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Bladder morbidity and hepatic fibrosis in mixed Schistosoma haematobium and S. mansoni infections: a population-wide study in northern Senegal

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dc.contributor.author Meurs, L.
dc.contributor.author Mbow, M.
dc.contributor.author Vereecken, K.
dc.contributor.author Menten, J.
dc.contributor.author Mboup, S.
dc.contributor.author Polman, K.
dc.date.accessioned 2012-12-14T10:25:17Z
dc.date.available 2012-12-14T10:25:17Z
dc.date.issued 2012
dc.identifier.issn 1935-2727
dc.identifier.doi http://dx.doi.org/10.1371/journal.pntd.0001829
dc.identifier.other ITG-B1B
dc.identifier.other ITG-B3B
dc.identifier.other ITG-C4A
dc.identifier.other ITG-BLA
dc.identifier.other MULTI
dc.identifier.other DBM
dc.identifier.other U-MHELM
dc.identifier.other DCS
dc.identifier.other U-CTU
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other E-only
dc.identifier.other Abstract
dc.identifier.other UPD53
dc.identifier.uri http://hdl.handle.net/10390/7257
dc.description.abstract BACKGROUND: The global distribution map of schistosomiasis shows a large overlap of Schistosoma haematobium- and S. mansoni-endemic areas in Africa. Yet, little is known about the consequences of mixed Schistosoma infections for the human host. A recent study in two neighboring co-endemic communities in Senegal indicated that infection intensities of both species were higher in mixed than in single infections. Here, we investigated the relationship between mixed Schistosoma infections and morbidity in the same population. So far, this has only been studied in children. METHODS: Schistosoma infection was assessed by microscopy. Schistosoma-specific morbidity was assessed by ultrasound according to WHO guidelines. Multivariable logistic regression models were used to identify independent risk factors for morbidity. PRINCIPAL FINDINGS: Complete parasitological and morbidity data were obtained from 403 individuals. Schistosoma haematobium-specific bladder morbidity was observed in 83% and S. mansoni-specific hepatic fibrosis in 27% of the participants. Bladder morbidity was positively associated with S. haematobium infection intensity (OR = 1.9 (95% CI 1.3-2.9) for a 10-fold increase in intensity). Moreover, people with mixed infections tended to have less bladder morbidity than those with single S. haematobium infections (OR = 0.3 (95% CI 0.1-1.1)). This effect appeared to be related to ectopic S. mansoni egg elimination in urine. Hepatic fibrosis on the other hand was not related to S. mansoni infection intensity (OR = 0.9 (95% CI 0.6-1.3)), nor to mixed infections (OR = 1.0 (95% CI 0.7-1.7)). CONCLUSIONS/SIGNIFICANCE: This is the first population-wide study on the relationship between mixed Schistosoma infections and morbidity. Mixed infections did not increase the risk of S. mansoni-associated morbidity. They even tended to reduce the risk of S. haematobium-associated morbidity, suggesting a protective effect of S. mansoni infection on bladder morbidity. These unexpected results may have important consequences for schistosomiasis control in co-endemic areas and warrant further investigation. en
dc.language English en
dc.subject Helminthic diseases en
dc.subject Schistosomiasis en
dc.subject Schistosoma haematobium en
dc.subject Schistosoma mansoni en
dc.subject Snails en
dc.subject Epidemiology en
dc.subject Mixed infections en
dc.subject Associations en
dc.subject Bladder en
dc.subject Morbidity en
dc.subject Hepatic en
dc.subject Fibrosis en
dc.subject Diagnosis en
dc.subject Microscopy en
dc.subject Ultrasonography en
dc.subject Risk factors en
dc.subject Age distribution en
dc.subject Risk assessment en
dc.subject Senegal en
dc.subject Africa, West en
dc.title Bladder morbidity and hepatic fibrosis in mixed Schistosoma haematobium and S. mansoni infections: a population-wide study in northern Senegal en
dc.type Article-E en
dc.citation.issue 9 en
dc.citation.jtitle PLoS Neglected Tropical Diseases en
dc.citation.volume 6 en
dc.citation.pages e1829 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/23029589
dc.citation.jabbreviation PLoS Negl Trop Dis en


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