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A cohort of 148 Cameroonian children infected with Schistosoma haematobium was followed before praziquantel therapy and 1, 2, 3, 5, and 12 months thereafter. Egg output, the reagent strip index (RSI, a pathological marker), and circulating anodic antigen (CAA) and circulating cathodic antigen (CCA) in serum and urine were quantified. At enrollment, the median level of egg output was 365/10 mL of urine; 97% of children had a positive RSI; CAA was detected in serum from 76% of children and in urine from 64%; and CCA was detected in serum from 55% of children and in urine from 87%. Two months after chemotherapy, egg output and RSI had decreased significantly; reinfection later developed in parallel with increases in the serum and urine concentrations of CAA and the urine concentrations of CCA. The measurement of CAA and CCA is useful for diagnosis, evaluation of disease severity, and follow-up of chemotherapy in individuals infected with S. haematobium.

The kinetics of indicators of lymphocyte activation were determined in non- and semiimmune patients with uncomplicated Plasmodium falciparum infection and in control subjects in Acre, Brazil. Delayed type hypersensitivity (DTH) to seven recall antigens was weakest in nonimmune patients. Both patient groups differed significantly from controls on admission (P less than .001 for both) and improved considerably after clindamycin therapy. Total serum IgG and IgM, but not antimalarial antibodies, were highest in nonimmune patients compared with semiimmune patients and controls during acute malaria. Immunoglobulin levels normalized after chemotherapy. A striking decrease of CD4+ peripheral blood lymphocytes, normalizing after chemotherapy, was seen in both patient groups, and was more pronounced in nonimmune patients. A slight increase in interleukin-2 receptor (IL-2R)-bearing cells was found in nonimmune patients. In addition, soluble plasma IL-2R was significantly elevated in them (P less than .001) and to a lesser extent in semiimmune patients. These findings were paralleled by significantly decreased IL-2 concentrations in plasma (P less than .001) during the acute phase of malaria, suggesting pronounced general immunosuppression in nonimmune malaria patients.

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