The Enemy of My Enemy is Perhaps My Friend: Intestinal schistosomiasis is associated with reduced malaria intensity in preschool children in Uganda.

Time: To be announced
Where:
To be announced

Authors

D McDowell1; J R Stothard2; L Hurt3; J Lello1
1 Cardiff School of Biosciences, Cardiff University, UK;  2 LSTM, UK;  3 Cardiff School of Medicine, Cardiff University, UK

Discussion

In sub-Saharan Africa, preschool – aged children (<6 years), typically bear the brunt of the malaria burden, constituting the largest number of child deaths. In addition, recent epidemiological surveys in Uganda show that intestinal schistosomiasis can be highly prevalent in this age group and cause significant morbidities. In the context of co-infection, either antagonistic or synergistic, it is essential that we better understand how these parasites interact within these young children. Furthermore, this age group offers a unique opportunity to gain a clearer insight into the interactions between Schistosoma mansoni and Plasmodium falciparum, as we follow an individual child’s infection dynamics and history with these two parasites through time. 

 

Using a mixed modelling approach, applied to previous longitudinal cohort data from the Schistosomiasis In Mothers and Infants (SIMI) study, we assessed the relationship between S. mansoni and P. falciparum infections in these young children, in the face of regular antiparasitic treatments. Despite the regular treatment in this study, of the 1211 preschool children in the cohort, the prevalence of infection for P. falciparum, S. mansoni and co-infected individuals remained constant over the study period. A single P. falciparum infection was by far the most prevalent and remained constant from the baseline survey to the 12 month survey (36.2% - 36.8%). Similarly, the prevalence of a single S. mansoni infection remained constant (13.7% - 13.4%) whereas the prevalence of co-infected individuals slightly decreased (36.8% - 31.6%).

 

We conclude, from the mixed models, that infection with S. mansoni is associated with a lower intensity of P. falciparum infection; however, this relationship becomes more complicated by host infection history, increasing age and the intensity of the S. mansoni infection. Looking ahead as treatment of young children with praziquantel is to be up scaled, understanding co-infection interactions in more detail is essential for the success of future public health initiatives to reduce the burden of intestinal schistosomiasis and malaria.   

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