Abstract
BackgroundHumans are susceptible to over 1400 pathogens. Co-infection by multiple pathogens is common, and can result in a range of neutral, facilitative, or antagonistic interactions within the host. Soil-transmitted helminths (STH) are powerful immunomodulators, but evidence of the effect of STH infection on the direction and magnitude of concurrent enteric microparasite infections is mixed.MethodsWe collected fecal samples from 891 randomly selected children and adults in rural Laos. Samples were analyzed for 5 STH species, 6 viruses, 9 bacteria, and 5 protozoa using a quantitative reverse transcription polymerase chain reaction (qRT-PCR) assay. We utilized logistic regression, controlling for demographics and household water, sanitation, and hygiene access, to examine the effect of STH infection on concurrent viral, bacterial, and protozoal infection.ResultsWe found that STH infection was associated with lower odds of concurrent viral infection [odds ratio (OR): 0.48, 95% confidence interval (CI): 0.28–0.83], but higher odds of concurrent bacterial infections (OR: 1.81, 95% CI: 1.06–3.07) and concurrent protozoal infections (OR: 1.50, 95% CI: 0.95–2.37). Trends were consistent across STH species.ConclusionsThe impact of STH on odds of concurrent microparasite co-infection may differ by microparasite taxa, whereby STH infection was negatively associated with viral infections but positively associated with bacterial and protozoal infections. Results suggest that efforts to reduce STH through preventive chemotherapy could have a spillover effect on microparasite infections, though the extent of this impact requires additional study. The associations between STH and concurrent microparasite infection may reflect a reverse effect due to the cross-sectional study design. Additional research is needed to elucidate the exact mechanism of the immunomodulatory effects of STH on concurrent enteric microparasite infection.
Highlights
IntroductionCo-infection by multiple pathogens is common, and can result in a range of neutral, facilitative, or antagonistic interactions within the host
Humans are susceptible to over 1400 pathogens
891 participants from 297 households were eligible for inclusion in this study because all three participants in the selected household returned their stool sample on the same day
Summary
Co-infection by multiple pathogens is common, and can result in a range of neutral, facilitative, or antagonistic interactions within the host. Humans are susceptible to over 1400 known parasite species, including viruses, bacteria, protozoa, helminths and fungi [1]. Co-infections result in a range of neutral, facilitative, or antagonistic interactions [3, 4]. These interactions have important implications for host susceptibility to infection, disease severity [3, 4], and treatment efficacy [5,6,7]. Soil-transmitted helminth (STH) infections are one of the most ubiquitous human infections, affecting over one billion people worldwide [8, 9]. Interactions between STH and microparasites (defined here as a virus, bacteria, or protozoa) within the human host and the impacts of these interactions on human health are poorly understood [11]
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