EDCTP Alumni Network

Title

Impact of schistosoma hematobium infection on immunological and clinical aspects of P. falciparum malaria in children

Objectives

This project aimed to study the impact of S. haematobium infection on P. falciparum malaria induced immune response and clinical features in school children residing in two communities in the vicinity of Lambaréné (PK15 and PK17), where the malaria incidence rate is 1.3 person-years. The research questions to be answered by the project are: 1. How are plasmodia-specific pro-inflammatory Th1 and Th17 immune responses affected by coinfection with S. haematobium? 2. How does S. haematobium infection influence the clinical and parasitological profile of P.falciparum malaria?

Host Organisation

Institution	Country
Medical Research Unit Albert Schweitzer Hospital	Gabon

Participants

Name	Institution	Country
Abraham Alabi	Albert Schweitzer Hospital	Gabon
Maria Yazdanbakhsh	Leiden University, The Netherlands	Netherlands

Study Design

Immunology studies of schisto/malaria co-infection

Results & Outcomes

754 school aged children were screened and 601 were included for follow-up. At baseline 141(19%) of the participants were positive for P. falciparum, 225/741(30%) were positive for Schistosoma hematobium, and 225/642 (33%) for soil-transmitted helminthes infestation: 128 (20.0%) for A. lumbricoides; 139 (22.0%) for T. trichiura; and 43 (7.0%) for hookworm. All infected children were treated accordingly and followedup. Preliminary results show that that the presence of P. falciparum infection was marked by an increase in innate and adaptive immune responsiveness while S. haematobium infection was characterized by an increased chemokine profile, with at the same time, lower pro inflammatory markers. When the study subjects were split into single infected and co-infected groups no effect of S. haematobium on the immune response of P. falciparum infected subjects was observed, neither for the innate nor for the adaptive component of the immune response. Therefore there no is effect of S. haematobium on the cytokine profile of subjects co-infected with P. falciparum. In capacity building the following achievements were made: • GCP, GCLP and bio-ethics training of the study investigators and field workers • 4 MSc students were enrolled at various institutions and supervised by the Senior Fellow. 3 MSc students have completed their courses. • 1 PhD student has been registered and is being co-supervised by the Senior Fellow. • Training in laboratory techniques e.g., flow cytometry and in vitro culture techniques and equipment service e.g. training on the BD Accuri flow cytometry platform was undertaken by the PhD student and the CERMEL Head of Research Laboratory.

Publications

Ayola A, Zinsou JF, Issifou S, Ateba-Ngoa U, Kassa RF, Feugap EN, Honkpehedji YJ, Dejon Agobe JC, Kenguele HM, Massinga- Loembe M, Agnandji ST, Mordmüller B, Ramharter M, Yazdanbakhsh M, Kremsner PG, Lell B. Randomized, Controlled, Assessor-Blind Clinical Trial To Assess the Efficacy of Singleversus Repeated-Dose Albendazole To Treat Ascaris lumbricoides, Trichuris trichiura, and Hookworm Infection. Antimicrobial Agents in Chemotherapy 2014, 58(5):2535.