S. Haematobium Infection and Chemotherapy-Induced Changes in Interleukin-6 and Acute Phase Proteins Associated with Inflammation in School Children in a Schistosomiasis-Endemic Area

Abstract

Objective: There is an increased risk of cases of direct and indirect morbidities as a result of stimulation of tissue-destructive inflammation caused by Schistosoma haematobium infection, hence the need to determine the levels of inflammatory markers in Schistosoma haematobium infected children and also determine the effect of repeated annual mass treatment on levels of interleukin-6 and acute phase proteins.Methodology: Urine specimens from 212 school children were collected and examined to determine prevalence of Schistosoma haematobium at baseline and 2 years following annual rounds of praziquantel treatment. Levels of 4 acute phase proteins were measured from serum samples from the participants using the magnetic bead-based immuno-assays at baseline and 2 years following praziquantel treatment. Sandwich enzyme-linked immunosorbent assay was used to determine levels of interleukin-6.Results: The overall pre-treatment prevalence of Schistosoma haematobium infection was 23.1% at baseline and 0.47% after 2 years of annual treatments. Schistosoma haematobium infected children had marginally higher levels of procalcitonin and tissue plasminogen activator before treatment though the difference of all three was not significant p>0.05 using Mann-Whitney non-parametric U test. Levels of ferritin and fibrinogen were lower in Schistosoma haematobium infected children before treatment, however the difference was also not significant p>0.05 using Mann-Whitney test. There was no association between infection status or interleukin-6 and the levels acute phase proteins p>0.05 for all acute phase proteins using the Mann-Whitney U test.Discussion and conclusion: Findings from this study suggest no bearing of Schistosoma haematobium infection status on level of acute phase proteins before and after annual treatment with praziquantel. The extent of inflammation cannot be determined using ferritin, tissue plasminogen activator and fibrinogen. Levels of interleukin-6 did not have any bearing on levels of acute phase proteins. There is a need to explore other acute phase proteins as inflammatory markers in Schistosoma haematobium infection.