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Molaei S, Asfaram S, Mashhadi Z, Mohammadi-Ghalehbin B, Iranpour S. Insights into parasites and COVID-19 co-infections in Iran: a systematic review. Trans R Soc Trop Med Hyg 2024; 118:350-358. [PMID: 38288655 DOI: 10.1093/trstmh/trae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 11/28/2023] [Accepted: 01/23/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND It is well-documented that using immunosuppressive drugs such as corticosteroids or cytokine blockers in treating coronavirus disease 2019 (COVID-19) increases the risk of co-infections. Here we systematically summarized the cases of COVID-19-associated parasitic infections (CAPIs) in Iran. METHODS From 19 February 2020 to 10 May 2023, all studies on Iranian patients suffering from CAPIs were collected from several databases using a systematic search strategy. RESULTS Of 540 records, 11 studies remained for data extraction. In this research, most of the studies were related to Lophomonas and Toxoplasma. Of 411 cases of CAPIs, toxoplasmosis (385 [93.7%]) had the highest rate of infection among Iranian patients, followed by blastocystosis (15 [3.6%]), fascioliasis (4 [0.97%]), leishmaniasis (3 [0.7%]), lophomoniasis (3 [0.7%]) and strongyloidiasis (1 [0.2%]). In general, Blastocystis enhanced diarrhoea in patients with COVID-19. Lophomonas, Toxoplasma and Strongyloides increased the severity of COVID-19, but Fasciola decreased its intensity. Patients with a history of cutaneous leishmaniasis showed mild symptoms of COVID-19. Also, patients with a prior history of hydatid cysts were not affected by COVID-19. CONCLUSIONS Due to the similar symptoms of some parasitic diseases and COVID-19 and immunosuppressive treatment regimens in these patients that may cause the reactivation or recurrence of parasitic infections, early diagnosis and treatment are required.
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Affiliation(s)
- Soheila Molaei
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Shabnam Asfaram
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Zahra Mashhadi
- School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Behnam Mohammadi-Ghalehbin
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
- Department of Microbiology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Sohrab Iranpour
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
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Aribodor OB, Azugo NO, Jacob EC, Ngenegbo UC, Onwusulu ND, Obika I, Obikwelu EM, Nebe OJ. Assessing urogenital schistosomiasis and female genital schistosomiasis (FGS) among adolescents in Anaocha, Anambra State, Nigeria: implications for ongoing control efforts. BMC Public Health 2024; 24:952. [PMID: 38566137 PMCID: PMC10988871 DOI: 10.1186/s12889-024-18378-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Urogenital schistosomiasis (UgS) remains a persistent health challenge among adolescents in Anambra State, Nigeria, despite ongoing control efforts. Mass praziquantel treatment programs, initiated in 2013, primarily target primary school-aged children (5-14 years old), leaving adolescents (10-19 years old) enrolled in secondary schools vulnerable to urogenital schistosomiaisis. Additionally, the extent of female genital schistosomiasis (FGS), a neglected gynaecological manifestation of UgS remains unclear. METHODOLOGY To address these gaps, a cross-sectional study was conducted in Anaocha Local Government Area from February to May 2023. Four hundred and seventy consenting adolescents aged 10-19 years were enrolled. Urinalysis including urine filtration was employed to confirm haematuria and detect urogenital schistosomiasis (UGS) among the participants. For females with heavy infections (≥ 50 eggs/10 ml urine), a gynaecologist performed colposcopy examinations, complemented by acetic acid and Lugol's iodine staining to assess for female genital schistosomiasis (FGS) lesions or other related reproductive health conditions. Socio-demographic data, including information on potential risk factors, were systematically collected using the Kobo ToolBox software, following gender-sensitive data collection guidelines. Data were analysed using SPSS version 25, incorporating descriptive statistics, multinomial logistic regression, odds ratios, and significance testing. RESULTS Among the 470 adolescents (52.8% females, 47.2% males) examined, an overall UgS prevalence of 14.5% was observed, with an average of 5.25 eggs per 10 ml of urine. Females had a slightly higher prevalence (16.1%), and 7.5% had heavy infections. Although gender differences in infection rates were not statistically significant, males had slightly higher odds of infection (OR: 1.332; 95% CI: 0.791-2.244; p-value: 0.280). Adolescents aged 10-14 had the highest prevalence, with significantly increased odds of infection (OR: 1.720; 95% CI: 1.012-2.923; p-value: 0.045). Colposcopy examinations of females with heavy infections revealed FGS lesions and co-infections with Trichomonas vaginalis. Haematuria, though prevalent (24.6%), was not the sole indicator, as those without it faced significantly higher odds of infection (OR: 2.924; 95% CI: 1.731-4.941; p-value: 0.000). Dysuria and genital itching/burning sensation were other UgS and FGS associated symptoms. Direct water contact was associated with higher infection odds (OR: 2.601; 95% CI: 1.007-6.716; p-value: 0.048). Various risk factors were associated with UgS. CONCLUSION The study highlights the need for a comprehensive Urogenital Schistosomiasis (UGS) control strategy that includes secondary school adolescents, emphasizes risk factor management, promotes safe water practices, and raises awareness about UGS and Female Genital Schistosomiasis (FGS) among adolescents, thus improving control efforts and mitigating this health challenge in the region.
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Affiliation(s)
- Ogechukwu B Aribodor
- Department of Zoology, Nnamdi Azikiwe University, Awka, Nigeria.
- Social Innovation in Health Initiative (SIHI) Hub, Nnamdi Azikiwe University, Awka, Nigeria.
| | - Nwadiuto O Azugo
- Department of Zoology, Nnamdi Azikiwe University, Awka, Nigeria
- Social Innovation in Health Initiative (SIHI) Hub, Nnamdi Azikiwe University, Awka, Nigeria
| | - Eunice C Jacob
- Department of Zoology, Nnamdi Azikiwe University, Awka, Nigeria
- Social Innovation in Health Initiative (SIHI) Hub, Nnamdi Azikiwe University, Awka, Nigeria
| | - Uche C Ngenegbo
- Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Nnaemeka D Onwusulu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ifeanyi Obika
- Department of Zoology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Emmanuel M Obikwelu
- Neglected Tropical Diseases Unit, Anambra State Ministry of Health, Awka, Nigeria
| | - Obiageli J Nebe
- Neglected Tropical Diseases Division, Federal Ministry of Health, Abuja, Nigeria
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3
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Perera DJ, Koger-Pease C, Paulini K, Daoudi M, Ndao M. Beyond schistosomiasis: unraveling co-infections and altered immunity. Clin Microbiol Rev 2024; 37:e0009823. [PMID: 38319102 PMCID: PMC10938899 DOI: 10.1128/cmr.00098-23] [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] [Indexed: 02/07/2024] Open
Abstract
Schistosomiasis is a neglected tropical disease caused by the helminth Schistosoma spp. and has the second highest global impact of all parasites. Schistosoma are transmitted through contact with contaminated fresh water predominantly in Africa, Asia, the Middle East, and South America. Due to the widespread prevalence of Schistosoma, co-infection with other infectious agents is common but often poorly described. Herein, we review recent literature describing the impact of Schistosoma co-infection between species and Schistosoma co-infection with blood-borne protozoa, soil-transmitted helminths, various intestinal protozoa, Mycobacterium, Salmonella, various urinary tract infection-causing agents, and viral pathogens. In each case, disease severity and, of particular interest, the immune landscape, are altered as a consequence of co-infection. Understanding the impact of schistosomiasis co-infections will be important when considering treatment strategies and vaccine development moving forward.
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Affiliation(s)
- Dilhan J. Perera
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Cal Koger-Pease
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Kayla Paulini
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Mohamed Daoudi
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Momar Ndao
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Canada
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Umbelino-Walker I, Wong F, Cassolato M, Pantelias A, Jacobson J, Kalume C. Integration of female genital schistosomiasis into HIV/sexual and reproductive health and rights and neglected tropical diseases programmes and services: a scoping review. Sex Reprod Health Matters 2023; 31:2262882. [PMID: 37850814 PMCID: PMC10586082 DOI: 10.1080/26410397.2023.2262882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Female genital schistosomiasis (FGS) affects approximately 56 million women and girls across sub-Saharan Africa and is associated with up to a threefold increased prevalence of HIV. Integrating FGS with HIV programmes as part of comprehensive sexual and reproductive health (SRH) services may be one of the most significant missed opportunities for preventing HIV incidence among girls and women. A search of studies published until October 2021 via Scopus and ProQuest was conducted using PRISMA guidelines to assess how FGS can be integrated into HIV/SRH and neglected tropical diseases (NTDs) programmes and services. Data extraction included studies that integrated interventions and described the opportunities and challenges. A total of 334 studies were identified, with 22 eligible for analysis and summarised conducting a descriptive numerical analysis and qualitative review. We adapted a framework for integrated implementation of FGS, HIV, and HPV/cervical cancer to thematically organise the results, classifying them into five themes: awareness and community engagement, diagnosis, treatment, burden assessment, and economic evaluation. Most activities pertained to awareness and community engagement (n = 9), diagnosis (n = 9) and were primarily connected to HIV/AIDS (n = 8) and school-based services and programming (n = 8). The studies mainly described the opportunities and challenges for integration, rather than presenting results from implemented integration interventions, highlighting an evidence gap on FGS integration into HIV/SRH and NTD programmes. Investments are needed to realise the potential of FGS integration to address the burden of this neglected disease and improve HIV and SRH outcomes for millions of women and girls at risk.
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Affiliation(s)
| | - Felicia Wong
- Independent Consultant, Frontline AIDS, Worthing, UK
| | | | | | - Julie Jacobson
- Managing Partner, Co-Founder, Bridges to Development, Seattle, WA, USA
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Ayob N, Burger RP, Belelie MD, Nkosi NC, Havenga H, de Necker L, Cilliers DP. Modelling the historical distribution of schistosomiasis-transmitting snails in South Africa using ecological niche models. PLoS One 2023; 18:e0295149. [PMID: 38033142 PMCID: PMC10688899 DOI: 10.1371/journal.pone.0295149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
Schistosomiasis is a vector-borne disease transmitted by freshwater snails and is prevalent in rural areas with poor sanitation and no access to tap water. Three snail species are known to transmit schistosomiasis in South Africa (SA), namely Biomphalaria pfeifferi, Bulinus globosus and Bulinus africanus. In 2003, a predicted prevalence of 70% was reported in tropical climates in SA. Temperature and rainfall variability can alter schistosomiasis-transmitting snails' development by increasing or decreasing their abundance and geographical distribution. This study aimed to map the historical distribution of schistosomiasis from 1950 to 2006 in SA. The snail sampling data were obtained from the historical National Snail Freshwater Collection (NFSC). Bioclimatic variables were extracted using ERA 5 reanalysis data provided by the Copernicus Climate Change Service. In this study, we used 19 bioclimatic and four soil variables. The temporal aggregation was the mean climatological period pre-calculated over the 40-year reference period with a spatial resolution of 0.5° x 0.5°. Multicollinearity was reduced by calculating the Variance Inflation Factor Core (VIF), and highly correlated variables (> 0.85) were excluded. To obtain an "ensemble" and avoid the integration of weak models, we averaged predictions using the True Skill Statistical (TSS) method. Results showed that the ensemble model achieved the highest Area Under the Curve (AUC) scores (0.99). For B. africanus, precipitation-related variables contributed to determining the suitability for schistosomiasis. Temperature and precipitation-related variables influenced the distribution of B. globosus in all three models. Biomphalaria pfeifferi showed that Temperature Seasonality (bio4) contributed the most (47%) in all three models. According to the models, suitable areas for transmitting schistosomiasis were in the eastern regions of South Africa. Temperature and rainfall can impact the transmission and distribution of schistosomiasis in SA. The results will enable us to develop future projections for Schistosoma in SA based on climate scenarios.
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Affiliation(s)
- Nisa Ayob
- Unit for Environmental Sciences and Management, North-West University, Mafikeng Campus, Mafikeng, South Africa
| | - Roelof P. Burger
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom Campus, Potchefstroom, South Africa
| | - Monray D. Belelie
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom Campus, Potchefstroom, South Africa
| | - Ncobile C. Nkosi
- Unit for Environmental Sciences and Management, North-West University, Mafikeng Campus, Mafikeng, South Africa
| | - Henno Havenga
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom Campus, Potchefstroom, South Africa
| | - Lizaan de Necker
- South African Institute for Aquatic Biodiversity (NRF-SAIAB), Makhanda, South Africa
- Water Research Group, Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - Dirk P. Cilliers
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom Campus, Potchefstroom, South Africa
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Sandema C, Daka V, Syapiila P, Tembo M, Sikalima J, Patel S, Mudenda S, Mfune RL, Mutanekelwa I, Zyambo C, Mwanakasale V. Prevalence and correlates of Schistosoma haematobium infections among school going-children aged 5 to 17 years in Kawama, Ndola, Zambia. Pan Afr Med J 2023; 45:170. [PMID: 37900207 PMCID: PMC10611913 DOI: 10.11604/pamj.2023.45.170.41193] [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: 07/25/2023] [Accepted: 08/17/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction schistosomiasis is a neglected tropical disease and remains a disease of public health concern. Despite its relative importance, paucity of information on schistosomiasis in urban settings such as Ndola remains. Here, we present findings on the prevalence and factors associated with Schistosoma haematobium (S. haematobium) infections among School-going children in the Kawama in Ndola district in Zambia, an urban area in the Copperbelt Province, Zambia. Methods we employed a cross-sectional study design among 354 school going-children between 5 and 17 years of age between November 2020 and February 2021. A Multivariate forward step-wise logistic regression model was used to determine the associations of risk factors. Adjusted odds ratios and 95% confidence intervals are reported. Results of the 354 school-going children included in the analysis, 13.3% had S. haematobium infection. Children who swam in the stream/dam were more likely to have S. haematobium infection as compared to those who did not (aOR 6.531, 95% CI: 2.90-14.69). Conclusion S. haematobium infection is endemic among school-going children in an urban setup of the Kawama area of Ndola City, Zambia. There is a need for targeted interventions to mitigate infections among this population.
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Affiliation(s)
- Chileshe Sandema
- Copperbelt University, Michael Chilufya School of Medicine, Public Health Department, P.O Box 71191, Ndola, Zambia
| | - Victor Daka
- Copperbelt University, Michael Chilufya School of Medicine, Public Health Department, P.O Box 71191, Ndola, Zambia
| | - Paul Syapiila
- Copperbelt University, Michael Chilufya School of Medicine, Public Health Department, P.O Box 71191, Ndola, Zambia
| | - Mathias Tembo
- Tropical Diseases Research Centre, Biomedical Sciences Department, P.O Box 71769, Ndola, Zambia
| | - Jay Sikalima
- Tropical Diseases Research Centre, Biomedical Sciences Department, P.O Box 71769, Ndola, Zambia
- Churches Health Association of Zambia, Molecular Laboratory Department, P.O.BOX 34511, Lusaka, Zambia
| | - Shivangi Patel
- Copperbelt University, Michael Chilufya School of Medicine, Public Health Department, P.O Box 71191, Ndola, Zambia
| | - Steward Mudenda
- University of Zambia, School of Health Sciences, Department of Pharmacy, P.O Box 50110, Lusaka, Zambia
| | - Ruth Lindizyani Mfune
- Copperbelt University, Michael Chilufya School of Medicine, Public Health Department, P.O Box 71191, Ndola, Zambia
| | - Imukusi Mutanekelwa
- Copperbelt University, Michael Chilufya School of Medicine, Public Health Department, P.O Box 71191, Ndola, Zambia
| | - Cosmas Zyambo
- University of Zambia, School of Public Health, Department of Community and Family Medicine, P.O. Box 50110, Lusaka, Zambia
| | - Victor Mwanakasale
- Copperbelt University, Michael Chilufya Sata School of Medicine, Basic Sciences Department, P.O Box 71191, Ndola, Zambia
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Abaasa A, Egesa M, Driciru E, Koopman JPR, Kiyemba R, Sanya RE, Nassuuna J, Ssali A, Kimbugwe G, Wajja A, van Dam GJ, Corstjens PLAM, Cose S, Seeley J, Kamuya D, Webb EL, Yazdanbakhsh M, Kaleebu P, Siddiqui AA, Kabatereine N, Tukahebwa E, Roestenberg M, Elliott AM. Establishing a single-sex controlled human Schistosoma mansoni infection model for Uganda: protocol for safety and dose-finding trial. IMMUNOTHERAPY ADVANCES 2023; 3:ltad010. [PMID: 37538934 PMCID: PMC10396375 DOI: 10.1093/immadv/ltad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Control of schistosomiasis depends on a single drug, praziquantel, with variable cure rates, high reinfection rates, and risk of drug resistance. A vaccine could transform schistosomiasis control. Preclinical data show that vaccine development is possible, but conventional vaccine efficacy trials require high incidence, long-term follow-up, and large sample size. Controlled human infection studies (CHI) can provide early efficacy data, allowing the selection of optimal candidates for further trials. A Schistosoma CHI has been established in the Netherlands but responses to infection and vaccines differ in target populations in endemic countries. We aim to develop a CHI for Schistosoma mansoni in Uganda to test candidate vaccines in an endemic setting. This is an open-label, dose-escalation trial in two populations: minimal, or intense, prior Schistosoma exposure. In each population, participants will be enrolled in sequential dose-escalating groups. Initially, three volunteers will be exposed to 10 cercariae. If all show infection, seven more will be exposed to the same dose. If not, three volunteers in subsequent groups will be exposed to higher doses (20 or 30 cercariae) following the same algorithm, until all 10 volunteers receiving a particular dose become infected, at which point the study will be stopped for that population. Volunteers will be followed weekly after infection until CAA positivity or to 12 weeks. Once positive, they will be treated with praziquantel and followed for one year. The trial registry number is ISRCTN14033813 and all approvals have been obtained. The trial will be subjected to monitoring, inspection, and/or audits.
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Affiliation(s)
- Andrew Abaasa
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | - Moses Egesa
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Richard E Sanya
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- African Population and Health Research Center, Nairobi, Kenya
| | | | - Agnes Ssali
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Anne Wajja
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | | | | | - Stephen Cose
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | - Janet Seeley
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | - Dorcas Kamuya
- Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
| | - Emily L Webb
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Pontiano Kaleebu
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | - Alison M Elliott
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene & Tropical Medicine, London, UK
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Okoro OJ, Deme GG, Okoye CO, Eze SC, Odii EC, Gbadegesin JT, Okeke ES, Oyejobi GK, Nyaruaba R, Ebido CC. Understanding key vectors and vector-borne diseases associated with freshwater ecosystem across Africa: Implications for public health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 862:160732. [PMID: 36509277 DOI: 10.1016/j.scitotenv.2022.160732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
The emerging and re-emerging vector-borne diseases transmitted by key freshwater organisms have remained a global concern. As one of the leading biodiversity hotspots, the African ecoregion is suggested to harbour the highest number of freshwater organisms globally. Among the commonly found organisms in the African ecoregion are mosquitoes and snails, with a majority of their life cycle in freshwater, and these freshwater organisms can transmit diseases or serve as carriers of devastating diseases of public health concerns. However, synthetic studies to link the evident abundant presence and wide distribution of these vectors across the freshwater ecosystems in Africa with the increasing emerging and re-emerging vector-borne diseases in Africa are still limited. Here, we reviewed documented evidence on vector-borne diseases and their transmission pathways in Africa to reduce the knowledge gap on the factors influencing the increasing emerging and re-emerging vector-borne diseases across Africa. We found the population distributions or abundance of these freshwater organisms to be increasing, which is directly associated with the increasing emerging and re-emerging vector-borne diseases across Africa. Furthermore, we found that although the current changing environmental conditions in Africa affect the habitats of these freshwater organisms, current changing environmental conditions may not be suppressing the population distributions or abundance of these freshwater organisms. Instead, we found that these freshwater organisms are extending their geographic ranges across Africa, which may have significant public health implications in Africa. Thus, our study demonstrates the need for future studies to integrate the environmental conditions of vectors' habitats to understand if these environmental conditions directly or indirectly influence the vectorial capacities and transmission abilities of vectors of diseases. We propose that such studies will be necessary to guide policymakers in making informed policies to help control vector-borne diseases.
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Affiliation(s)
- Onyekwere Joseph Okoro
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya
| | - Gideon Gywa Deme
- Department of Biology, Case Western Reserve University, Cleveland, OH 44106, USA; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya.
| | - Charles Obinwanne Okoye
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria; Biofuels Institute, School of Environment and Safety Engineering, Jiangsu University, Zhenjiang 212013, China; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya
| | - Sabina Chioma Eze
- Department of Biological Sciences, Faculty of Science, Federal University of Health Sciences, Otukpo 972221, Benue State, Nigeria; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya
| | - Elijah Chibueze Odii
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya
| | - Janet Temitope Gbadegesin
- School of Public Health, University of the Western Cape, South Africa; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya
| | - Emmanuel Sunday Okeke
- Department of Biochemistry, Faculty of Biological Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria; Natural Science Unit, School of General Studies, University of Nigeria, Nsukka 410001, Enugu State, Nigeria; Institute of Environmental Health and Ecological Security, School of Environment and Safety Engineering, Jiangsu University, Zhenjiang 212013, China; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya
| | - Greater Kayode Oyejobi
- Key Laboratory of Special Pathogens and Biosafety, Centre for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, Hubei, China; Department of Microbiology, Faculty of Basic and Applied Sciences, Osun State University, Osogbo 230212, Osun State, Nigeria; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya; School of Pharmaceutical Sciences, Wuhan University, Hubei, P.R. China. 430072
| | - Raphael Nyaruaba
- Key Laboratory of Special Pathogens and Biosafety, Centre for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, Hubei, China; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya
| | - Chike Chukwuenyem Ebido
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria; Organization of African Academic Doctors (OAAD), P.O. Box 14833-00100, Langata, Nairobi, Kenya.
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Bender Ignacio RA, Dasgupta S, Valdez R, Pandey U, Pasalar S, Alfaro R, Hladik F, Gornalusse G, Lama JR, Duerr A. Dynamic immune markers predict HIV acquisition and augment associations with sociobehavioral factors for HIV exposure. iScience 2022; 25:105632. [PMID: 36483014 PMCID: PMC9722478 DOI: 10.1016/j.isci.2022.105632] [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: 05/26/2022] [Revised: 10/21/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022] Open
Abstract
Prior studies attempting to link biomarkers of immune activation with risk of acquiring HIV have relied on cross sectional samples, most without proximity to HIV acquisition. We created a nested case-control study within the Sabes study in Peru, and assessed a panel of plasma immune biomarkers at enrollment and longitudinally, including within a month of diagnosis of primary HIV or matched timepoint in controls. We used machine learning to select biomarkers and sociobehavioral covariates predictive of HIV acquisition. Most biomarkers were indistinguishable between cases and controls one month before HIV diagnosis. However, levels differed between cases and controls at study entry, months to years earlier. Dynamic changes in IL-2, IL-7, IL-10, IP-10 and IL-12, rather than absolute levels, jointly predicted HIV risk when added to traditional risk factors, and there was modest effect modification of biomarkers on association between sociobehavioral risk factors and HIV acquisition.
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Affiliation(s)
- Rachel A. Bender Ignacio
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98104, USA,Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA,Department of Global Health, University of Washington, Seattle, WA 98195, USA,Corresponding author
| | - Sayan Dasgupta
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Rogelio Valdez
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Urvashi Pandey
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Siavash Pasalar
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Ricardo Alfaro
- Centro de Investigaciones Tecnológicas Biomédicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Bellavista, Lima 07006, Peru
| | - Florian Hladik
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA,Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Germán Gornalusse
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
| | - Javier R. Lama
- Asociación Civil Impacta Salud y Educación, Lima 15063, Peru,Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Ann Duerr
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA,Department of Global Health, University of Washington, Seattle, WA 98195, USA
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10
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Nemungadi TG, Furumele TE, Gugerty MK, Djirmay AG, Naidoo S, Kjetland EF. Establishing and Integrating a Female Genital Schistosomiasis Control Programme into the Existing Health Care System. Trop Med Infect Dis 2022; 7:tropicalmed7110382. [PMID: 36422933 PMCID: PMC9696272 DOI: 10.3390/tropicalmed7110382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/02/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022] Open
Abstract
Female genital schistosomiasis (FGS) is a complication of Schistosoma haematobium infection, and imposes a health burden whose magnitude is not fully explored. It is estimated that up to 56 million women in sub-Saharan Africa have FGS, and almost 20 million more cases will occur in the next decade unless infected girls are treated. Schistosomiasis is reported throughout the year in South Africa in areas known to be endemic, but there is no control programme. We analyze five actions for both a better understanding of the burden of FGS and reducing its prevalence in Africa, namely: (1) schistosomiasis prevention by establishing a formal control programme and increasing access to treatment, (2) introducing FGS screening, (3) providing knowledge to health care workers and communities, (4) vector control, and (5) water, sanitation, and hygiene. Schistosomiasis is focal in South Africa, with most localities moderately affected (prevalence between 10% and 50%), and some pockets that are high risk (more than 50% prevalence). However, in order to progress towards elimination, the five actions are yet to be implemented in addition to the current (and only) control strategy of case-by-case treatment. The main challenge that South Africa faces is a lack of access to WHO-accredited donated medication for mass drug administration. The establishment of a formal and funded programme would address these issues and begin the implementation of the recommended actions.
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Affiliation(s)
- Takalani Girly Nemungadi
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Communicable Disease Control Directorate, National Department of Health, Pretoria 0001, South Africa
- Correspondence:
| | - Tsakani Ernica Furumele
- Communicable Disease Control Directorate, National Department of Health, Pretoria 0001, South Africa
| | - Mary Kay Gugerty
- Evans School of Public Policy & Governance, University of Washington, Seattle, WA 98195-3055, USA
| | - Amadou Garba Djirmay
- Department of the Control of Neglected Tropical Diseases, World Health Organization, 1211 Geneva, Switzerland
| | - Saloshni Naidoo
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Eyrun Flörecke Kjetland
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, 0424 Oslo, Norway
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11
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Prevalence of Intestinal Parasites in HIV/AIDS-Infected Patients Attending Clinics in Selected Areas of the Eastern Cape. MICROBIOLOGY RESEARCH 2022. [DOI: 10.3390/microbiolres13030040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Intestinal parasites in HIV and AIDS patients increase the risk of gastroenteritis, adding to the complexity of the virus. According to the literature, their interactions are one of the factors leading to HIV replication and progression of AIDS in Africa. Chronic immunosuppression caused by HIV infection makes people vulnerable to parasitic infections, and this is associated with a CD4+ cell count of less than 100. The study describes the prevalence of intestinal parasites in patients attending HIV/AIDS clinics in certain areas of the Eastern Cape. Methods: A cross-sectional study was conducted among 600 patients from HIV/AIDS clinics in the Eastern Cape. Tambo Municipality and Amatole Municipality were the municipalities covered. These included the Ngangalizwe Community Clinic, Tsolo Gateway Clinic, Idutywa Health Centre, and Nqamakwe Health Centre. The stools of 600 participants were examined using direct wet saline/iodine embedding, formal ether concentration technique, and modified Ziehl–Neelsen methods. Results: The mean age of the study participants was 28.2 years. They were predominantly female (79.9%), mostly single (63.6%), and lived in rural (65.2%) and urban areas (34.8%). The prevalence of intestinal parasites was determined to be 30% (180/600) after screening 600 stool samples. The most frequently detected parasites were Ascaris lumbricoides (55.9%), Balantidium coli (15.1%), Entamoeba coli (11.3%), Diphyllobothrium latum (4.3%), Taenia species (3.8%), Schistosoma mansoni (1.6%), and Cryptosporidium spp. (1.6%). Males were affected more frequently (39.2%) than females (27.9%). The difference was statistically significant (p = 0.017). Among the identified intestinal parasites, A. lumbricoides, B. coli, and Taenia spp. were found at all four sites. Conclusion: This study has shed light on the high burden of intestinal parasites in HIV/AIDS patients in the Eastern Cape. Medication adherence, deworming, and sanitary hygiene practices are needed to enhance the control of infection in the affected communities and hence contribute to the control of the HIV pandemic.
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12
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Comparative mitogenomics of freshwater snails of the genus Bulinus, obligatory vectors of Schistosoma haematobium, causative agent of human urogenital schistosomiasis. Sci Rep 2022; 12:5357. [PMID: 35354876 PMCID: PMC8967911 DOI: 10.1038/s41598-022-09305-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/10/2022] [Indexed: 02/05/2023] Open
Abstract
AbstractAmong the snail genera most responsible for vectoring human-infecting schistosomes, Bulinus, Biomphalaria, and Oncomelania, the former is in many respects the most important. Bulinid snails host the most common human blood fluke, Schistosoma haematobium, responsible for approximately two-thirds of the estimated 237 million cases of schistosomiasis. They also support transmission of schistosomes to millions of domestic and wild animals. Nonetheless, our basic knowledge of the 37 Bulinus species remains incomplete, especially with respect to genome information, even including mitogenome sequences. We determined complete mitogenome sequences for Bulinus truncatus, B. nasutus, and B. ugandae, and three representatives of B. globosus from eastern, central, and western Kenya. A difference of the location of tRNA-Asp was found between mitogenomes from the three species of the Bulinus africanus group and B. truncatus. Phylogenetic analysis using partial cox1 sequences suggests that B. globosus is a complex comprised of multiple species. We also highlight the status of B. ugandae as a distinct species with unusual interactions with the S. haematobium group parasites deserving of additional investigation. We provide sequence data for potential development of genetic markers for specific or intraspecific Bulinus studies, help elucidate the relationships among Bulinus species, and suggest ways in which mitogenomes may help understand the complex interactions between Schistosoma and Bulinus snails and their relatives.
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13
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Duah E, Kenu E, Adela EM, Halm HA, Agoni C, Kumi RO. Assessment of urogenital schistosomiasis among basic school children in selected communities along major rivers in the central region of Ghana. Pan Afr Med J 2021; 40:96. [PMID: 34909084 PMCID: PMC8607954 DOI: 10.11604/pamj.2021.40.96.26708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 07/28/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction urogenital schistosomiasis affects school-aged children with impacts on health, growth, and cognitive development. Basic schools along active water bodies have a possibility of a high infection among the children. Methods we performed a school-based cross-sectional assessment of urogenital schistosomiasis among children in four selected rural communities along major rivers in the central region of Ghana. Three hundred and nine (309) basic school children class 1 to junior high school (JHS) 3 were recruited. Sociodemographic data and information on behavioral influences were collected with a structured written questionnaire. Laboratory examinations were conducted on fresh urine samples. Descriptive statistics and cross-tabulations with measures of association between variables, adjusted and unadjusted logistic regression analysis were performed on measured variables. Results we recorded a 10.4% prevalence of urogenital schistosomiasis. Schools in communities along the Kakum river recorded the highest disease burden (65.6%). The odds of infection among pupils who engage in irrigation activities were 4 folds more than those who do not engage in irrigation activities (adjusted odds ratio (aOR) (95%CI): 4.3 (1.6-12.1), P-value=0.005). Pupils of caregivers who resort to self-medication using local herbal concoctions had 14-fold more odds of infection compared to those who visit the health facility (aOR (95%CI): 14.4 (1.4-143.1), P-value=0.006). Conclusion poor health-seeking behaviors and lack of access to health facilities influenced the disease proportion among the children in these endemic communities.
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Affiliation(s)
- Evans Duah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.,Clinical Laboratory, Cape Coast Teaching Hospital, Cape Coast, Ghana.,Dream Laboratory Consult Limited, Cape Coast, Ghana
| | - Ernest Kenu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
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14
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Rinaldo D, Perez-Saez J, Vounatsou P, Utzinger J, Arcand JL. The economic impact of schistosomiasis. Infect Dis Poverty 2021; 10:134. [PMID: 34895355 PMCID: PMC8667389 DOI: 10.1186/s40249-021-00919-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The economic impact of schistosomiasis and the underlying tradeoffs between water resources development and public health concerns have yet to be quantified. Schistosomiasis exerts large health, social and financial burdens on infected individuals and households. While irrigation schemes are one of the most important policy responses designed to reduce poverty, particularly in sub-Saharan Africa, they facilitate the propagation of schistosomiasis and other diseases. METHODS We estimate the economic impact of schistosomiasis in Burkina Faso via its effect on agricultural production. We create an original dataset that combines detailed household and agricultural surveys with high-resolution geo-statistical disease maps. We develop new methods that use the densities of the intermediate host snails of schistosomiasis as instrumental variables together with panel, spatial and machine learning techniques. RESULTS We estimate that the elimination of schistosomiasis in Burkina Faso would increase average crop yields by around 7%, rising to 32% for high infection clusters. Keeping schistosomiasis unchecked, in turn, would correspond to a loss of gross domestic product of approximately 0.8%. We identify the disease burden as a shock to the agricultural productivity of farmers. The poorest households engaged in subsistence agriculture bear a far heavier disease burden than their wealthier counterparts, experiencing an average yield loss due to schistosomiasis of between 32 and 45%. We show that the returns to water resources development are substantially reduced once its health effects are taken into account: villages in proximity of large-scale dams suffer an average yield loss of around 20%, and this burden decreases as distance between dams and villages increases. CONCLUSIONS This study provides a rigorous estimation of how schistosomiasis affects agricultural production and how it is both a driver and a consequence of poverty. It further quantifies the tradeoff between the economics of water infrastructures and their impact on public health. Although we focus on Burkina Faso, our approach can be applied to any country in which schistosomiasis is endemic.
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Affiliation(s)
- Daniele Rinaldo
- Department of Economics and Land, Environment, Economics and Policy Institute (LEEP), University of Exeter, Exeter, England.
| | - Javier Perez-Saez
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jean-Louis Arcand
- Department of International Economics, The Graduate Institute of International and Development Studies, Geneva, Switzerland.,Fondation pour les études et recherches sur le développement international (FERDI), Clermont-Ferrand, France
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15
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Ademe M, Girma F. The Influence of Helminth Immune Regulation on COVID-19 Clinical Outcomes: Is it Beneficial or Detrimental? Infect Drug Resist 2021; 14:4421-4426. [PMID: 34737582 PMCID: PMC8558425 DOI: 10.2147/idr.s335447] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/19/2021] [Indexed: 12/28/2022] Open
Abstract
Immunologically, chronic worm infections prevent themselves from strong immune responses by skewing the host response towards a T helper 2 (Th2) type. The regulatory response initiated by helminth infections is supposed to temper responses to non-helminth antigens including viral infections which will, in turn, alter the clinical outcomes of infections. In view of this, recent reports highlighted the possible negative associations of severe COVID-19 and helminth co-infections in helminth-endemic regions. As the pathology of COVID-19 is primarily mediated by an excessive immune response and subsequent cytokine storm, which contributes to the poor prognosis of COVID-19, helminth-driven immune modulation will hypothetically contribute to the less severe outcomes of COVID-19. Nevertheless, emerging reports also stated that COVID-19 and helminth co-infections may have more hidden outcomes than predictable ones. Herein, the current knowledge on the interaction of COVID-19 and helminth co-infections will be discussed.
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Affiliation(s)
- Muluneh Ademe
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Friehiwot Girma
- Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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16
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De Boni L, Msimang V, De Voux A, Frean J. Trends in the prevalence of microscopically-confirmed schistosomiasis in the South African public health sector, 2011-2018. PLoS Negl Trop Dis 2021; 15:e0009669. [PMID: 34529659 PMCID: PMC8445405 DOI: 10.1371/journal.pntd.0009669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background Schistosomiasis, also known as bilharzia, is a chronic parasitic blood fluke infection acquired through contact with contaminated surface water. The illness may be mild or can cause significant morbidity with potentially serious complications. Children and those living in rural areas with limited access to piped water and services for healthcare are the most commonly infected. To address the prevalence of the disease in parts of South Africa (SA) effective national control measures are planned, but have not yet been implemented. This study aimed to estimate the prevalence and trends of public sector laboratory-confirmed schistosomiasis cases in SA over an eight-year (2011–2018) period, to inform future control measures. Methodology & principal findings This is a descriptive analysis of secondary data from the National Health Laboratory Service (NHLS). The study included all records of patients for whom microscopic examination detected Schistosoma species eggs in urine or stool specimens from January 2011 to December 2018. Crude estimates of the prevalence were calculated using national census mid-year provincial population estimates as denominators, and simple linear regression was used to analyse prevalence trends. A test rate ratio was developed to describe variations in testing volumes among different groups and to adjust prevalence estimates for testing variations. A total number of 135 627 schistosomiasis cases was analysed with the highest prevalence observed among males and individuals aged 5–19 years. We describe ongoing endemicity in the Eastern Cape Province, and indicate important differences in the testing between population groups. Conclusion While there was no overall change in the prevalence of schistosomiasis during the analysis period, an average of 36 people per 100 000 was infected annually. As such, this represents an opportunity to control the disease and improve quality of life of affected people. Laboratory-based surveillance is a useful method for reporting occurrence and evaluating future intervention programs where resources to implement active surveillance are limited. This is the first paper to describe the prevalence of human schistosomiasis in South Africa using nationally representative data. The prevalence remained consistent during the eight-year period, independent of increasing annual testing volumes. Groups with the highest burden included males and individuals aged 5–19 years. The schistosomiasis-endemic provinces of Limpopo, Mpumalanga and KwaZulu-Natal emerged as the highest-burdened areas, and ongoing endemicity in Eastern Cape Province was demonstrated. Western Cape Province likely reported cases imported from endemic provinces rather than being acquired by local transmission. In summary, schistosomiasis remains an important public health problem in South Africa that needs long-term sustainable, effective standardised interventions to reduce the burden. Passive laboratory-based surveillance is a practical tool for reporting prevalence, and could be used to monitor and evaluate future intervention programs.
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Affiliation(s)
- Liesl De Boni
- South African Field Epidemiology Training Programme, Johannesburg, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Veerle Msimang
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - Alex De Voux
- South African Field Epidemiology Training Programme, Johannesburg, South Africa
| | - John Frean
- University of the Witwatersrand, Johannesburg, South Africa
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
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17
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Pulmonary Vascular Diseases Associated with Infectious Disease-Schistosomiasis and Human Immunodeficiency Viruses. Clin Chest Med 2021; 42:71-80. [PMID: 33541618 DOI: 10.1016/j.ccm.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A wide variety of infectious diseases are major contributors to the causation of pulmonary vascular disease and, consequently, pulmonary hypertension, especially in the developing world. Schistosomiasis and human immunodeficiency virus are the most common infections that are known to contribute to pulmonary hypertension worldwide. The resultant inflammation and immunologic milieu caused by infection are the main pathologic processes affecting the pulmonary vasculature.
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18
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Aula OP, McManus DP, Jones MK, Gordon CA. Schistosomiasis with a Focus on Africa. Trop Med Infect Dis 2021; 6:109. [PMID: 34206495 PMCID: PMC8293433 DOI: 10.3390/tropicalmed6030109] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022] Open
Abstract
Schistosomiasis is a common neglected tropical disease of impoverished people and livestock in many developing countries in tropical Africa, the Middle East, Asia, and Latin America. Substantial progress has been made in controlling schistosomiasis in some African countries, but the disease still prevails in most parts of sub-Saharan Africa with an estimated 800 million people at risk of infection. Current control strategies rely primarily on treatment with praziquantel, as no vaccine is available; however, treatment alone does not prevent reinfection. There has been emphasis on the use of integrated approaches in the control and elimination of the disease in recent years with the development of health infrastructure and health education. However, there is a need to evaluate the present status of African schistosomiasis, primarily caused by Schistosoma mansoni and S. haematobium, and the factors affecting the disease as the basis for developing more effective control and elimination strategies in the future. This review provides an historical perspective of schistosomiasis in Africa and discusses the current status of control efforts in those countries where the disease is endemic.
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Affiliation(s)
- Oyime Poise Aula
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia;
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Donald P. McManus
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia;
| | - Malcolm K. Jones
- School of Veterinary Sciences, University of Queensland, Gatton 4343, Australia;
| | - Catherine A. Gordon
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia;
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19
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Wright CY, Kapwata T, du Preez DJ, Wernecke B, Garland RM, Nkosi V, Landman WA, Dyson L, Norval M. Major climate change-induced risks to human health in South Africa. ENVIRONMENTAL RESEARCH 2021; 196:110973. [PMID: 33684412 DOI: 10.1016/j.envres.2021.110973] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
There are many climatic changes facing South Africa which already have, or are projected to have, a detrimental impact on human health. Here the risks to health due to several alterations in the climate of South Africa are considered in turn. These include an increase in ambient temperature, causing, for example, a significant rise in morbidity and mortality; heavy rainfall leading to changes in the prevalence and occurrence of vector-borne diseases; drought-associated malnutrition; and exposure to dust storms and air pollution leading to the potential exacerbation of respiratory diseases. Existing initiatives and strategies to prevent or reduce these adverse health impacts are outlined, together with suggestions of what might be required in the future to safeguard the health of the nation. Potential roles for the health and non-health sectors as well as preparedness and capacity development with respect to climate change and health adaptation are considered.
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Affiliation(s)
- Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0001, South Africa; Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa.
| | - Thandi Kapwata
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2094, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2094, South Africa
| | - David Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; Laboratoire de l'Atmosphère et des Cyclones (UMR 8105 CNRS, Université de La Réunion, Météo France), 97744, Saint-Denis de La Réunion, France
| | - Bianca Wernecke
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2094, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2094, South Africa
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; Climate and Air Quality Modelling Research Group, Council for Scientific and Industrial Research, Pretoria, 0001, South Africa; Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2531, South Africa
| | - Vusumuzi Nkosi
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2094, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, 2094, South Africa; School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa
| | - Willem A Landman
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa; International Research Institute for Climate and Society, The Earth Institute of Columbia University, New York, NY, 10964, USA
| | - Liesl Dyson
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, 0001, South Africa
| | - Mary Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK
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20
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Banze L, Madureira AC, Zacarias BC, Nhacupe N, Mascaro-Lazcano C, Benson CA, Schooley RT, Noormahomed EV. Coinfection of HIV-1 with Schistosoma spp. and with Intestinal Parasites in Patients Attending Boane Health Center, Maputo Province, Mozambique. EC MICROBIOLOGY 2021; 17:3-16. [PMID: 36649459 PMCID: PMC9836084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background It is hypothesized that schistosomiasis and intestinal parasites increase susceptibility to HIV-1 infection and enhance AIDS progression by immunomodulation. This study aims to compare the prevalence and risk factors for schistosomiasis and intestinal parasites in HIV-1 infected and uninfected persons and to evaluate the association between HIV-1 induced immunosuppression and risk factors for parasite infection. Methods This was a cross-sectional study conducted at Boane Health Center in Boane village, Maputo Province from April to June 2017 in 280 patients aged over 5 years. From each of 140 HIV-1 infected or 140 HIV-1 uninfected persons, demographic and clinical data were collected as well as one stool and urine sample for parasitological analysis. All stool samples were processed using direct wet mount and Ritchie method for detection of common parasites, and modified Ziehl-Neelsen staining techniques to identify Cryptosporidium spp., Cystoisospora belli and Cyclospora spp. oocysts from children stools. The urine was sedimented and analyzed for S. haematobium eggs detection. Results The overall prevalence of parasitism in the study population was 46.8% (131/280). Fifty six percent of the HIV-1 infected persons (78/140) were infected by at least one parasite compared to 38% (53/140 of the HIV-1 uninfected persons (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.2-3.3).Further, HIV-1 infected persons were more likely to be infected by S. mansoni (OR 5.6, 95% CI 1.8-15.8) when compared to HIV-1 uninfected person and HIV-1 infected women were more likely to be infected by S. mansoni (OR 6.7 CI 95% 1.8-22.8%) when compared to HIV-1 uninfected women (p< 0.001). HIV-1 serostatus (OR 7.0, 95% CI 1.5-31.2). Multivariate logistic regression revealed that HIV-1 infected status (OR=1.813575), the use of river or lake as water sources either for drinking (OR=7.289245) or domestic chores (OR=9.16205) were significant risk factor for parasitic infection. Partcipants with secondary and higher school (OR=0.379) were less likely to have a parasitic infection compared with primary school or illiterate participants. Conclusions It is possible that the a high prevalence of schistosomiais and intestinal parasites in this region plays an important role on the transmission and pathogenesis of HIV.
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Affiliation(s)
- Lucas Banze
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
| | | | - Borges Cerveja Zacarias
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
| | - Noémia Nhacupe
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
| | | | - Constance A Benson
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, USA
| | - Robert T Schooley
- Department of Medicine, Infectious Diseases Division, University of California, San Diego, USA
| | - Emilia Virginia Noormahomed
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
- Department of Medicine, Infectious Diseases Division, University of California, San Diego, USA
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21
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McInally S, Wall K, Yu T, Tirouvanziam R, Kilembe W, Gilmour J, Allen SA, Hunter E. Elevated levels of inflammatory plasma biomarkers are associated with risk of HIV infection. Retrovirology 2021; 18:8. [PMID: 33731158 PMCID: PMC7968240 DOI: 10.1186/s12977-021-00552-6] [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: 12/21/2020] [Accepted: 03/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine if individuals, from HIV-1 serodiscordant couple cohorts from Rwanda and Zambia, who become HIV-positive have a distinct inflammatory biomarker profile compared to individuals who remain HIV-negative, we compared levels of biomarkers in plasma of HIV-negative individuals who either seroconverted (pre-infection) and became HIV-positive or remained HIV-negative (uninfected). RESULTS We observed that individuals in the combined cohort, as well as those in the individual country cohorts, who later became HIV-1 infected had significantly higher baseline levels of multiple inflammatory cytokines/chemokines compared to individuals who remained HIV-negative. Genital inflammation/ulceration or schistosome infections were not associated with this elevated profile. Defined levels of ITAC and IL-7 were significant predictors of later HIV acquisition in ROC predictive analyses, whereas the classical Th1 and Th2 inflammatory cytokines such as IL-12 and interferon-γ or IL-4, IL-5 and Il-13 were not. CONCLUSIONS Overall, the data show a significant association between increased plasma biomarkers linked to inflammation and immune activation and HIV acquisition and suggests that pre-existing conditions that increase systemic biomarkers represent a factor for increased risk of HIV infection.
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Affiliation(s)
- Samantha McInally
- Emory Vaccine Center at Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Kristin Wall
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tianwei Yu
- School of Data Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen, Guangdong Province, China
| | - Rabindra Tirouvanziam
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Center of CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | | | - Jill Gilmour
- Faculty of Medicine, Imperial College, London, SW7 2AZ, UK
| | - Susan A Allen
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Eric Hunter
- Emory Vaccine Center at Yerkes National Primate Research Center, Atlanta, GA, USA. .,Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
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22
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Xie S, Shalaby-Rana E, Hester A, Honeycutt J, Fu CL, Boyett D, Jiang W, Hsieh MH. Macroscopic and microscopic imaging modalities for diagnosis and monitoring of urogenital schistosomiasis. ADVANCES IN PARASITOLOGY 2021; 112:51-76. [PMID: 34024359 DOI: 10.1016/bs.apar.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Urogenital schistosomiasis remains a major global challenge. Optimal management of this infection depends upon imaging-based assessment of sequelae. Although established imaging modalities such as ultrasonography, plain radiography, magnetic resonance imaging (MRI), narrow band imaging, and computerized tomography (CT) have been used to determine tissue involvement by urogenital schistosomiasis, newer refinements in associated technologies may lead to improvements in patient care. Moreover, application of investigational imaging methods such as confocal laser endomicroscopy and two-photon microscopy in animal models of urogenital schistosomiasis are likely to contribute to our understanding of this infection's pathogenesis. This review discusses prior use of imaging in patients with urogenital schistosomiasis and experimentally infected animals, the advantages and limitations of these modalities, the latest radiologic developments relevant to this infection, and a proposed future diagnostic standard of care for management of afflicted patients.
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Affiliation(s)
- Shelly Xie
- Division of Urology, Children's National Hospital, Washington, DC, United States
| | - Eglal Shalaby-Rana
- Diagnostic Imaging and Radiology, Children's National Hospital, Washington, DC, United States
| | - Austin Hester
- Division of Urology, Children's National Hospital, Washington, DC, United States
| | - Jared Honeycutt
- Department of Microbiology and Immunology, Stanford University, Stanford, CA, United States
| | | | - Deborah Boyett
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, United States
| | - Wen Jiang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Michael H Hsieh
- Division of Urology, Children's National Hospital, Washington, DC, United States.
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23
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Opara KN, Akomalafe RT, Udoidung NI, Afia UU, Yaro CA, Bassey BE. Urogenital Schistosomiasis among Primary School Children in Rural Communities in Obudu, Southern Nigeria. Int J MCH AIDS 2021; 10:70-80. [PMID: 33614224 PMCID: PMC7873395 DOI: 10.21106/ijma.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Schistosomiasis is a Neglected Tropical Disease (NTD) that constitutes a public health problem in Sub-Saharan Africa (SSA), including Nigeria. There is need for updated information on the extent of the disease burden at community level to facilitate effective prioritization and monitoring of the disease. METHODS A cross-sectional study was conducted among school-aged children in Obudu Local Government Area (LGA), one of the 18 LGAs in Cross River State, Southern Nigeria. Seven schools from seven communities were randomly selected for this study. A total of 1,113 urine samples obtained from school-aged children were screened for Schistosoma haematobium (S. haematobium) eggs using standard parasitological method of diagnosis. Proteinuria and hematuria were evaluated using reagent test strips. RESULTS In this study, 153 (13.7%) children were infected with S. haematobium. More males (86 or 14.7%) were infected than females (67 or 12.7%); the differences were not statistically significant. The overall geometric mean intensity of infection was 13.3 eggs/10ml of urine. Females (13.69 eggs/10ml of urine) had the highest intensity of infection than males (12.91eggs/10ml of urine). Prevalence of hematuria was 152 (13.7%) (95% C.I. = 10.649 - 18.751%) while the prevalence of proteinuria was 172 (15.5%) (95% C.I. = 5.162 - 38.712%). Prevalence of infection significantly (p<0.001) varied among the schools from 7.8% to 28.9%. Children aged 5-9 years old had the highest prevalence of infection 46 (17.1%). The prevalence of urogenital schistosomiasis was 28.9%, 20.5% and 13.2%, respectively, among Betukwel, Ibong, and Ohong communities. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS Urinary schistosomiasis is still endemic in Obudu, Southern Nigeria but with decreased prevalence. Public health mitigation efforts such as mass chemotherapy, provision of safe water supply and sanitation facilities are recommended. Furthermore, health education should be encouraged within schools and communities.
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Affiliation(s)
- Kenneth N. Opara
- Department of Animal and Environmental Biology, Faculty of Science, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Rebecca T. Akomalafe
- Department of Animal and Environmental Biology, Faculty of Science, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Nsima I. Udoidung
- Department of Animal and Environmental Biology, Faculty of Science, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Udeme U. Afia
- Department of Animal and Environmental Biology, Faculty of Science, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Clement A. Yaro
- Department of Animal and Environmental Biology, Faculty of Science, University of Uyo, Uyo, Akwa Ibom State, Nigeria
- Department of Zoology, Faculty of Life Science, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Bassey E. Bassey
- Department of Animal and Environmental Biology, Faculty of Science, University of Uyo, Uyo, Akwa Ibom State, Nigeria
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Mehta SD, Okal D, Otieno F, Green SJ, Nordgren RK, Huibner S, Bailey RC, Bhaumik DK, Landay A, Kaul R. Schistosomiasis is associated with rectal mucosal inflammation among Kenyan men who have sex with men. Int J STD AIDS 2021; 32:694-703. [PMID: 33533314 DOI: 10.1177/0956462420985973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Schistosoma mansoni infection is hyperendemic in Lake Victoria communities and associated with cervicovaginal immune alterations and HIV acquisition. We assessed the hypothesis that schistosomiasis correlates with greater rectal inflammation in men who have sex with men (MSM) in Kisumu, Kenya. Methods: In this cross-sectional study of 38 HIV-negative MSM aged 18-35 years, schistosomiasis was diagnosed by urine circulating cathodic antigen (CCA). Microbiome was assessed in rectal swabs by 16S rRNA gene amplicon sequencing, and rectal inflammation by quartile normalized summative score of inflammatory cytokines (IL-1α, IL-1β, IL-8, and TNF-α). Elastic net (EN) regression identified taxa associated with inflammation. Multivariable linear regression estimated the association between inflammation score and schistosomiasis and bacteria identified in EN. Results: Most men were CCA positive (24/38; 63%), and median rectal inflammation score was significantly higher in these participants (11 vs. 8, p = 0.04). In multivariable regression, CCA-positive men had 2.85-point greater inflammation score (p = 0.009). The relative abundance of Succinivibrio (coefficient = -1.13, p = 0.002) and Pseudomonas (coefficient = -1.04, p = 0.001) were negatively associated with inflammation. Discussion: CCA positivity was associated with rectal mucosal inflammation, controlling for rectal microbiome composition. Given its high prevalence and contribution to inflammation, schistosomiasis may have important implications for HIV transmission in this vulnerable population.
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Affiliation(s)
- Supriya D Mehta
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Duncan Okal
- Nyanza Reproductive Health Society, Kisumu, Kenya
| | | | - Stefan J Green
- Sequencing Core, Research Resources Center, 14681University of Illinois at Chicago, Chicago, USA
| | - Rachel K Nordgren
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Sanja Huibner
- Division of Infectious Diseases, University of Toronto School of Medicine, Toronto, Canada
| | - Robert C Bailey
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Dulal K Bhaumik
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Alan Landay
- Department of Internal Medicine, 2468Rush University, Chicago, USA
| | - Rupert Kaul
- Division of Infectious Diseases, University of Toronto School of Medicine, Toronto, Canada
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25
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Chadwick DR, Sutherland RK, Raffe S, Pool E, Beadsworth M. British HIV Association guidelines on the management of opportunistic infection in people living with HIV: the clinical management of gastrointestinal opportunistic infections 2020. HIV Med 2020; 21 Suppl 5:1-19. [PMID: 33271637 DOI: 10.1111/hiv.13004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- D R Chadwick
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
| | - R K Sutherland
- Regional Infectious Diseases Unit, NHS Lothian, Edinburgh, UK
| | - S Raffe
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Erm Pool
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Mbj Beadsworth
- Tropical and Infectious Disease Unit, Royal Liverpool University Hospital (Liverpool University Hospitals Foundation Trust), Liverpool, UK
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26
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Choto ET, Mduluza T, Mutapi F, Chimbari MJ. Association of schistosomiasis and risk of prostate cancer development in residents of Murehwa rural community, Zimbabwe. Infect Agent Cancer 2020; 15:59. [PMID: 33042215 PMCID: PMC7541262 DOI: 10.1186/s13027-020-00327-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022] Open
Abstract
Background Prostatic male genital schistosomiasis and prostate cancer co-existence cases are uncommon however, some studies have indicated that schistosomiasis may trigger development of prostate cancer regardless of age. Schistosomiasis is a public health problem in sub-Saharan Africa and may account for some undocumented cases of schistosomiasis prostatic cancer in schistosome endemic rural communities. It is against this background that we investigated the association between schistosomiasis and risk of prostate cancer development in residents of Murehwa Community, a schistosomiasis endemic area. Methodology We conducted a cross sectional study involving 366 men residing in Murehwa District, Zimbabwe. Schistosoma haematobium and S. mansoni infection was diagnosed using urine filtration and Kato Katz techniques, respectively. Haematuria was detected using urinalysis reagent strip test. A structured questionnaire was used to obtain history of schistosomiasis infection among study participants. Risk of prostate cancer development was assessed by measuring prostate-specific antigen levels in serum using the ELISA. Results Prevalence of S. haematobium and S. mansoni infection was 12.3% and 1.4%, respectively. Individuals with schistosomiasis had higher prostate-specific antigen levels (mean 1.208 ± SD 1.557 ng/mL) compared to those without schistosomiasis (mean 0.7721 ± SD 1.173 ng/mL; p < 0.05). Older individuals > 50 years had higher prostate specific antigen levels (mean 0.7212 ± SD 1.313 ng/mL) compared to individuals < 50 years old (mean 0.4159 ± SD 0.8622 ng/mL; p < 0.05). Prostate-specific antigen levels log10 (mean 0.2584 ± SD 0.2128 ng/mL) and were associated to S. haematobium infection intensity log10 (mean 1.121 ± SD 0.5371 eggs/10 mL), r(s) = − 0.3225, p < 0.05. There was a correlation between prostate-specific antigen levels log10 (mean 0.2246 ± SD 0.1858 ng/mL) and S. haematobium infection intensity log10 (mean 1.169 ± SD 0.5568 eggs/10 mL) among participants with a history of schistosomiasis infection (r(s) = − 0.3520; p < 0.05). There was no correlation between prostate-specific antigen levels of > 4 ng/mL (mean 5.324 ± SD1.568 ng/mL) and schistosome eggs log10 (mean 1.057 ± SD 0.6730 eggs/10 mL; p > 0.05). Conclusion Urogenital schistosome infections and history of schistosome infections were associated with prostate specific antigen levels, an indicator for risk of prostate cancer. Therefore, S. haematobium schistosome egg burden was associated with the risk of prostate cancer development in adult males residing in Murehwa District, Zimbabwe.
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Affiliation(s)
- Emilia T Choto
- University of KwaZulu Natal, School of Nursing and Public Health, 6 College of Health Sciences, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041,7 South Africa
| | - Takafira Mduluza
- University of Zimbabwe, Biochemistry Department, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe.,University of KwaZulu Natal, School of Laboratory Medicine and Medical Sciences, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041 South Africa
| | - Francisca Mutapi
- Centre for Infection, Immunity and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Charlotte Auerbach Road, Edinburgh, EH9 3FL UK
| | - Moses J Chimbari
- University of KwaZulu Natal, School of Nursing and Public Health, 6 College of Health Sciences, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041,7 South Africa
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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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Analytical and Clinical Assessment of a Portable, Isothermal Recombinase Polymerase Amplification (RPA) Assay for the Molecular Diagnosis of Urogenital Schistosomiasis. Molecules 2020; 25:molecules25184175. [PMID: 32933094 PMCID: PMC7570534 DOI: 10.3390/molecules25184175] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 12/21/2022] Open
Abstract
Accurate diagnosis of urogenital schistosomiasis is crucial for disease surveillance and control. Routine diagnostic methods, however, lack sensitivity when assessing patients with low levels of infection still able to maintain pathogen transmission. Therefore, there is a need for highly sensitive diagnostic tools that can be used at the point-of-care in endemic areas. Recombinase polymerase amplification (RPA) is a rapid and sensitive diagnostic tool that has been used to diagnose several pathogens at the point-of-care. Here, the analytical performance of a previously developed RPA assay (RT-ShDra1-RPA) targeting the Schistosoma haematobium Dra1 genomic region was assessed using commercially synthesised S. haematobium Dra1 copies and laboratory-prepared samples spiked with S. haematobium eggs. Clinical performance was also assessed by comparing diagnostic outcomes with that of a reference diagnostic standard, urine-egg microscopy. The RT-ShDra1-RPA was able to detect 1 × 101 copies of commercially synthesised Dra1 DNA as well as one S. haematobium egg within laboratory-spiked ddH2O samples. When compared with urine-egg microscopy, the overall sensitivity and specificity of the RT-ShDra1-RPA assay was 93.7% (±88.7–96.9) and 100% (±69.1–100), respectively. Positive and negative predictive values were 100% (±97.5–100) and 50% (±27.2–72.8), respectively. The RT-ShDra1-RPA therefore shows promise as a rapid and highly sensitive diagnostic tool able to diagnose urogenital schistosomiasis at the point-of-care.
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Zirimenya L, Mahmud-Ajeigbe F, McQuillan R, Li Y. A systematic review and meta-analysis to assess the association between urogenital schistosomiasis and HIV/AIDS infection. PLoS Negl Trop Dis 2020; 14:e0008383. [PMID: 32542045 PMCID: PMC7316344 DOI: 10.1371/journal.pntd.0008383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/25/2020] [Accepted: 05/12/2020] [Indexed: 01/31/2023] Open
Abstract
Background Urogenital schistosomiasis and HIV/AIDS infections are widespread in sub-Saharan Africa (SSA) leading to substantial morbidity and mortality. The co-occurrence of both diseases has led to the possible hypothesis that urogenital schistosomiasis leads to increased risk of acquiring HIV infection. However, the available evidence concerning this association is inconsistent. The aim of this study was to systematically review and quantitatively synthesize studies that investigated the association between urogenital schistosomiasis and HIV/AIDS infection. Methods A systematic review basing on PRISMA guidelines was conducted. It is registered with PROSPERO, number CRD42018116648. We searched four databases, MEDLINE, EMBASE, Global Health and Global Index Medicus for studies investigating the association between urogenital schistosomiasis and HIV infection. Only studies published in English were considered. Results of the association were summarised by gender. A meta-analysis was performed for studies on females using random-effects model and a pooled OR with 95% confidence interval was reported. Results Of the 993 studies screened, only eight observational studies met the inclusion criteria. Across all studies, the reported unadjusted OR ranged from 0.78 to 3.76. The pooled estimate of unadjusted OR among females was 1.31 (95% CI: 0.87–1.99). Only four of the eight studies reported an adjusted OR. A separate meta-analysis done in the three studies among females that reported an adjusted OR showed that the pooled estimate was 1.85 (95% CI: 1.17–2.92). There were insufficient data to pool results for association between urogenital schistosomiasis and HIV infection in the males. Conclusion Our investigation supports the hypothesis of an association between urogenital schistosomiasis with HIV/AIDS infection in females. Due to insufficient evidence, no conclusion could be drawn in males with urogenital schistosomiasis. Large-scale prospective studies are needed in future. Urogenital schistosomiasis, caused by parasitic trematode Schistosoma haematobium is a significant source of morbidity in sub Saharan Africa. HIV infection caused by a retrovirus is of two subtypes HIV 1 and HIV 2, with subtype HIV 1 being found worldwide and more aggressive, leading to HIV/AIDS. Research on both of these diseases in the same settings, has shown that these diseases cross paths. This has led to the suggestion that there could be a possible association between the two. Here we describe a systematic review that was carried out to determine if there is an association between UGS and HIV/AIDS infections. We searched all published articles available in MEDLINE, EMBASE, Global Health (CABI), and Global Index Medicus before 28th January 2020. We found eight observational studies eligible to be included in the systematic review and no intervention study. Six of these studies were included in the meta-analysis. A summarized meta-analysis of the study findings with adjusted OR showed that there was a likely association between urogenital schistosomiasis and HIV/AIDS infections in females. However, due to limited papers in males, no conclusion could be drawn.
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Affiliation(s)
- Ludoviko Zirimenya
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- University of Edinburgh, Scotland, United Kingdom
- * E-mail:
| | - Fatima Mahmud-Ajeigbe
- University of Edinburgh, Scotland, United Kingdom
- Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria
| | | | - You Li
- University of Edinburgh, Scotland, United Kingdom
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Bochner AF, Baeten JM, Secor WE, van Dam GJ, Szpiro AA, Njenga SM, Corstjens PLAM, Newsam A, Mugo NR, Celum C, Mujugira A, McClelland RS, Barnabas RV. Associations between schistosomiasis and HIV-1 acquisition risk in four prospective cohorts: a nested case-control analysis. J Int AIDS Soc 2020; 23:e25534. [PMID: 32585078 PMCID: PMC7316390 DOI: 10.1002/jia2.25534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/08/2020] [Accepted: 05/04/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Globally, schistosomes infect approximately 200 million people, with 90% of infections in sub-Saharan Africa. Schistosomiasis is hypothesized to increase HIV-1 acquisition risk, and multiple cross-sectional studies reported strong associations. We evaluated this hypothesis within four large prospective cohorts. METHODS We conducted nested case-control analyses within three longitudinal cohorts of heterosexual HIV-1 serodiscordant couples and one female sex worker (FSW) cohort from Kenya and Uganda. The serodiscordant couples studies were conducted between 2004 and 2012 while the FSW cohort analysis included participant follow-up from 1993 to 2014. Cases HIV-1 seroconverted during prospective follow-up; three controls were selected per case. The presence of circulating anodic antigen in archived serum, collected prior to HIV-1 seroconversion, identified participants with active schistosomiasis; immunoblots determined the schistosome species. Data from serodiscordant couples cohorts were pooled, while the FSW cohort was analysed separately to permit appropriate confounder adjustment. RESULTS We included 245 HIV-1 seroconverters and 713 controls from the serodiscordant couples cohorts and 330 HIV-1 seroconverters and 962 controls from the FSW cohort. The prevalence of active schistosomiasis was 20% among serodiscordant couples and 22% among FSWs. We found no association between schistosomiasis and HIV-1 acquisition risk among males (adjusted odds ratio (aOR) = 0.99, 95% CI 0.59 to 1.67) or females (aOR = 1.21, 95% CI 0.64 to 2.30) in serodiscordant couples. Similarly, in the FSW cohort we detected no association (adjusted incidence rate ratio (aIRR) = 1.11, 95% CI 0.83 to 1.50). Exploring schistosome species-specific effects, there was no statistically significant association between HIV-1 acquisition risk and Schistosoma mansoni (serodiscordant couples: aOR = 0.90, 95% CI 0.56 to 1.44; FSW: aIRR = 0.83, 95% CI 0.53 to 1.20) or Schistosoma haematobium (serodiscordant couples: aOR = 1.06, 95% CI 0.46 to 2.40; FSW: aIRR = 1.64, 95% CI 0.93 to 2.87) infection. CONCLUSIONS Schistosomiasis was not a strong risk factor for HIV-1 acquisition in these four prospective studies. S. mansoni was responsible for the majority of schistosomiasis in these cohorts, and our results do not support the hypothesis that S. mansoni infection is associated with increased HIV-1 acquisition risk. S. haematobium infection was associated with a point estimate of elevated HIV-1 risk in the FSW cohort that was not statistically significant, and there was no trend towards a positive association in the serodiscordant couples cohorts.
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Affiliation(s)
- Aaron F Bochner
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Jared M Baeten
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
| | - W Evan Secor
- Division of Parasitic Diseases and MalariaCenter for Global HealthCenters for Disease Control and PreventionAtlantaGAUSA
| | - Govert J van Dam
- Department of ParasitologyLeiden University Medical CenterLeidenthe Netherlands
| | - Adam A Szpiro
- Department of BiostatisticsUniversity of WashingtonSeattleWAUSA
| | | | - Paul L A M Corstjens
- Department of Cell and Chemical BiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Austin Newsam
- Division of Parasitic Diseases and MalariaCenter for Global HealthCenters for Disease Control and PreventionAtlantaGAUSA
| | - Nelly R Mugo
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- Kenya Medical Research InstituteNairobiKenya
| | - Connie Celum
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
| | - Andrew Mujugira
- Infectious Diseases InstituteCollege of Health SciencesMakerere UniversityKampalaUganda
| | - R Scott McClelland
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
| | - Ruanne V Barnabas
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
- School of MedicineUniversity of WashingtonSeattleWAUSA
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Female Genital Schistosomiasis and HIV: Research Urgently Needed to Improve Understanding of the Health Impacts of This Important Coinfection. J Acquir Immune Defic Syndr 2019; 80:489-493. [PMID: 30730357 DOI: 10.1097/qai.0000000000001957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Evidence suggests that there are important interactions between HIV and female genital schistosomiasis (FGS) that may have significant effects on individual and population health. However, the exact way they interact and the health impacts of the interactions are not well understood. In this article, we discuss what is known about the interactions between FGS and HIV, and the potential impact of the interactions. This includes the likelihood that FGS is an important health problem for HIV-positive women in Schistosoma-endemic areas potentially associated with an increased risk of mortality, cancer, and infertility. In addition, it may be significantly impacting the HIV epidemic in sub-Saharan Africa by making young women more susceptible to HIV. We call for immediate action and argue that research is urgently required to address these knowledge gaps and propose a research agenda to achieve this.
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Wepnje GB, Anchang-Kimbi JK, Lehman LG, Kimbi HK. Evaluation of Urine Reagent Strip as a Tool for Routine Diagnosis of Maternal Urogenital Schistosomiasis at Antenatal Clinic Visit in Munyenge, South West Region, Cameroon. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2972630. [PMID: 31886198 PMCID: PMC6925756 DOI: 10.1155/2019/2972630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/19/2019] [Indexed: 11/29/2022]
Abstract
Urine reagent strip used in detecting microhaematuria has been recommended in pregnancy for diagnosis of urogenital schistosomiasis (UGS) during routine antenatal care (ANC). This study evaluated its sensitivity, specificity, and predictive values in the diagnosis of maternal UGS using filtration method as a reference test. We also assessed the variation in its performance in the diagnosis of UGS using multiple-sample collection. A total of 93 pregnant women reporting for first ANC clinic visit at any of the three functional health care centres (Munyenge Integrated Health Centre, Banga Annex Health Centre, and Trans African Health Centre) were enrolled and followed up for three consecutive monthly visits. Urine samples were observed microscopically for S. haematobium egg using urine filtration and screened for microhaematuria and proteinuria using urine reagent strips. Twenty-two (23.7%) out of the 93 women were diagnosed for UGS, all of whom showed S. haematobium egg excretion during all three visits. There was a significant difference (p < 0.001) between the prevalence of S. haematobium infection and the prevalence of microhaematuria. The intensity of infection was significantly higher in microhaematuria-positive women compared with microhaematuria-negative cases. Sensitivity of reagent strip ranged from 54.5 to 59.1%, while specificity was above 98.0% (range: 98.6-100%). The measure of agreement between urine filtration and reagent strip method was substantial (0.61-0.8) irrespective of different sampling periods. Urine reagent strip is a moderately sensitive method in the detection of UGS and will most likely identify women with high egg load burden. Proper diagnosis of schistosomiasis during pregnancy is recommended.
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Affiliation(s)
- Godlove Bunda Wepnje
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Judith Kuoh Anchang-Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Leopold Gustave Lehman
- Department of Animal Biology, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, The University of Bamenda, P.O. Box 39, Bambili, Cameroon
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Drew LB, Tang JH, Norris A, Reese PC, Mwale M, Mataya R, Wilkinson JP. Schistosomiasis among obstetric fistula patients in Lilongwe, Malawi. Malawi Med J 2019; 30:225-229. [PMID: 31798799 PMCID: PMC6863410 DOI: 10.4314/mmj.v30i4.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Schistosoma haematobium infection has been documented as an uncommon cause of vesicovaginal fistula (VVF) and can result in impaired wound healing of urogenital tissues. For these reasons, it could potentially be linked to an increased rate of obstetric fistula among women who experience obstructed labor and/or in a higher failure rate of fistula repair. Therefore, the primary objective of our study was to determine the prevalence of S. haematobium infection among women undergoing obstetric VVF repair in Lilongwe, Malawi. Our secondary objectives were to assess if S. haematobium infection could be a risk factor for obstetric fistula development or unsuccessful VVF repair in our patient population. Methods From July to October 2013, we conducted S. haematobium testing via urine microscopy on 96 patients undergoing obstetric VVF repair surgery at the Fistula Care Centre in Lilongwe, Malawi. Results The prevalence of S. haematobium infection among women undergoing obstetric VVF repair was 2% (n=2). Both women with S. haematobium had successful VVF repairs. Conclusions Although S. haematobium has the potential to be a risk factor for obstetric VVF formation or unsuccessful VVF repair, it was uncommon among the women in our clinic with obstetric VVF.
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Affiliation(s)
| | - Jennifer H Tang
- UNC Project-Malawi.,UNC Department of Obstetrics and Gynaecology
| | | | | | | | - Ronald Mataya
- Loma Linda University School of Public Health.,Malawi College of Medicine, Department of Obstetrics and Gynaecology
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Yegorov S, Joag V, Galiwango RM, Good SV, Okech B, Kaul R. Impact of Endemic Infections on HIV Susceptibility in Sub-Saharan Africa. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:22. [PMID: 31798936 PMCID: PMC6884859 DOI: 10.1186/s40794-019-0097-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/07/2019] [Indexed: 02/08/2023]
Abstract
Human immunodeficiency virus (HIV) remains a leading cause of global morbidity with the highest burden in Sub-Saharan Africa (SSA). For reasons that are incompletely understood, the likelihood of HIV transmission is several fold higher in SSA than in higher income countries, and most of these infections are acquired by young women. Residents of SSA are also exposed to a variety of endemic infections, such as malaria and various helminthiases that could influence mucosal and systemic immunology. Since these immune parameters are important determinants of HIV acquisition and progression, this review explores the possible effects of endemic infections on HIV susceptibility and summarizes current knowledge of the epidemiology and underlying immunological mechanisms by which endemic infections could impact HIV acquisition. A better understanding of the interaction between endemic infections and HIV may enhance HIV prevention programs in SSA.
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Affiliation(s)
- Sergey Yegorov
- 1Departments of Immunology and Medicine, University of Toronto, Toronto, Canada.,2Department of Pedagogical Mathematics and Natural Science, Faculty of Education and Humanities, Suleyman Demirel University, Almaty, Kazakhstan
| | - Vineet Joag
- 3Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN USA
| | - Ronald M Galiwango
- 1Departments of Immunology and Medicine, University of Toronto, Toronto, Canada
| | - Sara V Good
- 4Genetics & Genome Biology, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada.,5Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | | | - Rupert Kaul
- 1Departments of Immunology and Medicine, University of Toronto, Toronto, Canada.,7Department of Medicine, University Health Network, Toronto, Canada
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Bochner AF, Secor WE, Baeten JM, van Dam GJ, Szpiro AA, Njenga SM, Corstjens PLAM, Mackelprang RD, Mugo NR, Overbaugh J, Celum C, Mujugira A, McClelland RS, Barnabas RV. Schistosomiasis was not associated with higher HIV-1 plasma or genital set point viral loads among HIV seroconverters from four cohort studies. PLoS Negl Trop Dis 2019; 13:e0007886. [PMID: 31747411 PMCID: PMC6867600 DOI: 10.1371/journal.pntd.0007886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/27/2019] [Indexed: 01/08/2023] Open
Abstract
Background Many regions of sub-Saharan Africa experience a high prevalence of both schistosomiasis and HIV-1, leading to frequent coinfection. Higher plasma HIV-1 viral loads are associated with faster disease progression and genital HIV-1 loads are a primary determinant of HIV-1 transmission risk. We hypothesized that schistosome infection would be associated with higher HIV-1 viral loads in plasma and genital samples. Methods/Principal findings We utilized data from individuals who HIV-1 seroconverted while enrolled in one of four prospective cohort studies. Plasma and genital viral loads collected 4–24 months after the estimated date of HIV-1 acquisition, but prior to antiretroviral therapy initiation, were included. Detection of circulating anodic antigen in archived blood samples, collected prior to HIV-1 seroconversion, identified participants with active schistosomiasis; immunoblots determined the schistosome species causing infection. Our analysis included 370 HIV-1 seroconverters with plasma viral load results, of whom 82 (22%) had schistosomiasis. We did not find a statistically significant association between schistosomiasis and higher HIV-1 set point plasma viral loads (-0.17 log10 copies/ml, 95% CI -0.38 to 0.03); S. mansoni infection was associated with a lower set point (-0.34 log10 copies/ml, 95% CI -0.58 to -0.09). We found no association between schistosomiasis and cervical (+0.07 log10 copies/swab, 95% CI -0.20 to 0.34) or vaginal (+0.11 log10 copies/swab, 95% CI -0.17 to 0.39) set point viral loads; S. haematobium infection was associated with lower cervical viral loads (-0.59 log10 copies/swab, 95% CI -1.11 to -0.06). Conclusions/Significance These results do not support the hypotheses that schistosome coinfection increases plasma or genital HIV-1 viral loads. Schistosomiasis is a parasitic disease that is common in many parts of sub-Saharan Africa most affected by the HIV-1 epidemic. Schistosomiasis causes genital damage when schistosome ova become lodged in the female genital tract, inducing inflammation that may elevate HIV-1 genital viral loads and increase the risk of HIV-1 transmission. Schistosomiasis may also promote viral replication by facilitating cell-to-cell transmission of HIV-1, elevating HIV-1 plasma viral load levels. Using data from 370 individuals residing in Kenya or Uganda who acquired HIV-1 while participating in one of four prospective cohort studies, we tested the hypotheses that schistosomiasis increases plasma and genital viral load levels. We found no evidence that individuals with schistosomiasis had higher set point plasma viral load levels, a measure of viral replication obtained during the set point period 4–24 months after HIV-1 acquisition when viral load levels remain relatively stable. Additionally, we found no evidence that schistosomiasis was associated with higher female set point genital viral loads measured from vaginal or cervical swabs. Unexpectedly, we found that S. mansoni infection was associated with a decline in plasma viral load levels while S. haematobium infection was associated with a decline in cervical viral load levels. Thus, our results do not support the hypotheses that schistosomiasis increases plasma and genital HIV-1 viral loads.
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Affiliation(s)
- Aaron F. Bochner
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - W. Evan Secor
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jared M. Baeten
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- School of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Govert J. van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Adam A. Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | | | - Paul L. A. M. Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Romel D. Mackelprang
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | | | - Julie Overbaugh
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Connie Celum
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- School of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Andrew Mujugira
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - R. Scott McClelland
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- School of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Ruanne V. Barnabas
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- School of Medicine, University of Washington, Seattle, Washington, United States of America
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Ribeiro AR, Luis C, Fernandes R, Botelho MC. Schistosomiasis and Infertility: What Do We Know? Trends Parasitol 2019; 35:964-971. [PMID: 31623951 DOI: 10.1016/j.pt.2019.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 11/25/2022]
Abstract
There is increasing attention on the complex interactions occurring between schistosome parasites and their hosts. However, little is known about the occurrence, epidemiology, and mechanisms of schistosomiasis-associated infertility. In this article, we argue that an in-depth understanding of the interplay between parasites and the host endocrine system may significantly enhance current knowledge of infertility in infected individuals. We discuss the basic hormonal mechanisms that may lead to the discovery of entirely novel anthelmintic interventions against schistosomiasis.
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Affiliation(s)
- Ana Rita Ribeiro
- Ciências Químicas e das Biomoléculas, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde da Universidade do Porto (i3S), Porto, Portugal
| | - Carla Luis
- Departamento de Biomedicina, Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ruben Fernandes
- Ciências Químicas e das Biomoléculas, Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde da Universidade do Porto (i3S), Porto, Portugal
| | - Monica C Botelho
- Instituto de Investigação e Inovação em Saúde da Universidade do Porto (i3S), Porto, Portugal; Instituto Nacional de Saúde Dr Ricardo Jorge (INSA), Porto, Portugal.
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Obonyo CO, Muok EMO, Were V. Biannual praziquantel treatment for schistosomiasis. Hippokratia 2019. [DOI: 10.1002/14651858.cd013412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Charles O Obonyo
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
| | - Erick MO Muok
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
| | - Vincent Were
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
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Sacolo-Gwebu H, Chimbari M, Kalinda C. Prevalence and risk factors of schistosomiasis and soil-transmitted helminthiases among preschool aged children (1-5 years) in rural KwaZulu-Natal, South Africa: a cross-sectional study. Infect Dis Poverty 2019; 8:47. [PMID: 31202273 PMCID: PMC6571117 DOI: 10.1186/s40249-019-0561-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/28/2019] [Indexed: 02/17/2023] Open
Abstract
Background Despite efforts to control neglected tropical diseases (NTDs), schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa. Recent data suggest that these infections are prevalent among preschool aged children (PSAC) in poor communities. Evidence of schistosomiasis and soil-transmitted helminths (STH) infection patterns and prevalence among PSAC is essential for effective treatment and control programmes. The aim of the study was to determine the prevalence, intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District, South Africa. Methods A cross-sectional study was conducted among 1143 PSAC aged 1–5 years in 34 preschools and early childhood development (ECD) centres. Data on risk factors was collected using a semi-structured questionnaire. A Kruskal–Wallis test was used to compare the differences in infection intensity with age. Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status, sociodemographic, household, water and sanitation variables and hygiene practices of PSAC and their caregivers. Results We observed a low prevalence of Schistosoma haematobium (1.0%) and S. mansoni (0.9%). The prevalence of Ascaris lumbricoides (18.3%) was high compared to Trichuris trichiura (1.2%), hookworms (1.6%) and Taenia (6.4%). The odds of schistosome infection were lowest among PSAC under younger (15–24 years) caregivers (0.1, 95% CI: 0.02–0.54) and those who used tap water (0.3, 95% CI: 0.09–0.78) for domestic purposes. Schistosome infection was however higher among PSAC who bathed in river water (17.4, 95% CI: 5.96–51.04). STH infection on the other hand was lowest among PSAC who did not play in soil (0.1, 95% CI: 0.51–0.28), were from households that used tap water for domestic purposes (0.5, 95% CI: 0.27–0.80) and PSAC under the care of younger (25–35 years) caregivers (0.3, 95% CI: 0.10–0.75). The risk of STH infection was highest among PSAC who did not wash their hands with soap (3.5, 95% CI: 1.04–11.67) and PSAC whose nails were not trimmed (3.6, 95% CI: 1.75–7.26). Conclusions The findings show low prevalence and infection intensity of schistosomiasis and STH infection except A. lumbricoides among PSAC. Factors predicting schistosomiasis and STH infection among PSAC were related to caregivers’ age, educational status, water and hygiene practices. STH infection was exclusively associated with PSAC playing and handwashing habits. These findings highlight the need to include PSAC caregivers in schistosomiasis and STH prevention and control programmes. Electronic supplementary material The online version of this article (10.1186/s40249-019-0561-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hlengiwe Sacolo-Gwebu
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.
| | - Moses Chimbari
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa
| | - Chester Kalinda
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.,University of Namibia, Katima Mulilo Campus, Winela Road, Box 1096, Katima Mulilo, Namibia
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von Braun A, Trawinski H, Wendt S, Lübbert C. Schistosoma and Other Relevant Helminth Infections in HIV-Positive Individuals-an Overview. Trop Med Infect Dis 2019; 4:tropicalmed4020065. [PMID: 31013827 PMCID: PMC6631468 DOI: 10.3390/tropicalmed4020065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/03/2019] [Accepted: 04/10/2019] [Indexed: 11/16/2022] Open
Abstract
For many years, researchers have postulated that helminthic infections may increase susceptibility to HIV, and that immune activation may have contributed to the extensive spread of HIV in sub-Saharan Africa. In the meantime, immunological studies have provided some evidence in support of this hypothesis, while cross-sectional clinical studies were able to further support the assumed association between HIV infection and selected helminthic co-infections. However, as many of the helminthic infections relevant to HIV-infected patients belong to the group of “neglected tropical diseases”, as defined by the World Health Organization, a certain lack of attention has inhibited progress in fully scaling up treatment and prevention efforts. In addition, despite the fact that the challenges of co-infections have preoccupied clinicians for over two decades, relevant research questions remain unanswered. The following review aims to provide a concise overview of associations between HIV and selected helminthic co-infections concerning aspects of HIV acquisition and transmission, clinical and immunological findings in co-infected individuals, as well as treatment and prevention efforts.
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Affiliation(s)
- Amrei von Braun
- Division of Infectious Diseases and Tropical Medicine, Leipzig University Hospital, University of Leipzig, 04103 Leipzig, Germany.
- Interdisciplinary Center for Infectious Diseases, Leipzig University Hospital, 04103 Leipzig, Germany.
| | - Henning Trawinski
- Division of Infectious Diseases and Tropical Medicine, Leipzig University Hospital, University of Leipzig, 04103 Leipzig, Germany.
- Interdisciplinary Center for Infectious Diseases, Leipzig University Hospital, 04103 Leipzig, Germany.
| | - Sebastian Wendt
- Interdisciplinary Center for Infectious Diseases, Leipzig University Hospital, 04103 Leipzig, Germany.
- Institute for Medical Microbiology and Epidemiology of Infectious Diseases, Leipzig University Hospital, 04103 Leipzig, Germany.
| | - Christoph Lübbert
- Division of Infectious Diseases and Tropical Medicine, Leipzig University Hospital, University of Leipzig, 04103 Leipzig, Germany.
- Interdisciplinary Center for Infectious Diseases, Leipzig University Hospital, 04103 Leipzig, Germany.
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Wepnje GB, Anchang-Kimbi JK, Ndassi VD, Lehman LG, Kimbi HK. Schistosoma haematobium infection status and its associated risk factors among pregnant women in Munyenge, South West Region, Cameroon following scale-up of communal piped water sources from 2014 to 2017: a cross-sectional study. BMC Public Health 2019; 19:392. [PMID: 30971223 PMCID: PMC6458650 DOI: 10.1186/s12889-019-6659-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/14/2019] [Indexed: 11/24/2022] Open
Abstract
Background In 2014, a study in Munyenge revealed a high prevalence of urogenital schistosomiasis (UGS) among pregnant women. This study investigated he prevalence and risk factors of UGS in pregnancy following scale-up of piped water sources from 2014 to 2017. Secondly, we compared stream usage, stream contact behaviour, infection rate and intensity with the findings of 2014. Methods Consenting pregnant women reporting for antenatal care (ANC) in the different health facilities were enrolled consecutively between November 2016 and January 2018. Information on age, gravidity status, residence, marital status, educational level, occupation, household water source, frequency of contact with water and stream activities were obtained using a semi-structured questionnaire. Urine samples were examined for the presence of microhaematuria and S. haematobium ova using test strip and filtration/microscopy methods respectively. Data were analysed using univariate and multivariate regression analyses and relative risk reductions calculated. Results Of the 368 women enrolled, 22.3% (82) were diagnosed with UGS. Marital status (single) (aOR = 2.24, 95% CI: 1.04–4.79), primary - level of education (aOR = 2.0; 95% CI: 1.04–3.85) and domestic activity and bathing in the stream (aOR = 3.3; 95% CI: 1.83–6.01) increased risk of S. haematobium infection. Meanwhile, fewer visits (< 3 visits/week) to stream (aOR = 0.35, 95% CI = 0.17–0.74) reduced exposure to infection. Piped water usage was associated with reduced stream usage and eliminated the risk of infection among women who used safe water only. Compared with the findings of 2014, stream usage (RRR = 23 95% CI: 19–28), frequency (≥ 3 visits) (RRR = 69 95% CI: 59–77) and intensity of contact with water (RRR = 37 95% CI = 22–49) has reduced. Similarly, we observed a decrease in infection rate (RRR = 52, 95% CI = 40–62) and prevalence of heavy egg intensity (RRR = 71, 95% CI = 53–81). Conclusion Following increased piped water sources in Munyenge, S. haematobium infection has declined due to reduced stream contact. This has important implication in the control of UGS in pregnancy. Electronic supplementary material The online version of this article (10.1186/s12889-019-6659-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Godlove Bunda Wepnje
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Judith Kuoh Anchang-Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.
| | - Vicky Daonyle Ndassi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Leopold Gustave Lehman
- Department of Animal Biology, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Helen Kuokuo Kimbi
- Department of Medical Laboratory Science, Faculty of Health Sciences, University of Bamenda, P.O. Box 39, Bambili, Cameroon
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Hotez PJ, Harrison W, Fenwick A, Bustinduy AL, Ducker C, Sabina Mbabazi P, Engels D, Floerecke Kjetland E. Female genital schistosomiasis and HIV/AIDS: Reversing the neglect of girls and women. PLoS Negl Trop Dis 2019; 13:e0007025. [PMID: 30946746 PMCID: PMC6448816 DOI: 10.1371/journal.pntd.0007025] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- * E-mail:
| | - Wendy Harrison
- Schistosomiasis Control Initiative, Department of Epidemiology and Biostatistics, Imperial College London, United Kingdom
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Department of Epidemiology and Biostatistics, Imperial College London, United Kingdom
| | - Amaya L. Bustinduy
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Pamela Sabina Mbabazi
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Dirk Engels
- Uniting to Combat NTDs, London, United Kingdom
| | - Eyrun Floerecke Kjetland
- Regional Advisory Unit 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
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42
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Butrous G. Schistosome infection and its effect on pulmonary circulation. Glob Cardiol Sci Pract 2019; 2019:5. [PMID: 31024947 PMCID: PMC6472693 DOI: 10.21542/gcsp.2019.5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/17/2018] [Indexed: 02/06/2023] Open
Abstract
Schistosomiasis is the most common parasitic disease associated with pulmonary hypertension. It induces remodelling via complex inflammatory processes, which eventually produce the clinical manifestation of pulmonary hypertension. The pulmonary hypertension shows clinical signs and symptoms that are not distinguishable from other forms of pulmonary arterial hypertension.
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Affiliation(s)
- Ghazwan Butrous
- Professor of Cardiopulmonary Sciences, Medway School of Pharmacy, University of Kent, UK and University of Greenwich, Central Ave, Gillingham, Chatham ME4 4BF, Kent, UK
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Maju M, Sharma A, Beeram A, Ostrach B. A colonial legacy of HIV/AIDS, NTD, and STI super-syndemics: Eugenicist foreign aid and intertwined health burdens in Nigeria. Glob Public Health 2019; 14:1221-1240. [PMID: 30829113 DOI: 10.1080/17441692.2019.1582683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Syndemics theory has been applied to the structurally shaped, biologically facilitated co-occurrence of HIV/AIDS with Neglected Tropical Diseases (NTDs) and with sexually transmitted infections (STIs). The biological and social pathways of interaction between all three ailments have not yet been analysed together. The effects of these diseases are often exacerbated by structural factors including access to care and socioeconomic status. We explore the interrelated biological pathways and structural factors that have further heightened the risk for HIV/AIDS, NTDs, and STIs. Furthermore, we argue women in rural areas are at an increased risk for all three diseases due to biological and social factors including increased distance to quality care and lower reproductive autonomy. This paper integrates the established syndemics of HIV/NTDs and HIV/STIs within the historical and modern contexts of colonisation and neo-colonisation in Nigeria. We explore the effects of colonisation on women's health by evaluating the influence of foreign aid policies, structural programmes, and shifting gender norms. Applying a syndemic approach, juxtaposed by historical contextualisation, offers important implications for the prevention and treatment of HIV/AIDS, STIs, and NTDs. Our analysis suggests a perspective through which to view health of regions with a history of colonisation.
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Affiliation(s)
- Mehar Maju
- a Department of Community Health Sciences, UCLA Fielding School of Public Health , Los Angeles, CA , USA.,b Department of Anthropology , Boston University , Boston, MA , USA
| | - Andria Sharma
- c Department of Biology , Boston University , Boston, MA , USA.,d Rutgers New Jersey Medical School, School of Medicine, Newark , New Jersey , USA
| | - Archana Beeram
- c Department of Biology , Boston University , Boston, MA , USA.,e Imperial College London, School of Public Health , London , UK
| | - Bayla Ostrach
- f Family Medicine, and Affiliated Faculty, Medical Anthropology , Boston University School of Medicine , Boston, MA.,g Sociology and Anthropology , University of North Carolina Asheville , NC , USA
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Ajibola O, Rowan AD, Ogedengbe CO, Mshelia MB, Cabral DJ, Eze AA, Obaro S, Belenky P. Urogenital schistosomiasis is associated with signatures of microbiome dysbiosis in Nigerian adolescents. Sci Rep 2019; 9:829. [PMID: 30696838 PMCID: PMC6351658 DOI: 10.1038/s41598-018-36709-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/25/2018] [Indexed: 12/11/2022] Open
Abstract
Urogenital schistosomiasis is a neglected tropical disease caused by the parasite Schistosoma haematobium, which resides in the vasculature surrounding the urogenital system. Previous work has suggested that helminthic infections can affect the intestinal microbiome, and we hypothesized that S. haematobium infection could result in an alteration of immune system-microbiota homeostasis and impact the composition of the gut microbiota. To address this question, we compared the fecal microbiomes of infected and uninfected schoolchildren from the Argungu Local Government Area of Kebbi State, Nigeria, detecting significant differences in community composition between the two groups. Most remarkably, we observed a decreased abundance of Firmicutes and increased abundance of Proteobacteria - a shift in community structure which has been previously associated with dysbiosis. More specifically, we detected a number of changes in lower taxa reminiscent of inflammation-associated dysbiosis, including decreases in Clostridiales and increases in Moraxellaceae, Veillonellaceae, Pasteurellaceae, and Desulfovibrionaceae. Functional potential analysis also revealed an enrichment in orthologs of urease, which has been linked to dysbiosis and inflammation. Overall, our analysis indicates that S. haematobium infection is associated with perturbations in the gut microbiota and may point to microbiome disruption as an additional consequence of schistosome infection.
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Affiliation(s)
- Olumide Ajibola
- Department of Microbiology, Faculty of Science, Federal University Birnin Kebbi, Birnin Kebbi, Kebbi State, Nigeria.
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.
| | - Aislinn D Rowan
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, USA
| | - Clement O Ogedengbe
- Department of Medical Biochemistry, College of Medicine, University of Nigeria - Enugu Campus, Enugu, Nigeria
| | - Mari B Mshelia
- Department of Microbiology, Faculty of Science, Federal University Birnin Kebbi, Birnin Kebbi, Kebbi State, Nigeria
| | - Damien J Cabral
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, USA
| | - Anthonius A Eze
- Department of Medical Biochemistry, College of Medicine, University of Nigeria - Enugu Campus, Enugu, Nigeria
| | - Stephen Obaro
- Division of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
- International Foundation Against Infectious Diseases in Nigeria, Department of Pediatrics, Bayero University Kano, Kano, Nigeria
| | - Peter Belenky
- Department of Molecular Microbiology and Immunology, Division of Biology and Medicine, Brown University, Providence, RI, USA.
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Abstract
Schistosomiasis is a major cause of morbidity in the world; it is second only to malaria as a major infectious disease. Globally, it is estimated that the disease affects over 250 million people in 78 countries of the world and is responsible for some 280,000 deaths each year. The three major schistosomes infecting humans are Schistosoma mansoni, S. japonicum, and S. haematobium. This chapter covers a wide range of aspects of schistosomiasis, including basic biology of the parasites, epidemiology, immunopathology, treatment, control, vaccines, and genomics/proteomics. In this chapter, the reader will understand the significant toll this disease takes in terms of mortality and morbidity. A description of the various life stages of schistosomes is presented, which will be informative for both those unfamiliar with the disease and experienced scientists. Clinical and public health aspects are addressed that cover acute and chronic disease, diagnosis, current treatment regimens and alternative drugs, and schistosomiasis control programs. A brief overview of genomics and proteomics is included that details recent advances in the field that will help scientists investigate the molecular biology of schistosomes. The reader will take away an appreciation for general aspects of schistosomiasis and research advances.
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46
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Costain AH, MacDonald AS, Smits HH. Schistosome Egg Migration: Mechanisms, Pathogenesis and Host Immune Responses. Front Immunol 2018; 9:3042. [PMID: 30619372 PMCID: PMC6306409 DOI: 10.3389/fimmu.2018.03042] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022] Open
Abstract
Many parasitic worms possess complex and intriguing life cycles, and schistosomes are no exception. To exit the human body and progress to their successive snail host, Schistosoma mansoni eggs must migrate from the mesenteric vessels, across the intestinal wall and into the feces. This process is complex and not always successful. A vast proportion of eggs fail to leave their definite host, instead becoming lodged within intestinal or hepatic tissue, where they can evoke potentially life-threatening pathology. Thus, to maximize the likelihood of successful egg passage whilst minimizing host pathology, intriguing egg exit strategies have evolved. Notably, schistosomes actively exert counter-inflammatory influences on the host immune system, discreetly compromise endothelial and epithelial barriers, and modulate granuloma formation around transiting eggs, which is instrumental to their migration. In this review, we discuss new developments in our understanding of schistosome egg migration, with an emphasis on S. mansoni and the intestine, and outline the host-parasite interactions that are thought to make this process possible. In addition, we explore the potential immune implications of egg penetration and discuss the long-term consequences for the host of unsuccessful egg transit, such as fibrosis, co-infection and cancer development.
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Affiliation(s)
- Alice H. Costain
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Andrew S. MacDonald
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom
| | - Hermelijn H. Smits
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
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47
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Wall KM, Kilembe W, Vwalika B, Dinh C, Livingston P, Lee YM, Lakhi S, Boeras D, Naw HK, Brill I, Chomba E, Sharkey T, Parker R, Shutes E, Tichacek A, Secor WE, Allen S. Schistosomiasis is associated with incident HIV transmission and death in Zambia. PLoS Negl Trop Dis 2018; 12:e0006902. [PMID: 30543654 PMCID: PMC6292564 DOI: 10.1371/journal.pntd.0006902] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/04/2018] [Indexed: 12/11/2022] Open
Abstract
Background We examined relationships between schistosome infection, HIV transmission or acquisition, and all-cause death. Methods We retrospectively tested baseline sera from a heterosexual HIV-discordant couple cohort in Lusaka, Zambia with follow-up from 1994–2012 in a nested case-control design. Schistosome-specific antibody levels were measured by ELISA. Associations between baseline antibody response to schistosome antigens and incident HIV transmission, acquisition, and all-cause death stratified by gender and HIV status were assessed. In a subset of HIV- women and HIV+ men, we performed immunoblots to evaluate associations between Schistosoma haematobium or Schistosoma mansoni infection history and HIV incidence. Results Of 2,145 individuals, 59% had positive baseline schistosome-specific antibody responses. In HIV+ women and men, baseline schistosome-specific antibodies were associated with HIV transmission to partners (adjusted hazard ratio [aHR] = 1.8, p<0.005 and aHR = 1.4, p<0.05, respectively) and death in HIV+ women (aHR = 2.2, p<0.001). In 250 HIV- women, presence of S. haematobium-specific antibodies was associated with increased risk of HIV acquisition (aHR = 1.4, p<0.05). Conclusion Schistosome infections were associated with increased transmission of HIV from both sexes, acquisition of HIV in women, and increased progression to death in HIV+ women. Establishing effective prevention and treatment strategies for schistosomiasis, including in urban adults, may reduce HIV incidence and death in HIV+ persons living in endemic areas. This study explored the association between schistosome infections (a disease caused by parasitic flatworms, also known as ‘snail fever’, which is very common throughout sub-Saharan Africa) and human immunodeficiency virus (HIV). We found in Lusaka, the capital of Zambia, that schistosome infections were associated with transmission of HIV from adult men and women, and schistosome infections were also associated with increased HIV acquisition in adult women. We additionally found that schistosome infections were associated with death in HIV+ adult women. Since treatment of schistosome infections with praziquantel is inexpensive, effective, and safe, schistosomiasis prevention and treatment strategies may be a cost-effective way to reduce not only the symptoms associated with the infection, but also new cases of HIV and death among HIV+ persons. Though often viewed as an infection of predominantly rural areas and children, this study highlights that schistosomiasis prevention and treatment efforts are also needed in urban areas and among adults.
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Affiliation(s)
- Kristin M Wall
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.,Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America
| | - William Kilembe
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Bellington Vwalika
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.,Department of Gynecology and Obstetrics, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Cecile Dinh
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Paul Livingston
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Yeuk-Mui Lee
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Shabir Lakhi
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.,Department of Internal Medicine, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Debi Boeras
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Htee Khu Naw
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Ilene Brill
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.,Department of Epidemiology, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Elwyn Chomba
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.,Ministry of Home Affairs, Zambian Ministry of Health, Lusaka, Zambia.,School of Medicine, University of Zambia, Lusaka, Zambia
| | - Tyronza Sharkey
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Rachel Parker
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Erin Shutes
- Malaria Team, Global Health Program, Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Amanda Tichacek
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Susan Allen
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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48
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Hunter KS, Davies SJ. Host Adaptive Immune Status Regulates Expression of the Schistosome AMP-Activated Protein Kinase. Front Immunol 2018; 9:2699. [PMID: 30519243 PMCID: PMC6260181 DOI: 10.3389/fimmu.2018.02699] [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: 07/18/2018] [Accepted: 11/01/2018] [Indexed: 12/25/2022] Open
Abstract
Schistosomes exhibit profound developmental adaptations in response to the immune status of their mammalian host, including significant attenuation of parasite growth, development and reproduction in response to deficits in host adaptive immunity. These observations led us to hypothesize that schistosomes regulate the utilization of energy resources in response to immunological conditions within the host. To test this hypothesis, we identified and characterized the Schistosoma mansoni AMP-activated protein kinase (AMPK), a heterotrimeric enzyme complex that is central to regulating energy metabolism at the cellular and organismal level in eukaryotes. We show that expression of the catalytic α subunit is developmentally regulated during the parasite life cycle, with peak expression occurring in adult worms. However, the protein is present and phosphorylated in all life cycle stages examined, suggesting a need for active regulation of energy resources throughout the life cycle. In contrast, transcription of the AMPK α gene is down-regulated in cercariae and schistosomula, suggesting that the protein in these life cycle stages is pre-synthesized in the sporocyst and that expression must be re-initiated once inside the mammalian host. We also show that schistosome AMPK α activity in adult worms is sensitive to changes in the parasite's environment, suggesting a mechanism by which schistosome metabolism may be responsive to host immune factors. Finally, we show that AMPK α expression is significantly down-regulated in parasites isolated from immunodeficient mice, suggesting that modulation of parasite energy metabolism may contribute to the attenuation of schistosome growth and reproduction in immunodeficient hosts. These findings provide insights into the molecular interactions between schistosomes and their vertebrate hosts and suggest that parasite energy metabolism may represent a novel target for anti-schistosome interventions.
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Affiliation(s)
- Kasandra S Hunter
- Department of Microbiology and Immunology, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Stephen J Davies
- Department of Microbiology and Immunology, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
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A systematic review with epidemiological update of male genital schistosomiasis (MGS): A call for integrated case management across the health system in sub-Saharan Africa. Parasite Epidemiol Control 2018; 4:e00077. [PMID: 30662962 PMCID: PMC6324017 DOI: 10.1016/j.parepi.2018.e00077] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 10/16/2018] [Accepted: 10/16/2018] [Indexed: 02/03/2023] Open
Abstract
Male genital schistosomiasis (MGS) is a gender specific manifestation of urogenital schistosomiasis (UGS) first described in 1911 by Madden in Egypt. Today, while affecting millions of men and boys worldwide, MGS receives insufficient attention, especially in sub-Saharan Africa (SSA). To provide a systematic review with an epidemiological update of MGS, we inspected both online and hardcopy resources in our appraisal. A total of 147 articles were eventually identified, only 31 articles were exclusively focused on MGS with original or targeted research. From these, we discuss pertinent clinico-pathological features of MGS, highlight the possible connection and interplay with HIV, and assess current diagnostic techniques alongside consideration of their use and application in SSA. To appreciate the burden of MGS more fully, especially in endemic areas, there is a clear need for better surveillance and longitudinal population research to investigate the best point-of-care (POC) diagnostic and its performance through time. Furthermore, to optimise individual case management, exploration of alternative praziquantel dosing regimens is needed for MGS in men with or without HIV co-infection.
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50
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Bryant AS, Hallem EA. Temperature-dependent behaviors of parasitic helminths. Neurosci Lett 2018; 687:290-303. [PMID: 30336196 PMCID: PMC6240462 DOI: 10.1016/j.neulet.2018.10.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 02/07/2023]
Abstract
Parasitic helminth infections are the most common source of neglected tropical disease among impoverished global communities. Many helminths infect their hosts via an active, sensory-driven process in which environmentally motile infective larvae position themselves near potential hosts. For these helminths, host seeking and host invasion can be divided into several discrete behaviors that are regulated by both host-emitted and environmental sensory cues, including heat. Thermosensation is a critical sensory modality for helminths that infect warm-blooded hosts, driving multiple behaviors necessary for host seeking and host invasion. Furthermore, thermosensory cues influence the host-seeking behaviors of both helminths that parasitize endothermic hosts and helminths that parasitize insect hosts. Here, we discuss the role of thermosensation in guiding the host-seeking and host-infection behaviors of a diverse group of helminths, including mammalian-parasitic nematodes, entomopathogenic nematodes, and schistosomes. We also discuss the neural circuitry and molecular pathways that underlie thermosensory responses in these species.
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Affiliation(s)
- Astra S Bryant
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Elissa A Hallem
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
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