Skip to main content
Article thumbnail
Location of Repository

The impact of single versus mixed schistosome species infections on liver, spleen and bladder morbidity within Malian children pre- and post-praziquantel treatment

By Artemis Koukounari, Christl A Donnelly, Moussa Sacko, Adama D Keita, Aly Landouré, Robert Dembelé, Elisa Bosqué-Oliva, Albis F Gabrielli, Anouk Gouvras, Mamadou Traoré, Alan Fenwick and Joanne P Webster

Abstract

Abstract Background: In the developing world co-infections and polyparasitism within humans appear to be the rule rather than the exception, be it any combination of inter-specific and/or inter- and intra-Genera mixed infections. Mixed infections might generate synergistic or antagonistic interactions and thereby clinically affect individuals and/or impact parasite epidemiology. Methods: The current study uniquely assesses both Schistosoma mansoni- and Schistosoma haematobium-related morbidity of the liver and the bladder as assessed by ultrasound as well as spleen and liver morbidity through clinical exams. The impact of praziquantel (PZQ) treatment on such potential inter-specific schistosome interactions and resulting morbidity using uniquely detailed longitudinal data (pre- and one year post-PZQ treatment) arising from the National Schistosomiasis Control Program in three areas of Mali: Ségou, Koulikoro and Bamako, is also evaluated. At baseline, data were collected from up to 2196 children (aged 7-14 years), 844 of which were infected with S. haematobium only, 124 with S. mansoni only and 477 with both. Follow-up data were collected from up to 1265 children. Results: Results suggested lower liver morbidity in mixed compared to single S. mansoni infections and higher bladder morbidity in mixed compared to single S. haematobium infections. Single S. haematobium or S. mansoni infections were also associated with liver and spleen morbidity whilst only single S. haematobium infections were associated with bladder morbidity in these children (light S. haematobium infection OR: 4.3, p < 0.001 and heavy S. haematobium infection OR: 19, p < 0.001). PZQ treatment contributed to the regression of some of the forms of such morbidities. Conclusions: Whilst the precise biological mechanisms for these observations remain to be ascertained, the results illustrate the importance of considering mixed species infections in any analyses of parasite-induced morbidity, including that for the proposed Disability Adjusted Life Years (DALYs) revised estimates of schistosomiasis morbidity

Topics: DT Africa, R Medicine (General)
Publisher: BioMed Central
Year: 2010
DOI identifier: 10.1186/1471-2334-10-227
OAI identifier: oai:eprints.lse.ac.uk:37708
Provided by: LSE Research Online

Suggested articles

Citations

  1. (2001). A: Hepatosplenic schistosomiasis in field-based studies: a combined clinical and sonographic definition. Mem Inst Oswaldo Cruz doi
  2. (2004). Comparison of schistosome transmission in a single- and a double-cropped area in the rice irrigation scheme ‘Office du Niger’, Mali. Acta Trop doi
  3. (1990). Distribution of intermediate mollusc hosts in human schistosomiasis in the Office of Niger (Mali). II. Role of different habitats in the transmission]. Bull Soc Pathol Exot
  4. (1998). DJ: Schistosomiasis haematobia in Mali: prevalence rate in school-age children as index of endemicity in the community. Trop Med Int Health doi
  5. (2004). Djibrilla A: Emergence of Schistosoma mansoni in the Niger River valley Niger. Trans R Soc Trop Med Hyg doi
  6. (1996). Doehring E: Ultrasonographic assessment of Schistosoma mansoni and S. haematobium morbidity in Zimbabwean schoolchildren. doi
  7. (1990). Doumbo O: [Echographic morbidity due to Schistosoma haematobium in a peripheral district of Bamako in Mali Missabougou]. Bull Soc Pathol Exot
  8. (2004). Dunne DW: Morbidity in schistosomiasis: an update. Curr Opin Infect Dis
  9. (1989). Efficiency of focal molluscicide treatment against schistosomiasis reinfection in an irrigation scheme and in a small dams area in Mali. Preliminary communication. Trop Med Parasitol
  10. (1991). Ekani Bessala MM: Schistosoma mansoni eggs in urine.
  11. (2006). et al: Assessment of ultrasound morbidity indicators of schistosomiasis in the context of large-scale programs illustrated with experiences from Malian children. Am J Trop Med Hyg
  12. (2005). et al: Association of Schistosoma haematobium infection with protection against acute Plasmodium falciparum malaria in Malian children. Am J Trop Med Hyg
  13. (1994). et al: Lack of ultrasonographic evidence for severe hepatosplenic morbidity in schistosomiasis mansoni in Mali. Am J Trop Med Hyg
  14. (2006). Fenwick A: Implementation of national schistosomiasis control programmes in West Africa. Trends Parasitol doi
  15. (1993). GT: Is Schistosoma mansoni replacing Schistosoma haematobium in the Fayoum? Am J Trop Med Hyg
  16. (1992). GT: Schistosoma haematobium infection in Egyptian schoolchildren: demonstration of both hepatic and urinary tract morbidity by ultrasonography. Trans R Soc Trop Med Hyg doi
  17. (1998). GT: Ultrasound-detected hepatic periportal thickening in patients with prolonged pyrexia. Am J Trop Med Hyg
  18. (2004). Habbema JD: Measuring schistosomiasis case management of the health services in Ghana and Mali. Trop Med Int Health doi
  19. (2000). Hammam HM, et al: The epidemiology of schistosomiasis in Egypt: summary findings in nine governorates. Am J Trop Med Hyg
  20. (1999). Increase of intestinal schistosomiasis after praziquantel treatment in a Schistosoma haematobium and Schistosoma mansoni mixed focus. Acta Trop doi
  21. (2006). L: The control of schistosomiasis and soil-transmitted helminths in East Africa. Trends Parasitol doi
  22. (1982). Migasena P: Biological implications of polyparasitism. Rev Infect Dis doi
  23. (2007). Molyneux DH: Recent progress in integrated neglected tropical disease control. Trends Parasitol doi
  24. (2003). Nutrition status education participation and school achievement among Kenyan middle-school children. Nutrition (Burbank, Los Angeles County Calif) doi
  25. (2000). PM: Epidemic Schistosoma mansoni in a known S. haematobium area. Trans R Soc Trop Med Hyg doi
  26. (2003). PM: Interactions between Schistosoma haematobium and Schistosoma mansoni in humans in north Cameroon. Trop Med Int Health doi
  27. (1994). Schistosomiasis in Dogon country Mali: identification and prevalence of the species responsible for infection in the local community. Trans R Soc Trop Med Hyg doi
  28. (1999). Tchuem Tchuente LA: Mating interactions between Schistosoma haematobium doi
  29. (1996). The evolution and maintenance of virulence in microparasites. Emerg Infect Dis doi
  30. (2009). The saga of schistosome migration and attrition. Parasitology doi
  31. (2005). Tisch DJ: Reassessment of the cost of chronic helmintic infection: a meta-analysis of disability-related outcomes in endemic schistosomiasis. Lancet doi
  32. (2005). Towards control of schistosomiasis in sub-Saharan Africa. J Helminthol doi

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.