Helminthiasis remains a public health issue in endemic areas. Various drugshave been proposed to improve efficacy against helminths. The study aimed to assessthe safety and efficacy of three... Show moreHelminthiasis remains a public health issue in endemic areas. Various drugshave been proposed to improve efficacy against helminths. The study aimed to assessthe safety and efficacy of three different anthelmintic combinations to treat Trichuristrichiura infections. We conducted a randomized assessors-blind clinical trial involvingchildren aged 2–17 years with T. trichiura. Participants were randomly assigned to oneof three treatment arms. On the first and third days, all participants got albendazole400 mg, and on the second day, albendazole (arm A), mebendazole 500 mg (arm B), orpyrantel 125 mg/kg (arm C). We assessed treatment efficacy using the cure rate (CR) andegg reduction rate (ERR) at 3 and 6 weeks post-treatment. At 3 weeks post-treatment,ERR and CR were highest in study arm A [ERR = 94%, 95% confidence interval (CI):92–95; CR = 71%; 95% CI: 58–81] compared to the B and C arms. Decrease in ERR wassignificant only for arm B versus arm A (P-value <0.001); decrease in ERR was significantfor arms B and C (P-value <0.001). No statistical difference was observed in CR whencomparing arms A and B (P-value =1.00) and C (P-value =0.27). At 6 weeks, a decreasein ERR was observed in three arms, significant only for arm C, 81% (95% CI: 78–83). Asignificant increase in egg counts was observed between 3 and 6 weeks post-treatment.All treatments were safe with mild adverse events. Albendazole 400 mg/day (arm A)showed the highest efficacy against trichuriasis. Nonetheless, this treatment regimenwas able to cure half of the treated individuals highlighting concerns about controllingthe transmission of T. trichiura. Show less
Coinfection with Plasmodium falciparum and helminths may impact the immune response to these parasites because they induce different immune profiles. We studied the effects of coinfections on the... Show moreCoinfection with Plasmodium falciparum and helminths may impact the immune response to these parasites because they induce different immune profiles. We studied the effects of coinfections on the antibody profile in a cohort of 715 Mozambican children and adults using the Luminex technology with a panel of 16 antigens from P. falciparum and 11 antigens from helminths (Ascaris lumbricoides, hookworm, Trichuris trichiura, Strongyloides stercoralis, and Schistosoma spp.) and measured antigen-specific IgG and total IgE responses. We compared the antibody profile between groups defined by P. falciparum and helminth previous exposure (based on serology) and/or current infection (determined by microscopy and/or qPCR). In multivariable regression models adjusted by demographic, socioeconomic, water, and sanitation variables, individuals exposed/infected with P. falciparum and helminths had significantly higher total IgE and antigen-specific IgG levels, magnitude (sum of all levels) and breadth of response to both types of parasites compared to individuals exposed/ infected with only one type of parasite (P <= 0.05). There was a positive association between exposure/infection with P. falciparum and exposure/infection with helminths or the number of helminth species, and vice versa (P <= 0.001). In addition, children coexposed/coinfected tended (P = 0.062) to have higher P. falciparum parasitemia than those single exposed/infected. Our results suggest that an increase in the antibody responses in coexposed/coinfected individuals may reflect higher exposure and be due to a more permissive immune environment to infection in the host.IMPORTANCE Coinfection with Plasmodium falciparum and helminths may impact the immune response to these parasites because they induce different immune profiles. We compared the antibody profile between groups of Mozambican individuals defined by P. falciparum and helminth previous exposure and/or current infection. Our results show a significant increase in antibody responses in individuals coexposed/coinfected with P. falciparum and helminths in comparison with individuals exposed/infected with only one of these parasites, and suggest that this increase is due to a more permissive immune environment to infection in the host. Importantly, this study takes previous exposure into account, which is particularly relevant in endemic areas where continuous infections imprint and shape the immune system. Deciphering the implications of coinfections deserves attention because accounting for the real interactions that occur in nature could improve the design of integrated disease control strategies. Show less
