2019
DOI: 10.1111/cea.13335
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Do helminth infections underpin urban‐rural differences in risk factors for allergy‐related outcomes?

Abstract: Summary Background It is proposed that helminth exposure protects against allergy‐related disease, by mechanisms that include disconnecting risk factors (such as atopy) from effector responses. Objective We aimed to assess how helminth exposure influences rural‐urban differences in risk factors for allergy‐related outcomes in tropical low‐ and middle‐income countries. Methods In cross‐sectional surveys in Ugandan rural Schistosoma mansoni (Sm)‐endemic islands, and in nearby mainland urban communities with lowe… Show more

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Cited by 22 publications
(31 citation statements)
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“…The “rural survey” was the outcomes survey (September 2015 – August 2016) following three years of the Lake Victoria Island Intervention Study on Worms and Allergy-related diseases (LaVIISWA; ISRCTN47196031), a cluster-randomised trial of community-based standard versus intensive anthelminthic treatment, described previously [ 24 , 26 ]. The “urban survey” (September 2016 – September 2017) was designed purposely to collect data for comparison with the rural survey [ 28 ]. Urban survey participants were not randomised to standard versus intensive anthelminthic intervention; however, all other procedures were designed to be equivalent between the two surveys.…”
Section: Methodsmentioning
confidence: 99%
See 1 more Smart Citation
“…The “rural survey” was the outcomes survey (September 2015 – August 2016) following three years of the Lake Victoria Island Intervention Study on Worms and Allergy-related diseases (LaVIISWA; ISRCTN47196031), a cluster-randomised trial of community-based standard versus intensive anthelminthic treatment, described previously [ 24 , 26 ]. The “urban survey” (September 2016 – September 2017) was designed purposely to collect data for comparison with the rural survey [ 28 ]. Urban survey participants were not randomised to standard versus intensive anthelminthic intervention; however, all other procedures were designed to be equivalent between the two surveys.…”
Section: Methodsmentioning
confidence: 99%
“…We surveyed helminth-endemic Lake Victoria islands of Koome, Uganda [ [24] , [25] , [26] , [27] ] and proximate mainland urban communities with lower helminth exposure [ 28 ] as part of a set of studies on helminths and allergy-related outcomes. Vaccine responses were measured as a secondary outcome in these surveys.…”
Section: Introductionmentioning
confidence: 99%
“…Our findings that early‐life exposure to high bacterial content in drinking water is associated with a reduced risk of asthma and other atopic phenotypes lend further support to the hygiene hypothesis 21,22 and add to the growing number of potentially important exposures which may explain the lower prevalence of allergic diseases in rural environments 16,17,23,24 . It is becoming increasingly evident that biodiversity of microbial exposure provides resilience against asthma and allergies 25 .…”
Section: Discussionmentioning
confidence: 99%
“…The metabolic outcomes survey was conducted between April and November 2017 after four years of the anthelminthic intervention 22 . The survey in the urban setting was deliberately formulated to collect data in parallel with the LaVIISWA outcome surveys to enable rural-urban comparison of allergy-related 23,24 and metabolic outcomes. It was conducted in Entebbe municipality, Wakiso district, Uganda from September 2016 to September 2017.…”
Section: Study Design and Settingmentioning
confidence: 99%