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Aboagye IF, Addison YAA. Praziquantel efficacy, urinary and intestinal schistosomiasis reinfection - a systematic review. Pathog Glob Health 2023; 117:623-630. [PMID: 36394218 PMCID: PMC10498796 DOI: 10.1080/20477724.2022.2145070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Praziquantel (PZQ) has been extensively used as the drug of choice for the treatment of schistosomiasis on account of its safety and effectiveness against all major forms of schistosomiasis. However, low cure rate, reduced susceptibility of Schistosoma mansoni to PZQ and treatment failures in S. haematobium infections have been reported, raising concerns about its efficacy. Using the search terms, 'praziquantel efficacy, schistosomiasis, school children, reinfection' as well as defined inclusion criteria, and guided by the PRISMA guidelines, articles from 2001 to 2022 were selected from the PubMed and Google Scholar databases and reviewed to assess their importance to the research question. This review assessed the efficacy of PZQ against schistosomiasis and reinfection rates following treatment of Schistosoma infections in children. Majority of both intestinal and urinary schistosomiasis studies reported comparable egg reduction rates (ERRs) of 94.2% to 99.9% and 91.9% to 98%, respectively. However, ERRs suggestive of sub-optimal PZQ efficacy as well as generally high and comparable cure rates for intestinal (81.2%-99.1%) and urinary (79%-93.7%) schistosomiasis studies were reported. Schistosomiasis reinfection rates varied widely for urinary (8.1%-39.6%) and intestinal (13.9%-63.4%) studies within eight to 28 weeks following PZQ treatment. Praziquantel treatment of urinary and intestinal schistosomiasis should be accompanied by the provision of potable water, toilet, and recreational facilities to reduce reinfection and egg reduction rates and increase cure rate to expedite schistosomiasis elimination.
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Affiliation(s)
- Isaac Frimpong Aboagye
- Department of Animal Biology and Conservation Science, University of Ghana, Legon-Accra, Ghana
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Trienekens SCM, Faust CL, Besigye F, Pickering L, Tukahebwa EM, Seeley J, Lamberton PHL. Variation in water contact behaviour and risk of Schistosoma mansoni (re)infection among Ugandan school-aged children in an area with persistent high endemicity. Parasit Vectors 2022; 15:15. [PMID: 34991702 PMCID: PMC8734346 DOI: 10.1186/s13071-021-05121-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Annual mass drug administration with praziquantel has reduced schistosomiasis transmission in some highly endemic areas, but areas with persistent high endemicity have been identified across sub-Saharan Africa, including Uganda. In these areas many children are rapidly reinfected post treatment, while some children remain uninfected or have low-intensity infections. The aim of this mixed-methods study was to better understand variation in water contact locations, behaviours and infection risk in school-aged children within an area with persistent high endemicity to inform additional control efforts. METHODS Data were collected in Bugoto, Mayuge District, Uganda. Two risk groups were identified from a longitudinal cohort, and eight children with no/low-intensity infections and eight children with reinfections were recruited. Individual structured day-long observations with a focus on water contact were conducted over two periods in 2018. In all identified water contact sites, four snail surveys were conducted quarterly over 1 year. All observed Biomphalaria snails were collected, counted and monitored in the laboratory for Schistosoma mansoni cercarial shedding for 3 weeks. RESULTS Children came into contact with water for a range of purposes, either directly at the water sources or by coming into contact with water collected previously. Although some water contact practices were similar between the risk groups, only children with reinfection were observed fetching water for commercial purposes and swimming in water sources; this latter group of children also came into contact with water at a larger variety and number of sites compared to children with no/low-intensity infection. Households with children with no/low-intensity infections collected rainwater more often. Water contact was observed at 10 sites throughout the study, and a total of 9457 Biomphalaria snails were collected from these sites over four sampling periods. Four lake sites had a significantly higher Biomphalaria choanomphala abundance, and reinfected children came into contact with water at these sites more often than children with no/low-intensity infections. While only six snails shed cercariae, four were from sites only contacted by reinfected children. CONCLUSIONS Children with reinfection have more high-risk water contact behaviours and accessed water sites with higher B. choanomphala abundance, demonstrating that specific water contact behaviours interact with environmental features to explain variation in risk within areas with persistent high endemicity. Targeted behaviour change, vector control and safe water supplies could reduce reinfection in school-aged children in these settings.
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Affiliation(s)
- Suzan C. M. Trienekens
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Wellcome Centre for Integrative Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Institute of Health & Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Christina L. Faust
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Wellcome Centre for Integrative Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Fred Besigye
- Vector Control Division, Ministry of Health, Kampala, Uganda
| | - Lucy Pickering
- Institute of Health & Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | | | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Poppy H. L. Lamberton
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Wellcome Centre for Integrative Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Namulondo J, Mulindwa J, Nyangiri OA, Egesa M, Noyes H, Matovu E. Gene expression changes in mammalian hosts during schistosomiasis: a review. AAS Open Res 2021. [DOI: 10.12688/aasopenres.13312.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Schistosomiasis affects over 250 million people worldwide with an estimated mortality of more than 200,000 deaths per year in sub-Saharan Africa. Efforts to control schistosomiasis in the affected areas have mainly relied on mass administration of praziquantel, which kills adult but not immature worms of all Schistosoma species. Mammalian hosts respond differently to Schistosoma infection with some being more susceptible than others, which is associated with risk factors such as sociodemographic, epidemiological, immunological and/or genetic. Host genetic factors play a major role in influencing molecular processes in response to schistosomiasis as shown in gene expression studies. These studies highlight gene profiles expressed at different time points of infection using model animals. Immune function related genes; cytokines (Th1 and Th17) are upregulated earlier in infection and Th2 upregulated later indicating a mixed Th1/Th2 response. However, Th1 response has been shown to be sustained in S. japonicum infection. Immune mediators such as matrix metalloproteinases (Mmps) and tissue inhibitors of matrix metalloproteinases (Timps) are expressed later in the infection and these are linked to wound healing and fibrosis. Downregulation of metabolic associated genes is recorded in later stages of infection. Most mammalian host gene expression studies have been done using rodent models, with fewer in larger hosts such as bovines and humans. The majority of these studies have focused on S. japonicum infections and less on S. haematobium and S. mansoni infections (the two species that cause most global infections). The few human schistosomiasis gene expression studies so far have focused on S. japonicum and S. haematobium infections and none on S. mansoni, as far as we are aware. This highlights a paucity of gene expression data in humans, specifically with S. mansoni infection. This data is important to understand the disease pathology, identify biomarkers, diagnostics and possible drug targets.
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Transmission Dynamics of Schistosoma haematobium among School-Aged Children: A Cohort Study on Prevalence, Reinfection and Incidence after Mass Drug Administration in the White Nile State of Sudan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111537. [PMID: 34770050 PMCID: PMC8583024 DOI: 10.3390/ijerph182111537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/11/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022]
Abstract
The reinfection rate of schistosomiasis after mass drug administration (MDA) has not been documented in Sudan. We aimed to explore the transmission dynamics of urogenital schistosomiasis after MDA, targeting school-aged children in the White Nile State of Sudan, assessing the prevalence, reinfection rate, and incidence. A single dose of praziquantel (40 mg/kg) was administered to 1951 students in five primary schools from January to February 2018 immediately after a baseline survey, and follow-up surveys were performed at 2 weeks and 6 months after treatment. We examined Schistosoma haematobium eggs by centrifugation methods. The overall reinfection rate at 6 months after treatment was 9.8% (95% confidence interval: 0.5-17.4%). By school, the reinfection rate was highest in the Al Hidaib school, whose prevalence was highest at baseline. The reinfection rate was significantly higher in high-infection areas than low-infection areas (p = 0.02). Of the prevalence at 6 months in high-infection areas, 41% of cases were due to reinfection. MDA interventions are decided upon and undertaken at the district level. A more targeted treatment strategy should be developed with a particular focus on tracking high-risk groups, even within a school or a community.
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Demonstration of N, N-Dimethyldithiocarbamate as a Copper-Dependent Antibiotic against Multiple Upper Respiratory Tract Pathogens. Microbiol Spectr 2021; 9:e0077821. [PMID: 34468162 PMCID: PMC8557878 DOI: 10.1128/spectrum.00778-21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Transition metals are necessary cofactors and structural elements in living systems. Exposure to high concentrations of biologically important transition metals, such as zinc and copper, results in cell toxicity. At the infection site, the immune system deploys metal sorbent proteins (e.g., lactoferrin and calprotectin) to starve pathogens of necessary metals (such as iron), while phagocytes expose engulfed pathogens to high levels of other metals, such as copper and zinc. The opportunistic pathogen Streptococcus pneumoniae (the pneumococcus) encounters macrophages during initial and protracted infections. The pneumococcus employs a copper export pathway, which improves colonization and persistent infection of the nasopharynx and the upper respiratory tract. Because copper is tightly regulated in the host, we instead sought to leverage the localized power of nutritional immunity by identifying small molecules with copper-dependent toxicity (CDT) through a targeted screen of compounds for antibiotic efficacy. We chose to include dithiocarbamates, based on the copper synergy observed in other organisms with 1-(diethylthiocarbamoyldisulfanyl)-N,N-diethyl-methanethioamide (tetraethylthiuram disulfide, disulfiram). We observed CDT of some dithiocarbamates in S. pneumoniae. Only N,N-dimethyldithiocarbamate (DMDC) was consistently toxic across a range of concentrations with copper both in vitro and in vivo against the pneumococcus. We also observed various degrees of CDT in vitro using DMDC in Staphylococcus aureus, Coccidioides posadasii, and Schistosoma mansoni. Collectively, we demonstrate that the compound DMDC is a potent bactericidal compound against S. pneumoniae with antimicrobial efficacy against bacterial and fungal pathogens. IMPORTANCE With the rise of antibiotic resistance, approaches that add new antimicrobials to the current repertoire are vital. Here, we investigate putative and known copper ionophores in an attempt to intoxicate bacteria and use ionophore/copper synergy, and we ultimately find success with N,N-dimethyldithiocarbamate (DMDC). We show that DMDC has in vitro efficacy in a copper-dependent manner and kills pathogens across three different kingdoms, Streptococcus pneumoniae, Coccidioides posadasii, and Schistosoma mansoni, and in vivo efficacy against S. pneumoniae. As such, dithiocarbamates represent a new potential class of antimicrobials and thus warrant further mechanistic investigation.
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Adewale B, Heintz JR, Pastore CF, Rossi HL, Hung LY, Rahman N, Bethony J, Diemert D, Babatunde JA, Herbert DR. Parasitic helminth infections in humans modulate Trefoil Factor levels in a manner dependent on the species of parasite and age of the host. PLoS Negl Trop Dis 2021; 15:e0009550. [PMID: 34662329 PMCID: PMC8553090 DOI: 10.1371/journal.pntd.0009550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/28/2021] [Accepted: 10/07/2021] [Indexed: 11/19/2022] Open
Abstract
Helminth infections, including hookworms and Schistosomes, can cause severe disability and death. Infection management and control would benefit from identification of biomarkers for early detection and prognosis. While animal models suggest that Trefoil Factor Family proteins (TFF2 and TFF3) and interleukin-33 (IL-33) -driven type 2 immune responses are critical mediators of tissue repair and worm clearance in the context of hookworm infection, very little is known about how they are modulated in the context of human helminth infection. We measured TFF2, TFF3, and IL-33 levels in serum from patients in Brazil infected with Hookworm and/or Schistosomes, and compared them to endemic and non-endemic controls. TFF2 was specifically elevated by Hookworm infection in females, not Schistosoma or co-infection. This elevation was correlated with age, but not worm burden. TFF3 was elevated by Schistosoma infection and found to be generally higher in females. IL-33 was not significantly altered by infection. To determine if this might apply more broadly to other species or regions, we measured TFFs and cytokine levels (IFNγ, TNFα, IL-33, IL-13, IL-1β, IL-17A, IL-22, and IL-10) in both the serum and urine of Nigerian school children infected with S. haematobium. We found that serum levels of TFF2 and 3 were reduced by infection, likely in an age dependent manner. In the serum, only IL-10 and IL-13 were significantly increased, while in urine IFN-γ, TNF-α, IL-13, IL-1β, IL-22, and IL-10 were significantly increased in by infection. Taken together, these data support a role for TFF proteins in human helminth infection. Billions of people are infected with parasitic helminths across the globe, especially in resource poor regions. These infections can result in severe developmental delay, disability, and death. Adequate management of helminth infection would benefit from the identification of host biomarkers in easily obtained samples (e.g. serum or urine) that correlate to infection state. Our goal was to determine if specific proteins involved in tissue repair and immune modulation are altered by infection with specific helminth species in Brazil (hookworm and S. mansoni species of blood fluke) or Nigeria (S. haematobium species of blood fluke). One of these proteins, Trefoil Factor 2 (TFF2), was elevated in the serum of hookworm infected women from Brazil, while another, TFF3 is higher in women than men, but also increased by S. mansoni blood fluke infection. In contrast, both TFFs were decreased in the serum of Nigerian children infected by S. haematobium, while many pro-inflammatory cytokines were increased in the urine, where the eggs emerge from host tissue.
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Affiliation(s)
- Babatunde Adewale
- Public Health Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Jonathan R. Heintz
- University of Pennsylvania, Perlman School of Medicine Biostatistics Analysis Center, Philadelphia, Pennsylvania, United States of America
| | - Christopher F. Pastore
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, United States of Amerca
| | - Heather L. Rossi
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, United States of Amerca
| | - Li-Yin Hung
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, United States of Amerca
- Department of Medicine, Division of Experimental Medicine, University of California, San Francisco, San Francisco, California, United States of Amerca
| | - Nurudeen Rahman
- Public Health Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Jeff Bethony
- Department of Microbiology, Immunology & Tropical Medicine, George Washington University Medical Center, Washington, District of Columbia, United States of Amerca
| | - David Diemert
- Department of Microbiology, Immunology & Tropical Medicine, George Washington University Medical Center, Washington, District of Columbia, United States of Amerca
| | - James Ayorinde Babatunde
- Department of Biochemistry & Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - De’Broski R. Herbert
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, United States of Amerca
- Department of Medicine, Division of Experimental Medicine, University of California, San Francisco, San Francisco, California, United States of Amerca
- * E-mail:
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7
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Mabey D, Agler E, Amuasi JH, Hernandez L, Hollingsworth TD, Hotez PJ, Lammie PJ, Malecela MN, Matendechero SH, Ottesen E, Phillips RO, Reeder JC, Szwarcwald CL, Shott JP, Solomon AW, Steer A, Swaminathan S. Towards a comprehensive research and development plan to support the control, elimination and eradication of neglected tropical diseases. Trans R Soc Trop Med Hyg 2021; 115:196-199. [PMID: 33179054 PMCID: PMC7842110 DOI: 10.1093/trstmh/traa114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022] Open
Abstract
To maximise the likelihood of success, global health programmes need repeated, honest appraisal of their own weaknesses, with research undertaken to address any identified gaps. There is still much to be learned to optimise work against neglected tropical diseases. To facilitate that learning, a comprehensive research and development plan is required. Here, we discuss how such a plan might be developed.
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Affiliation(s)
- David Mabey
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | | | - John H Amuasi
- African Research Network for Neglected Tropical Diseases, Kumasi AK-039-5028, Ghana
| | - Leda Hernandez
- Department of Health, Infectious Disease Office, National Center for Disease Prevention and Control, Manila 1003, Philippines
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK
| | - Peter J Hotez
- Departments of Pediatrics and Molecular Virology & Microbiology, Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030s, USA.,Hagler Institute for Advanced Study at Texas A & M University, College Station, TX 77843, USA.,Department of Biology, Baylor University, Waco, TX 76706, USA.,James A. Baker III Institute of Public Policy, Rice University, Houston, TX 77005, USA.,Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A & M University, College Station, TX 77845, USA
| | - Patrick J Lammie
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA 30030, USA
| | - Mwelecele N Malecela
- Department of Control of Neglected Tropical Diseases, WHO 1211, Geneva, Switzerland
| | - Sultani H Matendechero
- Division of Communicable Disease Prevention and Control, Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - Eric Ottesen
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA 30030, USA
| | - Richard O Phillips
- Kumasi Center for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi AK-039-5028, Ghana
| | - John C Reeder
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Disease (TDR), 1211 Geneva 21040-900, Switzerland
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Joseph P Shott
- Division of Neglected Tropical Diseases, Office of Infectious Diseases, Bureau for Global Health, USAID, Washington, DC 20004, USA
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, WHO 1211, Geneva, Switzerland
| | - Andrew Steer
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria 3010, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
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Spencer SA, Linder C, Penney JMS, Russell HJ, Hyde K, Sheehy C, Reid A, Andriamasy EH, Raderalazasoa GU, Rakotomampianina DAL, Nandimbiniaina AM, Ranaivoson TN, Andrianiaina A, Cruickshank SM, Bustinduy AL, Stothard JR, Edosoa GT, Rahetilahy AM. Five-Year Follow-Up on the Prevalence and Intensity of Infections of Schistosoma mansoni in a Hard-to-Reach District of Madagascar. Am J Trop Med Hyg 2021; 104:1841-1850. [PMID: 33684064 PMCID: PMC8103437 DOI: 10.4269/ajtmh.20-1433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/10/2021] [Indexed: 01/15/2023] Open
Abstract
Schistosomiasis is a major public health problem in Madagascar. The WHO recommends preventive chemotherapy by mass drug administration (MDA) with praziquantel as the primary approach to control Schistosoma mansoni-related morbidity in endemic populations, alongside complementary interventions such as health education. The impact of annual MDA and health education programs was assessed in the hard-to-reach Marolambo district of eastern Madagascar, an area endemic for S. mansoni. Repeated cross-sectional studies undertaken 2015-2019 examined between 300 and 381 school-aged children (aged 5-14 years) annually. The prevalence and infection intensity of S. mansoni were assessed by urine-circulating cathodic antigen (CCA) dipsticks and coproscopy using Kato-Katz (KK) methodologies. After four rounds of annual MDA, a reduction in S. mansoni prevalence was seen in CCA (93.9% in year 1-87.7% in year 5; P = 0.007) and KK (73.9% in year 1-59.4% in year 5; P < 0.0001). The prevalence of heavy-intensity infections roughly halved from 23.7% to 10.1% (P < 0.0001), and the mean intensity of infection fell by 55.0% (480.2-216.3 eggs per gram of feces). A malacological survey found Biomphalaria pfeifferi snail intermediate hosts in multiple water contact sites including rice paddies, streams, and Nosivolo River. Despite reductions in infection prevalence and intensity, schistosomiasis still poses a significant public health challenge in Marolambo district. Twice yearly MDA cycles and/or community-wide MDA are suggested to better reduce infections. Expanding health education, improving standards of water, sanitation and hygiene, and attention on snail-related control will also be important, especially in rice paddy irrigated areas.
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Affiliation(s)
- Stephen A. Spencer
- Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom;,The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom;,Address correspondence to Stephen A. Spencer, Post-Graduate Medical Centre, Royal United Hospital, Combe Park, Bath BA1 3NG, United Kingdom. E-mail:
| | - Cortland Linder
- The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom
| | - James M. StJ. Penney
- The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom
| | - Hannah J. Russell
- The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom
| | - Kate Hyde
- The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom
| | - Caitlin Sheehy
- The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom
| | - Alice Reid
- Unité d’Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Emmanuel H. Andriamasy
- Faculté de Médecine, Université d’Antananarivo, Antananarivo, Madagascar;,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gina U. Raderalazasoa
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Anjara M. Nandimbiniaina
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tahiry N. Ranaivoson
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Antsa Andrianiaina
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sheena M. Cruickshank
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amaya L. Bustinduy
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - J. Russell Stothard
- Unité d’Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Glenn T. Edosoa
- World Health Organization, Madagascar Country Office, Antananarivo, Madagascar;,Ministère de la Santé Publique de Madagascar, Antananarivo, Madagascar
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Zacharia A, Mushi V, Makene T. A systematic review and meta-analysis on the rate of human schistosomiasis reinfection. PLoS One 2020; 15:e0243224. [PMID: 33270752 PMCID: PMC7714137 DOI: 10.1371/journal.pone.0243224] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/17/2020] [Indexed: 11/19/2022] Open
Abstract
While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity of information on the global reinfection rate of schistosomiasis. This systematic review and meta-analysis aimed at summarizing studies that estimated the reinfection rate of human schistosomiasis. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on reinfection rate of human schistosomiasis. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted using statistical R version 3.6.2 and R Studio using "meta" and "metafor" packages. Random effect model was employed to estimate pooled reinfection rates. Heterogeneity was determined using Cochran's Q (chi-square)-test and Higgins I2 statistics. A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5-9 scores) quality. The overal mean and pooled reinfection rates of schistosomiasis were 36.1% (±23.3%) and 33.2% (95% CI, 26.5-40.5%) respectively. For intestinal schistosomiasis, the mean and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8-51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3%- 29.2%) respectively. Cochran's Q (chi-square)-test and Higgins I2 statistic indicated significant heterogeneity across studies (p-values < 0.001, I2 values > 95%). Results of subgroup analysis showed that, the type of Schistosoma species, participants' age group, sample size and geographical area had influence on disparity variation in reinfection rate of schistosomiasis (p < 0.1). Despite the control measures in place, the re-infection rate is still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing intensive programmatic strategies for schistosomiasis elimination should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six months, intensive snails control and health education.
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Affiliation(s)
- Abdallah Zacharia
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Vivian Mushi
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Twilumba Makene
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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10
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Silva AIFD, Cantanhede SPD, Sousa JO, Lima RM, Silva-Souza N, Carvalho-Neta RNF, Almeida ZDSD, Santos DMS, Carvalho Neta AVD, Souza Serra IMRD, Tchaicka L. Community Perceptions on Schistosomiasis in Northeast Brazil. Am J Trop Med Hyg 2020; 103:1111-1117. [PMID: 32700657 DOI: 10.4269/ajtmh.18-0302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Schistosomiasis is a serious public health issue in the world infecting more than 200 million people. In Maranhão state, Brazil, the disease has a high prevalence in the Baixada Maranhense microregion, where the socioeconomic conditions, high prevalence of freshwater snails, elevated incidence of human infection, and large rodent populations make the area highly conducive to the life cycle and persistence of schistosomiasis. The objective of this study was to record the perception of residents and health/public education professionals regarding this parasitosis and also understand their knowledge of the relationship between schistosomiasis and the environment. We conducted 53 interviews addressing the socioeconomic, behavioral, and environmental issues surrounding schistosomiasis. It was recorded that the population believed the environment is the main cause of the disease and the fisherman may be stigmatized by their chance of having the disease. Health/public educational professionals in the region indicated that there were no regular educational campaigns, which contributed to the high rates of reinfection and the difficulties in preventing and controlling the spread of the disease. These data clearly demonstrate the need for interdisciplinary work that engages the community in gathering and disseminating knowledge and developing solutions to minimize the occurrence of this major health issue in the region.
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Affiliation(s)
| | - Selma Patrícia Diniz Cantanhede
- Departamento de Biologia, Laboratório de Biodiversidade Molecular, Programa de Pós-Graduação em Recursos Aquáticos e Pesca, Universidade Estadual do Maranhão, São Luís, Brazil
| | | | - Renata Martins Lima
- Departamento de Biologia, Universidade Estadual do Maranhão, São Luís, Brazil
| | - Nêuton Silva-Souza
- Departamento de Biologia, Laboratório de Parasitologia Humana, Universidade Estadual do Maranhão, São Luís, Brazil
| | - Raimunda Nonata Fortes Carvalho-Neta
- Departamento de Biologia, Laboratório de Biomarcadores em Organismos Aquáticos, Programa de Pós-Graduação em Recursos Aquáticos e Pesca, Universidade Estadual do Maranhão, São Luís, Brazil
| | - Zafira da Silva de Almeida
- Laboratório de Pesca e Ecologia Aquática-LabPEA, Programa de Pós-Graduação em Recursos Aquáticos e Pesca, Universidade Estadual do Maranhão, São Luís, Brazil
| | - Débora Martins Silva Santos
- Departamento de Biologia, Laboratório de Morfofisiologia Animal, Programa de Pós-Graduação em Recursos Aquáticos e Pesca, Universidade Estadual do Maranhão, São Luís, Brazil
| | - Alcina Vieira de Carvalho Neta
- Laboratório de Patologia Molecular - LPMol, Programa de Pós-Graduação em Ciência Animal, Universidade Estadual do Maranhão, São Luís, Brazil
| | | | - Lígia Tchaicka
- Departamento de Biologia, Laboratório de Biodiversidade Molecular, Programa de Pós-Graduação em Recursos Aquáticos e Pesca, Universidade Estadual do Maranhão, São Luís, Brazil
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11
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Analytical and Clinical Assessment of a Portable, Isothermal Recombinase Polymerase Amplification (RPA) Assay for the Molecular Diagnosis of Urogenital Schistosomiasis. Molecules 2020; 25:molecules25184175. [PMID: 32933094 PMCID: PMC7570534 DOI: 10.3390/molecules25184175] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 12/21/2022] Open
Abstract
Accurate diagnosis of urogenital schistosomiasis is crucial for disease surveillance and control. Routine diagnostic methods, however, lack sensitivity when assessing patients with low levels of infection still able to maintain pathogen transmission. Therefore, there is a need for highly sensitive diagnostic tools that can be used at the point-of-care in endemic areas. Recombinase polymerase amplification (RPA) is a rapid and sensitive diagnostic tool that has been used to diagnose several pathogens at the point-of-care. Here, the analytical performance of a previously developed RPA assay (RT-ShDra1-RPA) targeting the Schistosoma haematobium Dra1 genomic region was assessed using commercially synthesised S. haematobium Dra1 copies and laboratory-prepared samples spiked with S. haematobium eggs. Clinical performance was also assessed by comparing diagnostic outcomes with that of a reference diagnostic standard, urine-egg microscopy. The RT-ShDra1-RPA was able to detect 1 × 101 copies of commercially synthesised Dra1 DNA as well as one S. haematobium egg within laboratory-spiked ddH2O samples. When compared with urine-egg microscopy, the overall sensitivity and specificity of the RT-ShDra1-RPA assay was 93.7% (±88.7–96.9) and 100% (±69.1–100), respectively. Positive and negative predictive values were 100% (±97.5–100) and 50% (±27.2–72.8), respectively. The RT-ShDra1-RPA therefore shows promise as a rapid and highly sensitive diagnostic tool able to diagnose urogenital schistosomiasis at the point-of-care.
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12
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Impacts of host gender on Schistosoma mansoni risk in rural Uganda-A mixed-methods approach. PLoS Negl Trop Dis 2020; 14:e0008266. [PMID: 32401770 PMCID: PMC7219705 DOI: 10.1371/journal.pntd.0008266] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 04/02/2020] [Indexed: 12/12/2022] Open
Abstract
Background The World Health Organization identified Uganda as one of the 10 highly endemic countries for schistosomiasis. Annual mass drug administration (MDA) with praziquantel has led to a decline in intensity of Schistosoma mansoni infections in several areas. However, as hotspots with high (re)infection rates remain, additional research on risk factors and implementing interventions to complement MDA are required to further reduce disease burden in these settings. Through a mixed-methods study we aimed to gain deeper understanding of how gender may impact risk and reinfection in order to inform disease control programmes and ascertain if gender-specific interventions may be beneficial. Methodology/Principal findings In Bugoto, Mayuge District, Eastern Uganda we conducted ethnographic observations (n = 16) and examined epidemiology (n = 55) and parasite population genetics (n = 16) in school-aged children (SAC), alongside a community-wide household survey (n = 130). Water contact was frequent at home, school and in the community and was of domestic, personal care, recreational, religious or commercial nature. Qualitative analysis of type of activity, duration, frequency, level of submersion and water contact sites in children showed only few behavioural differences in water contact between genders. However, survey data revealed that adult women carried out the vast majority of household tasks involving water contact. Reinfection rates (96% overall) and genetic diversity were high in boys (pre-He = 0.66; post-He = 0.67) and girls (pre-He = 0.65; post-He = 0.67), but no differences in reinfection rates (p = 0.62) or genetic diversity by gender before (p = 0.54) or after (p = 0.97) treatment were found. Conclusions/Significance This mixed methods approach showed complementary findings. Frequent water exposure with few differences between boys and girls was mirrored by high reinfection rates and genetic diversity in both genders. Disease control programmes should consider the high reinfection rates among SAC in remaining hotspots of schistosomiasis and the various purposes and settings in which children and adults are exposed to water. Globally, over 230 million people are infected with schistosomiasis, an infectious disease caused by parasitic helminths. Humans can get infected when they contact water which contains Schistosoma parasites. Although the disease can be treated with a drug, people get rapidly reinfected in certain high-transmission settings. Drug treatment alone may not be sufficient to eliminate this disease and additional interventions such as health promotion or improvements in water and sanitation need to be scaled up. To provide recommendations to these control programmes we carried out interdisciplinary research in Eastern Uganda to understand the influence of gender on schistosomiasis risk. We found that the water contact behaviour of boys and girls is quite similar, and we did not see differences in reinfection or genetic diversity of the parasite between boys and girls. Differences in water contact between genders is greater in adults, and further research is required for these individuals. In this setting, infection rates are high in school-aged children and there are no differences between genders. These results emphasise improved control efforts for all school-aged children in communities like these. Our interdisciplinary approach provided complementary findings. Such an integrated approach can therefore have more power to meaningfully inform policy on schistosomiasis control.
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13
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Can Early Diagnosis of Varices, Regular Praziquantel, and Reduction of Hepatitis Coinfection Reduce Mortality among Patients Attended for Periportal Fibrosis in Northwestern Tanzania? A Case-Control Study. J Parasitol Res 2020; 2020:5484315. [PMID: 32231794 PMCID: PMC7094192 DOI: 10.1155/2020/5484315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/28/2020] [Indexed: 11/17/2022] Open
Abstract
Background Schistosoma mansoni is highly endemic in the Lake Zone part of Tanzania and most people are chronically infected. Periportal fibrosis (PPF) is the commonest complication of chronic S. mansoni infection documented in up to 42% of studied participants in the community-based studies. These patients are at high risk of mortality since most of them are diagnosed late with bleeding varices. At Bugando, Schistosoma-related varices contributed to 70% of patients admitted due to vomiting blood with a two months' mortality of over 10%. Earlier studies had reported higher mortality of up to 29% among patients with PPF even with the best in-hospital care. Understanding factors that increased the risk of mortality is important clinically in devising ways that can improve the outcome of this subgroup of patients. Methods A retrospective analysis of patients with PPF from 2015 through 2018 was done. Their sociodemographic, clinical, laboratory, ultrasonographic, endoscopic, and survival status data were collected for analysis. STATA 13 was used for analysis, the prevalence of varices, active schistosomiasis, and hepatitis B coinfection was determined. Cumulative mortality as a major outcome was also determined, and factors associated with increased risk of mortality were assessed by a logistic regression model. Results In total, 250 participants were included in this analysis. Majority, 222 (88.8%; 95% CI: 84.2-92.4) had active S. mansoni infection, and 40 (16.0%; 95% CI: 11.6-21.1) had S. mansoni-HBV coinfection. Cumulatively, 39 (15.6%; 95% CI: 11.3-20.7) patients died, with most deaths, 31 (79.5%; 95% CI: 63.5-90.7) occurring within two years following the diagnosis of PPF (chi2 = 6.3; p = 0.012). The odds of mortality were independently associated with fishing (OR: 10.8; 95% CI: 2.2-52; p = 0.003), upper gastro intestinal bleeding (OR: 2.4; 95% CI: 1.1-5.4; p = 0.037), HBV coinfection (OR: 3.3; 95% CI: 1.2-91; p = 0.019), and ascites (OR: 3.3; 95% CI: 1.3-8.2; p = 0.010). Conclusions In this, S. mansoni endemic area, varices, actives schistosomiasis, hepatitis B coinfection, and mortality are highly common. Screening for varices and initiation of prophylaxis, administration of praziquantel, and screening for hepatitis B should be part and parcel of care of these patients. The first two years of diagnosis, patients are at high risk of mortality; risk factors in this study should assist planning a closer follow-up of patients at risk of mortality to improve their long-term outcome.
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14
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Ellwanger JH, Kaminski VDL, Rodrigues AG, Kulmann-Leal B, Chies JAB. CCR5 and CCR5Δ32 in bacterial and parasitic infections: Thinking chemokine receptors outside the HIV box. Int J Immunogenet 2020; 47:261-285. [PMID: 32212259 DOI: 10.1111/iji.12485] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Abstract
The CCR5 molecule was reported in 1996 as the main HIV-1 co-receptor. In that same year, the CCR5Δ32 genetic variant was described as a strong protective factor against HIV-1 infection. These findings led to extensive research regarding the CCR5, culminating in critical scientific advances, such as the development of CCR5 inhibitors for the treatment of HIV infection. Recently, the research landscape surrounding CCR5 has begun to change. Different research groups have realized that, since CCR5 has such important effects in the chemokine system, it could also affect other different physiological systems. Therefore, the effect of reduced CCR5 expression due to the presence of the CCR5Δ32 variant began to be further studied. Several studies have investigated the role of CCR5 and the impacts of CCR5Δ32 on autoimmune and inflammatory diseases, various types of cancer, and viral diseases. However, the role of CCR5 in diseases caused by bacteria and parasites is still poorly understood. Therefore, the aim of this article is to review the role of CCR5 and the effects of CCR5Δ32 on bacterial (brucellosis, osteomyelitis, pneumonia, tuberculosis and infection by Chlamydia trachomatis) and parasitic infections (toxoplasmosis, leishmaniasis, Chagas disease and schistosomiasis). Basic information about each of these infections was also addressed. The neglected role of CCR5 in fungal disease and emerging studies regarding the action of CCR5 on regulatory T cells are briefly covered in this review. Considering the "renaissance of CCR5 research," this article is useful for updating researchers who develop studies involving CCR5 and CCR5Δ32 in different infectious diseases.
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Affiliation(s)
- Joel Henrique Ellwanger
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Valéria de Lima Kaminski
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Andressa Gonçalves Rodrigues
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Bruna Kulmann-Leal
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - José Artur Bogo Chies
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
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15
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Mogeni P, Vandormael A, Cuadros D, Appleton C, Tanser F. Impact of community piped water coverage on re-infection with urogenital schistosomiasis in rural South Africa. eLife 2020; 9:54012. [PMID: 32178761 PMCID: PMC7108860 DOI: 10.7554/elife.54012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/10/2020] [Indexed: 12/15/2022] Open
Abstract
Previously, we demonstrated that coverage of piped water in the seven years preceding a parasitological survey was strongly predictive of Schistosomiasis haematobium infection in a nested cohort of 1976 primary school children (Tanser, 2018). Here, we report on the prospective follow up of infected members of this nested cohort (N = 333) for two successive rounds following treatment. Using a negative binomial regression fitted to egg count data, we found that every percentage point increase in piped water coverage was associated with 4.4% decline in intensity of re-infection (incidence rate ratio = 0.96, 95% CI: 0.93–0.98, p=0.004) among the treated children. We therefore provide further compelling evidence in support of the scaleup of piped water as an effective control strategy against Schistosoma haematobium transmission.
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Affiliation(s)
- Polycarp Mogeni
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,KwaZulu-Natal Innovation and Sequencing Platform (KRISP), University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Alain Vandormael
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,KwaZulu-Natal Innovation and Sequencing Platform (KRISP), University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Diego Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, United States.,Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, United States
| | - Christopher Appleton
- School of Life Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Frank Tanser
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, United Kingdom
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16
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Woldegerima E, Bayih AG, Tegegne Y, Aemero M, Jejaw Zeleke A. Prevalence and Reinfection Rates of Schistosoma mansoni and Praziquantel Efficacy against the Parasite among Primary School Children in Sanja Town, Northwest Ethiopia. J Parasitol Res 2019; 2019:3697216. [PMID: 31179124 PMCID: PMC6507171 DOI: 10.1155/2019/3697216] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/25/2019] [Accepted: 04/02/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Schistosomiasis is among the most widespread chronic infections in the world. The magnitude of the infection may show variations across different areas with respect to time. Praziquantel is a first line drug of choice for the treatment of schistosomiasis although its low cure rate has been reported in different parts of the world. Thus, an assessment of the magnitude of the diseases, the efficacy of currently available drugs, and reinfection rates is crucial. OBJECTIVE Our principal objective is to determine the prevalence and reinfection rates of Schistosoma mansoni and to evaluate the efficacy of PZQ against Schistosoma mansoni. METHOD A school-based cross-sectional study was conducted on Sanja Elementary Schools, Sanja town, northwest Ethiopia. Stool specimens were examined using Kato-Katz method. Schoolchildren who tested positive for intestinal schistosomiasis and fulfilled the inclusion criteria took part in the efficacy and reinfection study. Positive participants were treated with 40 mg/kg of Praziquantel. Cure and egg reduction rates were evaluated three weeks after treatment. The intensity of infection was determined following the WHO's guideline. Moreover, the reinfection rate of those who were cured was evaluated after a six-month posttreatment period. Data were analyzed using SPSS version 20. RESULTS At baseline, 130 (35%) of the 372 schoolchildren were found infected with Schistosoma mansoni. Out of the 130 infected schoolchildren, 112 (86.2%) had moderate infection intensity. Among the S. mansoni positive schoolchildren, 80 were included as study participants for the evaluation of PZQ efficacy, based on the inclusion criteria established by WHO. The cure and egg reduction rates were found to be 90% (72/80) and 99.5%, respectively. Of the seventy-two schoolchildren considered for the determination of reinfection rate, after 6 months of posttreatment, 13.9% were found to be reinfected. CONCLUSION The schoolchildren in the three primary schools of Sanja are at moderate risk of the infection caused by S. mansoni. Although the therapeutic potency of PZQ at 40 mg/kg was efficient against S. mansoni, a high rate of reinfection was reported in the study site, suggesting the need for integrated schistosomiasis control measures.
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Affiliation(s)
- Eden Woldegerima
- University of Gondar Referral Hospital, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Genetu Bayih
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yalewayker Tegegne
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Aemero
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayalew Jejaw Zeleke
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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17
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Egesa M, Lubyayi L, Jones FM, van Diepen A, Chalmers IW, Tukahebwa EM, Bagaya BS, Hokke CH, Hoffmann KF, Dunne DW, Elliott AM, Yazdanbakhsh M, Wilson S, Cose S. Antibody responses to Schistosoma mansoni schistosomula antigens. Parasite Immunol 2018; 40:e12591. [PMID: 30239012 PMCID: PMC6492298 DOI: 10.1111/pim.12591] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/04/2018] [Indexed: 02/06/2023]
Abstract
While antigens from Schistosoma schistosomula have been suggested as potential vaccine candidates, the association between antibody responses with schistosomula antigens and infection intensity at reinfection is not well known. Schistosoma mansoni-infected individuals were recruited from a schistosomiasis endemic area in Uganda (n = 372), treated with 40 mg/kg praziquantel (PZQ) and followed up at five weeks and at one year post-treatment. Pre-treatment and five weeks post-treatment immunoglobulin (Ig) E, IgG1 and IgG4 levels against recombinant schistosomula antigens rSmKK7, rSmLy6A, rSmLy6B and rSmTSP7 were measured using ELISA. Factors associated with detectable pre-treatment or post-treatment antibody response against the schistosomula antigens and the association between five-week antibody responses and one year post-treatment reinfection intensity among antibody responders were examined. Being male was associated with higher pre-treatment IgG1 to rSmKK7, rSmLy6a and AWA. Five weeks post-treatment antibody responses against schistosomula antigens were not associated with one year post-treatment reinfection intensity among antibody responders' antibody levels against rSmKK7, rSmLy6B and rSmTSP7 dropped, but increased against rSmLy6A, AWA and SEA at five weeks post-treatment among antibody responders. S. mansoni-infected individuals exhibit detectable antibody responses to schistosomula antigens that are affected by treatment. These findings indicate that schistosomula antigens induce highly varied antibody responses and could have implications for vaccine development.
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Affiliation(s)
- Moses Egesa
- Department of Medical MicrobiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | - Lawrence Lubyayi
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | | | - Angela van Diepen
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Iain W. Chalmers
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | | | - Bernard S. Bagaya
- Department of Immunology and Molecular BiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
| | - Cornelis H. Hokke
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Karl F. Hoffmann
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | - David W. Dunne
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Alison M. Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
- Department of Clinical ResearchLondon School of Hygiene & Tropical MedicineLondonUK
| | - Maria Yazdanbakhsh
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Shona Wilson
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
- Department of Clinical ResearchLondon School of Hygiene & Tropical MedicineLondonUK
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18
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Egesa M, Lubyayi L, Tukahebwa EM, Bagaya BS, Chalmers IW, Wilson S, Hokke CH, Hoffmann KF, Dunne DW, Yazdanbakhsh M, Labuda LA, Cose S. Schistosoma mansoni schistosomula antigens induce Th1/Pro-inflammatory cytokine responses. Parasite Immunol 2018; 40:e12592. [PMID: 30239006 PMCID: PMC6492251 DOI: 10.1111/pim.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/15/2018] [Accepted: 09/04/2018] [Indexed: 12/16/2022]
Abstract
Larvae of Schistosoma (schistosomula) are highly susceptible to host immune responses and are attractive prophylactic vaccine targets, although cellular immune responses against schistosomula antigens in endemic human populations are not well characterized. We collected blood and stool from 54 Schistosoma mansoni-infected Ugandans, isolated peripheral blood mononuclear cells and stimulated them for 24 hours with schistosome adult worm and soluble egg antigens (AWA and SEA), along with schistosomula recombinant proteins rSmKK7, Lymphocyte Antigen 6 isoforms (rSmLy6A and rSmLy6B), tetraspanin isoforms (rSmTSP6 and rSmTSP7). Cytokines, chemokines and growth factors were measured in the culture supernatants using a multiplex luminex assay, and infection intensity was determined before and at 1 year after praziquantel (PZQ) treatment using the Kato-Katz method. Cellular responses were grouped and the relationship between groups of correlated cellular responses and infection intensity before and after PZQ treatment was investigated. AWA and SEA induced mainly Th2 responses. In contrast, rSmLy6B, rSmTSP6 and rSmTSP7 induced Th1/pro-inflammatory responses. While recombinant antigens rSmKK7 and rSmLy6A did not induce a Th1/pro-inflammatory response, they had an association with pre-treatment infection intensity after adjusting for age and sex. Testing more schistosomula antigens using this approach could provide immune-epidemiology identifiers necessary for prioritizing next generation schistosomiasis vaccine candidates.
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Affiliation(s)
- Moses Egesa
- Department of Medical MicrobiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | - Lawrence Lubyayi
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | | | - Bernard S. Bagaya
- Department of Immunology and Molecular BiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
| | - Iain W. Chalmers
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | - Shona Wilson
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Cornelis H. Hokke
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Karl F. Hoffmann
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | - David W. Dunne
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Maria Yazdanbakhsh
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Lucja A. Labuda
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
- Department of Clinical ResearchLondon School of Hygiene & Tropical MedicineLondonUK
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19
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Ndombi EM, Abudho B, Kittur N, Carter JM, Korir H, Riner DK, Ochanda H, Lee YM, Secor WE, Karanja DM, Colley DG. Effect of four rounds of annual school-wide mass praziquantel treatment for schistosoma mansoni control on schistosome-specific immune responses. Parasite Immunol 2018; 40:e12530. [PMID: 29604074 PMCID: PMC6001474 DOI: 10.1111/pim.12530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/22/2018] [Indexed: 11/27/2022]
Abstract
This study evaluated potential changes in antischistosome immune responses in children from schools that received 4 rounds of annual mass drug administration (MDA) of praziquantel (PZQ). In a repeated cross‐sectional study design, 210 schistosome egg‐positive children were recruited at baseline from schools in western Kenya (baseline group). Another 251 children of the same age range were recruited from the same schools and diagnosed with schistosome infection by microscopy (post‐MDA group). In‐vitro schistosome‐specific cytokines and plasma antibody levels were measured by ELISA and compared between the 2 groups of children. Schistosome soluble egg antigen (SEA) and soluble worm antigen preparation (SWAP) stimulated higher IL‐5 production by egg‐negative children in the post‐MDA group compared to the baseline group. Similarly, anti‐SEA IgE levels were higher in egg‐negative children in the post‐MDA group compared to the baseline group. Anti‐SEA and anti‐SWAP IgG4 levels were lower in egg‐negative children in the post‐MDA group compared to baseline. This resulted in higher anti‐SEA IgE/IgG4 ratios for children in the post‐MDA group compared to baseline. These post‐MDA immunological changes are compatible with the current paradigm that treatment shifts immune responses to higher antischistosome IgE:IgG4 ratios in parallel with a potential increase in resistance to reinfection.
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Affiliation(s)
- E M Ndombi
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.,School of Biological Sciences, University of Nairobi, Nairobi, Kenya.,Department of Pathology, Kenyatta University, Nairobi, Kenya
| | - B Abudho
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.,Department of Biomedical Sciences, Maseno University, Maseno, Kenya
| | - N Kittur
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - J M Carter
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - H Korir
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - D K Riner
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - H Ochanda
- School of Biological Sciences, University of Nairobi, Nairobi, Kenya
| | - Y-M Lee
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - W E Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D M Karanja
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - D G Colley
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA.,Department of Microbiology, University of Georgia, Athens, GA, USA
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Mass drug administration and the global control of schistosomiasis: successes, limitations and clinical outcomes. Curr Opin Infect Dis 2018; 29:595-608. [PMID: 27584590 DOI: 10.1097/qco.0000000000000312] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. Despite the well known short-term benefits of treating patients for schistosomiasis, the impact of mass drug administration (MDA) campaigns to control the disease in the long term remains unresolved. RECENT FINDINGS Many studies have advocated the success of MDA programs in order to attract donor funds for elimination efforts but such successes are often short-lived given the drug does not alter the life cycle of the organism or prevent reinfection. Within a matter of months to years after halting treatment, the prevalence, intensity of infection and morbidity of disease return to baseline levels. Other mitigating factors contribute to the failings of MDA campaigns namely: poverty, poor drug coverage, poor drug compliance, and, in the case of Asiatic schistosomiasis, zoonotic transmission. Genetic and innate and acquired immunologic mechanisms complicate the epidemiologic picture of schistosomiasis globally, and may contribute indirectly to MDA shortcomings. The possibility of drug resistance is an ever present concern because of the sole reliance on one drug, praziquantel. SUMMARY Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. The short-term benefits of MDA campaigns are well documented but the long-term benefits are questionable.
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Gazzinelli A, Oliveira-Prado R, Matoso LF, Veloso BM, Andrade G, Kloos H, Bethony JM, Assunção RM, Correa-Oliveira R. Schistosoma mansoni reinfection: Analysis of risk factors by classification and regression tree (CART) modeling. PLoS One 2017; 12:e0182197. [PMID: 28813451 PMCID: PMC5558968 DOI: 10.1371/journal.pone.0182197] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/13/2017] [Indexed: 01/28/2023] Open
Abstract
Praziquantel (PZQ) is an effective chemotherapy for schistosomiasis mansoni and a mainstay for its control and potential elimination. However, it does not prevent against reinfection, which can occur rapidly in areas with active transmission. A guide to ranking the risk factors for Schistosoma mansoni reinfection would greatly contribute to prioritizing resources and focusing prevention and control measures to prevent rapid reinfection. The objective of the current study was to explore the relationship among the socioeconomic, demographic, and epidemiological factors that can influence reinfection by S. mansoni one year after successful treatment with PZQ in school-aged children in Northeastern Minas Gerais state Brazil. Parasitological, socioeconomic, demographic, and water contact information were surveyed in 506 S. mansoni-infected individuals, aged 6 to 15 years, resident in these endemic areas. Eligible individuals were treated with PZQ until they were determined to be negative by the absence of S. mansoni eggs in the feces on two consecutive days of Kato-Katz fecal thick smear. These individuals were surveyed again 12 months from the date of successful treatment with PZQ. A classification and regression tree modeling (CART) was then used to explore the relationship between socioeconomic, demographic, and epidemiological variables and their reinfection status. The most important risk factor identified for S. mansoni reinfection was their “heavy” infection at baseline. Additional analyses, excluding heavy infection status, showed that lower socioeconomic status and a lower level of education of the household head were also most important risk factors for S. mansoni reinfection. Our results provide an important contribution toward the control and possible elimination of schistosomiasis by identifying three major risk factors that can be used for targeted treatment and monitoring of reinfection. We suggest that control measures that target heavily infected children in the most economically disadvantaged households would be most beneficial to maintain the success of mass chemotherapy campaigns.
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Affiliation(s)
- Andréa Gazzinelli
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
- * E-mail:
| | - Roberta Oliveira-Prado
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo Ferreira Matoso
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
| | - Bráulio M. Veloso
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gisele Andrade
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California Medical Center, San Francisco, California, United States of America
| | - Jeffrey M. Bethony
- Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Science, George Washington University, Washington DC, United States of America
| | - Renato M. Assunção
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Correa-Oliveira
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
- Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
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da Paz VRF, Sequeira D, Pyrrho A. Infection by Schistosoma mansoni during pregnancy: Effects on offspring immunity. Life Sci 2017; 185:46-52. [PMID: 28754617 DOI: 10.1016/j.lfs.2017.07.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/16/2017] [Accepted: 07/20/2017] [Indexed: 11/26/2022]
Abstract
About 25 million Brazilians live in areas at risk of contracting the disease caused by the trematoda Schistosoma mansoni, the schistosomiasis mansoni. Although the adult parasites inhabit the blood vessels, probably the main element responsible for the pathology of the disease are the eggs, whose deposition in the liver results in formation of granulomas and hypersensitivity mediated by CD4 T cells. In the course of infection, the profile of T helper 1 (Th1) and Th2 cytokines released by immune cells is correlated with the extent of inflammation in the granuloma and with the disease severity. While a Th1 immune response favors the local inflammation and the disease progression, the Th2 immune response has protective character. Also during pregnancy, it is essential a fine adjustment of a Th1/Th2 in the maternal-fetal interface, which ensures the pregnancy progress with peculiar immune characteristics. In particular, the maternal exposure to antigens has been associated with their presence in fetal circulation. The exposure to intrauterine antigens can imply an immune tolerance of the fetus to such components. In turn, the transfer of antigens and antibodies from mother to offspring during breastfeeding is an important stage of maturation and capacitation of immune offspring in future infections against pathogens. This review aims to gather bibliographic data to assist in the understanding of immunological features printed on offspring of mothers infected with S. mansoni, which affect latter immune responses to related or unrelated antigens.
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Affiliation(s)
| | - Danielly Sequeira
- Laboratory of Immunoparasitology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.; Laboratory of Taxonomy, Biochemistry and Fungi Bioprospecting, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Alexandre Pyrrho
- Clinical and Toxicological Analysis Department, Pharmacy College, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Santini-Oliveira M, Coler RN, Parra J, Veloso V, Jayashankar L, Pinto PM, Ciol MA, Bergquist R, Reed SG, Tendler M. Schistosomiasis vaccine candidate Sm14/GLA-SE: Phase 1 safety and immunogenicity clinical trial in healthy, male adults. Vaccine 2015; 34:586-594. [PMID: 26571311 DOI: 10.1016/j.vaccine.2015.10.027] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 10/01/2015] [Accepted: 10/08/2015] [Indexed: 01/19/2023]
Abstract
DESIGN Safety and immunogenicity of a recombinant 14kDa, fatty acid-binding protein(FABP) from Schistosoma mansoni (rSm14) were evaluated through an open, non-placebo-controlled, dose-standardized trial, performed at a single research site. The vaccine was formulated with glucopyranosyl lipid A (GLA) adjuvant in an oil-in-water emulsion (SE) and investigated in 20 male volunteers from a non-endemic area for schistosomiasis in the state of Rio de Janeiro, Brazil. Fifty microgram rSm14 with 10 μg GLA-SE (rSm14/GLA-SE)/dose were given intramuscularly three times with 30-day intervals. Participants were assessed clinically, biochemically and immunologically for up to 120 days. METHODS Participants were screened for inclusion by physical examination, haematology and blood chemistry; then followed to assess adverse events and immunogenicity. Sera were tested for IgG (total and isotypes) and IgE. T cell induction of cytokines IL-2, IL-5, IL-10, IFNγ and TNFα was assessed by Milliplex kit and flow cytometry. RESULTS The investigational product showed high tolerability; some self-limited, mild adverse events were observed during and after vaccine administration. Significant increases in Sm14-specific total IgG, IgG1 and IgG3 were observed 30 days after the first vaccination with specific IgG2 and IgG4 after 60 days. An increase in IgE antibodies was not observed at any time point. The IgG response was augmented after the second dose and 88% of all vaccinated subjects had developed high anti-Sm14 IgG titres 90 days after the first injection. From day 60 and onwards, there was an increase in CD4(+) T cells producing single cytokines, particularly TNFα and IL-2, with no significant increase of multi-functional TH1 cells. CONCLUSION Clinical trial data on tolerability and specific immune responses after vaccination of adult, male volunteers in a non-endemic area for schistosomiasis with rSm14/GLA-SE, support this product as a safe, strongly immunogenic vaccine against schistosomiasis paving the way for follow-up Phase 2 trials. Study registration ID: NCT01154049 at http://www.clinicaltrials.gov.
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Affiliation(s)
- Marilia Santini-Oliveira
- Instituto Nacional de Infectologia Evandro Chagas (INI), Fiocruz, Av. Brasil, No. 4365, Manguinhos, Rio de Janeiro, 21045-900, Brazil
| | - Rhea N Coler
- Infectious Disease Research Institute (IDRI), 1616, Eastlake Ave E, Suite 400, Seattle, WA 98102, USA
| | - Juçara Parra
- Fiocruz/MS, Rua Gabriel Abrão s/n, Jardim das Nações, Campo Grande, Mato Grosso do Sul, 79.081-746, Brazil
| | - Valdilea Veloso
- Instituto Nacional de Infectologia Evandro Chagas (INI), Fiocruz, Av. Brasil, No. 4365, Manguinhos, Rio de Janeiro, 21045-900, Brazil
| | - Lakshmi Jayashankar
- Infectious Disease Research Institute (IDRI), 1616, Eastlake Ave E, Suite 400, Seattle, WA 98102, USA
| | - Patricia M Pinto
- Laboratório de Esquistossomose Experimental, Instituto Oswaldo Cruz, Fiocruz, Av. Brasil, No. 4365, Manguinhos, 21045-900 Rio de Janeiro, Brazil
| | - Marcia A Ciol
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, 1959 NE Pacific St, UW Box 356490, Seattle, WA 98195-6490, USA
| | | | - Steven G Reed
- Infectious Disease Research Institute (IDRI), 1616, Eastlake Ave E, Suite 400, Seattle, WA 98102, USA
| | - Miriam Tendler
- Laboratório de Esquistossomose Experimental, Instituto Oswaldo Cruz, Fiocruz, Av. Brasil, No. 4365, Manguinhos, 21045-900 Rio de Janeiro, Brazil.
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Tanigawa C, Fujii Y, Miura M, Nzou SM, Mwangi AW, Nagi S, Hamano S, Njenga SM, Mbanefo EC, Hirayama K, Mwau M, Kaneko S. Species-Specific Serological Detection for Schistosomiasis by Serine Protease Inhibitor (SERPIN) in Multiplex Assay. PLoS Negl Trop Dis 2015; 9:e0004021. [PMID: 26291988 PMCID: PMC4546333 DOI: 10.1371/journal.pntd.0004021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/30/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Both Schistosoma mansoni and Schistosoma haematobium cause schistosomiasis in sub-Saharan Africa. We assessed the diagnostic value of selected Schistosoma antigens for the development of a multiplex serological immunoassay for sero-epidemiological surveillance. METHODOLOGY/PRINCIPAL FINDINGS Diagnostic ability of recombinant antigens from S. mansoni and S. haematobium was assessed by Luminex multiplex immunoassay using plasma from school children in two areas of Kenya, endemic for different species of schistosomiasis. S. mansoni serine protease inhibitor (SERPIN) and Sm-RP26 showed significantly higher reactivity to patient plasma as compared to the control group. Sm-Filamin, Sm-GAPDH, Sm-GST, Sm-LAP1, Sm-LAP2, Sm-Sm31, Sm-Sm32 and Sm-Tropomyosin did not show difference in reactivity between S. mansoni infected and uninfected pupils. Sm-RP26 was cross-reactive to plasma from S. haematobium patients, whereas Sm-SERPIN was species-specific. Sh-SEPRIN was partially cross-reactive to S. mansoni infected patients. ROC analysis for Sm-RP26, Sm-SERPIN and Sh-SERPIN showed AUC values of 0.833, 0.888 and 0.947, respectively. Using Spearman's rank correlation coefficient analysis, we also found significant positive correlation between the number of excreted eggs and median fluorescence intensity (MFI) from the multiplex immunoassays for Sm-SERPIN (ρ = 0.430, p-value = 0.003) and Sh-SERPIN (ρ = 0.433, p-value = 0.006). CONCLUSIONS/SIGNIFICANCE Sm-SERPIN is a promising species-specific diagnostic antigen. Sh-SEPRIN was partially cross-reactive to S. mansoni infected patients. SERPINs showed correlation with the number of excreted eggs. These indicate prospects for inclusion of SERPINs in the multiplex serological immunoassay system.
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Affiliation(s)
- Chihiro Tanigawa
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yoshito Fujii
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- * E-mail:
| | - Masashi Miura
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Samson Muuo Nzou
- Nagasaki University Institute of Tropical Medicine—Kenya Medical Research Institute Project, Nairobi, Kenya
- Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya
| | | | - Sachiyo Nagi
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Shinjiro Hamano
- Nagasaki University Institute of Tropical Medicine—Kenya Medical Research Institute Project, Nairobi, Kenya
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Sammy M. Njenga
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Matilu Mwau
- Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya
- Consortium for National Health Research (CNHR), Nairobi, Kenya
| | - Satoshi Kaneko
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Nagasaki University Institute of Tropical Medicine—Kenya Medical Research Institute Project, Nairobi, Kenya
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan
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Huang J, Hua W, Li J, Hua Z. Molecular docking to explore the possible binding mode of potential inhibitors of thioredoxin glutathione reductase. Mol Med Rep 2015; 12:5787-95. [PMID: 26239395 PMCID: PMC4581810 DOI: 10.3892/mmr.2015.4119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 06/22/2015] [Indexed: 12/15/2022] Open
Abstract
Praziquantel (PZQ) is the treatment of choice for schistosomiasis, one of the most important but neglected tropical diseases. Recently, however, Schistosoma have exhibited reduced susceptibility to PZQ, and an urgent need to develop new drugs to treat schistosomiasis has emerged. Thioredoxin glutathione reductase (TGR) plays a crucial role in the redox balance of the parasite, combining glutaredoxin (Grx), glutathione reductase and thioredoxin reductase (TR) activities. Several compounds, including oxadiazole 2-oxides, phosphinic acid amides, isoxazolones and phosphoramidites, have been identified as agents that inhibit TGR from Schistosoma mansoni (smTGR) and exhibit anti-schistosomal activity. 4-Phenyl-1,2,5-oxadiazole-3-carbonitrile-2-oxide has also been shown to be active against TGR from Schistosoma japonicum (sjTGR). The binding sites of these inhibitors, however, remain unclear. To explore the binding interactions of these compounds, we selected six compounds to dock into the NADPH binding site, the active site of the TR domain and the Grx active site of both smTGR and sjTGR using AutoDock 4.2.5.1. The results suggested that the most favoured binding site for all compounds in either sjTGR or smTGR was the oxidised glutathione-binding pocket of the TR domain. Although all of the compounds could fit into the sjTGR site, the inhibition efficiency of these compounds towards sjTGR was marginally lower than it was towards smTGR, suggesting that it would be necessary to design specific inhibitors of TGR for different Schistosoma species. The docking results showed that all compounds docking in smTGR and sjTGR adopted similar binding modes in the TR domain. Two peptide fragments from another subunit, Phe505′–Leu508′ and Pro572′–Thr577′, played a critical role in the interactions with the inhibitors. In conclusion, the present study has revealed binding mechanisms for potential inhibitors of Schistosoma TGRs and could lead to structure-based ligand design and the development of new anti-schistosomiasis drugs.
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Affiliation(s)
- Jingwei Huang
- The State Key Laboratory of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing, Jiangsu 210093, P.R. China
| | - Weijuan Hua
- Department of Biology, Jiangsu Second Normal University, Nanjing, Jiangsu 210013, P.R. China
| | - Jiahuang Li
- The State Key Laboratory of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing, Jiangsu 210093, P.R. China
| | - Zichun Hua
- The State Key Laboratory of Pharmaceutical Biotechnology, College of Life Sciences, Nanjing University, Nanjing, Jiangsu 210093, P.R. China
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Koonrungsesomboon N, Wadagni AC, Mbanefo EC. Molecular markers and Schistosoma-associated bladder carcinoma: A systematic review and meta-analysis. Cancer Epidemiol 2015; 39:487-96. [PMID: 26162479 DOI: 10.1016/j.canep.2015.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/20/2015] [Accepted: 06/22/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Molecular mechanisms and pathogenesis of schistosomal-associated bladder cancer (SABC), one of the most common malignancies in Africa and parts of the Middle East, is still unclear. Identification of host molecular markers involved in schistosomal related bladder carcinogenesis is of value in prediction of high-risk group, early detection and timely intervention. METHODS PubMed, Scopus, Google Scholar, Cochrane Library and African Journals Online databases were systematically searched and reviewed. A total of 63 articles reporting 41 host molecular factors were included in the meta-analysis. RESULTS Pooled odds ratio demonstrated associations of p53 expression, telomerase activity and sFas with SABC as compared to other schistosomal patients (p53 expression: OR=9.46, 95%CI=1.14-78.55, p=0.04; telomerase by TERT: OR=37.38, 95%CI=4.17-334.85, p=0.001; telomerase by TRAP: OR=10.36, 95%CI=6.08-17.64, p<0.00001; sFas: OR=34.37, 95%CI=3.32-355.51, p=0.003). In comparison to bladder cancers of other etiology, positive associations were found between SABC and p15 deletion, p16 deletion, telomerase activity and sFas (p15 deletion: OR=4.20, 95%CI=2.58-6.82, p<0.00001; p16 deletion: OR=4.93, 95%CI=2.52-9.65, p<0.00001; telomerase by TERT: OR=3.01, 95%CI=1.51-5.97, p=0.002; telomerase by TRAP: OR=2.66, 95%CI=1.18-6.01, p=0.02; sFas: OR=4.50, 95%CI=1.78-11.40, p=0.001). Other identified associations were reported by few numbers of studies to enable reliable interpretation. CONCLUSIONS Variations in gene expression or genomic alterations of some molecular markers in SABC as compared to non-SABC or other schistosomal patients were identified. These suggest minute differences in the pathogenesis and physiological profile of SABC, in relation to non-SABC.
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Affiliation(s)
- Nut Koonrungsesomboon
- Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan.
| | - Anita Carolle Wadagni
- Centre for Buruli Ulcer Screening and Treatment, Ministry of Health, Cotonou, BP 03, Allada, Benin.
| | - Evaristus Chibunna Mbanefo
- Department of Parasitology and Entomology, Faculty of Bioscience, Nnamdi Azikiwe University, P.M.B. 5025, Awka, Nigeria; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan.
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Mbanefo EC, Kumagai T, Kodama Y, Kurosaki T, Furushima-Shimogawara R, Cherif MS, Mizukami S, Kikuchi M, Huy NT, Ohta N, Sasaki H, Hirayama K. Immunogenicity and anti-fecundity effect of nanoparticle coated glutathione S-transferase (SjGST) DNA vaccine against murine Schistosoma japonicum infection. Parasitol Int 2015; 64:24-31. [PMID: 25603531 DOI: 10.1016/j.parint.2015.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/10/2014] [Accepted: 01/11/2015] [Indexed: 01/10/2023]
Abstract
There is still urgent need for a vaccine against schistosomiasis, especially in Schistosoma japonicum endemic areas where even a vaccine that will interrupt zoonotic transmission will be potentially effective as an intervention tool. We had developed a novel nanoparticle gene delivery system, which has proven efficacious in gene transfection to target immune cells with complementary adjuvant effect and high protective efficacy in several diseases. Here, we applied this nanoparticle system in combination with S. japonicum glutathione S-transferase (SjGST) DNA vaccine to show the immunogenicity and anti-fecundity effect of the nanoparticle coated vaccine formulation against murine schistosomiasis. The nanoparticle-coated DNA vaccine formulation induced desired immune responses. In comparison with the nanoparticle coated empty vector, it produced significantly increased antigen-specific humoral response, T-helper 1 polarized cytokine environment, higher proportion of IFN-γ producing CD4(+) T-cells and the concomitant decrease in IL-4 producing CD4(+) T-cells. Although there was no effect on worm burden, we recorded a marked reduction in tissue egg burden. There was up to 71.3% decrease in tissue egg burden and 55% reduction in the fecundity of female adult worms. Our data showed that SjGST DNA vaccine, delivered using the nanoparticle gene delivery system, produced anti-fecundity effect on female adult schistosomes as previously described by using conventional subunit vaccine with adjuvant, proving this DNA vaccine formulation as a promising candidate for anti-pathology and transmission blocking application.
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Affiliation(s)
- Evaristus Chibunna Mbanefo
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and Global COE Program, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan; Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan; Department of Parasitology and Entomology, Faculty of Bioscience, Nnamdi Azikiwe University, P.M.B. 5025, Awka, Nigeria
| | - Takashi Kumagai
- Section of Environmental Parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Science, 113-8519, Japan
| | - Yukinobu Kodama
- Department of Hospital Pharmacy, Nagasaki University Hospital, 1-7-1 Sakamoto, 852-8501, Japan
| | - Tomoaki Kurosaki
- Department of Hospital Pharmacy, Nagasaki University Hospital, 1-7-1 Sakamoto, 852-8501, Japan
| | - Rieko Furushima-Shimogawara
- Section of Environmental Parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Science, 113-8519, Japan
| | - Mahamoud Sama Cherif
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and Global COE Program, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan; Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan
| | - Shusaku Mizukami
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and Global COE Program, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan; Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan
| | - Mihoko Kikuchi
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and Global COE Program, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan; Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan
| | - Nguyen Tien Huy
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan
| | - Nobuo Ohta
- Section of Environmental Parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Science, 113-8519, Japan
| | - Hitoshi Sasaki
- Department of Hospital Pharmacy, Nagasaki University Hospital, 1-7-1 Sakamoto, 852-8501, Japan
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and Global COE Program, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan; Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Japan.
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