Host determinants of reinfection with schistosomes in humans: a systematic review and meta-analysis.
Host determinants of reinfection with schistosomes in humans: a systematic review and meta-analysis.
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DOI：
10.1371/journal.pntd.0003164
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发表时间：
2014-09
影响因子：
3.8
通讯作者：
Hirayama K
中科院分区：
文献类型：
--
作者：
Mbanefo EC;Huy NT;Wadagni AA;Eneanya CI;Nwaorgu O;Hirayama K
血吸虫病仍然是热带和亚热带地区的主要公共卫生负担。尽管有针对这种疾病的有效化疗（吡喹酮），但大规模给药（MDA）后会迅速发生再感染。由于整个人群不会以相同的速度再次感染，因此宿主因素可能在决定对血吸虫再次感染的抵抗力或易感性方面发挥主导作用。在这里，我们系统地回顾和荟萃分析了一些研究，这些研究报告了主要人类感染物种（曼氏沙门氏菌、日本沙门氏菌和埃及沙门氏菌）的再感染与宿主社会人口学、流行病学、免疫学和遗传因素之间的关联。 2013 年 10 月检索了 PubMed、Scopus、Google Scholar、Cochrane Review Library 和 Africa Journals Online 公共数据库，以检索评估宿主因素与血吸虫再感染之间关系的研究。进行荟萃分析以生成汇总比值比和标准化平均差，分别作为二分变量和连续变量的总体效果估计。还评估了纳入研究的质量评估、研究之间的异质性和发表偏倚。在最初的 2739 项记录中，分析中纳入了 109 项研究，其中只有 32 项研究（37 个数据集）符合定量数据合成的条件。在确定的几个宿主因素中，发现与年龄和治疗前强度有很强的正相关性，而与性别只有轻微的正相关性。这些因素是暴露和疾病传播的主要决定因素。发现与抗 SWA IgG4 水平显着正相关，与 IgE 水平相关总体呈负相关。这再次证实了 IgE/IgG4 平衡是血吸虫病保护性免疫的主要决定因素的概念。少数研究报告了其他确定的决定因素，以便进行解释。我们的数据有助于了解宿主与寄生虫之间的相互作用，因为它会影响再感染，并且是指导规划和定制针对高风险群体的社区干预措施的潜在工具。血吸虫病控制的主要挑战之一是，由于高再感染率，大规模用药后疾病患病率恢复到基线水平。宿主因素在决定血吸虫病和其他疾病再感染的抵抗力或易感性方面发挥着重要作用。我们系统地检索和分析了确定血吸虫再感染的潜在宿主决定因素的研究。在人口统计变量中，年龄而非性别与血吸虫再感染密切相关。治疗前感染强度也被认为是再感染的主要决定因素。与 IgG4 水平的正相关和与 IgE 水平的负相关再次证实了 IgE/IgG4 平衡是控制血吸虫病保护性免疫的主要因素的观点。少数研究报告了其他因素，以便做出正确的推论。这些结果有助于我们了解宿主与寄生虫的关系，因为它会影响再感染，并将有助于规划和瞄准有限的资源对高危人群进行干预。
Schistosomiasis is still a major public health burden in the tropics and subtropics. Although there is an effective chemotherapy (Praziquantel) for this disease, reinfection occurs rapidly after mass drug administration (MDA). Because the entire population do not get reinfected at the same rate, it is possible that host factors may play a dominant role in determining resistance or susceptibility to reinfection with schistosomes. Here, we systematically reviewed and meta-analyzed studies that reported associations between reinfection with the principal human-infecting species (S. mansoni, S. japonicum and S. haematobium) and host socio-demographic, epidemiological, immunological and genetic factors. PubMed, Scopus, Google Scholar, Cochrane Review Library and African Journals Online public databases were searched in October 2013 to retrieve studies assessing association of host factors with reinfection with schistosomes. Meta-analysis was performed to generate pooled odds ratios and standardized mean differences as overall effect estimates for dichotomous and continuous variables, respectively. Quality assessment of included studies, heterogeneity between studies and publication bias were also assessed. Out of the initial 2739 records, 109 studies were included in the analyses, of which only 32 studies with 37 data sets were eligible for quantitative data synthesis. Among several host factors identified, strong positive association was found with age and pre-treatment intensity, and only slightly for gender. These factors are major determinants of exposure and disease transmission. Significant positive association was found with anti-SWA IgG4 level, and a negative overall effect for association with IgE levels. This reconfirmed the concept that IgE/IgG4 balance is a major determinant of protective immunity against schistosomiasis. Other identified determinants were reported by a small number of studies to enable interpretation. Our data contribute to the understanding of host-parasite interaction as it affects reinfection, and is a potential tool to guide planning and tailoring of community interventions to target high-risk groups. One of the major challenges of schistosomiasis control is that disease prevalence reverts to baseline levels after mass drug administration due to high rate of reinfection. Host factors play a major role in determining resistance or susceptibility to reinfection with schistosomiasis and other diseases. We systematically searched and analyzed studies that identified potential host determinants of reinfection with schistosomes. Among demographic variables, age but not gender was strongly associated with reinfection with schistosomes. Pretreatment infection intensity was also identified as a major determinant of reinfection. Positive association with IgG4 levels and negative association with IgE levels reconfirmed the notion that IgE/IgG4 balance is the major factor controlling protective immunity against schistosomiasis. Other factors were reported by few studies to allow correct inferences. These results contribute to our understanding of host-parasite relationship as it affects reinfection, and will be useful for planning and targeting the limited resources for intervention on high-risk groups.
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DOI：
10.4269/ajtmh.1995.52.549
发表时间：
1995-06-01
影响因子：
3.3
作者：
ETARD, JF;AUDIBERT, M;DABO, A
通讯作者：
DABO, A
影响因子：
2.8
作者：
CAPRON, M;CAPRON, A
通讯作者：
CAPRON, A
影响因子：
2.8
作者：
DUNNE, DW;BUTTERWORTH, AE;STURROCK, RF
通讯作者：
STURROCK, RF
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
2.7
作者：
Acosta, LP;Aligui, GDL;Olveda, RM
通讯作者：
Olveda, RM