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Effect of age and initial infection intensity on the rate of reinfection with Trichuris trichiura after treatment

Published online by Cambridge University Press:  06 April 2009

D. A. P. Bundy
Affiliation:
Parasite Epidemiology Research Group, Imperial College, University of London, Prince Consort Road, London SW7 2BB
E. S. Cooper
Affiliation:
Parasite Epidemiology Research Group, Imperial College, University of London, Prince Consort Road, London SW7 2BB
D. E. Thompson
Affiliation:
Parasite Epidemiology Project, P.O. Box 306, Castries, LC
J. M. Didier
Affiliation:
Parasite Epidemiology Project, P.O. Box 306, Castries, LC
I. Simmons
Affiliation:
Ministry of Health, Castries, LC

Summary

The study examines the rate of re-acquisition of Trichuris trichiura infection after treatment in two populations, one of mixed age and the other of children with known preintervention infection intensity. A population living in a Caribbean village was treated with mebendazole and the rate of reacquisition of infection of four age classes (2–4, 5–10, 11–30, 30+ years) monitored over a 20-month period. The reinfection rate was higher in the child age-classes indicating either that children are more exposed to infection or that adults slowly develop a partially effective acquired immunity. A cohort of children (mean age 4·5 years) was separated into 3 intensity categories on the basis of expelled worm burdens and their rate of reacquisition of infection monitored over a 12-month period. The rate of reinfection was directly and positively associated with initial infection status. This may indicate that children with low intensity infections are consistently less exposed to infection or that they have effective immune responses. The latter conclusion, however, would imply that they had acquired this immunity early in life, and so appears to contradict the suggestion that resistance is only slowly acquired by adults. Reconciling these two conclusions may require more sophisticated immunological models than have been suggested previously for geohelminthiases.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1988

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References

REFERENCES

Anderson, R. M. (1987). Determinants of infection in human schistosomiasis. Baillière's Clinical Tropical Medicine and Communicable Diseases 2, 279300.Google Scholar
Anderson, R. M. & May, R. M. (1985). Helminth infections of humans: mathematical models, population dynamics and control. Advances in Parasitology 24, 1101.CrossRefGoogle ScholarPubMed
Anderson, R. M. & Medley, G. F. (1985). Community control of helminth infections of man by mass and selective chemotherapy. Parasitology 90, 629–60.CrossRefGoogle Scholar
Bensted-Smith, R., Anderson, R. M., Butterworth, A. E., Dalton, P. R., Kariuki, H. C., Koech, D., Mugambi, M., Ouma, J., Arap, , Siongok, T. K. & Sturrock, R. F. (1987). Evidence for predisposition of individual patients to reinfection with Schistosoma mansoni after treatment. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 651–4.CrossRefGoogle ScholarPubMed
Bradley, D. J. & McCullough, F. S. (1973). Egg output stability and the epidemiology of Schistosoma haematobium. II. An analysis of the epidemiology of endemic S. haematobium. Transactions of the Royal Society for Tropical Medicine and Hygiene 67, 491500.CrossRefGoogle Scholar
Bundy, D. A. P. (1986). Epidemiological aspects of Trichuris and trichuriasis in Caribbean communities. Transactions of the Royal Society for Tropical Medicine and Hygiene 80, 706–18.CrossRefGoogle ScholarPubMed
Bundy, D. A. P. & Cooper, E. S. (1988). The evidence for predisposition to trichuriasis in humans: comparison of institutional and community studies. Annals of Tropical Medicine and Parasitology (in the Press).CrossRefGoogle Scholar
Bundy, D. A. P., Cooper, E. S., Thompson, D. E., Anderson, R. M. & Didier, J. M. (1987 a). Age-related prevalence and intensity of Trichuris trichiura infection in a St. Lucian community. Transactions of the Royal Society for Tropical Medicine and Hygiene 81, 8594.CrossRefGoogle Scholar
Bundy, D. A. P., Cooper, E. S., Thompson, D. E., Didier, J. M., Anderson, R. M. & Simmons, I. (1987 b). Predisposition to Trichuris trichiura infections in humans. Epidemiology and Infection 98, 6571.CrossRefGoogle Scholar
Bundy, D. A. P. & Golden, M. H. N. (1987). The impact of host nutrition on gastro-intestinal helminth populations. Parasitology 95, 623–35.CrossRefGoogle Scholar
Bundy, D. A. P., Thompson, D. E., Cooper, E. S. & Blanchard, J. (1985 a). Rate of expulsion of Trichuris trichiura with multiple and single dose regimens of albendazole. Transactions of the Royal Society for Tropical Medicine and Hygiene 79, 641–4.CrossRefGoogle ScholarPubMed
Bundy, D. A. P., Thompson, D. E., Cooper, E. S., Golden, M. H. N. & Anderson, R. M. (1985 b). Population dynamics and chemotherapeutic control of Trichuris trichiura infection of children in Jamaica and St. Lucia. Transactions of the Royal Society for Tropical Medicine and Hygiene 79, 759–64.CrossRefGoogle ScholarPubMed
Bundy, D. A. P., Thompson, D. E., Golden, M. H. N., Cooper, E. S., Anderson, R. M. & Harland, P. S. E. (1985 c). Population distribution of Trichuris trichiura in a community of Jamaican children. Transactions of the Royal Society for Tropical Medicine and Hygiene 79, 232–7.CrossRefGoogle Scholar
Butterworth, A. E., Bensted-Smith, R., Capron, A., Capron, M., Dalton, P. R., Dunne, D. W., Grzych, J. M., Kariuki, H. C., Khalife, J., Koech, D., Mugambi, M., Ouma, J. H., Arap Siongok, T. K. & Sturrock, R. F. (1987). Immunity in human schistosomiasis mansoni. Prevention by blocking antibodies of the expression of immunity in young children. Parasitology 94, 281300.CrossRefGoogle ScholarPubMed
Butterworth, A. E., Capron, M., Cordingley, J. S., Dalton, P. R., Dunne, D. W., Kariuki, H. C., Kimani, G., Koech, D., Mugambi, M., Ouma, J. H., Prentice, M. A., Richardson, B. A., Arap Siongok, T. K., Sturrock, R. F & Taylor, D. W. (1985). Immunity after treatment of human schistosomiasis mansoni. II. Identification of resistant individuals, and analysis of their immune responses. Transactions of the Royal Society for Tropical Medicine and Hygiene 79, 393408.CrossRefGoogle ScholarPubMed
Cabrera, B. D. (1981). Reinfection and infection rate studies of soil-transmitted helminthiasis in Juban, Sorsogon. In Collected Papers on the Control of Soil-Transmitted Helminthiases, vol. 1. pp. 181191. Tokyo, Japan: Asian Parasite Control Organisation.Google Scholar
Chai, J. Y., Seo, B. S., Lee, S. H. & Cho, S. Y. (1983). Epidemiological studies on Ascaris lumbricoides reinfection in rural communities in Korea. II. Age-specific reinfection rates and familiar aggregation of the reinfected cases. Korean Journal of Parasitology 21, 142–9.CrossRefGoogle Scholar
Cooper, E. S. & Bundy, D. A. P. (1986). Trichuriasis in St. Lucia. In Diarrhoea and Malnutrition in Childhood (ed. McNeish, A. S. and Walker-Smith, J. A.), pp. 9196. London: Butterworths.CrossRefGoogle Scholar
Elkins, D. B., Haswell-Elkins, M. & Anderson, R. M. (1986). The epidemiology and control of intestinal helminths in the Pulicat Lake region of Southern India: 1. Study design and pre- and post-treatment observations on Ascaris lumbricoides infection. Transactions of the Royal Society for Tropical Medicine and Hygiene 80, 774–92.CrossRefGoogle Scholar
Haswell-Elkins, M. R., Elkins, D. B., Manjula, K., Michael, E. & Anderson, R. M. (1987). The distribution and abundance of Enterobius vermicularis in a South Indian fishing community. Parasitology 95, 323–37.CrossRefGoogle Scholar
Kennedy, M. W., Gordon, A. M. S., Tomlinson, L. A. & Qurishi, F. (1986). Genetic (major histocompatibility complex?) control of the antibody repertoire to the secreted antigens of Ascaris. Parasite Immunology 9, 269–73.CrossRefGoogle Scholar
Pritchard, D. I. (1986). Antigens of gastrointestinal nematodes. Transactions of the Royal Society for Tropical Medicine and Hygiene 80, 728–34.CrossRefGoogle ScholarPubMed
Schad, G. A. & Anderson, R. M. (1985). Predisposition to hookworm infection in humans. Science 228, 1537–40.CrossRefGoogle ScholarPubMed
Sturrock, R. F., Kimani, R., Cottrell, B. J., Butterworth, A. E., Seitz, W. M., Siongok, T. K. & Houba, V. (1983). Observations on possible immunity to reinfection among Kenyan schoolchildren after treatment for Schistosoma mansoni. Transactions of the Royal Society for Tropical Medicine and Hygiene 77, 363–71.CrossRefGoogle ScholarPubMed
Wakelin, D. (1985). Genetic control of immunity to helminth infections. Parasitology Today 1, 1723.CrossRefGoogle ScholarPubMed
Warren, K. S. (1973). Regulation of the prevalence and intensity of schistosomiasis in man: immunology or ecology? Journal of Infectious Diseases 127, 595609.CrossRefGoogle ScholarPubMed
Wassom, D. L., Krco, C. J. & David, C. S. (1987). I-E expression and susceptibility to parasite infection. Immunology Today 8, 3943.CrossRefGoogle Scholar
Wilkins, H. A., Blumenthal, U. J., Hagan, P., Hayes, R. J. & Tulloch, S. (1987). Resistance to reinfection after treatment of urinary schistosomiasis. Transactions of the Royal Society for Tropical Medicine and Hygiene 81, 2935.CrossRefGoogle ScholarPubMed
Yodmani, B., Sornami, S., Phatihatakorn, W. & Harinasuta, C. (1983). Re-infection of ascariasis after treatment with Pyrantel Pamoate and the factors relating to its active transmission in a slum in Bangkok. In Collected Papers on the Control of Soil-Transmitted Helminthiases, vol. 2, pp. 89100. Tokyo, Japan: Asian Parasite Control Organisation.Google Scholar