Abstract
BackgroundSub-Saharan Africa harbors the majority of the global burden of malaria and schistosomiasis infections. The co-endemicity of these two tropical diseases has prompted investigation into the mechanisms of coinfection, particularly the competing immunological responses associated with each disease. Epidemiological studies have shown that infection with Schistosoma mansoni is associated with a greater malaria incidence among school-age children.MethodologyWe developed a co-epidemic model of malaria and S. mansoni transmission dynamics which takes into account key epidemiological interaction between the two diseases in terms of elevated malaria incidence among individuals with S. mansoni high egg output. The model was parameterized for S. mansoni high-risk endemic communities, using epidemiological and clinical data of the interaction between S. mansoni and malaria among children in sub-Saharan Africa. We evaluated the potential impact of the S. mansoni–malaria interaction and mass treatment of schistosomiasis on malaria prevalence in co-endemic communities.Principal FindingsOur results suggest that in the absence of mass drug administration of praziquantel, the interaction between S. mansoni and malaria may reduce the effectiveness of malaria treatment for curtailing malaria transmission, in S. mansoni high-risk endemic communities. However, when malaria treatment is used in combination with praziquantel, mass praziquantel administration may increase the effectiveness of malaria control intervention strategy for reducing malaria prevalence in malaria- S. mansoni co-endemic communities.Conclusions/SignificanceSchistosomiasis treatment and control programmes in regions where S. mansoni and malaria are highly prevalent may have indirect benefits on reducing malaria transmission as a result of disease interactions. In particular, mass praziquantel administration may not only have the direct benefit of reducing schistosomiasis infection, it may also reduce malaria transmission and disease burden.
Highlights
Malaria is highly endemic throughout sub-Saharan Africa in which 85% of global malaria cases and 90% of malaria deaths occur [1]
Using epidemiological data on the increased risk of malaria incidence in S. mansoni endemic communities from Senegal, we developed a co-epidemic model of malaria and S. mansoni transmission dynamics to address key epidemiological interactions between the two diseases
Parameterizing our model for S. mansoni highrisk endemic communities, we show that the interaction between S. mansoni and malaria may reduce the effectiveness of malaria treatment for curtailing malaria transmission
Summary
Malaria is highly endemic throughout sub-Saharan Africa in which 85% of global malaria cases and 90% of malaria deaths occur [1]. Schistosoma mansoni (the causative agent of intestinal schistosomiasis) is likewise prevalent in many sub-Saharan African countries [2,3], accounting for approximately one-third of the total cases of schistosomiasis in the region [4] Both malaria and intestinal schistosomiasis share similar epidemiological distributions and present challenges to public health and socio-economic development throughout these regions [5]. Due to their coendemicity, there has been increased investigation into the interactive pathology between malaria and S. mansoni [6,7,8,9]. Epidemiological studies have shown that infection with Schistosoma mansoni is associated with a greater malaria incidence among school-age children
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