TY - JOUR
T1 - Schistosoma haematobium effects on Plasmodium falciparum infection modified by soil-transmitted helminths in school-age children living in rural areas of Gabon
AU - Dejon-Agobé, Jean Claude
AU - Zinsou, Jeannot Fréjus
AU - Honkpehedji, Yabo Josiane
AU - Ateba-Ngoa, Ulysse
AU - Edoa, Jean-Ronald
AU - Adegbite, Bayodé Roméo
AU - Mombo-Ngoma, Ghyslain
AU - Agnandji, Selidji Todagbe
AU - Ramharter, Michael
AU - Kremsner, Peter Gottfried
AU - Lell, Bertrand
AU - Grobusch, Martin Peter
AU - Adegnika, Ayôla Akim
PY - 2018/8
Y1 - 2018/8
N2 - Background: Malaria burden remains high in the sub-Saharan region where helminths are prevalent and where children are often infected with both types of parasites. Although the effect of helminths on malaria infection is evident, the impact of these co-infections is not clearly elucidated yet and the scarce findings are conflicting. In this study, we investigated the effect of schistosomiasis, considering soil-transmitted helminths (STH), on prevalence and incidence of Plasmodium falciparum infection. Methodology: This longitudinal survey was conducted in school-age children living in two rural communities in the vicinity of Lambaréné, Gabon. Thick blood smear light microscopy, urine filtration and the Kato-Katz technique were performed to detect malaria parasites, S. haematobium eggs and, STH eggs, respectively. P. falciparum carriage was assessed at inclusion, and incidence of malaria and time to the first malaria event were recorded in correlation with Schistosoma carriage status. Stratified multivariate analysis using generalized linear model was used to assess the risk of plasmodium infection considering interaction with STH, and survival analysis to assess time to malaria. Main findings: The overall prevalence on subject enrolment was 30%, 23% and 9% for S. haematobium, P. falciparum infections and co-infection with both parasites, respectively. Our results showed that schistosomiasis in children tends to increase the risk of plasmodium infection but a combined effect with Trichuris trichiura or hookworm infection clearly increase the risk (aOR = 3.9 [95%CI: 1.7–9.2]). The incidence of malaria over time was 0.51[95%CI: 0.45–0.57] per person-year and was higher in the Schistosoma-infected group compared to the non-infected group (0.61 vs 0.43, p = 0.02), with a significant delay of time-to first-malaria event only in children aged from 6 to 10-years-old infected with Schistosoma haematobium. Conclusions: Our results suggest that STH enhance the risk for P. falciparum infection in schistosomiasis-positive children, and when infected, that schistosomiasis enhances susceptibility to developing malaria in young children but not in older children.
AB - Background: Malaria burden remains high in the sub-Saharan region where helminths are prevalent and where children are often infected with both types of parasites. Although the effect of helminths on malaria infection is evident, the impact of these co-infections is not clearly elucidated yet and the scarce findings are conflicting. In this study, we investigated the effect of schistosomiasis, considering soil-transmitted helminths (STH), on prevalence and incidence of Plasmodium falciparum infection. Methodology: This longitudinal survey was conducted in school-age children living in two rural communities in the vicinity of Lambaréné, Gabon. Thick blood smear light microscopy, urine filtration and the Kato-Katz technique were performed to detect malaria parasites, S. haematobium eggs and, STH eggs, respectively. P. falciparum carriage was assessed at inclusion, and incidence of malaria and time to the first malaria event were recorded in correlation with Schistosoma carriage status. Stratified multivariate analysis using generalized linear model was used to assess the risk of plasmodium infection considering interaction with STH, and survival analysis to assess time to malaria. Main findings: The overall prevalence on subject enrolment was 30%, 23% and 9% for S. haematobium, P. falciparum infections and co-infection with both parasites, respectively. Our results showed that schistosomiasis in children tends to increase the risk of plasmodium infection but a combined effect with Trichuris trichiura or hookworm infection clearly increase the risk (aOR = 3.9 [95%CI: 1.7–9.2]). The incidence of malaria over time was 0.51[95%CI: 0.45–0.57] per person-year and was higher in the Schistosoma-infected group compared to the non-infected group (0.61 vs 0.43, p = 0.02), with a significant delay of time-to first-malaria event only in children aged from 6 to 10-years-old infected with Schistosoma haematobium. Conclusions: Our results suggest that STH enhance the risk for P. falciparum infection in schistosomiasis-positive children, and when infected, that schistosomiasis enhances susceptibility to developing malaria in young children but not in older children.
KW - Albendazole/administration & dosage
KW - Animals
KW - Anthelmintics/therapeutic use
KW - Antimalarials/administration & dosage
KW - Artemether, Lumefantrine Drug Combination/administration & dosage
KW - Child
KW - Female
KW - Gabon/epidemiology
KW - Helminthiasis/complications
KW - Humans
KW - Malaria, Falciparum/complications
KW - Male
KW - Plasmodium falciparum
KW - Praziquantel/administration & dosage
KW - Risk Factors
KW - Schistosoma haematobium
KW - Schistosomiasis haematobia/complications
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85054799198&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30080853
U2 - https://doi.org/10.1371/journal.pntd.0006663
DO - https://doi.org/10.1371/journal.pntd.0006663
M3 - Article
C2 - 30080853
SN - 1935-2727
VL - 12
JO - PLoS neglected tropical diseases
JF - PLoS neglected tropical diseases
IS - 8
M1 - e0006663
ER -