Abstract
In nature, organisms are commonly infected by an assemblage of different parasite species or by genetically distinct parasite strains that interact in complex ways. Linked to co-infections, pathocoenosis, a term proposed by M. Grmek in 1969, refers to a pathological state arising from the interactions of diseases within a population and to the temporal and spatial dynamics of all of the diseases. In the long run, malaria was certainly one of the most important component of past pathocoenoses. Today this disease, which affects hundreds of millions of individuals and results in approximately one million deaths each year, is always highly endemic in over 20% of the world and is thus co-endemic with many other diseases. Therefore, the incidences of co-infections and possible direct and indirect interactions with Plasmodium parasites are very high. Both positive and negative interactions between malaria and other diseases caused by parasites belonging to numerous taxa have been described and in some cases, malaria may modify the process of another disease without being affected itself. Interactions include those observed during voluntary malarial infections intended to cure neuro-syphilis or during the enhanced activations of bacterial gastro-intestinal diseases and HIV infections. Complex relationships with multiple effects should also be considered, such as those observed during helminth infections. Moreover, reports dating back over 2000 years suggested that co- and multiple infections have generally deleterious consequences and analyses of historical texts indicated that malaria might exacerbate both plague and cholera, among other diseases. Possible biases affecting the research of etiological agents caused by the protean manifestations of malaria are discussed. A better understanding of the manner by which pathogens, particularly Plasmodium, modulate immune responses is particularly important for the diagnosis, cure, and control of diseases in human populations.
Highlights
More than 1400 parasite species, including viruses, bacteria, fungi, protozoa and helminths, infect humans (Taylor et al, 2001), and the simultaneous presence of multiple species or of multiple strains of the same species in the human body is commonplace (Cox, 2001; Brogden et al, 2005; Balmer and Tanner, 2011)
Reports dating back over 2000 years suggested that co- and multiple infections have generally deleterious consequences and analyses of historical texts indicated that malaria might exacerbate both plague and cholera, among other diseases
Malarial infection has been associated with both immunosuppression and immunoactivation, leading to B-cell proliferation and an increase in peripheral-blood Epstein–Barr virus (EBV) loads; the incidence of endemic Burkitt’s lymphoma (eBL) is low relative to the high prevalence of both malaria and EBV within the pediatric populations, suggesting the involvement of additional factors in its etiology
Summary
Malaria was certainly one of the most important component of past pathocoenoses Today this disease, which affects hundreds of millions of individuals and results in approximately one million deaths each year, is always highly endemic in over 20% of the world and is co-endemic with many other diseases. The incidences of co-infections and possible direct and indirect interactions with Plasmodium parasites are very high Both positive and negative interactions between malaria and other diseases caused by parasites belonging to numerous taxa have been described and in some cases, malaria may modify the process of another disease without being affected itself.
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