Ascaris co-infection does not alter malaria-induced anaemia in a cohort of Nigerian preschool children.
Ascaris co-infection does not alter malaria-induced anaemia in a cohort of Nigerian preschool children.
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DOI：
10.1186/1475-2875-12-1
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发表时间：
2013-01-02
期刊：
影响因子：
3
通讯作者：
Lamb TJ
中科院分区：
文献类型：
--
作者：
Abanyie FA;McCracken C;Kirwan P;Molloy SF;Asaolu SO;Holland CV;Gutman J;Lamb TJ
疟疾和类蛔虫等肠道寄生虫的共同感染很常见。疟疾寄生虫诱导促炎免疫反应，导致疟疾感染中出现的致病性后遗症，如疟疾贫血。众所周知，蛔虫可以创造一种抗炎免疫环境，理论上可以抵消抗疟疾的炎症免疫反应，从而将疟疾贫血的严重程度降到最低。本研究考察蛔虫合并感染是否能使疟疾贫血的严重程度最小化。对2006-2007年在尼日利亚学龄前（6-59个月）儿童中进行的抗虫治疗效果随机对照试验的数据进行了分析，以检验疟疾和蛔虫合并感染对贫血严重程度的影响。在基线、4个月和8个月时，对儿童进行疟疾、寄生虫和贫血检测。这项研究分析了690名受试者。使用广义线性混合模型来评估感染状态与蛔虫和疟原虫强度与贫血严重程度之间的关系，贫血的定义为血红蛋白低于11 g/dL。在本研究过程中，疟疾流行率为35-78%。在受疟疾感染的儿童中，55%在基线时合并感染蛔虫，60%在4个月后合并感染，48%在8个月后合并感染，这突显了该人群中疟疾-线虫合并感染的持续流行。在整个研究过程中，人群中贫血受试者的百分比在基线时为84%，在8个月的时间点为77%。感染疟疾的儿童患贫血的几率是未感染疟疾儿童的四到五倍。蛔虫感染本身并没有增加贫血的几率，这表明疟疾是这一人群中贫血的主要原因。单独感染疟疾的儿童和同时感染疟疾和蛔虫的儿童在贫血的严重程度上没有显著差异。在这组尼日利亚学龄前儿童中，疟疾感染是导致贫血的主要因素。蛔虫合并感染既没有加重也没有减轻疟疾贫血的严重程度。
Co-infection with malaria and intestinal parasites such as Ascaris lumbricoides is common. Malaria parasites induce a pro-inflammatory immune response that contributes to the pathogenic sequelae, such as malarial anaemia, that occur in malaria infection. Ascaris is known to create an anti-inflammatory immune environment which could, in theory, counteract the anti-malarial inflammatory immune response, minimizing the severity of malarial anaemia. This study examined whether Ascaris co-infection can minimize the severity of malarial anaemia. Data from a randomized controlled trial on the effect of antihelminthic treatment in Nigerian preschool-aged (6–59 months) children conducted in 2006–2007 were analysed to examine the effect of malaria and Ascaris co-infection on anaemia severity. Children were enrolled and tested for malaria, helminths and anaemia at baseline, four, and eight months. Six hundred and ninety subjects were analysed in this study. Generalized linear mixed models were used to assess the relationship between infection status and Ascaris and Plasmodium parasite intensity on severity of anaemia, defined as a haemoglobin less than 11 g/dL. Malaria prevalence ranged from 35-78% over the course of this study. Of the malaria-infected children, 55% were co-infected with Ascaris at baseline, 60% were co-infected four months later and 48% were co-infected eight months later, underlining the persistent prevalence of malaria-nematode co-infections in this population. Over the course of the study the percentage of anaemic subjects in the population ranged between 84% at baseline and 77% at the eight-month time point. The odds of being anaemic were four to five times higher in children infected with malaria compared to those without malaria. Ascaris infection alone did not increase the odds of being anaemic, indicating that malaria was the main cause of anaemia in this population. There was no significant difference in the severity of anaemia between children singly infected with malaria and co-infected with malaria and Ascaris. In this cohort of Nigerian preschool children, malaria infection was the major contributor to anaemia status. Ascaris co-infection neither exacerbated nor ameliorated the severity of malarial anaemia.
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