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      Assessment of the effect of Schistosoma haematobium co infection on malaria parasites and immune responses in rural populations in Gabon: study protocol

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          Abstract

          Background

          Malaria and helminth co infection are common in tropical and subtropical areas where they affect the life of millions of people. While both helminth and malaria parasites have immunomodulatory activities, little is known about the consequence of co-infections on malaria antigen specific immune responses.

          Method/Design

          This study will be conducted in two rural areas of the Moyen Ogooué province in Gabon, endemic for both Plasmodium falciparum and Schistosoma haematobium infections. Participants, 5 to 50 years old, will be enrolled and grouped according to their infection status. S. haematobium and malaria parasites will be detected, demographic and clinical data will be recorded and blood will be collected for hematological as well as for immunological assays. The level of antibody specific to Plasmodium falciparum blood stage and gametocyte antigens will be measured using ELISA. PBMC will be isolated for phenotyping of different T cell subsets ex vivo by flow cytometry and for culture and cytokine response assessment.

          Discussion

          We will provide a comprehensive picture of the interaction between schistosomes and malaria parasites which co-localize in peripheral blood. We will test the hypothesis that schistosome infection has an impact on specific humoral as well as on cellular immune responses to malaria antigens.

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          Most cited references39

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          Immune regulation by helminth parasites: cellular and molecular mechanisms.

          Immunology was founded by studying the body's response to infectious microorganisms, and yet microbial prokaryotes only tell half the story of the immune system. Eukaryotic pathogens--protozoa, helminths, fungi and ectoparasites--have all been powerful selective forces for immune evolution. Often, as with lethal protozoal parasites, the focus has been on acute infections and the inflammatory responses they evoke. Long-lived parasites such as the helminths, however, are more remarkable for their ability to downregulate host immunity, protecting themselves from elimination and minimizing severe pathology in the host.
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            Epidemiology of plasmodium-helminth co-infection in Africa: populations at risk, potential impact on anemia, and prospects for combining control.

            Human co-infection with Plasmodium falciparum and helminths is ubiquitous throughout Africa, although its public health significance remains a topic for which there are many unknowns. In this review, we adopted an empirical approach to studying the geography and epidemiology of co-infection and associations between patterns of co-infection and hemoglobin in different age groups. Analysis highlights the extensive geographic overlap between P. falciparum and the major human helminth infections in Africa, with the population at coincident risk of infection greatest for hookworm. Age infection profiles indicate that school-age children are at the highest risk of co-infection, and re-analysis of existing data suggests that co-infection with P. falciparum and hookworm has an additive impact on hemoglobin, exacerbating anemia-related malarial disease burden. We suggest that both school-age children and pregnant women--groups which have the highest risk of anemia--would benefit from an integrated approach to malaria and helminth control.
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              The nature and consequences of coinfection in humans

              Summary Objective Many fundamental patterns of coinfection (multi-species infections) are undescribed, including the relative frequency of coinfection by various pathogens, differences between single-species infections and coinfection, and the burden of coinfection on human health. We aimed to address the paucity of general knowledge on coinfection by systematically collating and analysing data from recent publications to understand the types of coinfection and their effects. Methods From an electronic search to find all publications from 2009 on coinfection and its synonyms in humans we recorded data on i) coinfecting pathogens and their effect on ii) host health and iii) intensity of infection. Results The most commonly reported coinfections differ from infections causing highest global mortality, with a notable lack of serious childhood infections in reported coinfections. We found that coinfection is generally reported to worsen human health (76% publications) and exacerbate infections (57% publications). Reported coinfections included all kinds of pathogens, but were most likely to contain bacteria. Conclusions These results suggest differences between coinfected patients and those with single infections, with coinfection having serious health effects. There is a pressing need to quantify the tendency towards negative effects and to evaluate any sampling biases in the coverage of coinfection research.
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                Author and article information

                Contributors
                ulyssus700@yahoo.fr
                zinaff@gmail.com
                rfkassa@yahoo.fr
                elianenfe@gmail.com
                hyjosiane@yahoo.fr
                mmassingaloembe@lambarene.org
                hkenguele@gmail.com
                mymhankoma@yahoo.fr
                honopetty@yahoo.com
                lindawammes@gmail.com
                moustaphazero@yahoo.fr
                Y.C.M.Kruize@lumc.nl
                ghyslain.mombongoma@gmail.com
                hlary2000@gmail.com
                jcagobe@yahoo.fr
                isaadou2002@yahoo.fr
                bertrand.lell@gmail.com
                H.H.Smits@lumc.nl
                peter.kremsner@uni-tuebingen.de
                M.Yazdanbakhsh@lumc.nl
                a.a.adegnika@medizin.uni-tuebingen.de
                Journal
                Springerplus
                Springerplus
                SpringerPlus
                Springer International Publishing (Cham )
                2193-1801
                29 July 2014
                29 July 2014
                2014
                : 3
                : 388
                Affiliations
                [ ]Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon
                [ ]Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
                [ ]Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
                [ ]Faculté de Médecine, Université des Sciences de la Santé de Libreville, BP: 4009, Libreville, Gabon
                [ ]Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec Teaching Hospital, 30 Avenue Pasteur, BP 7325, Dakar, Senegal
                [ ]Institute of Tropical Medicine of Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium
                Article
                1100
                10.1186/2193-1801-3-388
                4128953
                1542e31b-ad1e-4722-9d6d-c9348022757f
                © Ateba Ngoa et al.; licensee Springer. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                : 10 March 2014
                : 15 July 2014
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2014

                Uncategorized
                malaria,helminths,co-infection,cellular immune response,study protocols,epidemiology,gabon,africa

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