Abstract
Schistosoma mansoni is a parasite which causes significant public-health issues, with over 240 million people infected globally. In Uganda alone, approximately 11.6 million people are affected. Despite over a decade of mass drug administration in this country, hyper-endemic hotspots persist, and individuals who are repeatedly heavily and rapidly reinfected are observed. Human blood-type antigens are known to play a role in the risk of infection for a variety of diseases, due to cross-reactivity between host antibodies and pathogenic antigens. There have been conflicting results on the effect of blood type on schistosomiasis infection and pathology. Moreover, the effect of blood type as a potential intrinsic host factor on S. mansoni prevalence, intensity, clearance, and reinfection dynamics and on co-infection risk remains unknown. Therefore, the epidemiological link between host blood type and S. mansoni infection dynamics was assessed in three hyper-endemic communities in Uganda. Longitudinal data incorporating repeated pretreatment S. mansoni infection intensities and clearance rates were used to analyse associations between blood groups in school-aged children. Soil-transmitted helminth coinfection status and biometric parameters were incorporated in a generalised linear mixed regression model including age, gender, and body mass index (BMI), which have previously been established as significant factors influencing the prevalence and intensity of schistosomiasis. The analysis revealed no associations between blood type and S. mansoni prevalence, infection intensity, clearance, reinfection, or coinfection. Variations in infection profiles were significantly different between the villages, and egg burden significantly decreased with age. While blood type has proven to be a predictor of several diseases, the data collected in this study indicate that it does not play a significant role in S. mansoni infection burdens in these high-endemicity communities.
Highlights
IntroductionSchistosomiasis is a debilitating, neglected tropical disease with over 240 million people infected globally [1]
The purpose of this study was to evaluate the association between host blood type and its effect on S. mansoni infection dynamics, with repeated observations over time in school-aged children (SAC)
As with many areas in subSaharan Africa, despite these efforts, the burden remains high. This may be partly explained by low mass drug administration (MDA) coverage [46], but even when children are given observed praziquantel treatment, clearance rates are low [47], many are very rapidly reinfected [2,47], and several remain heavily infected over repeated time points
Summary
Schistosomiasis is a debilitating, neglected tropical disease with over 240 million people infected globally [1]. Despite over a decade of mass drug administration (MDA) in many sub-Saharan African countries, hyperendemic hotspots persist, where individuals are repeatedly heavily and rapidly reinfected [2,3]. A range of factors may contribute to persistent hotspots relating to the environment, such as sanitation or snail habitat suitability [4,5]; and to parasite or host influences, including variation in genetic background, immune responses [6], and/or drug efficacy [7]. Individuals can vary in their predisposition to Microorganisms 2021, 9, 2448.
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