IMMUNO-EPIDEMIOLOGY OF HUMAN GEOHELMINTHIASIS - ECOLOGICAL AND IMMUNOLOGICAL DETERMINANTS OF WORM BURDEN
IMMUNO-EPIDEMIOLOGY OF HUMAN GEOHELMINTHIASIS - ECOLOGICAL AND IMMUNOLOGICAL DETERMINANTS OF WORM BURDEN
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DOI：
10.1017/s0031182000075284
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发表时间：
1992-01-01
期刊：
影响因子：
2.4
通讯作者：
MEDLEY, GF
中科院分区：
文献类型：
--
作者：
BUNDY, DAP;MEDLEY, GF
土壤蠕虫病的发病率和传播动力学是由社区感染强度的模式决定的。了解这些模式的决定因素需要结合实地，实验室和理论研究。年龄特异性再感染和易感现象的研究表明，凸的年龄强度分布和感染强度异质性的主要决定因素是感染的建立率，而不是成虫死亡率。反过来，感染率又取决于是否接触感染和是否受到感染。证据表明，暴露，至少对口腔传播的土蠕虫，随年龄而变化，是高度异质性的主机之间。土蠕虫病的免疫反应是有力的，寄生虫特异性，宿主之间的异质性，年龄和感染剂量依赖性，但尚未令人信服地显示出保护性。由于免疫反应本身是一个函数的曝光，解开生态和免疫之间的相互作用，作为决定因素的土蠕虫蠕虫负担将需要同时评估这两个过程，通过免疫流行病学研究。
The morbidity and transmission dynamics of geohelminthiases are determined by the patterns of infection intensity in the community. Understanding the determinants of these patterns requires a combination of field, laboratory and theoretical study. Studies of age-specific reinfection, and of the phenomenon of predisposition, indicate that the major determinant of convex age-intensity profiles and of heterogeneity in infection intensity is the rate of establishment of infection, rather than the rate of adult worm mortality. The rate of establishment is, in turn, determined by exposure to, and protection from, infection. The evidence indicates that exposure, at least to the orally-transmitted geohelminths, varies with age and is highly heterogeneous between hosts. The immune response in geohelminthiasis is vigorous, parasite-specific, heterogeneous between hosts, and both age and infection dose dependent, but has yet to be convincingly shown to be protective. Since the immune response is itself a function of exposure, unravelling the interaction between ecology and immunology as determinants of geohelminth worm burden will require simultaneous assessment of both processes via immuno-epidemiological study.