<i>Schistosoma mansoni</i> and <scp>HIV</scp> infection in a Ugandan population with high <scp>HIV</scp> and helminth prevalence

Sanya, Richard E.; Muhangi, Lawrence; Nampijja, Margaret; Nannozi, Victoria; Nakawungu, Prossy Kabuubi; Abayo, Elson; Webb, Emily L.; Elliott, Alison M; Nerima, Barbara; Mirembe, Beatrice; Okello, J; Levin, Jonathan; Namutebi, Milly; Zziwa, Christopher; Nakazibwe, Esther; Tumusiime, Josephine; Ninsiima, Carol; Kamukama, Grace; Amongin, Susan; Akello, Mirriam; Kammerer, Robert; Sewankambo, Moses; Nsubuga, Denis; Nakawungu, Prossy Kabubi; Niwagaba, Emmanuel; Oduru, Gloria; Kabami, Grace; Kabagenyi, Joyce; Nkurunungi, Gyaviira; Muwonge, Fred; Kizito, Dennison; Cose, Stephen; Abiriga, David; Mbaraga, Bonaventure; Musoke, R N; George, Wambi; Kaweesa, James; Tukahebwa, Edridah M.

doi:10.1111/tmi.12545

Cited by 31 publications

(38 citation statements)

References 24 publications

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“…HIV prevalence in Koome was around 21% in adults aged 18+ in 2016 [19]. Based on data from a household survey conducted in 2013, as part of the LaVIISWA study [20], within the 15-25 year age group, reported alcohol misuse (defined as consuming at least five alcoholic drinks per day in the last 12 months on average), prevalence was 5%-6%.…”

Section: Study Setting Design and Proceduresmentioning

confidence: 99%

“…Adolescence is a vulnerability window for initiation and continuation of polysubstance use and associated harms [3]. For instance, globally, the prevalence of current drinking increases from 26.5% among [15][16][17][18][19] year olds to 40.7% among [20][21][22][23][24] year olds, while the prevalence of heavy episodic drinking increases from 13.6% to 21.8% [1]. An estimated 14% of all deaths among [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] year olds are attributable to alcohol [4].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15–24 Years in Fishing Communities in Uganda

Kuteesa

Weiss

Cook

et al. 2020

IJERPH

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Background: We determined the prevalence of and risk factors for alcohol misuse and illicit drug use among young Ugandans in fishing communities, a recognised “key population” for human immunodeficiency virus (HIV) infection. Methods: We conducted a cross-sectional survey among young people (15–24 years) in fishing communities in Koome, Uganda, in December 2017–July 2018. Using Audio-Assisted Self-Interviewing, we collected data on socio-demographic characteristics and alcohol use, including the Alcohol Use Disorders Identification Test (AUDIT) and timeline follow-back calendar (TLFB). Blood samples were analysed for HIV, herpes simplex virus 2 (HSV2), and Phosphatidyl ethanol (PEth 16:0/18:1). Urine samples were analysed for illicit drugs. Results: Among 1281 participants (52.7% male, mean age 20 years), 659 (51.4%) reported ever drinking alcohol, 248 (19.4%) had 12-month-AUDIT ≥ 8, and 261 (20.5%) had whole-blood PEth 16:0/18:1 concentration ≥ 20 ng/mL, indicating significant consumption. In multivariable analyses, PEth 16:0/18:1 ≥ 20ng/mL, AUDIT ≥ 8 and binge drinking (≥6 standard drinks per drinking occasion in the previous month from TLFB) were all strongly associated with older age, low education, smoking, and HSV2. Illicit drug use prevalence was 5.2% and was associated with older age, low education, being single, and smoking. Conclusion: Levels of alcohol misuse were high among young people in fishing communities and associated with HSV2, a proxy for risky sexual behaviour. Alcohol and illicit drug harm reduction services and HIV prevention programs in Uganda should prioritise young fisherfolk.

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Section: Study Setting Design and Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15–24 Years in Fishing Communities in Uganda

Kuteesa

Weiss

Cook

et al. 2020

IJERPH

Self Cite

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“…Several population-based studies in Tanzania and Uganda, which included both men and women, did not find an increased prevalence of HIV among those with S. mansoni infection. 5,6 Neither of these studies stratified data by gender, and both relied on schistosome egg excretion as the primary endpoint, which is less sensitive than schistosome antigen testing 7 and may be diminished in the setting of HIV infection. 8,9 Of note, in a subset of the Ugandan individuals who underwent urine schistosome antigen testing, the odds ratio (OR) for HIV infection was 1.5 with a P value of 0.19, suggesting that the study may have lacked sufficient power to detect a smaller increased risk.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Of note, in a subset of the Ugandan individuals who underwent urine schistosome antigen testing, the odds ratio (OR) for HIV infection was 1.5 with a P value of 0.19, suggesting that the study may have lacked sufficient power to detect a smaller increased risk. 6 One other study that did use schistosome antigen testing in Uganda also did not report effects of S. mansoni infection on men and women separately. 10 Therefore, we conducted a large epidemiologic study to determine the relationship between S. haematobium, S. mansoni, and HIV infections among men in regions of Tanzania where schistosome infection is endemic.…”

Section: Introductionmentioning

confidence: 99%

Schistosomiasis and Human Immunodeficiency Virus in Men in Tanzania

et al. 2017

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Abstract. Schistosomiasis is a parasitic worm infection that affects over 260 million individuals worldwide. Women with schistosome infections have been demonstrated to have a 4-fold increase in the odds of human immunodeficiency virus (HIV) infection compared with women without schistosome infections. A relationship between schistosome and HIV infections has not been clearly defined in men. Among 674 men aged 18-50 years living in rural Tanzania, we identified 429 (63.6%) who had a schistosome infection as defined by serum positivity for schistosome circulating anodic antigen, visualization of parasite eggs in urine or stool, or both. HIV infection was identified in 38 (5.6%). The odds of HIV infection was 1.3 [95% confidence interval = 0.6-2.5] (P = 0.53) among men with any schistosome infection (Schistosoma haematobium or Schistosoma mansoni), and it was 1.4 [0.6-3.3] (P = 0.43) among men with S. haematobium infection. Men with S. haematobium infection were significantly more likely to report the symptom of hemospermia than men without S. haematobium infection. We conclude that schistosome infections appear to have little to no association with HIV infection in men.

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“…The study was conducted in fishing communities on the shores of Lake Victoria in Masaka district, Uganda, where HIV prevalence among adults was estimated to be 29% and S. mansoni infection more than 50% 16, 21, 22 .…”

Section: Methodsmentioning

confidence: 99%

Effect of high-intensity versus low-intensity praziquantel treatment on HIV disease progression in HIV and Schistosoma mansoni co-infected patients: a randomised controlled trial

Abaasa¹,

Asiki²,

Ekii³

et al. 2018

Wellcome Open Res

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Background: It has been hypothesised that Schistosoma co-infection exacerbates HIV progression, and hence anthelminthic intervention in co-infected individuals will delay it. We evaluated effects of high-intensity versus low-intensity praziquantel treatment of schistosomiasis on HIV disease progression among co-infected patients from fishing populations around Lake Victoria, Uganda. Methods: Between August 2012 and September 2015, we conducted an open-label randomised, controlled trial. Adults, antiretroviral therapy-naïve, CD4 counts ≥350 cells/μl, HIV and S. mansoni co-infected, were randomised 1:1 to praziquantel (40mg/kg) given quarterly (starting at enrolment) or annually (starting 12 weeks after enrolment; such that low-intensity participants were still untreated when sampled at 12 weeks). A non-randomised HIV-positive S. mansoni-negative comparison group was recruited. The primary outcome was mean change in plasma viral load at 12 and 60 weeks. Results: In total 363 participants (high-intensity 113, low-intensity 113, comparison group 137) were recruited; 96 (85.0%), 97 (85.8%) and 107 (78.1%) completed 60 weeks of follow up, respectively. Adjusting for baseline age and viral load, the geometric mean ratio (aGMR [95%CI]) viral load for high-intensity vs low-intensity groups at 12 weeks was 0.90 [0.65, 1.25] p=0.55 and at 60 weeks 1.88 [0.78, 4.53] p=0.16. Results in the comparison group were similar to trial arms. High-intensity, compared to low-intensity, treatment resulted in substantially lower S. mansoni prevalence at all follow up visits (p<0.05). Conclusions: In communities with a high burden of both S. mansoni and HIV infection, high-intensity treatment of S. mansoni does not delay HIV progression despite relevant benefit for parasite clearance. Trial registration: ISRCTN15371662 (17/11/2016)

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Schistosoma mansoni and HIV infection in a Ugandan population with high HIV and helminth prevalence

Cited by 31 publications

References 24 publications

Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15–24 Years in Fishing Communities in Uganda

Epidemiology of Alcohol Misuse and Illicit Drug Use Among Young People Aged 15–24 Years in Fishing Communities in Uganda

Schistosomiasis and Human Immunodeficiency Virus in Men in Tanzania

Effect of high-intensity versus low-intensity praziquantel treatment on HIV disease progression in HIV and Schistosoma mansoni co-infected patients: a randomised controlled trial

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