Implications of helminth immunomodulation on COVID-19 co-infections

Coronavirus disease 2019 (COVID-19) and helminths infections can be in a synergistic epidemic in developing and suburban areas of industrialized countries. The coinfected hosts will derive a parasite-specific Th2 innate and adaptive immune response with CD4+ T cells, eosinophils, interleukin-4, interleukin-5, and interleukin-10. In the early stages of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, virus-specific Th1 cytotoxic CD8+ T cell, interleukin-6, interferon-γ, and interleukin-27 by lung are keys in controlling viral replication in the lung epithelial cells and limiting the pathology to other organs, like the intestine. CD4+ and CD8+ T cells are associated with protective immunity against and during COVID-19. However, viral evasion mechanisms occur. Interference of the interferon-γ secretion, like in helminths immunomodulation, can contribute to COVID-19 severity. Immunomodulation can result in mild, moderate, or severe COVID-19 depending on which helminth is coinfecting by regulating or avoiding host cytokine and pro-inflammatory response, decreasing viral load, and affecting vaccine-induced antibody response. We discuss the implications of immunomodulation on COVID-19 caused by helminth co-infection and for public health in the context of COVID-19 vaccine use in helminth endemic zones

Examining and predicting under-the-table payments for health care in Albania: An application of the theory of planned behavior

The World Bank and the Albanian Ministry of Health report that the majority of Albanian citizens make illegal, under-the-table payments for health care. Qualitative studies have identified some factors associated with these informal payments, but the problem has not been systematically examined using established theoretical models. The purpose of this study was to examine and predict under-the-table payments using the theory of planned behavior (TPB). Self-administered surveys were completed by 222 Albanian citizens. The constructs of the theory explained 34% of the variance in intentions to make under-the-table payments, with attitude toward the behavior making the strongest contribution. Using the TPB to examine the practice of making under-the-table payments has indicated specific areas that can be targeted by policy interventions