 1.36% of the infections were of light, moderate and heavy parasite intensities, respectively. T. trichiura had a national average prevalence of 1.15% (95% CI 0.90%-1.20%) and 80.45%, 13.18% and 6.36% infections were of light, moderate and heavy parasite intensities, respectively. The national cumulative prevalence of the three STH infections was 22.74% (95% CI 22.15%-23.33%), with58.44% (45/77) of the districts requiring mass treatment according to WHO recommendations. In all of the surveyed districts, multiple infections by STH species were common, and boys seemed more at risk of hookworm and Ascaris infections. Conclusions This first national mapping provided an overview of the epidemiological pattern of STH infections and was essential for the implementation of a control strategy with an effective preventive chemotherapy treatment (PCT). Results show that while preventive chemotherapy is not indicated for children in 32/77 districts, 43 require annual deworming and two require twice yearly deworming. If no environmental change occurs, and no mass treatment is delivered, prevalence is likely to remain stable for many years owing to poor hygiene and sanitation. Benin, like other low or moderate-income countries in the African continent, is endemic for several neglected tropical diseases, including soil-transmitted helminthiases. The National Program for Neglected Tropical Diseases of the Ministry of Health has conducted the national STH mapping using the Kato-Katz method to assess the baseline epidemiological status in all 77 districts of Benin, in order to guide implementation of a preventive chemotherapy program using albendazole. The results of the survey showed that infection with at least one of the three targeted species (hookworm, roundworm or whipworm) affected 20% or more of school aged children in 45 out of 77 districts, and which therefore require PCT. Hookworm infection was the most prevalent followed by ascariasis and trichuriasis. Boys were significantly more likely than girls to be infected with hookworm or ascariasis.
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Affiliation(s)
- Moudachirou Ibikounlé
- National Control Program of Communicable Diseases, Ministry of Health of Benin, Cotonou, Benin
- Department of Zoology, Faculty of Sciences and Techniques, University of Abomey-Calavi, Cotonou, Benin
- * E-mail: ,
| | - Ablavi Onzo-Aboki
- Department of Zoology, Faculty of Sciences and Techniques, University of Abomey-Calavi, Cotonou, Benin
| | - Justin Doritchamou
- Department of Zoology, Faculty of Sciences and Techniques, University of Abomey-Calavi, Cotonou, Benin
| | - Jean-Jacques Tougoué
- Research Triangle Institute, Washington, District of Columbia, United States of America, Research Triangle Park, NC, United States of America
| | - Pélagie Mimonnou Boko
- National Control Program of Communicable Diseases, Ministry of Health of Benin, Cotonou, Benin
| | - Boris S. Savassi
- Department of Zoology, Faculty of Sciences and Techniques, University of Abomey-Calavi, Cotonou, Benin
| | - Edoux Joel Siko
- Department of Zoology, Faculty of Sciences and Techniques, University of Abomey-Calavi, Cotonou, Benin
| | - Aboudou Daré
- Research Triangle Institute, Washington, District of Columbia, United States of America, Research Triangle Park, NC, United States of America
| | - Wilfrid Batcho
- National Control Program of Communicable Diseases, Ministry of Health of Benin, Cotonou, Benin
| | - Achille Massougbodji
- Department of Parasitology and Mycology, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Dorothée Akoko Kindé-Gazard
- Department of Parasitology and Mycology, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Achille Kaboré
- Research Triangle Institute, Washington, District of Columbia, United States of America, Research Triangle Park, NC, United States of America
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Berger BA, Bartlett AH, Saravia NG, Galindo Sevilla N. Pathophysiology of Leishmania Infection during Pregnancy. Trends Parasitol 2017; 33:935-946. [PMID: 28988681 DOI: 10.1016/j.pt.2017.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/28/2017] [Accepted: 08/30/2017] [Indexed: 12/11/2022]
Abstract
The pathological processes resulting from parasitic infection are known to have important impacts on the mother child dyad during pregnancy. The roles of parasite transmission and the maternal immune response have been described in diseases such as malaria, toxoplasmosis, and trypanosomiasis. However, the impact of parasites of the genus Leishmania, etiological agents of the neglected tropical diseases tegumentary leishmaniasis (TL) and visceral leishmaniasis (VL), is comparatively less well known, though it is an increasingly recognized concern for infected mothers and their fetuses. In this review, we first consider the pathophysiology of placental infection and transplacental transmission of this parasite, and then discuss the role and mechanisms of the maternal immune system in simultaneously mediating maternal-fetal infection and adverse pregnancy outcomes.
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Affiliation(s)
- Brandon A Berger
- University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
| | - Allison H Bartlett
- University of Chicago Comer Children's Hospital, Section of Infectious Disease, Chicago, IL, USA
| | - Nancy Gore Saravia
- Centro Internacional de Entrenamiento e Investigaciones Médicas, Cali, Colombia
| | - Norma Galindo Sevilla
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
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Frequency of Toxocara spp. antibodies in umbilical cords of newborns attended atthe University Hospital in Southern Brazil and factors associated with infection. Acta Trop 2017; 170:43-47. [PMID: 28188768 DOI: 10.1016/j.actatropica.2017.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 12/13/2016] [Accepted: 02/03/2017] [Indexed: 11/22/2022]
Abstract
Toxocariasis is a neglected and geographically widespread parasitic disease. The detection of specific antibodies associated with this disease is required to confirm its clinical diagnosis and to aid in prevention. Although helminth infection during pregnancy can promote foetal immune responses with long-term effects, specific information regarding the risk of Toxocara spp. infection to the human foetus during pregnancy is lacking. Therefore, the present study aimed to investigate the frequency of antibodies against Toxocara spp. in umbilical cord serum samples to determine the neonatal risk factors associated with Toxocara spp. infection. A cross-sectional study of the frequency of specific antibodies against Toxocara spp. was performed on umbilical cord samples of 280 neonates. A cord blood sample was obtained from each newborn after parturition, and serum samples were examined by enzyme-linked immunoassay. Epidemiological data were obtained through a questionnaire regarding obstetric history (abortion history, premature birthhistory, and pregnancy and birth numbers), general aspects (animal contact anddiet) and socio-economic factors. The frequency of anti-Toxocara spp. IgG antibodies in the umbilical cords of neonates was 20% in serum pre-adsorbed with Ascaris spp. antigen. Family income and dog ownership were considered risk factors associated with infection. No association was found between reproductive disorders and Toxocara seropositivity. The 20% frequency rate of anti-Toxocara spp. IgG antibodies in sera from umbilical cords of newborns can be related to IgG binding at the maternal-foetal interface, requiring greater care during pregnancy. Anti-Toxocara IgM and IgE antibodies no were found in umbilical cord serum samples, indicating that no vertical transmission of these parasites occurred in this population. Studies regarding antibodies against Toxocara spp. in umbilical cord sera are important for determining neonatal exposure to these parasites.
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The impact of prenatal exposure to parasitic infections and to anthelminthic treatment on antibody responses to routine immunisations given in infancy: Secondary analysis of a randomised controlled trial. PLoS Negl Trop Dis 2017; 11:e0005213. [PMID: 28178298 PMCID: PMC5298230 DOI: 10.1371/journal.pntd.0005213] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 11/28/2016] [Indexed: 11/25/2022] Open
Abstract
Background Chronic parasitic infections are associated with active immunomodulation which may include by-stander effects on unrelated antigens. It has been suggested that pre-natal exposure to parasitic infections in the mother impacts immunological development in the fetus and hence the offspring’s response to vaccines, and that control of parasitic infection among pregnant women will therefore be beneficial. Methodology/Principal findings We used new data from the Entebbe Mother and Baby Study, a trial of anthelminthic treatment during pregnancy conducted in Uganda, to further investigate this hypothesis. 2705 mothers were investigated for parasitic infections and then randomised to albendazole (400mg) versus placebo and praziquantel (40mg/kg) during pregnancy in a factorial design. All mothers received sulfadoxine/pyrimethamine for presumptive treatment of malaria. Offspring received Expanded Programme on Immunisation vaccines at birth, six, 10 and 14 weeks. New data on antibody levels to diphtheria toxin, three pertussis antigens, Haemophilus influenzae type B (HiB) and Hepatitis B, measured at one year (April 2004 –May 2007) from 1379 infants were analysed for this report. Additional observational analyses relating maternal infections to infant vaccine responses were also conducted. Helminth infections were highly prevalent amongst mothers (hookworm 43.1%, Mansonella 20.9%, Schistosoma mansoni 17.3%, Strongyloides 11.7%, Trichuris 8.1%) and 9.4% had malaria at enrolment. In the trial analysis we found no overall effect of either anthelminthic intervention on the measured infant vaccine responses. In observational analyses, no species was associated with suppressed responses. Strongyloidiasis was associated with enhanced responses to pertussis toxin, HiB and Hep B vaccine antigens. Conclusions/Significance Our results do not support the hypothesis that routine anthelminthic treatment during pregnancy has a benefit for the infant’s vaccine response, or that maternal helminth infection has a net suppressive effect on the offspring’s response to vaccines. Trial Registration ISRCTN.com ISRCTN32849447 Parasitic infections, such as worms and malaria, have potent effects on the human immune system. These effects include modification of immune responses in the fetus and infant if a mother has a parasitic infection during pregnancy. These immunological changes can influence the way a child responds to the same infection when exposed in later life. It has been suggested that the immunological changes might also influence how the child responds to the vaccines given in infancy, and that treating mothers for parasitic infections when they are pregnant might be helpful. In this study we compared responses to vaccines between infants of mothers who had, or had not, been treated for worms while they were pregnant. We found no overall differences. We also compared vaccine responses between groups of mothers with and without parasitic infections. We found no evidence that the parasitic infections were associated with reduced responses in the children. This means that, although treating worms during pregnancy may have some benefits, improvements in the children’s responses to vaccines are not likely to be among them.
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Francis JP, Richmond PC, Strickland D, Prescott SL, Pomat WS, Michael A, Nadal-Sims MA, Edwards-Devitt CJ, Holt PG, Lehmann D, van den Biggelaar AHJ. Cord blood Streptococcus pneumoniae-specific cellular immune responses predict early pneumococcal carriage in high-risk infants in Papua New Guinea. Clin Exp Immunol 2016; 187:408-417. [PMID: 27859014 PMCID: PMC5290304 DOI: 10.1111/cei.12902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/03/2016] [Accepted: 10/27/2016] [Indexed: 12/01/2022] Open
Abstract
In areas where Streptococcus pneumoniae is highly endemic, infants experience very early pneumococcal colonization of the upper respiratory tract, with carriage often persisting into adulthood. We aimed to explore whether newborns in high‐risk areas have pre‐existing pneumococcal‐specific cellular immune responses that may affect early pneumococcal acquisition. Cord blood mononuclear cells (CBMC) of 84 Papua New Guinean (PNG; high endemic) and 33 Australian (AUS; low endemic) newborns were stimulated in vitro with detoxified pneumolysin (dPly) or pneumococcal surface protein A (PspA; families 1 and 2) and compared for cytokine responses. Within the PNG cohort, associations between CBMC dPly and PspA‐induced responses and pneumococcal colonization within the first month of life were studied. Significantly higher PspA‐specific interferon (IFN)‐γ, tumour necrosis factor (TNF)‐α, interleukin (IL)‐5, IL‐6, IL‐10 and IL‐13 responses, and lower dPly‐IL‐6 responses were produced in CBMC cultures of PNG compared to AUS newborns. Higher CBMC PspA‐IL‐5 and PspA‐IL‐13 responses correlated with a higher proportion of cord CD4 T cells, and higher dPly‐IL‐6 responses with a higher frequency of cord antigen‐presenting cells. In the PNG cohort, higher PspA‐specific IL‐5 and IL‐6 CBMC responses were associated independently and significantly with increased risk of earlier pneumococcal colonization, while a significant protective effect was found for higher PspA‐IL‐10 CBMC responses. Pneumococcus‐specific cellular immune responses differ between children born in pneumococcal high versus low endemic settings, which may contribute to the higher risk of infants in high endemic settings for early pneumococcal colonization, and hence disease.
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Affiliation(s)
- J P Francis
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - P C Richmond
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - D Strickland
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - S L Prescott
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - W S Pomat
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - A Michael
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - M A Nadal-Sims
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - C J Edwards-Devitt
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - P G Holt
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - D Lehmann
- Telethon Kids Institute, University of Western Australia, Perth, Australia
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Bal M, Ranjit M, Achary KG, Satapathy AK. Maternal Filarial Infection Influences the Development of Regulatory T Cells in Children from Infancy to Early Childhood. PLoS Negl Trop Dis 2016; 10:e0005144. [PMID: 27861499 PMCID: PMC5115651 DOI: 10.1371/journal.pntd.0005144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 10/27/2016] [Indexed: 11/18/2022] Open
Abstract
Background Children born from filarial infected mothers are comparatively more susceptible to filarial infection than the children born to uninfected mothers. But the mechanism of such increased susceptibility to infection in early childhood is not exactly known. Several studies have shown the association of active filarial infection with T cell hypo-responsiveness which is mediated by regulatory T cells (Tregs). Since the Tregs develop in the thymus from CD4+ CD25hi thymocytes at an early stage of the human fetus, it can be hypothesized that the maternal infection during pregnancy affects the development of Tregs in children at birth as well as early childhood. Hence the present study was designed to test the hypothesis by selecting a cohort of pregnant mothers and children born to them subsequently in a filarial endemic area of Odisha, India. Methodology and Principal finding A total number of 49 pregnant mothers and children born to them subsequently have been followed up (mean duration 4.4 years) in an area where the microfilariae (Mf) rate has come down to <1% after institution of 10 rounds of annual mass drug administration (MDA). The infection status of mother, cord and children were assessed through detection of microfilariae (Mf) and circulating filarial antigen (CFA). Expression of Tregs cells were measured by flow cytometry. The levels of IL-10 were evaluated by using commercially available ELISA kit. A significantly high level of IL-10 and Tregs have been observed in children born to infected mother compared to children of uninfected mother at the time of birth as well as during early childhood. Moreover a positive correlation between Tregs and IL-10 has been observed among the children born to infected mother. Significance From these observations we predict that early priming of the fetal immune system by filarial antigens modulate the development of Tregs, which ultimately scale up the production of IL-10 in neonates and creates a milieu for high rate of acquisition of infection in children born to infected mothers. The mechanism of susceptibility and implication of the results in global elimination programme of filariasis has been discussed. Lymphatic filariasis caused by thread like filarial worms involves asymptomatic to acute and/or disfiguring chronic conditions like lymphoedema, elephantiasis and scrotal swelling. Infection occurs when filarial parasites are transmitted to humans through mosquitoes. Adult worms lodge in the lymphatic system and disrupt the immune system that causes the disease. Nonetheless the infection if present during pregnancy, it affects the immune system of the unborn child in such a way that they become more susceptible to infection. But how the immune system of a fetus is affected by the maternal filarial infection is not known. Since regulatory T cells are responsible for development of hyporesponsiveness, a condition that supports the active filarial infection, and develops in thymus at an early stage of the human fetal development, we hypothesized that maternal filarial infection might be affecting the development of Tregs cell. Because Tregs secret IL-10, a regulatory cytokine, we have also measured its level in children born to infected and uninfected mother and correlate it with Tregs. We have observed a significantly high as well as a positive correlation between Tregs and IL-10 levels in children born to infected mother than the children of uninfected mother at the time of birth as well as early childhood indicating that Tregs and IL-10 contribute to immune modulation during pregnancy. Since ongoing MDA excludes pregnant mothers and children below 2 years of age, hence implementation of supervised therapy at the time of adolescent through MDA may help the programme in achieving the target of global elimination of LF by 2020.
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Affiliation(s)
- Madhusmita Bal
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Odisha, India
- * E-mail:
| | - Manoranjan Ranjit
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Odisha, India
| | - K. Gopinath Achary
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Odisha, India
| | - Ashok K. Satapathy
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Odisha, India
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Abstract
Helminths are parasitic nematodes and trematodes, grouped together because of morphological similarities and commonalities in the effects infections have on hosts. These include complications such as anemia and biasing of immune responses, which can alter susceptibility for other diseases. For pregnant women, these complications might have implications for pregnancy outcomes or neonatal health. Here, I review studies of helminth infections during pregnancy, and ask the following questions: Do helminths affect maternal health or pregnancy outcomes? Are there consequences of maternal infection for infants? What are the effects of antihelminth treatment during pregnancy? The evidence suggests that the answers to these questions depend on the particular helminth species in question, maternal nutritional status, and the presence or absence of comorbid infection with other species, such as malaria. Moreover, there may also be unexpected consequences of treatment, as maternal infections can affect the priming of infant immune systems, with potential effects on infants later in life. These complex interactions suggest that a consideration of the evolutionary history of human–helminth interactions, as well as the ecological context of infections, can help to clarify an understanding of these host–parasite interactions and provide direction for future investigations.
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Affiliation(s)
- Aaron D Blackwell
- Department of Anthropology, University of California, Santa Barbara, Santa Barbara, CA, USA
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Maizels RM, McSorley HJ. Regulation of the host immune system by helminth parasites. J Allergy Clin Immunol 2016; 138:666-675. [PMID: 27476889 PMCID: PMC5010150 DOI: 10.1016/j.jaci.2016.07.007] [Citation(s) in RCA: 337] [Impact Index Per Article: 42.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 07/25/2016] [Accepted: 07/25/2016] [Indexed: 01/01/2023]
Abstract
Helminth parasite infections are associated with a battery of immunomodulatory mechanisms that affect all facets of the host immune response to ensure their persistence within the host. This broad-spectrum modulation of host immunity has intended and unintended consequences, both advantageous and disadvantageous. Thus the host can benefit from suppression of collateral damage during parasite infection and from reduced allergic, autoimmune, and inflammatory reactions. However, helminth infection can also be detrimental in reducing vaccine responses, increasing susceptibility to coinfection and potentially reducing tumor immunosurveillance. In this review we will summarize the panoply of immunomodulatory mechanisms used by helminths, their potential utility in human disease, and prospective areas of future research.
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Affiliation(s)
- Rick M Maizels
- Wellcome Trust Centre for Molecular Parasitology, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom.
| | - Henry J McSorley
- Centre for Inflammation Research, University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom
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Arinola GO, Morenikeji OA, Akinwande KS, Alade AO, Olateru-Olagbegi O, Emmanuel P, Rahamon SK. Serum Micronutrients in Helminth-infected Pregnant Women and Children: Suggestions for Differential Supplementation During Anti-helminthic Treatment. Ann Glob Health 2016; 81:705-10. [DOI: 10.1016/j.aogh.2015.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Sasagawa S, Nishimura Y, Kon T, Yamanaka Y, Murakami S, Ashikawa Y, Yuge M, Okabe S, Kawaguchi K, Kawase R, Tanaka T. DNA Damage Response Is Involved in the Developmental Toxicity of Mebendazole in Zebrafish Retina. Front Pharmacol 2016; 7:57. [PMID: 27014071 PMCID: PMC4789406 DOI: 10.3389/fphar.2016.00057] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/29/2016] [Indexed: 11/13/2022] Open
Abstract
Intestinal helminths cause iron-deficiency anemia in pregnant women, associated with premature delivery, low birth weight, maternal ill health, and maternal death. Although benzimidazole compounds such as mebendazole (MBZ) are highly efficacious against helminths, there are limited data on its use during pregnancy. In this study, we performed in vivo imaging of the retinas of zebrafish larvae exposed to MBZ, and found that exposure to MBZ during 2 and 3 days post-fertilization caused malformation of the retinal layers. To identify the molecular mechanism underlying the developmental toxicity of MBZ, we performed transcriptome analysis of zebrafish eyes. The analysis revealed that the DNA damage response was involved in the developmental toxicity of MBZ. We were also able to demonstrate that inhibition of ATM significantly attenuated the apoptosis induced by MBZ in the zebrafish retina. These results suggest that MBZ causes developmental toxicity in the zebrafish retina at least partly by activating the DNA damage response, including ATM signaling, providing a potential adverse outcome pathway in the developmental toxicity of MBZ in mammals.
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Affiliation(s)
- Shota Sasagawa
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Yuhei Nishimura
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of MedicineTsu, Japan; Mie University Medical Zebrafish Research CenterTsu, Japan; Department of Systems Pharmacology, Mie University Graduate School of MedicineTsu, Japan; Department of Omics Medicine, Mie University Industrial Technology Innovation InstituteTsu, Japan; Department of Bioinformatics, Mie University Life Science Research CenterTsu, Japan
| | - Tetsuo Kon
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Yukiko Yamanaka
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Soichiro Murakami
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Yoshifumi Ashikawa
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Mizuki Yuge
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Shiko Okabe
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Koki Kawaguchi
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Reiko Kawase
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of Medicine Tsu, Japan
| | - Toshio Tanaka
- Department of Molecular and Cellular Pharmacology, Pharmacogenomics and Pharmacoinformatics, Mie University Graduate School of MedicineTsu, Japan; Mie University Medical Zebrafish Research CenterTsu, Japan; Department of Systems Pharmacology, Mie University Graduate School of MedicineTsu, Japan; Department of Omics Medicine, Mie University Industrial Technology Innovation InstituteTsu, Japan; Department of Bioinformatics, Mie University Life Science Research CenterTsu, Japan
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Bal M, Sahu PK, Mandal N, Satapathy AK, Ranjit M, Kar SK. Maternal Infection Is a Risk Factor for Early Childhood Infection in Filariasis. PLoS Negl Trop Dis 2015. [PMID: 26225417 PMCID: PMC4520468 DOI: 10.1371/journal.pntd.0003955] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Global Program to Eliminate Lymphatic Filariasis (GPELF) launched by WHO aims to eliminate the disease by 2020. To achieve the goal annual mass drug administration (MDA) with diethylcarbamazine (DEC) plus albendazole (ABZ) has been introduced in all endemic countries. The current policy however excludes pregnant mothers and children below two years of age from MDA. Since pregnancy and early childhood are critical periods in determining the disease outcome in older age, the present study was undertaken to find out the influence of maternal filarial infection at the time of pregnancy on the susceptibility outcome of children born in a community after implementation of MDA for the first time. Methodology and Principal Findings The participants in this cohort consists of pregnant mothers and their subsequently born children living in eight adjacent villages endemic for filarial infections, in Khurda District, Odisha, India, where MDA has reduced microfilariae (Mf) rate from 12% to 0.34%. Infection status of mother and their children were assessed by detection of Mf as well as circulating filarial antigen (CFA) assay. The present study reveals a high rate of acquiring filarial infection by the children born to infected mother than uninfected mothers even though Mf rate has come down to < 1% after implementation of ten rounds of MDA. Significance To attain the target of eliminating lymphatic filariasis the current MDA programme should give emphasis on covering the women of child bearing age. Our study recommends incorporating supervised MDA to Adolescent Reproductive and Sexual Health Programme (ARSH) to make the adolescent girls free from infection by the time of pregnancy so as to achieve the goal. Lymphatic filariasis, commonly known as elephantiasis, is a painful and profoundly disfiguring disease. A massive global effort has been undertaken to eliminate this disease by 2020 using annual mass drug administration (MDA). However the MDA excludes pregnant women and children below two years of age, which are the two critical periods thought to be playing a major role in determining the disease susceptibility in older age. We have been working on the impact of filarial infection at the time of pregnancy on neonates since 2009 in India. We have assessed the impact of maternal infection among a group of children from the time of their birth till they attain early childhood. We have observed that children born to mothers having filarial infection at the time of pregnancy were more prone to infection at early childhood than born to infection free mother in an area having very low infection rate after MDA. Our finding reveals that infection in mother at the time of pregnancy plays a crucial role in acquiring infection in children. Hence to achieve the goal of elimination of filariasis the women of child bearing age should be treated with antifilarials through MDA under supervision.
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Affiliation(s)
- Madhusmita Bal
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Bhubaneswar, Odisha, India
- * E-mail:
| | - Prakash K. Sahu
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Nityananda Mandal
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Ashok K. Satapathy
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Manoranjan Ranjit
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Shatanu K. Kar
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Chandrasekharpur, Bhubaneswar, Odisha, India
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Santos PC, Lehmann LM, Lorenzi C, Hirsch C, Telmo PL, Mattos GT, Cadore PS, Klafke GB, Berne MEA, Gonçalves CV, Scaini CJ. The Seropositivity of Toxocara spp. Antibodies in Pregnant Women Attented at the University Hospital in Southern Brazil and the Factors Associated with Infection. PLoS One 2015; 10:e0131058. [PMID: 26146833 PMCID: PMC4492739 DOI: 10.1371/journal.pone.0131058] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/28/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human toxocariasis is a parasitic zoonosis with a worldwide distribution but is underdiagnosed with an underestimated impact on human health. The ingestion of embryonated eggs of Toxocara spp. present on the hands or in contaminated food or water is the main mode of infection. The only record of Toxocara congenital infection in humans occurred in a premature infant. Helminth infections during pregnancy may be associated with reproductive disorders. Studies investigating the occurrence of toxocariasis in pregnancy are scarce, as is research on the possible implications of these parasites in reproductive health. The aim of this study was to determine the seroprevalence of antibodies to Toxocara spp. in pregnant women and to identify risk factors associated with its infection. METHODOLOGY/PRINCIPAL FINDINGS The cross-sectional study of the seropositivity of specific antibodies for Toxocara spp. was performed on 280 pregnant women. Serum samples were examined with enzyme-linked immunoassay. Epidemiological data were obtained through a questionnaire containing information about obstetric history, general life style choices, and the social and economic status of the women. The prevalence of Toxocara spp. IgG in pregnant women was 6.4%. Some of the risk factors associated with the infection were owning dogs (p = 0.003), living in the city centre (p = 0.028), living at the city beach (p = 0.003), and having a family income at or below minimum wage (p < 0.001). There was no association between reproductive disorders and Toxocara seropositivity. CONCLUSIONS/SIGNIFICANCE The seroprevalence of 6.4% for Toxocara spp. in pregnant women shows that there was exposure to the parasite. The study demonstrates the need for attention for the completion of clinical diagnosis parameters, as well as the expansion of highly specific serological studies in different regions to understand the impact of toxocariasis in pregnancy.
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Affiliation(s)
- Paula Costa Santos
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Lis Maurente Lehmann
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Carolina Lorenzi
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Carolina Hirsch
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Paula Lima Telmo
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Gabriela Torres Mattos
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Priscila Silva Cadore
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Gabriel Baracy Klafke
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Maria Elisabeth Aires Berne
- Laboratory of Parasitology, Institute of Biology, Department of Microbiology and Parasitology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Carla Vitola Gonçalves
- Obstetric Center, University Hospital of Rio Grande–Rio Grande, Rio Grande do Sul, Brazil
| | - Carlos James Scaini
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
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