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Mpakosi A, Cholevas V, Tzouvelekis I, Passos I, Kaliouli-Antonopoulou C, Mironidou-Tzouveleki M. Autoimmune Diseases Following Environmental Disasters: A Narrative Review of the Literature. Healthcare (Basel) 2024; 12:1767. [PMID: 39273791 PMCID: PMC11395540 DOI: 10.3390/healthcare12171767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/02/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Environmental disasters are extreme environmental processes such as earthquakes, volcanic eruptions, landslides, tsunamis, floods, cyclones, storms, wildfires and droughts that are the consequences of the climate crisis due to human intervention in the environment. Their effects on human health have alarmed the global scientific community. Among them, autoimmune diseases, a heterogeneous group of disorders, have increased dramatically in many parts of the world, likely as a result of changes in our exposure to environmental factors. However, only a limited number of studies have attempted to discover and analyze the complex association between environmental disasters and autoimmune diseases. This narrative review has therefore tried to fill this gap. First of all, the activation pathways of autoimmunity after environmental disasters have been analyzed. It has also been shown that wildfires, earthquakes, desert dust storms and volcanic eruptions may damage human health and induce autoimmune responses to inhaled PM2.5, mainly through oxidative stress pathways, increased pro-inflammatory cytokines and epithelial barrier damage. In addition, it has been shown that heat stress, in addition to increasing pro-inflammatory cytokines, may also disrupt the intestinal barrier, thereby increasing its permeability to toxins and pathogens or inducing epigenetic changes. In addition, toxic volcanic elements may accelerate the progressive destruction of myelin, which may potentially trigger multiple sclerosis. The complex and diverse mechanisms by which vector-borne, water-, food-, and rodent-borne diseases that often follow environmental diseases may also trigger autoimmune responses have also been described. In addition, the association between post-disaster stress and the onset or worsening of autoimmune disease has been demonstrated. Given all of the above, the rapid restoration of post-disaster health services to mitigate the flare-up of autoimmune conditions is critical.
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Affiliation(s)
- Alexandra Mpakosi
- Department of Microbiology, General Hospital of Nikaia "Agios Panteleimon", 18454 Piraeus, Greece
| | | | - Ioannis Tzouvelekis
- School of Agricultural Technology, Food Technology and Nutrition, Alexander Technological Educational Institute of Thessaloniki, 57400 Thessaloniki, Greece
| | - Ioannis Passos
- Surgical Department, 219, Mobile Army, Surgical Hospital, 68300 Didymoteicho, Greece
| | | | - Maria Mironidou-Tzouveleki
- Department of Pharmacology, School of Medical, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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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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Yohana C, Bakuza JS, Kinung’hi SM, Nyundo BA, Rambau PF. The trend of schistosomiasis related bladder cancer in the lake zone, Tanzania: a retrospective review over 10 years period. Infect Agent Cancer 2023; 18:10. [PMID: 36800971 PMCID: PMC9938995 DOI: 10.1186/s13027-023-00491-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/28/2022] [Indexed: 02/21/2023] Open
Abstract
INTRODUCTION Bladder cancer is a possible outcome of chronic urinary schistosomiasis in many endemic countries. In Tanzania, the Lake Victoria area is one of the areas with the highest prevalence of urinary schistosomiasis and higher incidences of squamous cell carcinoma (SCC) of the urinary bladder. A previous study in the area over one decade (2001-2010) showed SCC to be common in patients aged below 50 years. With various prevention and intervention programs there are likely to be notable changes in schistosomiasis-related urinary bladder cancer, which is currently unknown. Updated information on the status of SCC in this area will be useful for giving an insights into efficacy of control interventions implemented and help guide the initiation of new ones. Therefore, this study was done to determine the current trend of schistosomiasis-related bladder cancer in lake zone, Tanzania. METHODS This was a descriptive retrospective study of histologically confirmed urinary bladder cancer cases diagnosed at the Pathology Department of Bugando Medical Centre over 10 years period. The patient files and histopathology reports were retrieved and information was extracted. Data were analyzed using Chi-square and student t-test. RESULTS A total of 481 patients were diagnosed with urinary bladder cancer during the study period whereby, 52.6% were males and 47.4% were females. The mean age regardless of histological type of cancer was 55 ± 14.2 years. The SCC was the commonest histological type accounting for 57.0%, followed by transitional cell carcinoma 37.6%, and 5.4% were adenocarcinomas. The Schistosoma haematobium eggs were observed in 25.2% and were commonly associated with SCC (p = 0.001). Poorly differentiated cancers were observed mostly in females (58.6%) compared to males (41.4%) (p = 0.003). Muscular invasion of the urinary bladder by cancer was observed in 11.4% of the patients, and this was significantly higher in non-squamous than in squamous cancers (p = 0.034). CONCLUSION Schistosomiasis-related cancers of the urinary bladder in the Lake zone of Tanzania is still a problem. Schistosoma haematobium eggs were associated with SCC type indicating the persistence of infection in the area. This calls for more efforts on preventive and intervention programs to reduce the burden of urinary bladder cancer in the lake zone.
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Affiliation(s)
- Coletha Yohana
- Department of Natural Sciences, Mbeya University of Science and Technology (MUST), P.O Box 131, Mbeya, Tanzania.
| | - Jared S. Bakuza
- grid.8193.30000 0004 0648 0244Department of Biological Sciences, Dar es Salaam University College of Education (DUCE), P.O Box 2329, Dar es Salaam, Tanzania
| | - Safari M. Kinung’hi
- grid.416716.30000 0004 0367 5636National Institute for Medical Research (NIMR), P.O Box 1462, Mwanza, Tanzania
| | - Bruno A. Nyundo
- grid.8193.30000 0004 0648 0244Department of Zoology and Wildlife Conservation, University of Dar Es Salaam, P.O Box 35064, Dar es Salaam, Tanzania
| | - Peter F. Rambau
- grid.411961.a0000 0004 0451 3858Department of Pathology, Catholic University of Health and Allied Sciences-Bugando (CUHAS-Bugando), Box 1464, Mwanza, Tanzania
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Mohammed H, Landeryou T, Chernet M, Liyew EF, Wulataw Y, Getachew B, Difabachew H, Phillips A, Maddren R, Ower A, Mekete K, Belay H, Endrias T, Anjulo U, Tasew G, Anderson R, Tollera G, Abate E. Comparing the accuracy of two diagnostic methods for detection of light Schistosoma haematobium infection in an elimination setting in Wolaita Zone, South Western Ethiopia. PLoS One 2022; 17:e0267378. [PMID: 35486627 PMCID: PMC9053789 DOI: 10.1371/journal.pone.0267378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/07/2022] [Indexed: 11/18/2022] Open
Abstract
Reagent urinalysis dipstick and filtration have been recommended diagnostic methods for the detection of urogenital schistosomiasis. However, the accurate diagnosis of light infections using these methods presents a major challenge. This study evaluates the diagnosis accuracy of light infection with Schistosoma haematobium in study participants living in Wolaita Zone, an area targeted for sustainable control of Schistosomiasis, and ultimately interrupt transmission. Urine samples were collected from children and adults in surveys carried out during baseline and longitudinal sentinel site surveys conducted from 2018 to 2020. All urine samples were tested using a reagent urinalysis dipstick test (Haemastix) to detect microhaematuria with reference urine filtration technique as a proxy for S. haematobium infection. Sensitivity and specificity were determined in diagnosing urogenital schistosomiasis. Cohen’s Kappa statistics was done for the agreement of these diagnostic methods. A total of 12,102 participants were enrolled in the current baseline study. Among them, 285 (2.35%) samples tested positive for microhaematuria and 21 (0.20%) positive for S. haematobium eggs. A total of 4,357 samples were examined in year 1 and year 2 using urine dipsticks, and urine filtration 172 (3.95%) and 2 (0.05%) were positive for microhaematuria and S. haematobium eggs. The reagent urinalysis dipsticks showed the highest sensitivity and specificity for diagnosing light intensity of infection,100% (95% CI:85.18–100.00) and 97.4% (95% CI: 97.10–97.60), respectively. There is a slight agreement between the two methods (Kappa = 0.09, 95% CI: 0.01–0.18). The present study revealed very low prevalence and light intensity of S. haematobium infections. The study also highlights that the dipstick test is considered a useful adjunct diagnostic tool for population-based control of urogenital schistosomiasis.
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Affiliation(s)
- Hussein Mohammed
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- * E-mail:
| | - Toby Landeryou
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Melkie Chernet
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ewnetu Firdawek Liyew
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Wulataw
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Birhanu Getachew
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Hailemariam Difabachew
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Anna Phillips
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Rosie Maddren
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Alison Ower
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Kalkidan Mekete
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Habtamu Belay
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tujuba Endrias
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ufaysa Anjulo
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Wolaita, Ethiopia
| | - Geremew Tasew
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Roy Anderson
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Getachew Tollera
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ebba Abate
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Musaigwa F, Kamdem SD, Mpotje T, Mosala P, Abdel Aziz N, Herbert DR, Brombacher F, Nono JK. Schistosoma mansoni infection induces plasmablast and plasma cell death in the bone marrow and accelerates the decline of host vaccine responses. PLoS Pathog 2022; 18:e1010327. [PMID: 35157732 PMCID: PMC8893680 DOI: 10.1371/journal.ppat.1010327] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 03/03/2022] [Accepted: 02/01/2022] [Indexed: 11/23/2022] Open
Abstract
Schistosomiasis is a potentially lethal parasitic disease that profoundly impacts systemic immune function in chronically infected hosts through mechanisms that remain unknown. Given the immunoregulatory dysregulation experienced in infected individuals, this study examined the impact of chronic schistosomiasis on the sustainability of vaccine-induced immunity in both children living in endemic areas and experimental infections in mice. Data show that chronic Schistosoma mansoni infection impaired the persistence of vaccine specific antibody responses in poliovirus-vaccinated humans and mice. Mechanistically, schistosomiasis primarily fostered plasmablast and plasma cell death in the bone marrow and removal of parasites following praziquantel treatment reversed the observed cell death and partially restored vaccine-induced memory responses associated with increased serum anti-polio antibody responses. Our findings strongly suggest a previously unrecognized mechanism to explain how chronic schistosomiasis interferes with an otherwise effective vaccine regimen and further advocates for therapeutic intervention strategies that reduce schistosomiasis burden in endemic areas prior to vaccination. Schistosoma mansoni (S. mansoni), a schistosomiasis disease-causing parasite species, is most common in sub-Saharan Africa. Schistosoma mansoni can influence immune responses and trigger physiological imbalances in their human and animal hosts, which improve their survival and multiplication in the host. These influences can disrupt the host’s ability to maintain long term protective immunity mounted by vaccines for infectious diseases. Here, we investigated the impact of S. mansoni infection on poliovirus vaccine immunity in school-aged children and mice. We found that the parasite reduced its host’s ability to maintain protective blood antibodies produced by immune responses to poliovirus vaccines. We also found that S. mansoni infection reduces the maintenance of antibody-producing plasma cells in the bone marrow of vaccinated mice. Our data showed that treating S. mansoni infected children and mice with praziquantel mitigated the parasite’s negative influences on vaccine immunity. These findings suggest that in regions where schistosomiasis is endemic, the Schistosoma spp. parasites may be notable causes of suboptimal viral vaccine immunity maintenance by children, leaving them vulnerable to vaccine-preventable diseases.
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Affiliation(s)
- Fungai Musaigwa
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
| | - Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Wellcome Centre for Infectious Diseases Research in Africa and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Thabo Mpotje
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
| | - Paballo Mosala
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
| | - Nada Abdel Aziz
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Chemistry Department, Faculty of Science, Cairo University, Giza, Egypt
| | - De’Broski R. Herbert
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Justin Komguep Nono
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Laboratory of ImmunoBiology and Helminth Infections, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
- * E-mail:
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Nalugwa A, Tukahebwa EM, Olsen A, Nuwaha F. Regression of Schistosoma mansoni associated morbidity among Ugandan preschool children following praziquantel treatment: A randomised trial. PLoS One 2021; 16:e0259338. [PMID: 34780499 PMCID: PMC8592404 DOI: 10.1371/journal.pone.0259338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/06/2021] [Indexed: 11/18/2022] Open
Abstract
Preschool children suffer from morbidity attributable to Schistosoma mansoni. We compared a single and double dose of praziquantel treatment on the regression of S. mansoni associated morbidity in children less than six years in Uganda. We measured the sizes of spleen and liver as well as liver fibrosis before treatment and 8 months after treatment among children who either received one dose (n = 201) or two doses (n = 184) of praziquantel (standard oral dose of 40 mg/kg body weight). Heamoglobin measurements were also taken. Overall, liver enlargement reduced from 52.2% (95% CI (Confidence interval) 45.1, 59.3) to 17.9% (95% CI 12.9, 23.9) with a single dose and from 48.4 (95% CI 40.9, 55.8) to 17.9% (95% CI 12.7, 24.3) with a double dose and there was no significant difference between the changes in proportion of children with enlarged liver between the two treatment groups. The proportion of children with enlarged spleen was not significantly reduced in the group treated with either one or two doses, 47.8% (95% CI 41.7, 54.9) to 45.3% (95% CI 38.3, 52.4) and 48.4% (95% CI 40.9,55.8) to 40.8% 95% CI 33.6, 48.2), respectively. Liver fibrosis detected among children getting single dose (n = 9) or double doses (n = 13) resolved after treatment with praziquantel. The number of children with low heamoglobin significantly reduced from 51.2% (95% CI 44.1, 58.3) to 0.5% (0.2, 0.8) and 61.4% (95% CI 53.9,68.5) to 1.1% (95% CI 0.1, 3.9) after single and double dose treatment, respectively. These results suggest that there is no evidence of a difference in effect between one dose of praziquantel and two doses in reversing morbidity attributable to S. mansoni among children less than six years of age.
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Affiliation(s)
- Allen Nalugwa
- Child Health and Development Centre, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Annette Olsen
- Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Fred Nuwaha
- Disease Control and Prevention, Makerere University, Kampala, Uganda
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Hybridized Zoonotic Schistosoma Infections Result in Hybridized Morbidity Profiles: A Clinical Morbidity Study amongst Co-Infected Human Populations of Senegal. Microorganisms 2021; 9:microorganisms9081776. [PMID: 34442855 PMCID: PMC8401530 DOI: 10.3390/microorganisms9081776] [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: 06/24/2021] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Hybridization of infectious agents is a major emerging public and veterinary health concern at the interface of evolution, epidemiology, and control. Whilst evidence of the extent of hybridization amongst parasites is increasing, their impact on morbidity remains largely unknown. This may be predicted to be particularly pertinent where parasites of animals with contrasting pathogenicity viably hybridize with human parasites. Recent research has revealed that viable zoonotic hybrids between human urogenital Schistosoma haematobium with intestinal Schistosoma species of livestock, notably Schistosoma bovis, can be highly prevalent across Africa and beyond. Examining human populations in Senegal, we found increased hepatic but decreased urogenital morbidity, and reduced improvement following treatment with praziquantel, in those infected with zoonotic hybrids compared to non-hybrids. Our results have implications for effective monitoring and evaluation of control programmes, and demonstrate for the first time the potential impact of parasite hybridizations on host morbidity.
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Ojo JA, Adedokun SA, Akindele AA, Olorunfemi AB, Otutu OA, Ojurongbe TA, Thomas BN, Velavan TP, Ojurongbe O. Prevalence of urogenital and intestinal schistosomiasis among school children in South-west Nigeria. PLoS Negl Trop Dis 2021; 15:e0009628. [PMID: 34314428 PMCID: PMC8345861 DOI: 10.1371/journal.pntd.0009628] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 08/06/2021] [Accepted: 07/05/2021] [Indexed: 01/25/2023] Open
Abstract
Background The risk of co-infection with Schistosoma haematobium and S. mansoni and the potential harmful effect on morbidity and control is enhanced by the overlapping distribution of both species in sub-Saharan Africa. Despite the reported high endemicity of both species in Nigeria, studies on the spread and effect of their mixed infection are limited. Therefore, a cross-sectional survey was conducted among school children in two communities in South-west Nigeria to investigate the prevalence of mixed human schistosome infection, intensity, and possible ectopic egg elimination. Methods Urine and stool samples were collected from consenting school children in Ilie and Ore communities of Osun State, Nigeria. Schistosoma haematobium eggs were detected in urine using the urine filtration technique, while S. mansoni eggs were detected in stool using the Kato–Katz thick smear technique. Results The study enrolled 466 primary and secondary school children (211; 45.3% males vs. 255; 54.7% females; mean age 11.6 ± 3.16 years). The overall prevalence of schistosomiasis was 40% (185/466), with 19% (89/466) recording single S. haematobium infection while 9% (41/465) had a single S. mansoni infection. The geometric mean egg count for S. haematobium was 189.4 egg/10ml urine; 95% CI: range 115.9–262.9, while for S. mansoni, it was 115.7 epg; 95% CI: range 78.4–152.9. The prevalence of ectopic S mansoni (S. mansoni eggs in urine) was 4.7%, while no ectopic S. haematobium (S. haematobium eggs in stool) was recorded. Mixed infection of S. haematobium/S. mansoni had a prevalence of 9.5% (44/466). More females (54.5%) presented with S. haematobium/S. mansoni co-infection. For both parasites, males had higher infection intensity, with a significant difference observed with S. haematobium (p = 0.0004). Hematuria was significant in individuals with single S. haematobium infection (p = 0.002), mixed ectopic S. haematobium/S. mansoni (p = 0.009) and mixed S. haematobium/S. mansoni/ectopic S. mansoni (p = 0.0003). Conclusions These findings suggest the probability of interspecific interactions between S. haematobium and S. mansoni. Scaling up of mass administration of praziquantel and control measures in the study areas is highly desirable. In sub-Saharan Africa, human schistosomiasis is a neglected disease of public health concern caused mostly by Schistosoma haematobium and Schistosoma mansoni. The overlapping range of both species in Africa considerably increases the chance of co-infection. School-aged children are the most vulnerable, as they participate in water contact activities that expose them to free-swimming cercariae released by infected snail species in freshwater. This study examined the probable mixed human Schistosoma infections and associated disease variables in school children in the communities of Ilie and Ore in southwest Nigeria. This study reveals a high prevalence of mixed S. haematobium and S. mansoni, and ectopic S. mansoni eggs (S. mansoni eggs in urine) elimination, highlighting the possible ongoing control challenges in this area. Furthermore, this study indicates that some form of inter-specific interaction exists between S. haematobium and S. mansoni, and may produce potentially significant consequences for developing morbidity in the study areas.
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Affiliation(s)
- Johnson A. Ojo
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Samuel A. Adedokun
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Akeem A. Akindele
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Adedolapo B. Olorunfemi
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Olawumi A. Otutu
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Taiwo A. Ojurongbe
- Department of Mathematical Sciences, Osun State University, Osogbo, Nigeria
| | - Bolaji N. Thomas
- Department of Biomedical Sciences, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester New York, United States of America
| | - Thirumalaisamy P. Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam
| | - Olusola Ojurongbe
- Department of Medical Microbiology & Parasitology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
- * E-mail:
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Mawa PA, Kincaid-Smith J, Tukahebwa EM, Webster JP, Wilson S. Schistosomiasis Morbidity Hotspots: Roles of the Human Host, the Parasite and Their Interface in the Development of Severe Morbidity. Front Immunol 2021; 12:635869. [PMID: 33790908 PMCID: PMC8005546 DOI: 10.3389/fimmu.2021.635869] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/25/2021] [Indexed: 12/14/2022] Open
Abstract
Schistosomiasis is the second most important human parasitic disease in terms of socioeconomic impact, causing great morbidity and mortality, predominantly across the African continent. For intestinal schistosomiasis, severe morbidity manifests as periportal fibrosis (PPF) in which large tracts of macro-fibrosis of the liver, visible by ultrasound, can occlude the main portal vein leading to portal hypertension (PHT), sequelae such as ascites and collateral vasculature, and ultimately fatalities. For urogenital schistosomiasis, severe morbidity manifests as pathology throughout the urinary system and genitals, and is a definitive cause of squamous cell bladder carcinoma. Preventative chemotherapy (PC) programmes, delivered through mass drug administration (MDA) of praziquantel (PZQ), have been at the forefront of schistosomiasis control programmes in sub-Saharan Africa since their commencement in Uganda in 2003. However, despite many successes, 'biological hotspots' (as distinct from 'operational hotspots') of both persistent high transmission and morbidity remain. In some areas, this failure to gain control of schistosomiasis has devastating consequences, with not only persistently high infection intensities, but both "subtle" and severe morbidity remaining prevalent. These hotspots highlight the requirement to revisit research into severe morbidity and its mechanisms, a topic that has been out of favor during times of PC implementation. Indeed, the focality and spatially-structured epidemiology of schistosomiasis, its transmission persistence and the morbidity induced, has long suggested that gene-environmental-interactions playing out at the host-parasite interface are crucial. Here we review evidence of potential unique parasite factors, host factors, and their gene-environmental interactions in terms of explaining differential morbidity profiles in the human host. We then take the situation of schistosomiasis mansoni within the Albertine region of Uganda as a case study in terms of elucidating the factors behind the severe morbidity observed and the avenues and directions for future research currently underway within a new research and clinical trial programme (FibroScHot).
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Affiliation(s)
- Patrice A. Mawa
- Immunomodulation and Vaccines Programme, Medical Research Council-Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) Uganda Research Unit, Entebbe, Uganda
- Department of Immunology, Uganda Virus Research Institute, Entebbe, Uganda
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Julien Kincaid-Smith
- Centre for Emerging, Endemic and Exotic Diseases (CEEED), Department of Pathobiology and Population Sciences (PPS), Royal Veterinary College, University of London, Herts, United Kingdom
| | | | - Joanne P. Webster
- Centre for Emerging, Endemic and Exotic Diseases (CEEED), Department of Pathobiology and Population Sciences (PPS), Royal Veterinary College, University of London, Herts, United Kingdom
| | - Shona Wilson
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
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10
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Kamdem SD, Kuemkon EM, Kamguia LM, Tchanana GK, Konhawa F, Nche F, Oumarou A, Hamza M, Essomba RG, Kengne M, Ondigui BE, Assoumou MCO, Brombacher F, Nono JK. An ultrasound-based referential of body height-adjusted normal liver organometry in school children from Bokito in rural Cameroon. Sci Rep 2020; 10:2773. [PMID: 32066761 PMCID: PMC7026466 DOI: 10.1038/s41598-020-59613-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/22/2020] [Indexed: 11/16/2022] Open
Abstract
The grading system for ultrasonographic assessment of Schistosoma mansoni morbidity is crucial for evaluation of control programs. This requires prior definition of normal liver organometric ranges in the population from the endemic area. A cross-sectional study was conducted in a S. mansoni endemic area in rural Cameroon. 1002 Participants were screened and 234 of them, free from all common liver-affecting diseases in the area (schistosomiasis, malaria, hepatitis B and C) and with no ultrasonographic signs of liver disease were selected and their liver parameters measured by ultrasonography. All statistics were considered significant for p-values < 0.05. Normal dimensions of livers lobe sizes, portal vein wall thickness and portal vein diameters are reported. The liver organometric data are presented for the entire study population as a whole and separately for males and females as prediction plots, with observed values and fitted regression line with 95% confidence. Reference ranges for liver parameters (size, portal vein thickness and diameter) adjusted for body height established in the current study are novel for Cameroon. The prediction plots generated should improve the accuracy of the assessment of liver morbidity by ultrasonography in the region.
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Affiliation(s)
- Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
| | - Erve Martial Kuemkon
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Leonel Meyo Kamguia
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Gladys K Tchanana
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
- CIAB EXACT Medical Laboratory, Yaoundé, Cameroon
| | - Francis Konhawa
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Frungwa Nche
- Faculty of medicine and biomedical sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - René Ghislain Essomba
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
- National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | - Michel Kengne
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | | | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Justin Komguep Nono
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.
- Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.
- Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon.
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11
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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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12
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Kamdem SD, Konhawa F, Kuemkon EM, Meyo Kamguia L, Tchanana GK, Nche F, Oumarou A, Hamza M, Ouratou Y, Tcheutchoua MN, Ghislain Essomba R, Ngogang MP, Kengne M, Netongo PM, Ondigui BE, Okomo Assoumou MC, Brombacher F, Nono JK. Negative Association of Interleukin-33 Plasma Levels and Schistosomiasis Infection in a Site of Polyparasitism in Rural Cameroon. Front Immunol 2019; 10:2827. [PMID: 31849991 PMCID: PMC6901687 DOI: 10.3389/fimmu.2019.02827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022] Open
Abstract
Background: This study aimed to investigate the association of plasma levels of IL-33, a mucosal alarmin known to elicit type-2 immunity, with infection and liver fibrosis profiles of school children from an endemic area for Schistosoma mansoni, malaria and hepatitis (B & C) in rural Cameroon. Methods: A cross-sectional study enrolling schoolchildren from 5 public schools was conducted. Single schistosomiasis, malaria and hepatitis infections or co-infections were assessed by kato katz, microscopy, and rapid diagnostic tests, respectively. Hepatic fibrosis was assessed by ultrasound according to WHO Niamey guidelines and plasma levels of Interleukin 33 were determined by ELISA. All statistics were performed using R studio software. Principal findings: We found a prevalence of 13.5% (37/275), 18.2% (50/275), and 8% (22/275), respectively for schistosomiasis, malaria and hepatitis (B or C) single infections. Only 7.6% (21/275) of co-infections were reported. Although Plasma IL-33 showed a minimal negative risk for schistosomiasis infection (AOR 0.99; 95% CI 0.97–1.01), S. mansoni infected participants had lower levels of plasma IL-33 (p = 0.003) which decreased significantly as eggs burdens increased (p = 0.01) with a negative Pearson coefficient of r = −0.22. Hepatic fibrosis occurred in 47.3% (130/275) of our study population independently from plasma levels of IL-33 (AOR 1.00; 95% CI 0.99–1.01). Conclusion/Significance: Our data failed to show an association between plasma IL-33 levels and liver disease but convincingly report on a negative association between plasma IL-33 levels and schistosomiasis infection and egg burden in school children from a polyparasitic schistosomiasis endemic area.
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Affiliation(s)
- Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
| | - Francis Konhawa
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Erve Martial Kuemkon
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Leonel Meyo Kamguia
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Gladys K Tchanana
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,CIAB EXACT Medical Laboratory, Yaoundé, Cameroon
| | - Frungwa Nche
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Yasmine Ouratou
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - René Ghislain Essomba
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | | | - Michel Kengne
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Palmer Masumbe Netongo
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon.,Department of Biochemistry, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Justin Komguep Nono
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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13
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Anyan WK, Abonie SD, Aboagye-Antwi F, Tettey MD, Nartey LK, Hanington PC, Anang AK, Muench SB. Concurrent Schistosoma mansoni and Schistosoma haematobium infections in a peri-urban community along the Weija dam in Ghana: A wake up call for effective National Control Programme. Acta Trop 2019; 199:105116. [PMID: 31356786 DOI: 10.1016/j.actatropica.2019.105116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/31/2019] [Accepted: 07/25/2019] [Indexed: 11/30/2022]
Abstract
Globally over 200 million people are infected with schistosomiasis, and approximately 80% are caused by just two of five species, Schistosoma haematobium and Schitosoma mansoni that are broadly distributed, and often overlap across sub-Saharan Africa. Like most neglected tropical diseases, mortality is low (an estimated 200,000 deaths annually) and morbidity is considerably high and probably underestimated. Surprisingly, little attention has been given to co-infection with these two species. We have studied co-infection with S. mansoni and S. haematobium in a peri-urban community in Ghana, one of the most highly endemic countries for schistosomiasis. We collected and examined snails of the two intermediate host species from the reservoir adjacent to the community. We also used microscopical examination of stool and urine samples to determine the level of concurrent S. mansoni and S. haematobium infections in school and administered questionnaires to assess water contact activities that predispose pupils to infections Examination of the snail hosts revealed that 0.7% (7/896) of Bulinus truncatus and 1.7% (14/780) of Biomphalaria pfeifferi snails were found to be hosting cercariae morphologically consistent with that of S. haematobium and S. mansoni respectively. The overall prevalence values for urogenital and intestinal schistosomiasis were 66.8% (135/202) and 90.1% (163/181) respectively. Only 50 of 181 schistosome-infected pupils had single-species infections and the remaining 131 pupils presented concurrent infections. Among the 131 infected with both species were 50 individuals having only S. mansoni eggs in stool and S. haematobium eggs in urine (conventional presentation). Eighty-one children (81) had eggs of both species in either urine and/or stool (ectopic presentation). From these 81, 63 had eggs of both species in urine, 6 had both species in stool, and 12 had eggs of both species present in both urine and stool. A comparatively large number of individuals from the concurrent infected group presented high and moderate infection intensities than the single infected groups. The overwhelmingly high prevalence of concurrent infections indicates further study of co-infection is needed, and points to a need call for a holistic disease control plan so Ghana can be part of nations to achieve the WHO roadmap target for schistosomiasis control by 2020.
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Affiliation(s)
- William K Anyan
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana.
| | - Severin D Abonie
- Department of Animal Biology and Conservation Science, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Fred Aboagye-Antwi
- Department of Animal Biology and Conservation Science, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Mabel D Tettey
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Linda K Nartey
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | | | - Abraham K Anang
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Susan B Muench
- Biology Department, State University of New York at Geneseo, Geneseo, NY, USA
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14
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Tetteh-Quarcoo PB, Akuetteh BK, Owusu IA, Quayson SE, Attah SK, Armah R, Afutu E, Afrah A, Addo-Osafo K, Smith C, Gyasi RK, Ayeh-Kumi PF. Cytological and Wet Mount Microscopic Observations Made in Urine of Schistosoma haematobium-Infected Children: Hint of the Implication in Bladder Cancer. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2019; 2019:7912186. [PMID: 31565106 PMCID: PMC6745107 DOI: 10.1155/2019/7912186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/23/2019] [Accepted: 08/17/2019] [Indexed: 12/03/2022]
Abstract
BACKGROUND Schistosomiasis is the second major human parasitic disease next to malaria, in terms of socioeconomic and public health consequences, especially in sub-Saharan Africa. Schistosoma haematobium (S. haematobium) is a trematode and one of the species of Schistosoma that cause urogenital schistosomiasis (urinary schistosomiasis). Although the knowledge of this disease has improved over the years, there are still endemic areas, with most of the reported cases in Africa, including Ghana. Not much has been done in Ghana to investigate cytological abnormalities in individuals within endemic communities, although there are epidemiologic evidences linking S. haematobium infection with carcinoma of the bladder. AIM The aim of this study was to identify microscopic and cytological abnormalities in the urine deposits of S. haematobium-infected children. METHODOLOGY Three hundred and sixty-seven (367) urine samples were collected from school children in Zenu and Weija communities. All the samples were examined microscopically for the presence of S. haematobium eggs, after which the infected samples and controls were processed for cytological investigation. RESULTS S. haematobium ova were present in 66 (18.0%) out of the 367 urine samples. Inflammatory cells (82%, 54/66), hyperkeratosis (47%, 31/66), and squamous cell metaplasia (24%, 16/66) were the main observations made during the cytological examination of the S. haematobium-infected urine samples. CONCLUSION Cytological abnormalities in S. haematobium-infected children may play an important role in the severity of the disease, leading to the possible development of bladder cancer in later years, if early attention is not given. Therefore, routine cytological screening for urogenital schistosomiasis patients (especially children) at hospitals in S. haematobium-endemic locations is recommended.
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Affiliation(s)
- Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Benjamin K. Akuetteh
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Irene A. Owusu
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Solomon E. Quayson
- Department of Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Simon K. Attah
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Robert Armah
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Emmanuel Afutu
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Ama Afrah
- Department of Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Kantanka Addo-Osafo
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Cecilia Smith
- Department of Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Richard K. Gyasi
- Department of Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Patrick F. Ayeh-Kumi
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
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15
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Nono JK, Kamdem SD, Netongo PM, Dabee S, Schomaker M, Oumarou A, Brombacher F, Moyou-Somo R. Schistosomiasis Burden and Its Association With Lower Measles Vaccine Responses in School Children From Rural Cameroon. Front Immunol 2018; 9:2295. [PMID: 30356757 PMCID: PMC6189399 DOI: 10.3389/fimmu.2018.02295] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/17/2018] [Indexed: 12/19/2022] Open
Abstract
Background and Methods: Schistosomiasis is debilitating and reported to impair immune responsiveness of infected hosts. In Cameroon, mass drug administration (MDA) is used in schoolchildren to reduce transmission of S. haematobium and S. mansoni. The effects of MDA and the impact of schistosomiasis on the titers of antibodies in vaccinated children have been poorly studied. We therefore assessed the prevalence of schistosomiasis in schoolchildren, eight months after MDA, in two locations: Barombi Koto (BK), endemic for S. haematobium (N = 169) and Yoro (Y), endemic for S. mansoni (N = 356). Age, gender, residence time and frequency of contact with river water were assessed as risk factors for infection and morbidity in both localities. In 70 schoolchildren from BK and 83 from Y, ultrasound was used to assess morbidity according to the WHO guidelines. Evaluation of measles antibodies was performed in previously vaccinated schoolchildren (14 with S. haematobium and 12 egg-negative controls from BK and 47 with S. mansoni and12 egg-negative controls from Y). Principal Findings and conclusions: The prevalence of S. haematobium was 25. 4% in BK (43/169) and 34.8% for S. mansoni in Y (124/356), indicating the persistent transmission of schistosomiasis despite MDA. Older age (AOR 1.31; 95%CI 1.12–1.54) and higher frequencies of exposure to river water (AOR 1.99; 95%CI 1.03–3.86) were identified as risks for infection in BK whereas only older age (OR 1.15; 95%CI 1.04–1.27) was a risk for infection in Y. Bladder pathology (score 2 to 5) was observed in 29.2% (7/24) of egg-positive children in BK and liver pathology (pattern C) in 31.1% (19/61) of egg-positive children in Y. There was a positive correlation between S. haematobium egg burden and bladder pathology (AOR 1.01; 95% CI 0.99–1.02) and positive correlation between S. mansoni-driven liver pathology and female gender (AOR 3.01; 95% CI 0.88–10.26). Anti-measles antibodies in vaccinated children were significantly lower in S. mansoni-infected when compared to egg-negative controls (p = 0.001), which was not observed in the S. haematobium-infected group from BK. Our results demonstrate a questionable efficacy of MDA alone in halting schistosomiasis transmission and confirm a possible immunomodulatory effect of S. mansoni on response to vaccines.
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Affiliation(s)
- Justin Komguep Nono
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon.,Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | - Smritee Dabee
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Michael Schomaker
- Centre for Infectious Disease Epidemiology & Research, University of Cape Town, Cape Town, South Africa
| | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Roger Moyou-Somo
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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16
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Atalabi TE, Adoh SD, Eze KM. The current epidemiological status of urogenital schistosomiasis among primary school pupils in Katsina State, Nigeria: An imperative for a scale up of water and sanitation initiative and mass administration of medicines with Praziquantel. PLoS Negl Trop Dis 2018; 12:e0006636. [PMID: 29979684 PMCID: PMC6051670 DOI: 10.1371/journal.pntd.0006636] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/18/2018] [Accepted: 06/25/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Human schistosomiasis, a debilitating and chronic disease, is among a set of 17 neglected tropical infectious diseases of poverty that is currently posing a threat to the wellbeing of 2 billion people in the world. The SHAWN/WASH and MAM programmes in the study area require epidemiological data to enhance their effectiveness. We therefore embarked on this cross-sectional study with the aim of investigating the prevalence, intensity and risk factors of urogenital schistosomiasis. METHODOLOGY/ PRINCIPAL FINDINGS Interviewed 484 respondents produced terminal urine samples (between 10.00h - 14.00h) which were analyzed with Medi ─Test Combi 10 and centrifuged at 400 r.p.m for 4 minutes using C2 series Centurion Scientific Centrifuge. Eggs of S. haematobium were identified with their terminal spines using Motic Binocular Microscope. Data were analyzed with Epi Info 7. In this study, the overall prevalence and arithmetic mean intensity of the infection were 8.68% (6.39─ 11.64) and 80.09 (30.92─129.28) eggs per 10ml of urine respectively. Urogenital schistosomiasis was significantly associated with knowledge about the snail host (χ2 = 4.23; P = 0.0398); water contact activities (χ2 = 25.788; P = 0.0001), gender (χ2 = 16.722; P = 0.0001); age (χ2 = 9.589; P = 0.0019); economic status of school attended (χ2 = 4.869; P = 0.0273); residence distance from open water sources (χ2 = 10.546; P = 0.0012); mothers' occupational (χ2 = 6.081; P = 0.0137) and educational status (χ2 = 4.139; P = 0.0419). CONCLUSION/ SIGNIFICANCE The overall prevalence obtained in this survey shows that the study area was at a low-risk degree of endemicity for urogenital schistosomiasis. Beneath this is a subtle, latent and deadly morbidity-inducing heavy mean intensity of infection, calling for urgent implementation of WHO recommendation that MAM with PZQ be carried out twice for School-Age Children (enrolled or not enrolled) during their primary schooling age (once each at the point of admission and graduation). The criteria for classifying endemic areas for schistosomiasis should also be reviewed to capture the magnitude of mean intensity of infection rather than prevalence only as this may underplay its epidemiological severity.
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Affiliation(s)
- Tolulope Ebenezer Atalabi
- Department of Biological Sciences, Faculty of Science, Federal University Dutsin-Ma, Dutsin-Ma, Katsina State, Nigeria
| | - Stephen Dumebi Adoh
- Department of Biological Sciences, Faculty of Science, Federal University Dutsin-Ma, Dutsin-Ma, Katsina State, Nigeria
| | - Kingsley Marvin Eze
- Department of Biological Sciences, Faculty of Science, Federal University Dutsin-Ma, Dutsin-Ma, Katsina State, Nigeria
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Evolutionary epidemiology of schistosomiasis: linking parasite genetics with disease phenotype in humans. Int J Parasitol 2017; 48:107-115. [PMID: 29154994 DOI: 10.1016/j.ijpara.2017.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 06/15/2017] [Accepted: 07/05/2017] [Indexed: 12/21/2022]
Abstract
Here we assess the role of parasite genetic variation in host disease phenotype in human schistosomiasis by implementing concepts and techniques from environmental association analysis in evolutionary epidemiology. Schistosomiasis is a tropical disease that affects more than 200 million people worldwide and is caused by parasitic flatworms belonging to the genus Schistosoma. While the role of host genetics has been extensively studied and demonstrated, nothing is yet known on the contribution of parasite genetic variation to host disease phenotype in human schistosomiasis. In this study microsatellite genotypes of 1561 Schistosoma mansoni larvae collected from 44 human hosts in Senegal were linked to host characteristics such as age, gender, infection intensity, liver and bladder morbidity by means of multivariate regression methods (on each parasite locus separately). This revealed a highly significant association between allelic variation at the parasite locus L46951 and host infection intensity and bladder morbidity. Locus L46951 is located in the 3' untranslated region of the cGMP-dependent protein kinase gene that is expressed in reproductive organs of adult schistosome worms and appears to be linked to egg production. This putative link between parasite genetic variation and schistosomiasis disease phenotype sets the stage for further functional research.
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Oyeyemi OT, Odaibo AB. Maternal urogenital schistosomiasis; monitoring disease morbidity by simple reagent strips. PLoS One 2017; 12:e0187433. [PMID: 29091946 PMCID: PMC5665599 DOI: 10.1371/journal.pone.0187433] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/19/2017] [Indexed: 11/18/2022] Open
Abstract
Background Urine analysis is one of the recommended antenatal guidelines for early diagnosis of pregnancy-associated complications. While in practice, urine analysis by dipstick had been used to provide useful information on other urinary tract infections, its applications for early detection of urogenital schistosomiasis in pregnant women is often times not given due attention in most endemic areas. Our study therefore assessed the performance of some common urinalysis parameters in the diagnosis of maternal urogenital schistosomiasis in endemic rural communities of Nigeria. Methodology/Principal findings The cross-sectional epidemiologic survey of urogenital schistosomiasis was conducted among pregnant women in Yewa North Local Government, Ogun State, Nigeria. The women were microscopically examined for infection with Schistosoma haematobium, visually observed for macrohematuria, and screened for microhematuria and proteinuria using standard urine chemical reagent strips. Of 261 volunteered participants, 19.9% tested positive for S. haematobium infection. The proportion of microhematuria (23.8%) was significantly higher than that of macrohematuria (3.8%) and proteinuria (16.8%) (P<0.05). Microhematuria with sensitivity (82.7%) and specificity (89.0%) was the best diagnostic indicator of urogenital schistosomiasis. Macrohematuria with the least sensitivity (11.8%) was however the most specific (98.1%) for diagnosing urogenital schistosomiasis in pregnant women. Maximum microhematuria sensitivity (100.0%) was observed in women between 15–19 years but sensitivity was consistently low in older age groups. Maximum sensitivity, specificity and predictive values (100.0%) were recorded for microhematuria in first trimester women. Diagnostic efficiency of proteinuria and macrohematuria was also better in the first trimester women except the 25.0% specificity recorded for proteinuria. The overall diagnostic performance of microhematuria and proteinuria was better in secundigravidae. Conclusions/Significance Microhematuria can be used for early detection of urogenital schistosomiasis in endemic areas especially in younger women. However because microhematuria is a condition that occurs during pregnancy and in several other diseases, it is necessary to compliment the diagnosis with other diagnostic tools such as microscopy and serology. Treatment with praziquantel is recommended for the women in their late trimesters after follow up test in order to avert associated adverse pregnancy outcomes.
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Affiliation(s)
- Oyetunde T. Oyeyemi
- Department of Biological Sciences, University of Medical Sciences, Ondo, Ondo State, Nigeria
- * E-mail: ,
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Mduluza T, Mutapi F. Putting the treatment of paediatric schistosomiasis into context. Infect Dis Poverty 2017; 6:85. [PMID: 28388940 PMCID: PMC5384153 DOI: 10.1186/s40249-017-0300-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 04/04/2017] [Indexed: 12/19/2022] Open
Abstract
Despite increased international efforts to control schistosomiasis using preventive chemotherapy, several challenges still exist in reaching the target populations. Until recently, preschool-aged children had been excluded from the recommended target population for mass drug administration, i.e. primary school children aged 6-15 years. Our studies and those of others provided the evidence base for the need to treat preschool-aged children that led to recommendations by the World Health Organization to include preschool-aged children in treatment programmes in 2010. The major challenge now lies in the unavailability of a child-size formulation of the appropriate anthelmintic drug, praziquantel.The currently available formulation of praziquantel presents several problems. First, it is a large tablet, making it difficult for young children and infants to swallow it and thus requires its breaking/crushing to allow for safe uptake. Second, it is bitter so it is often mixed with a sweetener to make it palatable for young children. Third, the current formulation of 600 mg does not allow for flexible dose adjustments for this age group. Thus, there is a need to formulate a child-appropriate praziquantel tablet.This paper discusses the target product profile for paediatric praziquantel, as well as knowledge gaps pertinent to the successful control of schistosome infection and disease in preschool-aged children.
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Affiliation(s)
- Takafira Mduluza
- Biochemistry Department, University of Zimbabwe, P.O. Box MP167, Mount Pleasant, Harare, Zimbabwe
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Francisca Mutapi
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Charlotte Auerbach Road, Edinburgh, EH9 3FL UK
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Barda B, Coulibaly JT, Hatz C, Keiser J. Ultrasonographic evaluation of urinary tract morbidity in school-aged and preschool-aged children infected with Schistosoma haematobium and its evolution after praziquantel treatment: A randomized controlled trial. PLoS Negl Trop Dis 2017; 11:e0005400. [PMID: 28222149 PMCID: PMC5336295 DOI: 10.1371/journal.pntd.0005400] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/03/2017] [Accepted: 02/10/2017] [Indexed: 11/18/2022] Open
Abstract
Background Schistosoma haematobium infections are responsible for significant urinary tract (UT) complications. Schistosomiasis control programs aim to reduce morbidity, yet the extent of morbidity in preschool-aged children and the impact of treatment on morbidity reduction are not well studied. Methodology Our study was embedded in a randomized, placebo-controlled, single-blind trial in Côte d’Ivoire, which evaluated the efficacy and safety of three doses (20, 40 and 60 mg/kg) of praziquantel in school-aged (SAC) and preschool-aged (PSAC) children infected with S. haematobium. Enrolled children were invited to participate in an ultrasound examination prior and six months after treatment. At these time points 3 urine samples were collected for parasitological and clinical examinations. Principal findings 162 PSAC and 141 SAC participated in the ultrasound examination at baseline, of which 128 PSAC and 122 SAC were present at follow-up. At baseline 43% (70/162) of PSAC had UT morbidity, mostly at bladder level and 7% had hydronephrosis. 67% (94/141) of SAC revealed mainly moderate UT pathology, 4% presented pseudopolyps on the bladder wall, and 6% had pyelectasis. At follow up, 45% of PSAC and 58% of SAC were S. haematobium positive, mostly harboring light infection intensities (41% and 51%, respectively). Microhematuria was present in 33% of PSAC and 42% of SAC and leukocyturia in 53% and 40% of PSAC and SAC, respectively. 50% (64/128) of PSAC and 58% (71/122) of SAC presented urinary tract morbidity, which was mainly mild. A significant correlation (p<0.05) was observed between praziquantel treatment and reversal of S. haematobium induced morbidity. Progression of UT pathology decreased with increasing praziquantel dosages. A worsening of morbidity was observed among children in the placebo group. Conclusion/Significance Bladder morbidity is widespread among PSAC. Praziquantel treatment is significantly associated with the reversal of S. haematobium induced morbidity, which underscores the importance of preventive chemotherapy programs. These programs should be expanded to PSAC to prevent or decrease the prevalence of morbidity in young children. This trial is registered as an International Standard Randomized Controlled Trial, number ISRCTN15280205. Schistosoma haematobium is a parasite that infects the human genito-urinary tract. People get infected with the parasite through contact with fresh water and children are at major risk. The complications linked to this infection are due to an inflammation caused by accumulation of the eggs in peri-bladder veins. If not treated, infections can last years and different degrees of severity are observed. These range from thickening of the bladder wall and blurriness of the mucosa to more serious lesions such as pseudo polyps and masses in the bladder that can, with time, evolve in cancer of the bladder. We analyzed preschool-aged children (PSAC) and school-aged children (SAC) with ultrasound before and after praziquantel treatment. Children were randomly assigned to different doses of praziquantel (20, 40 or 60 mg/kg) or to placebo at baseline. Six months after treatment all children underwent another ultrasound of the urinary tract. We included 162 PSAC and 141 SAC at baseline, of which 128 PSAC and 122 SAC had a second ultrasound evaluation six months afterwards. In addition, urine was sampled at both time points for presence of blood, proteins and signs of infection (leukocytes and nitrates). Six months post-treatment 45% of PSAC and 58% of SAC were S. haematobium positive. Already at the first screening 43% of PSAC and 67% of SAC had bladder lesions. After treatment 50% of PSAC and 58% of SAC still had pathology linked to the infection. We found a correlation between the treatment dose and healing of bladder lesions. On the other hand, we experienced an aggravation of lesions in the placebo group. Praziquantel is given to SAC as preventive chemotherapy every year at national level, where this parasite is endemic. This program should be expanded and include PSAC as well in order to reduce the consequences of infection.
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Affiliation(s)
- Beatrice Barda
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Jean T. Coulibaly
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Christoph Hatz
- University of Basel, CH-4003 Basel, Switzerland
- Medical Department, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
- * E-mail:
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21
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Epidemiological Interactions between Urogenital and Intestinal Human Schistosomiasis in the Context of Praziquantel Treatment across Three West African Countries. PLoS Negl Trop Dis 2015; 9:e0004019. [PMID: 26469347 PMCID: PMC4607489 DOI: 10.1371/journal.pntd.0004019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/30/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In many parts of sub-Saharan Africa, urogenital and intestinal schistosomiasis co-occur, and mixed species infections containing both Schistosoma haematobium and S. mansoni can be common. During co-infection, interactions between these two species are possible, yet the extent to which such interactions influence disease dynamics or the outcome of control efforts remains poorly understood. METHODOLOGY/PRINCIPAL FINDINGS Here we analyse epidemiological data from three West African countries co-endemic for urogenital and intestinal schistosomiasis (Senegal, Niger and Mali) to test whether the impact of praziquantel (PZQ) treatment, subsequent levels of re-infection or long-term infection dynamics are altered by co-infection. In all countries, positive associations between the two species prevailed at baseline: infection by one species tended to predict infection intensity for the other, with the strength of association varying across sites. Encouragingly, we found little evidence that co-infection influenced PZQ efficacy: species-specific egg reduction rates (ERR) and cure rates (CR) did not differ significantly with co-infection, and variation in treatment success was largely geographical. In Senegal, despite positive associations at baseline, children with S. mansoni co-infection at the time of treatment were less intensely re-infected by S. haematobium than those with single infections, suggesting competition between the species may occur post-treatment. Furthermore, the proportion of schistosome infections attributable to S. mansoni increased over time in all three countries examined. CONCLUSIONS/SIGNIFICANCE These findings suggest that while co-infection between urinary and intestinal schistosomes may not directly affect PZQ treatment efficacy, competitive interspecific interactions may influence epidemiological patterns of re-infection post-treatment. While re-infection patterns differed most strongly according to geographic location, interspecific interactions also seem to play a role, and could cause the community composition in mixed species settings to shift as disease control efforts intensify, a situation with implications for future disease management in this multi-species system.
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22
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Meurs L, Brienen E, Mbow M, Ochola EA, Mboup S, Karanja DMS, Secor WE, Polman K, van Lieshout L. Is PCR the Next Reference Standard for the Diagnosis of Schistosoma in Stool? A Comparison with Microscopy in Senegal and Kenya. PLoS Negl Trop Dis 2015. [PMID: 26217948 PMCID: PMC4517772 DOI: 10.1371/journal.pntd.0003959] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The current reference test for the detection of S. mansoni in endemic areas is stool microscopy based on one or more Kato-Katz stool smears. However, stool microscopy has several shortcomings that greatly affect the efficacy of current schistosomiasis control programs. A highly specific multiplex real-time polymerase chain reaction (PCR) targeting the Schistosoma internal transcriber-spacer-2 sequence (ITS2) was developed by our group a few years ago, but so far this PCR has been applied mostly on urine samples. Here, we performed more in-depth evaluation of the ITS2 PCR as an alternative method to standard microscopy for the detection and quantification of Schistosoma spp. in stool samples. METHODOLOGY/PRINCIPAL FINDINGS Microscopy and PCR were performed in a Senegalese community (n = 197) in an area with high S. mansoni transmission and co-occurrence of S. haematobium, and in Kenyan schoolchildren (n = 760) from an area with comparatively low S. mansoni transmission. Despite the differences in Schistosoma endemicity the PCR performed very similarly in both areas; 13-15% more infections were detected by PCR when comparing to microscopy of a single stool sample. Even when 2-3 stool samples were used for microscopy, PCR on one stool sample detected more infections, especially in people with light-intensity infections and in children from low-risk schools. The low prevalence of soil-transmitted helminthiasis in both populations was confirmed by an additional multiplex PCR. CONCLUSIONS/SIGNIFICANCE The ITS2-based PCR was more sensitive than standard microscopy in detecting Schistosoma spp. This would be particularly useful for S. mansoni detection in low transmission areas, and post-control settings, and as such improve schistosomiasis control programs, epidemiological research, and quality control of microscopy. Moreover, it can be complemented with other (multiplex real-time) PCRs to detect a wider range of helminths and thus enhance effectiveness of current integrated control and elimination strategies for neglected tropical diseases.
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Affiliation(s)
- Lynn Meurs
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eric Brienen
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Moustapha Mbow
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Elizabeth A. Ochola
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Diana M. S. Karanja
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - W. Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail: ,
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Davis SM, Wiegand RE, Mulama F, Kareko EI, Harris R, Ochola E, Samuels AM, Rawago F, Mwinzi PM, Fox LM, Odiere MR, Won KY. Morbidity associated with schistosomiasis before and after treatment in young children in Rusinga Island, western Kenya. Am J Trop Med Hyg 2015; 92:952-8. [PMID: 25758651 DOI: 10.4269/ajtmh.14-0346] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 01/19/2015] [Indexed: 11/07/2022] Open
Abstract
Schistosoma mansoni infection is a major cause of organomegaly and ultimately liver fibrosis in adults. Morbidity in pre-school-aged children is less defined, and they are currently not included in mass drug administration (MDA) programs for schistosomiasis control. We report results of a study of the association of schistosomiasis with organomegaly in a convenience sample of 201 children under 7 years old in Rusinga, Kenya on two cross-sectional visits, before and after praziquantel treatment. Data included stool examination and serology for schistosomiasis, the Niamey ultrasound protocol to stage hepatosplenic morbidity including organomegaly, and potential confounders including malaria. Unadjusted and adjusted Poisson regressions were performed. The baseline prevalence of schistosomiasis by antibody and/or stool was 80.3%. Schistomiasis was associated with hepatomegaly (adjusted prevalence ratio [aPR] = 1.4; 95% confidence interval [CI]: 1.0-2.1) and splenomegaly (aPR = 2.1; 95% CI: 1.2-3.7). The association with hepatomegaly persisted posttreatment (aPR = 1.4; 95% CI: 1.1-1.6). Schistosomiasis was associated with morbidity in this cohort. Efforts to include young children in mass treatment campaigns should intensify.
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Affiliation(s)
- Stephanie M Davis
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Ryan E Wiegand
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Fridah Mulama
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Edmund Ireri Kareko
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Robert Harris
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Elizabeth Ochola
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Aaron M Samuels
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Fredrick Rawago
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Pauline M Mwinzi
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - LeAnne M Fox
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Maurice R Odiere
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
| | - Kimberly Y Won
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia; Kenya Medical Research Institute, Neglected Tropical Diseases Unit, Kisumu, Kenya; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Radiology, Geisel School of Medicine at Dartmouth University, Hanover, New Hampshire
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Akpata R, Neumayr A, Holtfreter MC, Krantz I, Singh DD, Mota R, Walter S, Hatz C, Richter J. The WHO ultrasonography protocol for assessing morbidity due to Schistosoma haematobium. Acceptance and evolution over 14 years. Systematic review. Parasitol Res 2015; 114:1279-89. [DOI: 10.1007/s00436-015-4389-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 02/05/2015] [Indexed: 01/26/2023]
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25
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Mutengo MM, Mwansa JCL, Mduluza T, Sianongo S, Chipeta J. High Schistosoma mansoni disease burden in a rural district of western Zambia. Am J Trop Med Hyg 2014; 91:965-72. [PMID: 25246696 DOI: 10.4269/ajtmh.13-0612] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Schistosoma mansoni disease is endemic in most parts of rural Zambia, and associated complications are common. We conducted a cross-sectional study among 754 people in rural communities of Kaoma District, western Zambia to determine the burden of S. mansoni infection and associated morbidity. Parasitology and ultrasonography assessments were conducted on consenting participants. The overall prevalence of S. mansoni infection and geometric mean egg count (GMEC) were 42.4% (304) and 86.6 eggs per gram (95% confidence interval = 75.6-99.6), respectively. Prevalence was highest in the age group of 15-19 years old (adjusted prevalence ratio = 1.70, P = 0.017). S. mansoni-related portal fibrosis was detected in 26% of the participants screened. Participants above 39 years old were 2.93 times more likely to have fibrosis than the 7-9 years old age group (P = 0.004). The study highlights the high burden of S. mansoni disease in this area and calls for immediate interventions to avert complications associated with the disease.
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Affiliation(s)
- Mable M Mutengo
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka, Zambia; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia; Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe; Department of Pediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia
| | - James C L Mwansa
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka, Zambia; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia; Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe; Department of Pediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia
| | - Takafira Mduluza
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka, Zambia; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia; Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe; Department of Pediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia
| | - Sandie Sianongo
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka, Zambia; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia; Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe; Department of Pediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia
| | - James Chipeta
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka, Zambia; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia; Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe; Department of Pediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia
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26
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Meurs L, Mbow M, Boon N, Vereecken K, Amoah AS, Labuda LA, Dièye TN, Mboup S, Yazdanbakhsh M, Polman K. Cytokine responses to Schistosoma mansoni and Schistosoma haematobium in relation to infection in a co-endemic focus in northern Senegal. PLoS Negl Trop Dis 2014; 8:e3080. [PMID: 25101661 PMCID: PMC4125161 DOI: 10.1371/journal.pntd.0003080] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 06/27/2014] [Indexed: 11/20/2022] Open
Abstract
Background In Africa, many areas are co-endemic for the two major Schistosoma species, S. mansoni and S. haematobium. Epidemiological studies have suggested that host immunological factors may play an important role in co-endemic areas. As yet, little is known about differences in host immune responses and possible immunological interactions between S. mansoni and S. haematobium in humans. The aim of this study was to analyze host cytokine responses to antigens from either species in a population from a co-endemic focus, and relate these to S. mansoni and S. haematobium infection. Methodology Whole blood cytokine responses were investigated in a population in the north of Senegal (n = 200). Blood was stimulated for 72 h with schistosomal egg and adult worm antigens of either Schistosoma species. IL-10, IL-5, IFN-γ, TNF-α, and IL-2 production was determined in culture supernatants. A multivariate (i.e. multi-response) approach was used to allow a joint analysis of all cytokines in relation to Schistosoma infection. Principal Findings Schistosoma haematobium egg and worm antigens induced higher cytokine production, suggesting that S. haematobium may be more immunogenic than S. mansoni. However, both infections were strongly associated with similar, modified Th2 cytokine profiles. Conclusions/Significance This study is the first to compare S. mansoni and S. haematobium cytokine responses in one population residing in a co-endemic area. These findings are in line with previous epidemiological studies that also suggested S. haematobium egg and worm stages to be more immunogenic than those of S. mansoni. In the developing world, over 207 million people are infected with blood-dwelling parasitic Schistosoma worms. Schistosoma haematobium and S. mansoni are the most widespread species. In Africa, they often occur together in the same area, with many people carrying both species. Yet, little is known about the differences in immune response that the human host develops against these two species. It is also unknown whether the presence of one species may affect the immune response to the other. We here investigated 200 people from an area in the north of Senegal where both species occur. They were examined for Schistosoma infections, as well as for immune responses to the two species. We observed that both infections were characterized by very similar cytokine responses. However, S. haematobium antigens induced higher levels of cytokines than S. mansoni. This suggests that S. haematobium may give rise to stronger immune responses, and may help to explain differences between the two most important Schistosoma species regarding the occurrence of infection and morbidity.
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Affiliation(s)
- Lynn Meurs
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | - Moustapha Mbow
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nele Boon
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Kim Vereecken
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Abena Serwaa Amoah
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Lucja A. Labuda
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Tandakha Ndiaye Dièye
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Katja Polman
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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27
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Skelly PJ. The use of imaging to detect schistosomes and diagnose schistosomiasis. Parasite Immunol 2014; 35:295-301. [PMID: 23647173 DOI: 10.1111/pim.12040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 04/22/2013] [Indexed: 11/29/2022]
Abstract
Several imaging modalities have been employed to examine schistosomes and monitor schistosome-induced pathology. Ultrasound is a noninvasive imaging method that has long been used in the laboratory and in the field to evaluate pathological changes, notably fibrosis, that arise as a consequence of the host response to schistosome eggs lodging in a variety of tissues. Ultrasonography has been widely used to monitor changes in the extent of fibrosis and in spleen/liver enlargement following chemotherapeutic treatment for schistosomiasis. Imaging methods to monitor schistosomes themselves in vivo (as opposed to detecting schistosome-induced pathology) include positron emission tomography and fluorescence molecular tomography. Both approaches rely on schistosome uptake of tracers that are introduced into infected animals and that can be detected externally. These methods have been used to successfully detect schistosomes in vivo and to monitor their elimination following chemotherapeutic treatment. Direct monitoring of live schistosomes in vivo has been achieved using intravital microscopy, when the infected tissues of anaesthetized animals are exposed. Finally, schistosome eggs have been visualized by confocal laser scanning microscopy in infected mice as well as in a human patient with schistosomiasis hematobium. Further advances in imaging technologies seem likely to provide greater insight into disease progression and into the biology of schistosomes in the most relevant setting-within a live animal.
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Affiliation(s)
- P J Skelly
- Department of Infectious Disease and Global Health, Molecular Helminthology Laboratory, Tufts Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA.
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28
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Meurs L, Mbow M, Boon N, van den Broeck F, Vereecken K, Dièye TN, Abatih E, Huyse T, Mboup S, Polman K. Micro-geographical heterogeneity in Schistosoma mansoni and S. haematobium infection and morbidity in a co-endemic community in northern Senegal. PLoS Negl Trop Dis 2013; 7:e2608. [PMID: 24386499 PMCID: PMC3873272 DOI: 10.1371/journal.pntd.0002608] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 11/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosoma mansoni and S. haematobium are co-endemic in many areas in Africa. Yet, little is known about the micro-geographical distribution of these two infections or associated disease within such foci. Such knowledge could give important insights into the drivers of infection and disease and as such better tailor schistosomiasis control and elimination efforts. METHODOLOGY In a co-endemic farming community in northern Senegal (346 children (0-19 y) and 253 adults (20-85 y); n = 599 in total), we studied the spatial distribution of S. mansoni and S. haematobium single and mixed infections (by microscopy), S. mansoni-specific hepatic fibrosis, S. haematobium-specific urinary tract morbidity (by ultrasound) and water contact behavior (by questionnaire). The Kulldorff's scan statistic was used to detect spatial clusters of infection and morbidity, adjusted for the spatial distribution of gender and age. PRINCIPAL FINDINGS Schistosoma mansoni and S. haematobium infection densities clustered in different sections of the community (p = 0.002 and p = 0.023, respectively), possibly related to heterogeneities in the use of different water contact sites. While the distribution of urinary tract morbidity was homogeneous, a strong geospatial cluster was found for severe hepatic fibrosis (p = 0.001). Particularly those people living adjacent to the most frequently used water contact site were more at risk for more advanced morbidity (RR = 6.3; p = 0.043). CONCLUSIONS/SIGNIFICANCE Schistosoma infection and associated disease showed important micro-geographical heterogeneities with divergent patterns for S. mansoni and S. haematobium in this Senegalese community. Further in depth investigations are needed to confirm and explain our observations. The present study indicates that local geospatial patterns should be taken into account in both research and control of schistosomiasis. The observed extreme focality of schistosomiasis even at community level, suggests that current strategies may not suffice to move from morbidity control to elimination of schistosomiasis, and calls for less uniform measures at a finer scale.
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Affiliation(s)
- Lynn Meurs
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Moustapha Mbow
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | - Nele Boon
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Frederik van den Broeck
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | | | - Tandakha Ndiaye Dièye
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | | | - Tine Huyse
- Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Leuven, Belgium
| | - Souleymane Mboup
- Laboratory of Bacteriology and Virology, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Senegal
| | - Katja Polman
- Institute of Tropical Medicine, Antwerp, Belgium
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29
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Turner JD, Meurs L, Dool P, Bourke CD, Mbow M, Dièye TN, Mboup S, Polman K, Mountford AP. Schistosome infection is associated with enhanced whole-blood IL-10 secretion in response to cercarial excretory/secretory products. Parasite Immunol 2013; 35:147-56. [DOI: 10.1111/pim.12028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 01/15/2013] [Indexed: 01/21/2023]
Affiliation(s)
- J. D. Turner
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
| | - L. Meurs
- Department of Biomedical Sciences; Institute of Tropical Medicine; Antwerp; Belgium
| | - P. Dool
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
| | - C. D. Bourke
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
| | - M. Mbow
- Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital; Dakar; Senegal
| | - T. N. Dièye
- Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital; Dakar; Senegal
| | - S. Mboup
- Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec University Hospital; Dakar; Senegal
| | - K. Polman
- Department of Biomedical Sciences; Institute of Tropical Medicine; Antwerp; Belgium
| | - A. P. Mountford
- Department of Biology; Centre for Immunology and Infection; University of York; York; UK
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