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Effectiveness of antimalarial drug combinations in treating concomitant urogenital schistosomiasis in malaria patients in Lambaréné, Gabon: A non-randomised event-monitoring study. PLoS Negl Trop Dis 2022; 16:e0010899. [DOI: 10.1371/journal.pntd.0010899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 11/10/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
Background
Urogenital schistosomiasis is prevalent in many malaria endemic regions of sub-Saharan Africa and can lead to long-term health consequences if untreated. Antimalarial drugs used to treat uncomplicated malaria have shown to exert some activity against Schistosoma haematobium. Here, we explore the efficacy on concomitant urogenital schistosomiasis of first-line recommended artemisinin-based combination therapies (ACTs) and investigational second-generation ACTs when administered for the treatment of uncomplicated malaria in Gabon.
Methods
Microscopic determination of urogenital schistosomiasis was performed from urine samples collected from patients with confirmed uncomplicated malaria. Egg excretion reduction rate and cure rate were determined at 4-weeks and 6-weeks post-treatment with either artesunate-pyronaridine, artemether-lumefantrine, artesunate-amodiaquine or artefenomel-ferroquine.
Results
Fifty-two (16%) out of 322 malaria patients were co-infected with urogenital schistosomiasis and were treated with antimalarial drug combinations. Schistosoma haematobium egg excretion rates showed a median reduction of 100% (interquartile range (IQR), 17% to 100%) and 65% (IQR, -133% to 100%) at 4-weeks and 6-weeks post-treatment, respectively, in the artesunate-pyronaridine group (n = 20) compared to 35% (IQR, −250% to 70%) and 65% (IQR, -65% to 79%) in the artemether-lumefantrine group (n = 18). Artesunate-amodiaquine (n = 2) and artefenomel-ferroquine combination (n = 3) were not able to reduce the rate of eggs excreted in this limited number of patients. In addition, cure rates were 56% and 37% at 4- and 6-weeks post-treatment, respectively, with artesunate-pyronaridine and no cases of cure were observed for the other antimalarial combinations.
Conclusions
Antimalarial treatments with artesunate-pyronaridine and artemether-lumefantrine reduced the excretion of S. haematobium eggs, comforting the hypothesis that antimalarial drugs could play a role in the control of schistosomiasis.
Trial Registration
This trial is registered with clinicaltrials.gov, under the Identifier NCT04264130.
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Betouke Ongwe ME, Mouwenda YD, Stam KA, Kremsner PG, Lell B, Diemert D, Bethony J, Bottazzi ME, Hotez PJ, Leeuwen RV, Grobusch MP, Adegnika AA, Mayboroda OA, Yazdanbakhsh M. Investigation of urinary metabolomics in a phase I hookworm vaccine trial in Gabon. PLoS One 2022; 17:e0275013. [PMID: 36155987 PMCID: PMC9512193 DOI: 10.1371/journal.pone.0275013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 08/05/2022] [Indexed: 11/18/2022] Open
Abstract
Metabolomics provides a powerful tool to study physiological changes in response to various perturbations such as vaccination. We explored whether metabolomic changes could be seen after vaccination in a phase I trial where Gabonese adults living either in rural or semi-urban areas received the subunit hookworm vaccine candidates (Na-GST-1 and Na-APR-1 (M74) adjuvanted with Alhydrogel plus GLA-AF (n = 24) or the hepatitis B vaccine (n = 8) as control. Urine samples were collected and assayed using targeted 1H NMR spectroscopy. At baseline, a set of metabolites significantly distinguished rural from semi-urban individuals. The pre- and post-vaccination comparisons indicated significant changes in few metabolites but only one day after the first vaccination. There was no relationship with immunogenicity. In conclusion, in a small phase 1 trial, urinary metabolomics could distinguish volunteers with different environmental exposures and reflected the safety of the vaccines but did not show a relationship to immunogenicity.
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Affiliation(s)
- Madeleine Eunice Betouke Ongwe
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut de Recherches en Écologie Tropicale, Centre National de la Recherche Scientifique et Technologique (CENAREST), Lambaréné, Gabon
- * E-mail:
| | - Yoanne D. Mouwenda
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Koen A. Stam
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter G. Kremsner
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - David Diemert
- George Washington University, Washington, DC, United States of America
| | - Jeff Bethony
- George Washington University, Washington, DC, United States of America
| | - Maria E. Bottazzi
- Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - Remko V. Leeuwen
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Martin P. Grobusch
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
- Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Center, Amsterdam Public Health; Amsterdam Infection & Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Ayola A. Adegnika
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), Tübingen, Germany
| | - Oleg A. Mayboroda
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
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Dejon-Agobé JC, Edoa JR, Adegnika AA, Grobusch MP. Schistosomiasis in Gabon from 2000 to 2021 - A review. Acta Trop 2022; 228:106317. [PMID: 35051384 DOI: 10.1016/j.actatropica.2022.106317] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Schistosomiasis is a public health issue of concern in Gabon, with the disease being reported from all regions of the country. The topic has been of interest for the local researchers and physicians for over two decades. The objective of this narrative review was to provide an overview of the research activities in the area from 2000 to early 2021. METHODS We performed a narrative literature review. The search strategy was designed to get a broad overview of the different research topics on schistosomiasis and the national control programme, and included grey literature. RESULTS A total of 159 articles was screened, and 42 were included into the review in addition to the grey literature. During the past two decades, the work on schistosomiasis originated from five out of the nine provinces of the country, with diverse aspects of the disease investigated; including immunology, epidemiology, diagnosis and treatment. Several studies investigated various aspects of schistosomiasis-related morbidity in the respective study populations. The body of work demonstrates that much effort was made to understand the details of the host immune response to schistosomiasis, and the immune profile changes induced in patients treated with praziquantel. Although some MDA campaigns were conducted in the country; little, however, is known on the epidemiological situation of the disease, particularly of its distribution within the population, as well as co-infections with other parasitic diseases also endemic in the area. CONCLUSION Progress has been made over the past two decades in the understanding of schistosomiasis in the country, including disease-related morbidity and its interaction with other parasitic infections, and the immunology and epidemiology of the disease. However, for optimising control of the disease, there is a need to fine-tune these findings with detailed local epidemiological and malacological data. We call for such studies to accomplish the knowledge of schistosomiasis in the country, particularly in areas of moderate or high endemicity, and recommend this approach to comparable schistosomiasis-endemic areas elsewhere.
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Dejon Agobé JC, Kariuki HC, Zinsou JF, Honkpehedji YJ, Grobusch MP, Adegnika AA. Pilot Malacology Surveys for the Intermediate Hosts of Schistosomiasis in Rural and Semi-Urban Areas of the Moyen-Ogooué Province, Gabon. Trop Med Infect Dis 2021; 7:tropicalmed7010001. [PMID: 35051117 PMCID: PMC8779524 DOI: 10.3390/tropicalmed7010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
The objective of this pilot malacological survey was to identify the snail intermediate hosts for Schistosoma haematobium in endemic rural and semi-urban areas of Gabon. Snails were collected, morphologically identified, and tested for infection by cercarial shedding. Released cercariae were morphologically identified using low-power light microscopy. A total of six species of snails were collected throughout the study area, with Bulinus truncatus, B. forskalii, and Potadoma spp. being the most predominant species collected. Only the Bulinus species were tested for infection by cercarial shedding, of which only B. truncatus shed cercariae. Some B. truncatus shed mammalian schistosome cercariae, while others shed Gymnocephalus cercariae. Our results indicate that B. truncatus appears to be a potential intermediate host of schistosomiasis in Gabon, where cases of S. haematobium, S. guineensis, and S. intercalatum infection are reported. However, it will be important to further understand the species diversity and transmission dynamics of schistosomes.
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Affiliation(s)
- Jean Claude Dejon Agobé
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné P.O. Box 242, Gabon; (J.C.D.A.); (J.F.Z.); (Y.J.H.); (M.P.G.)
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Henry Curtis Kariuki
- School of Medicine and Health Sciences, Kenya Methodist University (KeMU), P.O. Box 267, Meru 60200, Kenya;
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné P.O. Box 242, Gabon; (J.C.D.A.); (J.F.Z.); (Y.J.H.); (M.P.G.)
- Leiden Medical University Centre, University of Leiden, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné P.O. Box 242, Gabon; (J.C.D.A.); (J.F.Z.); (Y.J.H.); (M.P.G.)
- Leiden Medical University Centre, University of Leiden, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Martin Peter Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné P.O. Box 242, Gabon; (J.C.D.A.); (J.F.Z.); (Y.J.H.); (M.P.G.)
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné P.O. Box 242, Gabon; (J.C.D.A.); (J.F.Z.); (Y.J.H.); (M.P.G.)
- Leiden Medical University Centre, University of Leiden, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
- Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
- German Centre for Infection Research (DZIF), Partner Site Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
- German Centre for Infection Research (DZIF), African Partner Institution, CERMEL, Lambaréné P.O. Box 242, Gabon
- Correspondence:
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Tangie E, Walters A, Hsu NJ, Fisher M, Magez S, Jacobs M, Keeton R. BCG-mediated protection against M. tuberculosis is sustained post-malaria infection independent of parasite virulence. Immunology 2021; 165:219-233. [PMID: 34775598 DOI: 10.1111/imm.13431] [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: 07/24/2021] [Revised: 09/15/2021] [Accepted: 09/28/2021] [Indexed: 11/28/2022] Open
Abstract
Tuberculosis (TB) and malaria remain serious threats to global health. Bacillus Calmette-Guerin (BCG), the only licensed vaccine against TB protects against severe disseminated forms of TB in infants but shows poor efficacy against pulmonary TB in adults. Co-infections have been reported as one of the factors implicated in vaccine inefficacy. Given the geographical overlap of malaria and TB in areas where BCG vaccination is routinely administered, we hypothesized that virulence-dependent co-infection with Plasmodium species could alter the BCG-specific immune responses thus resulting in failure to protect against Mycobacterium tuberculosis. We compared virulent Plasmodium berghei and non-virulent Plasmodium chabaudi, their effects on B cells, effector and memory T cells, and the outcome on BCG-induced efficacy against M. tuberculosis infection. We demonstrate that malaria co-infection modulates both B- and T-cell immune responses but does not significantly alter the ability of the BCG vaccine to inhibit the growth of M. tuberculosis irrespective of parasite virulence. This malaria-driven immune regulation may have serious consequences in the early clinical trials of novel vaccines, which rely on vaccine-specific T-cell responses to screen novel vaccines for progression to the more costly vaccine efficacy trials.
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Affiliation(s)
- Emily Tangie
- Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Health Sciences Faculty, University of Cape Town, Observatory, South Africa
| | - Avril Walters
- Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Health Sciences Faculty, University of Cape Town, Observatory, South Africa
| | - Nai-Jen Hsu
- Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Health Sciences Faculty, University of Cape Town, Observatory, South Africa
| | - Michelle Fisher
- South African Tuberculosis Vaccine Initiative, University of Cape Town, Observatory, South Africa
| | - Stefan Magez
- Laboratory for Cellular and Molecular Immunology (CMIM), Department of Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Biochemistry and Microbiology, Ghent University, Gent, Belgium.,Laboratory for Biomedical Research, Department of Molecular Biotechnology, Environment Technology and Food Technology, Ghent University Global Campus, Incheon, Korea
| | - Muazzam Jacobs
- Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Health Sciences Faculty, University of Cape Town, Observatory, South Africa.,National Health Laboratory Service, Cape Town, South Africa.,Infectious Disease Research Unit, University of Cape Town, Observatory, South Africa
| | - Roanne Keeton
- Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Health Sciences Faculty, University of Cape Town, Observatory, South Africa
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Dejon-Agobé JC, Zinsou JF, Honkpehedji YJ, Edoa JR, Adegbité BR, Beh-Mba R, Kremsner PG, Adegnika AA, Grobusch MP. Knowledge, attitudes and practices pertaining to urogenital schistosomiasis in Lambaréné and surrounding areas, Gabon. Parasit Vectors 2021; 14:486. [PMID: 34551819 PMCID: PMC8456596 DOI: 10.1186/s13071-021-04905-0] [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] [Received: 01/25/2021] [Accepted: 07/29/2021] [Indexed: 11/12/2022] Open
Abstract
Background Control of schistosomiasis remains a priority in endemic areas. Local epidemiological data are necessary for a tailored control programme, including data on population behaviour in relation to the disease. The objective of this study was to assess schistosomiasis-related knowledge, attitudes and practices in the general population of Lambaréné, a small city in Gabon, in order to optimise the design and implementation of a local control programme that is tailored to need. Methods The study was cross-sectional in nature. Eligible adults and children living in the study area who volunteered (with informed consent) to participate in the study were interviewed using standardised questionnaires, one of which was a simplified version of the primary questionnaire for participants aged 6–13 years. Data on the participants’ knowledge, attitudes and practices that enhance the risk for contracting schistosomiasis were collected. Results A total of 602 participants were included. The mean (± standard deviation) age was 21.2 (± 15.0) years, the female:male gender ratio was 1.6 and 289 (48%) participants completed the simplified version the questionnaire. Of the 602 participants, 554 (92%) reported past or current contact with freshwater, 218 (36%) reported a history of a diagnosis of schistosomiasis and 193 (32%) reported past intake of praziquantel medication. The overall levels of knowledge and adequate attitudes toward schistosomiasis among young adults and adults were 68 and 73%, respectively. The proportion of participants pursuing risk-enhancing practices (REP) was 60% among the whole study population. Location was significantly associated with differences in knowledge and REP levels. A history of confirmed schistosomiasis and larger family size were significantly associated with an increase in good knowledge and REP levels. However, the indication of freshwater-associated activities was only associated with a significant increase in the REP level. Conclusions The results of this survey reveal a high level of population exposure to schistosomiasis, which is in line with known prevalence of schistosomiasis in Lambaréné and its surroundings. The local population has a reasonable level of knowledge of and adequate attitudes toward schistosomiasis but the level of REP is high, particularly in areas where piped water is absent. In terms of interventions, improving hygiene should have the highest priority, but in a context where provision of safe water is difficult to achieve, the effectiveness of praziquantel treatment and the education of at-risk populations on the need for protective behaviours should be a prominent feature of any local control programme. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04905-0.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin
| | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin
| | - Jean Ronald Edoa
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Bayodé Roméo Adegbité
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin
| | - Romuald Beh-Mba
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Peter Gottfried Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Institut Für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Center for Infection Research (DZIF), Tübingen, Germany
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin.,Institut Für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Center for Infection Research (DZIF), Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon. .,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, The Netherlands. .,Institut Für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany. .,Masanga Medical Research Unit, Masanga, Sierra Leone. .,Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
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Remppis J, Verheyden A, Bustinduy AL, Heller T, García-Tardón N, Manouana GP, Obiang R, Adegnika AA, Grobusch MP, Ramharter M, Joekes E, Bélard S. Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS)-pilot evaluation of a simple point-of-care ultrasound protocol and short training program for detecting urinary tract morbidity in highly endemic settings. Trans R Soc Trop Med Hyg 2021; 114:38-48. [PMID: 31735956 DOI: 10.1093/trstmh/trz101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/19/2019] [Accepted: 09/05/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Urogenital schistosomiasis (UGS) causes inflammation and fibrosis of the urinary tract. In resource-limited settings, affordable tools for morbidity assessment in clinical care are needed. Point-of-care ultrasound has not yet been validated for UGS-related pathology. METHODS We developed a protocol for Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS), assessing pathology of the bladder wall, ureters and kidneys. Following standardized training, two clinicians performed FASUS on children and adults with hematuria in Lambaréné, Gabon. Recorded ultrasound clips were remotely reviewed by two ultrasound experts as a diagnostic reference. RESULTS In 2015 and 2016, scans were performed in 118 patients. The image quality was sufficient in 90% of bladder views and more than 97% of kidney views. UGS-compatible pathology was detected in 51/118 (43%) by the operator and in 46/107 (43%) by the experts among baseline scans of sufficient quality. Inter-rater agreement between operators and experts was very good (κ > 0.8) for hydronephrosis and good (κ > 0.6) for bladder wall thickening. CONCLUSIONS FASUS is a promising clinical, point-of-care tool for detecting UGS-related urinary tract morbidity in symptomatic patients. Based on larger validation studies, appropriate diagnostic and therapeutic algorithms for the use of FASUS should be established.
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Affiliation(s)
- J Remppis
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon.,Department of Haematology and Oncology, Children's University Hospital, Hoppe-Seyler-Straße 1, 72076 Tübingen, Germany.,Institute of Tropical Medicine, University of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
| | - A Verheyden
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon
| | - A L Bustinduy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - T Heller
- Lighthouse Clinic, Kamuzu Central Hospital, Area 33 Mzimba Street. P.O. Box 106, Lilongwe, Malawi
| | - N García-Tardón
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon.,Clinical Chemistry Laboratory, Isala, Dr. van Heesweg 2, 8025 AB Zwolle, the Netherlands
| | - G P Manouana
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon.,Institute of Tropical Medicine, University of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
| | - R Obiang
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon
| | - A A Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon.,Institute of Tropical Medicine, University of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.,German Center for Infection Research, Wilhelmstraße 27, 72074 Tübingen, Germany
| | - M P Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon.,Institute of Tropical Medicine, University of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.,Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - M Ramharter
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon.,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine University Medical Center Hamburg-Eppendorf, Bernhard-Nocht-Straße 74, 20359 Hamburg, Germany
| | - E Joekes
- Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool L3 5QA, UK.,Department of Radiology, Royal Liverpool University Hospital NHS Trust, Prescot St, Liverpool L7 8XP, UK
| | - S Bélard
- Centre de Recherches Médicales de Lambaréné (CERMEL), B.P: 242 Lambaréné, Gabon.,Department of Paediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 10117 Berlin, Germany.,Berlin Institute of Health, Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
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Dejon-Agobé JC, Adegnika AA, Grobusch MP. Haematological changes in Schistosoma haematobium infections in school children in Gabon. Infection 2021; 49:645-651. [PMID: 33486713 PMCID: PMC8316219 DOI: 10.1007/s15010-020-01575-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/30/2020] [Indexed: 01/03/2023]
Abstract
Background Schistosomiasis is a parasitic disease affecting the blood cell. As a chronic disease, schistosomiasis particularly impacts on the human host’s haematological profile. We assessed here the impact of urogenital schistosomiasis on the full blood counts (FBC) as proxy diagnostic tool for schistosomiasis. Methods A cross-sectional study was conducted among school children living in Lambaréné, Gabon. Schistosomiasis status was determined using urine filtration technique. EDTA blood samples were analysed using a Pentra ABX 60® analyzer. Results Compared to their infection-free counterparts, school children infected with Schistosoma haematobium displayed an altered FBC profile, with changes in all three blood cell lines. Adjusted for praziquantel intake, soil-transmitted helminthic infections and Plasmodium falciparum infection status, schistosomiasis was independently associated with a decreasing trend of mean haemoglobin (β = − 0.20 g/dL, p-value = 0.08) and hematocrit (β = − 0.61%, p-value = 0.06) levels, a lower mean MCV (β = − 1.50µm3, p-value = 0.02) and MCH (β = − 0.54 pg, p-value = 0.04), and higher platelet (β = 28.2 103/mm3, p-value = 0.002) and leukocyte (β = 1.13 103/mm3, p-value = 0.0003) counts, respectively. Conclusions Schistosomiasis is associated with a characteristic FBC profile of schoolchildren living in Lambaréné, indicating the necessity to consider schistosomiasis as a single cause of disease, or a co-morbidity, when interpreting FBC in endemic areas.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, BP 242, Lambaréné, Gabon.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Ayôla A Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, BP 242, Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands.,Institut Für Tropenmedizin, Eberhard Karls University Tübingen, 72074, Tübingen, Germany.,German Center for Infection Research, Partner Site Tübingen, 72074, Tübingen, Germany.,Fondation Pour la Recherche Scientifique, 72 BP 045, Cotonou, Benin
| | - Martin P Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, BP 242, Lambaréné, Gabon. .,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands. .,Institut Für Tropenmedizin, Eberhard Karls University Tübingen, 72074, Tübingen, Germany. .,Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone. .,Institute of Infectious Diseases and Molecular Medicine (IIDMM), Cape Town, Republic of South Africa.
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9
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Honkpehedji YJ, Adegnika AA, Dejon-Agobe JC, Zinsou JF, Mba RB, Gerstenberg J, Rakotozandrindrainy R, Rakotoarivelo RA, Rasamoelina T, Sicuri E, Schwarz NG, Corstjens PLAM, Hoekstra PT, van Dam GJ, Kreidenweiss A. Prospective, observational study to assess the performance of CAA measurement as a diagnostic tool for the detection of Schistosoma haematobium infections in pregnant women and their child in Lambaréné, Gabon: study protocol of the freeBILy clinical trial in Gabon. BMC Infect Dis 2020; 20:718. [PMID: 32993559 PMCID: PMC7523491 DOI: 10.1186/s12879-020-05445-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosoma antigen detection in urine is a valuable diagnostic approach for schistosomiasis control programmes because of the higher sensitivity compared to parasitological methods and preferred sampling of urine over stool. Highly accurate diagnostics are important in low Schistosoma transmission areas. Pregnant women and young children could particularly benefit from antigen testing as praziquantel (PZQ) can be given to only confirmed Schistosoma cases. This prevents the unborn baby from unnecessary exposure to PZQ. We present here the protocol of a diagnostic study that forms part of the freeBILy project. The aim is to evaluate the accuracy of circulating anodic antigen (CAA) detection for diagnosis of Schistosoma haematobium infections in pregnant women and to validate CAA as an endpoint measure for anti-Schistosoma drug efficacy. The study will also investigate Schistosoma infections in infants. METHODS A set of three interlinked prospective, observational studies is conducted in Gabon. The upconverting phosphor lateral flow (UCP-LF) CAA test is the index diagnostic test that will be evaluated. The core trial, sub-study A, comprehensively evaluates the accuracy of the UCP-LF CAA urine test against a set of other Schistosoma diagnostics in a cross-sectional trial design. Women positive for S. haematobium will proceed with sub-study B and will be randomised to receive PZQ treatment immediately or after delivery followed by weekly sample collection. This approach includes comparative monitoring of CAA levels following PZQ intake and will also contribute further data for safety of PZQ administration during pregnancy. Sub-study C is a longitudinal study to determine the incidence of S. haematobium infection as well as the age for first infection in life-time. DISCUSSION The freeBILy trial in Gabon will generate a comprehensive set of data on the accuracy of the UCP-LF CAA test for the detection of S. haematobium infection in pregnant women and newborn babies and for the use of CAA as a marker to determine PZQ efficacy. Furthermore, incidence of Schistosoma infection in infants will be reported. Using the ultrasensitive diagnostics, this information will be highly relevant for Schistosoma prevalence monitoring by national control programs as well as for the development of medicaments and vaccines. TRIAL REGISTRATION The registration number of this study is NCT03779347 ( clinicaltrials.gov , date of registration: 19 December 2018).
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Affiliation(s)
- Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
- German Center for Infection Research (DZIF), Tübingen, Germany
| | - Jean Claude Dejon-Agobe
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeannot Fréjus Zinsou
- 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
| | - Jacob Gerstenberg
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | | | | | | | - Elisa Sicuri
- Fundación Privada Instituto de Salud Global Barcelona, Barcelona, Spain
| | | | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands.
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10
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Nouatin O, Ateba Ngoa U, Ibáñez J, Dejon-Agobe JC, Mordmüller B, Edoa JR, Mougeni F, Brückner S, Bouyoukou Hounkpatin A, Esen M, Theisen M, Moutairou K, Hoffman SL, Issifou S, Luty AJF, Loembe MM, Agnandji ST, Lell B, Kremsner PG, Adegnika AA. Effect of immune regulatory pathways after immunization with GMZ2 malaria vaccine candidate in healthy lifelong malaria-exposed adults. Vaccine 2020; 38:4263-4272. [PMID: 32386747 PMCID: PMC7297038 DOI: 10.1016/j.vaccine.2020.04.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/08/2020] [Accepted: 04/20/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite appreciable immunogenicity in malaria-naive populations, many candidate malaria vaccines are considerably less immunogenic in malaria-exposed populations. This could reflect induction of immune regulatory mechanisms involving Human Leukocyte Antigen G (HLA-G), regulatory T (Treg), and regulatory B (Breg) cells. Here, we addressed the question whether there is correlation between these immune regulatory pathways and both plasmablast frequencies and vaccine-specific IgG concentrations. METHODS Fifty Gabonese adults with lifelong exposure to Plasmodium spp were randomized to receive three doses of either 30 µg or 100 µg GMZ2-CAF01, or 100 µg GMZ2-alum, or control vaccine (rabies vaccine) at 4-week intervals. Only plasma and peripheral blood mononuclear cells isolated from blood samples collected before (D0) and 28 days after the third vaccination (D84) of 35 participants were used to measure sHLA-G levels and anti-GMZ2 IgG concentrations, and to quantify Treg, Breg and plasmablast cells. Vaccine efficacy was assessed using controlled human malaria infection (CHMI) by direct venous inoculation of Plasmodium falciparum sporozoites (PfSPZ Challenge). RESULTS The sHLA-G concentration increased from D0 to D84 in all GMZ2 vaccinated participants and in the control group, whereas Treg frequencies increased only in those receiving 30 µg or 100 µg GMZ2-CAF01. The sHLA-G level on D84 was associated with a decrease of the anti-GMZ2 IgG concentration, whereas Treg frequencies on D0 or on D84, and Breg frequency on D84 were associated with lower plasmablast frequencies. Importantly, having a D84:D0 ratio of sHLA-G above the median was associated with an increased risk of P. falciparum infection after sporozoites injection. CONCLUSION Regulatory immune responses are induced following immunization. Stronger sHLA-G and Treg immune responses may suppress vaccine induced immune responses, and the magnitude of the sHLA-G response increased the risk of Plasmodium falciparum infection after CHMI. These findings could have implications for the design and testing of malaria vaccine candidates in semi-immune individuals.
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Affiliation(s)
- Odilon Nouatin
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany; Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany; Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, Cotonou, Benin.
| | - Ulysse Ateba Ngoa
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon.
| | - Javier Ibáñez
- Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Jean Claude Dejon-Agobe
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Benjamin Mordmüller
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany; Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.
| | - Jean Ronald Edoa
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany.
| | - Fabrice Mougeni
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon
| | - Sina Brückner
- Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany.
| | - Aurore Bouyoukou Hounkpatin
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Meral Esen
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany; Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.
| | - Michael Theisen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark and Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Kabirou Moutairou
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, Cotonou, Benin.
| | | | - Saadou Issifou
- Fondation pour la Recherche Scientifique, 72 BP45 Cotonou, Benin.
| | - Adrian J F Luty
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, MERIT UMR D216, Benin; Université de Paris, MERIT, IRD, Paris, France.
| | - Marguerite M Loembe
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany; Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.
| | - Selidji Todagbé Agnandji
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany; Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
| | - Peter G Kremsner
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany; Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, BP: 242 Lambaréné, Gabon; Institut für Tropenmedizin, Universität Tubingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany; Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany; Leiden University Medical Centre (LUMC), 2333 ZA Leiden, the Netherlands.
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11
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Murambiwa P, Silas E, Mdleleni Y, Mukaratirwa S. Chemokine, cytokine and haematological profiles in Sprague-Dawley rats co-infected with Plasmodium berghei ANKA and Trichinella zimbabwensis-A laboratory animal model for malaria and tissue-dwelling nematodes co-infection. Heliyon 2020; 6:e03475. [PMID: 32140591 PMCID: PMC7044667 DOI: 10.1016/j.heliyon.2020.e03475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 01/10/2020] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Malaria remains a major cause of mortality and morbidity in sub-Saharan Africa (SSA) and tissue-dwelling helminth parasites (TDHPs) are also prevalent in this region presenting a geographical overlap in endemicity. There is paucity of information on the specific host immune responses elicited at different phases of the life cycle by the co-infecting helminth parasites. This study aimed at using a laboratory animal model to determine selected chemokine, cytokine and hematological profiles in Sprague-Dawley rats co-infected with Plasmodium berghei ANKA (Pb) and a tissue-dwelling nematode, Trichinella zimbabwensis (Tz). One-hundred-and-sixty-eight male Sprague-Dawley rats (90–150g) were randomly divided into four experimental groups; Control (n = 42), Pb-infected (n = 42), Tz-infected (n = 42) and Pb + Tz-infected group (n = 42). Trichinella zimbabwensis infection (3 muscle larvae/g body weight per os) was done on day 0 while intra-peritoneal Pb infection (105 parasitised RBCs) was done at day 28 of the 42-day experimental study for the co-infection group which corresponded with day 0 of the Pb group on the protocol. Haematological parameters, cytokines (TNF-α, IL-10, IL-4, IL-6), chemokines (CXCL10, CCL5, CCL11) and burden of Tz adult worms and muscle larvae burden were determined as per need for each group. Results showed that Tz infection predisposed the co-infected animals towards rapid development of Pb parasitaemia during co-infection, reaching a higher peak percentage parasitaemia at day 7 post-infection than the Pb mono-infected group at day 6 post-infection. Animals in the co-infected group also exhibited severe anaemia, basophilia, neutrophilia, eosinophilia and lymphopenia at day 7 post Pb infection compared to the control groups. Significant elevation of Pb parasitaemia coincided with elevated pro-inflammatory cytokine TNF-α (P < 0.001), regulatory anti-inflammatory IL-10 (P < 0.001), and pro-inflammatory chemokines CXCL10 (P < 0.001) concentration in comparison to control group, at day 7 post Pb infection. Our results confirm that co-infection of Pb with Tz resulted in increased Pb parasitaemia compared to the control group in the early stages of infection and this might translate to severe malaria.
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Affiliation(s)
- Pretty Murambiwa
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4000, South Africa
| | - Ekuyikeno Silas
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4000, South Africa
| | - Yanga Mdleleni
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4000, South Africa
| | - Samson Mukaratirwa
- School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4000, South Africa.,One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
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12
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Dejon-Agobé JC, Edoa JR, Honkpehedji YJ, Zinsou JF, Adégbitè BR, Ngwese MM, Mangaboula A, Lell B, Grobusch MP, Mordmüller B, Adegnika AA. Schistosoma haematobium infection morbidity, praziquantel effectiveness and reinfection rate among children and young adults in Gabon. Parasit Vectors 2019; 12:577. [PMID: 31823806 PMCID: PMC6905022 DOI: 10.1186/s13071-019-3836-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/03/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa carries most of the global burden of schistosomiasis. To optimize disease control and reduce morbidity, precise data are needed for control measures adapted to the local epidemiological situation. The objective of this study is to provide baseline information on schistosomiasis dynamics, including praziquantel (PZQ) treatment outcome in children and young adults living in the vicinity of Lambaréné, Gabon. METHODS Eligible volunteers were included into a prospective longitudinal study. Urine filtration technique was used to detect eggs in urine for schistosomiasis diagnosis. Subjects were treated with 60 mg of PZQ once per month for three consecutive months, and the outcome was assessed by cure rate (CR) and egg reduction rate (ERR). RESULTS A total of 328 volunteers were enrolled in the study with a mean (± SD) age of 12.2 ± 4.7 years-old. The female-to-male ratio was 0.99. Out of 258 participants in total, 45% had schistosomiasis during the survey and 43% presented with heavy infections. The incidences of haematuria and schistosomiasis were 0.11 and 0.17 person-years, respectively. After the first and third dose of PZQ, overall ERR of 93% and 95% were found, respectively; while the CR were 78% and 88%, respectively. Both ERR (100 vs 88%) and CR (90 vs 68%) were higher among females than males after the first dose. The CR increased for both groups after the third dose to 95% and 80%, respectively. After the first PZQ dose, ERR was higher for heavy compared to light infections (94 vs 89%), while the CR was higher for light than for heavy infections (87 vs 59%). After the third PZQ dose, ERR increased only for light infections to 99%, while CR increased to 98% and 75% for light and for heavy infections, respectively. The reinfection rate assessed at a mean of 44.6 weeks post-treatment was 25%. CONCLUSIONS The prevalence of schistosomiasis is moderate in communities living in the vicinity of Lambaréné, where a subpopulation with a high risk of reinfection bears most of the burden of the disease. To improve schistosomiasis control in this scenario, we suggest education of these high-risk groups to seek themselves a one-year PZQ treatment. Trial registration clinicaltrials.gov Identifier NCT02769103. Registered 11 May 2016, retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02769013.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Ance Mangaboula
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
- German Center for Infection Research, Tübingen, Germany
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13
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Schistosoma haematobium and Plasmodium falciparum co-infection in Nigeria 2001–2018: A systematic review and meta-analysis. SCIENTIFIC AFRICAN 2019. [DOI: 10.1016/j.sciaf.2019.e00186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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14
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Haemostatic changes in urogenital schistosomiasis haematobium: a case-control study in Gabonese schoolchildren. J Helminthol 2019; 94:e84. [PMID: 31500673 DOI: 10.1017/s0022149x19000798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In many tropical areas schistosomiasis is a major health problem causing hepatosplenic, intestinal or urogenital complaints. Hepatosplenic schistosomiasis mansoni is also characterized by blood coagulation abnormalities. Liver pathology plays a role in the development of haemostatic changes and the parasitic infection may directly affect coagulation. However, these contributing factors cannot be studied separately in hepatosplenic schistosomiasis infections. This pilot study provides insight in haemostatic changes in urinary schistosomiasis by studying coagulation parameters in schistosomiasis haematobium-infected Gabonese schoolchildren. Selection on urinary schistosomiasis patients without hepatosplenic complaints allows for the investigation of the direct effects of the parasite on haemostasis. Levels of von Willebrand Factor (VWF) antigen, active VWF and osteoprotegerin were elevated, indicating inflammation-mediated endothelial activation. In contrast to hepatosplenic schistosomiasis, thrombin-antithrombin complex and D-dimer levels were not affected. Despite its small sample size, this study clearly indicates that Schistosoma haematobium directly alters the activation status of the endothelium, without initiation of coagulation.
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15
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Dejon-Agobé JC, Zinsou JF, Honkpehedji YJ, Ateba-Ngoa U, Edoa JR, Adegbite BR, Mombo-Ngoma G, Agnandji ST, Ramharter M, Kremsner PG, Lell B, Grobusch MP, Adegnika AA. Schistosoma haematobium effects on Plasmodium falciparum infection modified by soil-transmitted helminths in school-age children living in rural areas of Gabon. PLoS Negl Trop Dis 2018; 12:e0006663. [PMID: 30080853 PMCID: PMC6095623 DOI: 10.1371/journal.pntd.0006663] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/16/2018] [Accepted: 07/05/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Malaria burden remains high in the sub-Saharan region where helminths are prevalent and where children are often infected with both types of parasites. Although the effect of helminths on malaria infection is evident, the impact of these co-infections is not clearly elucidated yet and the scarce findings are conflicting. In this study, we investigated the effect of schistosomiasis, considering soil-transmitted helminths (STH), on prevalence and incidence of Plasmodium falciparum infection. METHODOLOGY This longitudinal survey was conducted in school-age children living in two rural communities in the vicinity of Lambaréné, Gabon. Thick blood smear light microscopy, urine filtration and the Kato-Katz technique were performed to detect malaria parasites, S. haematobium eggs and, STH eggs, respectively. P. falciparum carriage was assessed at inclusion, and incidence of malaria and time to the first malaria event were recorded in correlation with Schistosoma carriage status. Stratified multivariate analysis using generalized linear model was used to assess the risk of plasmodium infection considering interaction with STH, and survival analysis to assess time to malaria. MAIN FINDINGS The overall prevalence on subject enrolment was 30%, 23% and 9% for S. haematobium, P. falciparum infections and co-infection with both parasites, respectively. Our results showed that schistosomiasis in children tends to increase the risk of plasmodium infection but a combined effect with Trichuris trichiura or hookworm infection clearly increase the risk (aOR = 3.9 [95%CI: 1.7-9.2]). The incidence of malaria over time was 0.51[95%CI: 0.45-0.57] per person-year and was higher in the Schistosoma-infected group compared to the non-infected group (0.61 vs 0.43, p = 0.02), with a significant delay of time-to first-malaria event only in children aged from 6 to 10-years-old infected with Schistosoma haematobium. CONCLUSIONS Our results suggest that STH enhance the risk for P. falciparum infection in schistosomiasis-positive children, and when infected, that schistosomiasis enhances susceptibility to developing malaria in young children but not in older children.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Yabo Josiane Honkpehedji
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ulysse Ateba-Ngoa
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Jean-Ronald Edoa
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Bayodé Roméo Adegbite
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
| | - Ghyslain Mombo-Ngoma
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Departement de Parasitologie-Mycologie, Faculté de Médecine, Université des Sciences de la Santé, Owendo, Gabon
| | - Selidji Todagbe Agnandji
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Michael Ramharter
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I, Department of Medicine, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Gottfried Kremsner
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherche Médicales de Lambaréné (CERMEL) and African Partner Institution, German Center for Infection Research, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
- Institute of Tropical Medicine, University of Tübingen and Partner site Tübingen, German Center for Infection Research, Tübingen, Germany
- * E-mail:
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16
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Ateba-Ngoa U, Jones S, Zinsou JF, Honkpehedji J, Adegnika AA, Agobe JCD, Massinga-Loembe M, Mordmüller B, Bousema T, Yazdanbakhsh M. Associations Between Helminth Infections, Plasmodium falciparum Parasite Carriage and Antibody Responses to Sexual and Asexual Stage Malarial Antigens. Am J Trop Med Hyg 2016; 95:394-400. [PMID: 27273645 DOI: 10.4269/ajtmh.15-0703] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 12/28/2015] [Indexed: 12/28/2022] Open
Abstract
Infections with helminths and Plasmodium spp. overlap in their geographical distribution. It has been postulated that helminth infections may influence malarial transmission by altering Plasmodium falciparum gametocytogenesis. This cross-sectional study assessed the effect of helminth infections on P. falciparum gametocyte carriage and on humoral immune responses to sexual stage antigens in Gabon. Schistosoma haematobium and filarial infections as well as P. falciparum asexual forms and gametocyte carriage were determined. The antibody responses measured were to sexual (Pfs230, Pfs48/45) and asexual P. falciparum antigens (AMA1, MSP1, and GLURP). A total of 287 subjects were included. The prevalence of microscopically detectable P. falciparum asexual parasites was higher in S. haematobium-infected subjects in comparison to their uninfected counterparts (47% versus 26%, P = 0.003), but this was not different when filarial infections were considered. Plasmodium falciparum gametocyte carriage was similar between Schistosoma- or filaria-infected and uninfected subjects. We observed a significant decrease of Pfs48/45 immunoglobulin G titer in S. haematobium-infected subjects (P = 0.037), whereas no difference was seen for Pfs230 antibody titer, nor for antibodies to AMA1, MSP1, or GLURP. Our findings suggest an effect of S. haematobium on antibody responses to some P. falciparum gametocyte antigens that may have consequences for transmission-blocking immunity.
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Affiliation(s)
- Ulysse Ateba-Ngoa
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.
| | - Sophie Jones
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jeannot Fréjus Zinsou
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Josiane Honkpehedji
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Ayola Akim Adegnika
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Jean-Claude Dejon Agobe
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Marguerite Massinga-Loembe
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Teun Bousema
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom. Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
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17
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Nouatin O, Gbédandé K, Ibitokou S, Vianou B, Houngbegnon P, Ezinmegnon S, Borgella S, Akplogan C, Cottrell G, Varani S, Massougbodji A, Moutairou K, Troye-Blomberg M, Deloron P, Luty AJF, Fievet N. Infants' Peripheral Blood Lymphocyte Composition Reflects Both Maternal and Post-Natal Infection with Plasmodium falciparum. PLoS One 2015; 10:e0139606. [PMID: 26580401 PMCID: PMC4651557 DOI: 10.1371/journal.pone.0139606] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 09/14/2015] [Indexed: 11/19/2022] Open
Abstract
Maternal parasitoses modulate fetal immune development, manifesting as altered cellular immunological activity in cord blood that may be linked to enhanced susceptibility to infections in early life. Plasmodium falciparum typifies such infections, with distinct placental infection-related changes in cord blood exemplified by expanded populations of parasite antigen-specific regulatory T cells. Here we addressed whether such early-onset cellular immunological alterations persist through infancy. Specifically, in order to assess the potential impacts of P. falciparum infections either during pregnancy or during infancy, we quantified lymphocyte subsets in cord blood and in infants' peripheral blood during the first year of life. The principal age-related changes observed, independent of infection status, concerned decreases in the frequencies of CD4+, NKdim and NKT cells, whilst CD8+, Treg and Teff cells' frequencies increased from birth to 12 months of age. P. falciparum infections present at delivery, but not those earlier in gestation, were associated with increased frequencies of Treg and CD8+ T cells but fewer CD4+ and NKT cells during infancy, thus accentuating the observed age-related patterns. Overall, P. falciparum infections arising during infancy were associated with a reversal of the trends associated with maternal infection i.e. with more CD4+ cells, with fewer Treg and CD8+ cells. We conclude that maternal P. falciparum infection at delivery has significant and, in some cases, year-long effects on the composition of infants' peripheral blood lymphocyte populations. Those effects are superimposed on separate and independent age- as well as infant infection-related alterations that, respectively, either match or run counter to them.
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MESH Headings
- Adult
- Antigens, Protozoan/genetics
- Antigens, Protozoan/immunology
- Benin
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/pathology
- Female
- Fetal Blood/immunology
- Fetal Blood/parasitology
- Humans
- Immunophenotyping
- Infant
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Lymphocyte Count
- Malaria, Falciparum/immunology
- Malaria, Falciparum/parasitology
- Malaria, Falciparum/pathology
- Natural Killer T-Cells/immunology
- Natural Killer T-Cells/pathology
- Placenta/immunology
- Placenta/parasitology
- Placenta/pathology
- Plasmodium falciparum/immunology
- Pregnancy
- Pregnancy Complications, Parasitic/immunology
- Pregnancy Complications, Parasitic/parasitology
- Pregnancy Complications, Parasitic/pathology
- Retrospective Studies
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/pathology
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Affiliation(s)
- Odilon Nouatin
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Komi Gbédandé
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Samad Ibitokou
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Bertin Vianou
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Parfait Houngbegnon
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Sem Ezinmegnon
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Sophie Borgella
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France
| | - Carine Akplogan
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Gilles Cottrell
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Stefania Varani
- Unit of Microbiology, Department of Diagnostic, Experimental and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Achille Massougbodji
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
| | - Kabirou Moutairou
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Marita Troye-Blomberg
- Department of Molecular Biosciences, the Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Philippe Deloron
- Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Adrian J. F. Luty
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Nadine Fievet
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Benin
- Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
- * E-mail:
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18
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Ateba-Ngoa U, Adegnika AA, Zinsou JF, Kassa Kassa RF, Smits H, Massinga-Loembe M, Mordmüller B, Kremsner PG, Yazdanbakhsh M. Cytokine and chemokine profile of the innate and adaptive immune response of Schistosoma haematobium and Plasmodium falciparum single and co-infected school-aged children from an endemic area of Lambaréné, Gabon. Malar J 2015; 14:94. [PMID: 25890010 PMCID: PMC4365807 DOI: 10.1186/s12936-015-0608-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 02/09/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Helminths and malaria are among the most prevalent infectious diseases in the world. They both occur in tropical area where they often affect the same populations. There are studies suggesting an effect of helminths on malariometric indices. For example, malaria attacks as well as disease severity has been shown to be influenced by a concurrent chronic helminth infection. However, there are also studies that show no effect of concurrent helminth infections on malarial outcomes. To start addressing this issue, the effect of chronic Schistosoma haematobium infection on both the innate and adaptive immune response of Plasmodium falciparum-infected subjects was assessed in an area endemic for both these infections in Gabon. METHOD Subjects infected with S. haematobium and or P. falciparum, as well as a control group with neither of these infections, were recruited. For innate immune response, heparinized blood was obtained and cultured for 24 hours with a panel of TLR ligands. For adaptive immune response, PBMC was isolated and stimulated with SEB for 72 hours. Cytokines and chemokines were measured in supernatants using a multiplex beads array immunoassay. Principal Component analysis was used to assess pattern of cytokine and chemokine responses representing the innate and adaptive components of the immune system. RESULTS Overall it was observed that the presence of P. falciparum infection was marked by an increase in innate and adaptive immune responsiveness while S. haematobium infection was characterized by an increased chemokine profile, with at the same time, lower pro inflammatory markers. When the study subjects were split into single infected and co-infected groups no effect of S. haematobium on the immune response of P. falciparum infected subjects was observed, neither for the innate nor for the adaptive component of the immune response. CONCLUSION This study provides original information on the cellular immune response of S. haematobium and/or P. falciparum in infected subjects. It rules out an effect of S. haematobium on the cytokine profile of subjects co-infected with P. falciparum.
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Affiliation(s)
- Ulysse Ateba-Ngoa
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands. .,Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Ayola Akim Adegnika
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands. .,Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Jeannot F Zinsou
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | | | - Hermelijn Smits
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands.
| | - Marguerite Massinga-Loembe
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Peter G Kremsner
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074, Tübingen, Germany. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, ZA, The Netherlands. .,Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon.
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