Soil-transmitted helminths: A critical review of the impact of co-infections and implications for control and elimination

Researchers have raised the possibility that soil-transmitted helminth (STH) infections might modify the host's immune response against other systemic infections. STH infections can alter the immune response towards type 2 immunity that could then affect the likelihood and severity of other illnesses. However, the importance of co-infections is not completely understood, and the impact and direction of their effects vary considerably by infection. This review synthesizes evidence regarding the relevance of STH co-infections, the potential mechanisms that explain their effects, and how they might affect control and elimination efforts. According to the literature reviewed, there are both positive and negative effects associated with STH infections on other diseases such as malaria, human immunodeficiency virus (HIV), tuberculosis, gestational anemia, pediatric anemia, neglected tropical diseases (NTDs) like lymphatic filariasis, onchocerciasis, schistosomiasis, and trachoma, as well as Coronavirus Disease 2019 (COVID-19) and human papillomavirus (HPV). Studies typically describe how STHs can affect the immune system and promote increased susceptibility, survival, and persistence of the infection in the host by causing a TH2-dominated immune response. The co-infection of STH with other diseases has important implications for the development of treatment and control strategies. Eliminating parasites from a human host can be more challenging because the TH2-dominated immune response induced by STH infection can suppress the TH1 immune response required to control other infections, resulting in an increased pathogen load and more severe disease. Preventive chemotherapy and treatment are currently the most common approaches used for the control of STH infections, but these approaches alone may not be adequate to achieve elimination goals. Based on the conclusions drawn from this review, integrated approaches that combine drug administration with water, sanitation and hygiene (WASH) interventions, hygiene education, community engagement, and vaccines are most likely to succeed in interrupting the transmission of STH co-infections. Gaining a better understanding of the behavior and relevance of STH co-infections in the context of elimination efforts is an important intermediate step toward reducing the associated burden of disease

Nutrientes foliares de espécies arbóreas de três estádios sucessionais de floresta ombrófila densa no sul do Brasil Leaf nutrient content of tree species from three successional stages of tropical rain forest in south Brazil

As concentrações de macro e micronutrientes foliares de espécies arbóreas foram avaliadas em três estádios sucessionais (inicial, intermediário e avançado) de uma floresta ombrófila densa das terras baixas, no litoral do Estado do Paraná, crescendo sobre solo arenoso e oligotrófico. Dentre as espécies arbóreas mais importantes de cada estádio sucessional (quatro iniciais; oito intermediárias; 11 avançadas), coletou-se folhas maduras de cinco diferentes indivíduos de cada estádio sucessional para a análise química dos seguintes elementos: N, P, K, Ca, Mg, C, Zn, Fe, Cu e Mn. As espécies do estádio inicial possuem as menores concentrações médias foliares de N, P, K, Zn, Fe e a maior concentração de Mg e estas concentrações são estatisticamente diferentes (p <0,05), quando comparadas com os valores médios dos demais estádios. Nos estádios intermediário e avançado, as concentrações médias de N, Ca e Mg, assim como os micronutrientes estão dentro dos valores esperados para florestas tropicais. As concentrações médias de K, nos estádios inicial e intermediário, e as concentrações médias de P, em todos os estádios, encontram-se abaixo dos valores reportados para as florestas tropicais. A relação C/N é alta (>25:1), apesar da tendência de diminuir à medida que avança a sucessão. O aumento da concentração da maioria dos nutrientes foliares analisados ao longo do gradiente sucessional está associado, possivelmente, com o incremento do acúmulo da serapilheira sobre o solo, o que proporciona ciclagem de nutrientes mais intensa e maiores concentrações de nutrientes no solo.<br>We investigated the leaf nutrient content of trees species from three distinct successional stages (early, intermediate, late) of a lowland rain forest located near the coast of Paraná State, Brazil. This forest grows on sandy soil with low nutrient content. We collected mature leaves from five different individuals of each sucessional stages of the most important tree species of each successional stage (four of the early; eight of the intermediate and 11 of the late stages) for chemical analysis of following elements: N, P, K, Ca, Mg, C, Zn, Fe, Cu e Mn. The species from early sucessional stage have lower contents of N, P, K, Zn, Fe, and higher contents of Mg. These concentrations are statistically different (p <0,05) when compared to mean values of the other stages. For the intermediate and late successional stages, the average nutrient concentrations of N, Ca, Mg and micronutrients are within the range of values expected for tropical forests. Foliar K concentration, from early and intermediate successional stages, and foliar P concentration, for all successional stages, are below the reported range of values for tropical forests. The C/N ratio is high (>25:1), despite of the tendency to decrease as succession advances. The increment of concentration of the most studied foliar nutrients along the successional gradient is probably related to the accumulation of litter above the soil that provides a more adequate environment for efficient nutrient cycling and higher nutrient concentration in the soil