Abstract
BackgroundIntestinal helminths have been proposed to have a protective role against allergic sensitization and atopic diseases. However, consistent data demonstrating this are lacking in Sub-Saharan countries. We aimed to assess the association between intestinal helminths and allergic disorders among school children enrolled in mass deworming program in Sululta, Ethiopia.MethodsA cross sectional study was conducted among 526 school children aged 5 to 14 years old from primary government schools in Sululta district, Ethiopia. An interviewer-led questionnaire administered to parents provided information on demographic and lifestyle variables. Questions on allergic disease symptoms were collected using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire 6 months following deworming treatments. Atopy was defined as a positive skin prick test reaction to one or both dust mite (Dermatophagoides) and German cockroach (Blatella germanica) allergens. Fresh stool samples were collected, processed, and examined by direct wet mount, Kato-Katz technique, and formol-ether concentration technique. Multivariate logistic regressions were used to assess the association between allergic disorder and helminths infection.ResultsOf the total 526 school children, 58.2% were females. Overall, 24% (126/526) had allergic symptoms, 5.1% (27/526) had atopy, and 16.9% (89/526) had intestinal helminths. There was no association between helminthic infection and self-reported allergic symptoms (P = 0.317), but Ascaris lumbricoides infection was positively associated with atopy (AOR = 4.307, 95% CI 1.143–16.222, P = 0.031). Atopy was related to increased allergy symptoms (AOR = 2.787, 95% CI 1.253–6.197, P = 0.012), and family history of allergy was associated with increased childhood allergy (AOR = 2.753, 95% CI 1.565–4.841, P = 0.001). Deworming in the past 6 months showed a reduced odd of self-reported allergic symptoms (AOR = 0.581, 95% CI 0.366–0.954, P = 0.034).ConclusionWhile no significant association between self-reported allergy and helminths was found in this study, this may have been due to the low prevalence and intensity of helminthic infection in the sample. There was a positive association between Ascaris lumbricoides and atopy. To further examine the underlying mechanism behind this positive association, a longitudinal study is needed.
Highlights
Intestinal helminths have been proposed to have a protective role against allergic sensitization and atopic diseases
This study provides no evidence of significant association between overall helminthic infection and self-reported allergic symptoms
We found a significant association between parental histories of allergic symptoms with childhood allergy disorders
Summary
Intestinal helminths have been proposed to have a protective role against allergic sensitization and atopic diseases. While the prevalence of allergic diseases tends to be lower in developing countries than in developed countries, this is starting to change, with the allergic diseases becoming more common in developing countries [1]. This rise has been highly linked to many factors, such as environmental allergens, changes in lifestyles, and a decline of bacterial infection, viral infection, and helminthic infection [2]. Numerous studies have shown that helminthic infection may be protective, playing a crucial role in shaping human health. This protective role is largely explained by the hygiene hypothesis. Inconsistent epidemiological evidences have emerged, and helminths infections are associated with decreased prevalence of atopy [9,10,11], while others showed either positive, negative, or no relation between helminthic infection and allergic disease [12, 13]
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