Multiple infection with<i>Plasmodium</i>and helminths in communities of low and relatively high socio-economic status

Tshikuka, Jose-Gaby; Scott, Marilyn; Gray‐Donald, Katherine; Kalumba, O.-N.

doi:10.1080/00034983.1996.11813053

Cited by 62 publications

(45 citation statements)

References 22 publications

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“…Even when controlling for parasitemia, malaria was most severe in Mf Ϫ coinfected mice, and this was associated with increased interferon-g responsiveness. Thus, in Mf Ϫ mice, filariasis upset a delicate immunological balance in malaria infection and exacerbated malariainduced immunopathology.Helminth infections are prevalent throughout tropical regions where malaria is transmitted [1][2][3][4][5]. Interactions among infections commonly alter disease severity [6,7], and malaria-helminth coinfection can either exacerbate [8,9] or ameliorate [10] the severity of disease in human hosts.…”

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confidence: 99%

Malaria‐Filaria Coinfection in Mice Makes Malarial Disease More Severe unless Filarial Infection Achieves Patency

et al. 2005

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Coinfections are common in natural populations, and the literature suggests that helminth coinfection readily affects how the immune system manages malaria. For example, type 1-dependent control of malaria parasitemia might be impaired by the type 2 milieu of preexisting helminth infection. Alternatively, immunomodulatory effects of helminths might affect the likelihood of malarial immunopathology. Using rodent models of lymphatic filariasis (Litomosoides sigmodontis) and noncerebral malaria (clone AS Plasmodium chabaudi chabaudi), we quantified disease severity, parasitemia, and polyclonal splenic immune responses in BALB/c mice. We found that coinfected mice, particularly those that did not have microfilaremia (Mf(-)), had more severe anemia and loss of body mass than did mice with malaria alone. Even when controlling for parasitemia, malaria was most severe in Mf(-) coinfected mice, and this was associated with increased interferon- gamma responsiveness. Thus, in Mf(-) mice, filariasis upset a delicate immunological balance in malaria infection and exacerbated malaria-induced immunopathology.

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Malaria‐Filaria Coinfection in Mice Makes Malarial Disease More Severe unless Filarial Infection Achieves Patency

et al. 2005

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“…10,11 However, epidemiologic studies evaluating helminthic coinfection with malaria among non-pregnant adults and children have provided conflicting results, suggesting that immune responses may be helminth-dependent, with other factors, such as stage and intensity of infection and age of the host, playing an important role. [12][13][14][15][16][17] These complex relationships remain even less clear among pregnant or human immunodeficiency virus (HIV)-infected patients.…”

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confidence: 99%

Associations between Peripheral Plasmodium falciparum Malaria Parasitemia, Human Immunodeficiency Virus, and Concurrent Helminthic Infection among Pregnant Women in Malawi

Thigpen¹,

Filler²,

Kazembe³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Approximately 2 billion persons worldwide are infected with schistosomiasis and soil-transmitted helminthes (STH), many in areas where endemic malaria transmission coexists. Few data exist on associations between these infections. Nested within a larger clinical trial, primigravid and secundigravid women provided blood samples for human immunodeficiency virus (HIV) testing and peripheral malaria films and stool and urine for evaluation of STH and Schistosoma spp. during their initial antenatal clinic visit. The most common parasitic infections were malaria (37.6%), S. haematobium (32.3%), and hookworm (14.4%); 14.2% of women were HIV-infected. S. haematobium infection was associated with lower malarial parasite densities (344 versus 557 parasites/μL blood; P < 0.05). In multivariate analysis, HIV and hookworm infection were independently associated with malaria infection (adjusted odds ratio = 1.9 and 95% confidence interval = 1.2–3.0 for HIV; adjusted odds ratio = 1.9 and 95% confidence interval = 1.03–3.5 for hookworm). Concurrent helminthic infection had both positive and negative effects on malaria parasitemia among pregnant women in Malawi.

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“…Results in human studies have also been conflicting. Some studies have shown that helminth infections protect against malaria-associated morbidity (12-17), while others indicate that coinfections enhance clinical malaria (18)(19)(20)(21)(22) or have no influence on malaria outcome (23,24). A number of factors can contribute to differing results, such as parasite exposure (large single or repeated smaller infections), age, the duration of prior infections, and the methods of data collection and analysis (25).…”

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Protective Effect of Chronic Schistosomiasis in Baboons Coinfected with Schistosoma mansoni and Plasmodium knowlesi

et al. 2016

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c Malaria and schistosomiasis coinfections are common, and chronic schistosomiasis has been implicated in affecting the severity of acute malaria. However, whether it enhances or attenuates malaria has been controversial due the lack of appropriately controlled human studies and relevant animal models. To examine this interaction, we conducted a randomized controlled study using the baboon (Papio anubis) to analyze the effect of chronic schistosomiasis on severe malaria. Two groups of baboons (n ‫؍‬ 8 each) and a schistosomiasis control group (n ‫؍‬ 3) were infected with 500 Schistosoma mansoni cercariae. At 14 and 15 weeks postinfection, one group was given praziquantel to treat schistosomiasis infection. Four weeks later, the two groups plus a new malaria control group (n ‫؍‬ 8) were intravenously inoculated with 10 5 Plasmodium knowlesi parasites and monitored daily for development of severe malaria. A total of 81% of baboons exposed to chronic S. mansoni infection with or without praziquantel treatment survived malaria, compared to only 25% of animals infected with P. knowlesi only (P ‫؍‬ 0.01). Schistosome-infected animals also had significantly lower parasite burdens (P ‫؍‬ 0.004) than the baboons in the P. knowlesi-only group and were protected from severe anemia. Coinfection was associated with increased spontaneous production of interleukin-6 (IL-6), suggesting an enhanced innate immune response, whereas animals infected with P. knowlesi alone failed to develop mitogen-driven tumor necrosis factor alpha and IL-10, indicating the inability to generate adequate protective and balancing immunoregulatory responses. These results indicate that chronic S. mansoni attenuates the severity of P. knowlesi coinfection in baboons by mechanisms that may enhance innate immunity to malaria. P olyparasitism is common in low-resource countries, especially in sub-Saharan Africa. Coinfections may alter disease outcomes and affect both drug and vaccine efficacies (1, 2). The majority of studies on coinfections have focused on interactions between malaria and chronic helminth infections. Interest in studying malaria and schistosomiasis, in particular, comes from the major overlap of the two diseases in areas where they are endemic and the fact that these infections account for a large proportion of global morbidity and mortality (3, 4). Because of the chronicity of schistosome infection, most studies have focused on its impact on susceptibility to clinical malaria.Studies on malaria and schistosomiasis coinfections in human and animal models have generated contradicting results. Although some animal studies have shown that chronic schistosomiasis protects against severe malaria (5), others have reported that a concurrent schistosome infection enhances the severity of malaria (6-10). Many factors may account for these differences, including mouse strain, duration and intensity of the helminth infection, Plasmodium strain or species, inoculum size, or route of malaria infection (skin or blood stage) (11). An important limitat...

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Multiple infection withPlasmodiumand helminths in communities of low and relatively high socio-economic status

Cited by 62 publications

References 22 publications

Malaria‐Filaria Coinfection in Mice Makes Malarial Disease More Severe unless Filarial Infection Achieves Patency

Malaria‐Filaria Coinfection in Mice Makes Malarial Disease More Severe unless Filarial Infection Achieves Patency

Associations between Peripheral Plasmodium falciparum Malaria Parasitemia, Human Immunodeficiency Virus, and Concurrent Helminthic Infection among Pregnant Women in Malawi

Protective Effect of Chronic Schistosomiasis in Baboons Coinfected with Schistosoma mansoni and Plasmodium knowlesi

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