Risk factors for schistosomiasis morbidity in the total study population.

<p>OR) Odds Ratio; 95%CI) 95% Confidence Interval; Ref.) Reference category; N/A) Not Applicable; *) <i>p</i><0.05; **) <i>p</i><0.01; ***) <i>p</i><0.001.</p>a<p>For <i>S. haematobium</i>-specific bladder morbidity, the trend with age was significant at the level of <i>p</i> = 0.025 in the uni- and <i>p</i> = 0.043 in the multivariable analysis. For <i>S. mansoni</i>-specific hepatic fibrosis, the trend with age was significant in the crude analysis (<i>p</i><0.001). In the adjusted analysis the ORs for hepatic fibrosis increased with age in Diokhor Tack (<i>p</i><0.001) but they did not vary with age in Ndieumeul.</p>b<p>OR for a 10-fold increase in infection intensity.</p

<i>Schistosoma haematobium</i>-associated bladder morbidity, hematuria and <i>S. haematobium</i> infection in the two co-endemic communities studied.

a<p>GM) Geometric Mean; calculated for microscopically <i>S. haematobium</i>-positive individuals only.</p

Bladder and liver co-morbidity in the two co-endemic communities studied.

<p>Number of cases.</p

The effect of mixed <i>Schistosoma</i> infection on bladder morbidity and on hepatic fibrosis.

<p>OR) Odds Ratio; 95%CI) 95% Confidence Interval; Ref.) Reference category; N/A) Not Applicable; *) <i>p</i><0.05; **) <i>p</i><0.01; ***) <i>p</i><0.001.</p>a<p>The trends with age were not significant for <i>S. haematobium</i>-specific bladder morbidity, but for <i>S. mansoni</i>-specific hepatic fibrosis, they were at the level of <i>p</i><0.001 in both analyses.</p>b<p>OR for a 10-fold increase in infection intensity.</p>c<p>Mixed infections as compared to single <i>S. haematobium</i> infections.</p>d<p>Mixed infections as compared to single <i>S. mansoni</i> infections.</p

Age distribution of schistosomiasis morbidity in the two co-endemic communities studied.

<p>Colored stacks indicate morbidity prevalences and continuous black lines indicate mean 10log-transformed infection intensities among positive subjects with the standard error of the mean (whiskers). <b>Panel A:</b> Different forms of <i>S. haematobium</i>-specific bladder morbidity are denoted by a color gradient: light yellow stacks designate a urinary bladder score of 1, bright yellow a score of 2 and orange (3 and 4), red (5) and violet (6) indicate higher morbidity scores. The dotted red line indicates hematuria prevalence in a subsample (n = 317). <b>Panel B:</b> The severity of <i>S. mansoni</i>-specific fibrosis is denoted by a color gradient. Yellow stacks designate liver image pattern C, orange pattern D, red pattern E, and violet stacks indicate pattern F. Striped stacks designate those with borderline liver morbidity (pattern B, not classified as morbidity).</p

<i>S. mansoni</i> egg elimination, infection intensity and bladder morbidity in subjects passing <i>S. haematobium</i> eggs in urine.

a<p>GM) Geometric Mean; 95%CI) 95% Confidence Interval.</p

<i>Schistosoma mansoni</i>-associated hepatic fibrosis and <i>S. mansoni</i> infection in the two co-endemic communities studied.

a<p>GM) Geometric Mean; calculated for microscopically <i>S. mansoni</i>-positive individuals only. N/A) Not Applicable.</p

Variation in <i>Schistosoma</i> antigen-induced cytokine responses in relation to <i>Schistosoma</i> infection status.

<p>Each three-dimensional (3D) nMDS ordination is represented in two 2D planes (<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd.0003080.s001" target="_blank">Supporting Information S1</a>) as in <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd-0003080-g001" target="_blank">Figure 1</a>: Left and right panels represent the 1^st and 2^nd, and 2^nd and 3^rd dimensions, respectively. <b>Panels A</b> and <b>B</b> show the <i>S. mansoni</i> egg antigen (SEAm)-induced cytokine profile, <b>Panels C</b> and <b>D</b> that of <i>S. haematobium</i> SEA(h), <b>Panels E</b> and <b>F</b> that of <i>S. mansoni</i> adult worm antigens (AWAm), and <b>Panels G</b> and <b>H</b> show <i>S. haematobium</i> AWA(h)-induced cytokine profiles. Dots represent individuals and distances between dots approximate the rank order of dissimilarities in cytokine profiles between the respective individuals with stress values (i.e. discrepancies) of 0.051 for SEAm, 0.041 for SEAh, 0.058 for AWAm, and 0.061 for AWAh. Red arrows indicate linear gradients of normalized net cytokine responses on which the nMDS is based. The length of the arrows is proportional to the goodness of fit onto the cytokine profile within one 2D plane, and arrows are only depicted if their fit was significant at the level of <i>p</i> = 0.05 in 3D ordinations (see <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd-0003080-t004" target="_blank">Table 4</a>), as well as in the respective 2D planes. Green dots represent uninfected individuals, dark blue those with single <i>S. mansoni</i> infections, light blue single <i>S. haematobium</i>, and the other colors indicate people with mixed infections: pink indicates mixed infections without ectopic egg elimination, yellow mixed infections with <i>S. mansoni</i> in feces as well as in urine and <i>S. haematobium</i> in urine, and red dots represent one individual with both <i>S. mansoni</i> and <i>S. haematobium</i> eggs in urine (possibly a hybrid species <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd.0003080-Meurs1" target="_blank">[4]</a>–<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd.0003080-Huyse1" target="_blank">[6]</a>; see also <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd-0003080-t001" target="_blank">Table 1</a>). Ellipsoids represent 95% confidence intervals for average group scores, for different infection statuses: uninfected (‘N’), single <i>S. mansoni</i> (‘M’), single <i>S. haematobium</i> (‘H’), versus mixed infection (‘MH’). Ellipsoids are drawn using the function ‘ordiellipse’, and only depicted if the fit of infection status onto the cytokine profile was significant at the level of <i>p</i> = 0.05 in 3D ordinations (see <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd-0003080-t004" target="_blank">Table 4</a>), as well as in the respective 2D planes. In Panel A and G, the labels for single <i>S. mansoni</i> (‘M’) and mixed infection (‘MH’) are overlapping. ^aThe biological a posteriori interpretation of nMDS1 (left x-axis) and nMDS2 (y-axis) were added between brackets on the axis labels, but nMDS3 (right x-axis) could not be interpreted.</p

<i>Schistosoma</i> infections in the study population.

a<p><i>Schistosoma mansoni</i> eggs that were ectopically excreted in the urine had a <i>S. mansoni</i>-like morphology but may have had a genetically hybrid constitution <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd.0003080-Meurs1" target="_blank">[4]</a>, <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003080#pntd.0003080-Huyse1" target="_blank">[6]</a>.</p

Spatial distribution of self-reported use of the different water contact sites.

<p>Black circles and crosses indicate households that were included and excluded from the analysis, respectively. Roman numerals indicate water contact sites. Blue circles indicate clusters of people that reported to frequent a given water contact site indicated by an arrow. Participants in the northeastern cluster were more likely to frequent site II (3/4 <i>versus</i> 5/273;<i>p</i> = 0.005), participants in the middle cluster to frequent site III (4/17 <i>versus</i> 2/260; <i>p</i> = 0.022), and those from the southwestern cluster to frequent site V (8/53 <i>versus</i> 1/224; <i>p</i> = 0.001) than those living outside the respective clusters.</p