[Show abstract][Hide abstract] ABSTRACT: Helminthic infections concomitant with malaria are common in inter-tropical areas. A recent study showed that mice co-infected with Schistosoma mansoni and Plasmodium chabaudi develop higher P. chabaudi parasitaemia and had a higher mortality rate. This important observation deserved to be further investigated among human populations.
Malaria attacks were recorded in 512 children aged 6–15 years living in Richard Toll (Northern Senegal) among whom 336 were infected by S. mansoni, and 175 were not. The incidence rate of malaria attacks was significantly higher among S. mansoni-infected individuals, particularly those carrying the highest worm loads, as compared to uninfected subjects (26.6% versus 16,4 %). In contrast, the rate of malaria attacks was lower, without reaching significance, in medium grade S. mansoni infections. Thus, infection by S. mansoni affects susceptibility to malaria, but this can vary according to the intensity of parasite load. The immunological mechanisms underlying this dual effect need to be further explored.
[Show abstract][Hide abstract] ABSTRACT: Since the few indirect markers available for assessing the development and the stage of intestinal schistosomiasis morbidity are weakly specific, endoscopy is still the only method able to detect severe forms of pathology. Therefore, we evaluated the isotype antibody response to the current schistosome antigen preparation (soluble egg antigens [SEA]) in 142 Senegalese patients infected with Schistosoma mansoni. They were stratified into three different stages of pathology according to ultrasonographic, endoscopic, and clinical parameters (stage 1 = no detectable pathology; stage 2 = moderate morbidity; stage 3 = severe forms of pathology). Only median specific IgG4, IgE, and IgA responses changed according to the stage of pathology. The IgA level was significantly higher in stages 2 and 3 compared with stage 1, and the IgE level was higher in stage 3 compared with stage 1. A high specific IgG4 level was observed only in stage 3 and was significantly different compared with stage 2. We show an association between the variability of the specific response to SEA and the degree of morbidity, and demonstrate that IgA and IgG4 responses could be combined markers to easily discriminate the different stages of pathology due to infection with S. mansoni.
The American journal of tropical medicine and hygiene 09/2004; 71(2):202-5. · 2.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In recently exposed communities, intensity of schistosomiasis infection increases as children age and then drops again in adulthood, indicating that host maturity is an important aspect of resistance to schistosomiasis. We investigated whether the cellular immune response to the parasite was correlated with age in subjects with similar daily patterns of exposure, current intensities of infection and number of years of exposure. The cellular immune response of subjects with either 'low' (under 200 eggs per gram (EPG)) or 'high' (over 400 EPG) intensities of infection was investigated, in a recently established focus where subjects had similar histories of exposure and number of years of experience with Schistosoma mansoni. Subject's whole blood was cultured with adult worm antigen (AWA), a mixture of phytohaemagglutinin (PHA) and lipopolysaccharide (LPS), or left unstimulated, and culture supernatants were tested for IL-4, IL-5, IL-10 and IFN-gamma. Children and adults tended to respond differently to schistosome antigen. The most statistically significant illustration of this was the negative correlation between age and IL-5 produced by samples from people with low intensities of infection cultured with AWA (P < 0.003, P < 0.05 after Bonferroni correction). IL-10 produced by samples cultured with PHA and LPS was also notably lower in children than in adults, although not formally significant after Bonferroni correction. This indicates that it is possible for age, independently of intensity of infection or experience with the parasite, to influence the immune response to schistosomiasis.
[Show abstract][Hide abstract] ABSTRACT: The epidemiological coexistence of schistosomiasis and malaria is frequently observed in developing countries. Co-infection with malaria in children could influence the development of acquired immunity associated with the resistance or the pathology of schistosomiasis. In the present study, performed during May to June 1996 in Senegal, the humoral immune response to Schistosoma haematobium 28 kDa glutathione S-transferase (Sh28GST) vaccinal antigen and to soluble egg antigens (SEA) has been evaluated in individuals infected by S. haematobium. Specific immunoglobulin G3 (IgG3) and IgE responses were significantly higher in co-infected children with Plasmodium falciparum compared with children infected with S. haematobium only. In addition, circulating levels of interferon-gamma (IFN-gamma), interleukin-10 (IL-10), and soluble tumor necrosis factor receptor II (sTNF-RII), 3 parameters associated with schistosomiasis morbidity, were significantly increased in co-infected children. Taken together, this study indicated that malaria co-infection can both influence the acquired specific immune response to schistosome antigens and unbalance the regulation of inflammatory factors closely involved in schistosomiasis pathology.
Transactions of the Royal Society of Tropical Medicine and Hygiene 05/2003; 97(3):361-4. DOI:10.1016/S0035-9203(03)90170-2 · 1.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In an epidemic focus in northern Senegal, adults had lower intensities of infection than adolescents, a phenomenon that could not be attributed to immunity acquired over the previous 10-15 years of exposure to the parasite because all age groups had had the same number of years' experience of the worm. This article considers whether this pattern could have been because of higher levels of exposure to the parasite in younger age groups. Personal contact with infected water was recorded using a questionnaire in Schistosoma mansoni foci not more than 3 years old and in another, 10-year-old focus. Many aspects of contact (e.g. frequency, duration or time of day of contact) may contribute to the number of encounters with infective cercariae (true exposure), so various assumptions regarding the relationship between water contact and true exposure were tested resulting in a range of exposure indices. People reported a mean of 4.4 separate contacts, and spent a median of 57 min per day in water. Patterns of water contact differed depending on the exposure index used, e.g. considering duration, males spent a longer time in water than females (P < 0.001). But using frequency, females had more contacts with water than males in most villages (P < 0.001). Generally, exposure levels dropped as people become aged (P < 0.001) and residents of the older focus were more exposed than residents of other foci (P < 0.002). Intensity of (re)infection was not related to exposure either alone or in models incorporating age, sex and/or village irrespective of the index used. There is therefore evidence that age, sex and place of residence determine exposure but none to suggest that exposure had an influence on the relationship between these factors and intensity of infection. We propose therefore that in this population other factors have principal importance in determining intensity of infection.
Tropical Medicine & International Health 03/2003; 8(2):100-8. DOI:10.1046/j.1365-3156.2003.00993.x · 2.30 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Studies on the compatibility between Bulinus truncatus and Schistosoma haematobium from various areas in the Senegal River basin (SRB) were carried out, to investigate the role of B. truncatus in the epidemiology of urinary schistosomiasis in Senegal. The results show that B. truncatus from the Lower Valley is not compatible with S. haematobium from the Middle Valley. Interestingly, the study reveals that B. truncatus from the Upper Valley is compatible with S. haematobium from the same area, and that S. haematobium from the Middle Valley is compatible with B. truncatus from the Lower Valley. Bulinus truncatus naturally infected with S. haematobium have been collected from the Upper Valley of the SRB. These results indicate that B. truncatus is involved in the urinary schistosomiasis in Senegal.
Pathogens and Global Health 04/2002; 96(2):175-80. DOI:10.1179/000349802125000420 · 1.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper summarizes and concludes in-depth field investigations on suspected resistance of Schistosoma mansoni to praziquantel in northern Senegal. Praziquantel at 40 mg/kg usually cures 70-90% of S. mansoni infections. In an initial trial in an epidemic S. mansoni focus in northern Senegal, only 18% of the cases became parasitologically negative 12 weeks after treatment, although the reduction in mean egg counts was within normal ranges (86%). Among other hypotheses to explain the observed low cure rate in this focus, the possibility of drug resistance or tolerance had to be considered. Subsequent field trials with a shorter follow-up period (6-8 weeks) yielded cure rates of 31-36%. Increasing the dose to 2 x 30 mg/kg did not significantly improve cure rates, whereas treatment with oxamniquine at 20 mg/kg resulted in a normal cure rate of 79%. The efficacy of praziquantel in this focus could be related to age and pre-treatment intensity but not to other host factors, including immune profiles and water contact patterns. Treatment with praziquantel of individuals from the area residing temporarily in an urban region with no transmission, and re-treatment after 3 weeks of non-cured individuals within the area resulted in normal cure rates (78-88%). The application of an epidemiological model taking into account the relation between egg counts and actual worm numbers indicated that the low cure rates in this Senegalese focus could be explained by assuming a 90% worm reduction after treatment with praziquantel; in average endemic situations, such a drug efficacy would result in normal cure rates. Laboratory studies by others on the presence or absence of praziquantel resistance in Senegalese schistosome strains have so far been inconclusive. We conclude that there is no convincing evidence for praziquantel-resistant S. mansoni in Senegal, and that the low cure rates can be attributed to high initial worm loads and intense transmission in this area.
Tropical Medicine & International Health 12/2001; 6(11):864-73. DOI:10.1046/j.1365-3156.2001.00811.x · 2.30 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The cellular and humoral acquired immune responses to Schistosoma haematobium 28 kD gluthathione S-Transferase (Sh28GST) antigen were evaluated in a Senegalese population chronically infected with S. haematobium parasite. We show a gender-dependent immune response in adult individuals presenting similar intensities of infection. Indeed, the specific IgA response and production of TGF-beta and IL-10 were found significantly higher in females compared to males. In addition, we showed that this profile was combined with a weak production of Th1-related cytokines (TNFalpha and IFNgamma) and was associated with an absence of proliferation to the antigen. A significantly higher Nuclear Matrix Protein 41/7 secretion, an apoptosis marker, was specifically observed in mononuclear blood cell cultures of females suggesting that a specific cell death process was engaged in a gender-dependent manner. This specific profile could be associated with the so-called T helper type-3 (Th3) immune response specifically promoting the production of IgA and would be developed upon the down-regulation of the specific Type-1 response by a probable cell death mechanism. This gender-dependent immune regulation, which may be under the influence of nonimmunological factors like sexual hormones, may be related to the chronicity of the infection.
[Show abstract][Hide abstract] ABSTRACT: The vectorial capacity of Biomphalaria pfeifferi from Ndiangue, Senegal, was investigated with an allopatric isolate of Schistosoma mansoni from Nkolbisson, Cameroon. The snail infection rate after exposure to a single miracidium per snail (MD1) was 56. 3 %, and 91.6%, for snails exposed to 5 miracidia per snail (MD5). The minimum pre-patent period was 21 days. The mean total cercarial production for the MDI group was 18,511 cercariae per snail, and 9757 cercariae for the MD5 group. The maximum production of cercariae for 1 day was 4892 observed in a snail from the MDI group at day 43 post-infection. The mean longevity of snails was higher in group MD1 (88 days p.i.) than in group MD5 (65 days p.i.). The chronobiological emergence pattern revealed a circadian rhythm with one shedding peak at mid-day. Comparisons are made with the vectorial capacity of the sympatric combination of B. pfeifferi Senegal/S. mansoni Senegal.
[Show abstract][Hide abstract] ABSTRACT: The vectorial capacity of Biomphalaria
pfeifferi from Ndiangue, Senegal, was investigated with an allopatric isolate of
mansoni from Nkolbisson, Cameroon. The snail infection rate after exposure to a single miracidium per snail
(MD1) was 56·3%, and 91·6% for snails exposed to 5 miracidia per snail (MD5). The minimum pre-patent period was
21 days. The mean total cercarial production for the MD1 group was 18511 cercariae per snail, and 9757 cercariae for
the MD5 group. The maximum production of cercariae for 1 day was 4892 observed in a snail from the MD1 group at
day 43 post-infection. The mean longevity of snails was higher in group MD1 (88 days p.i.) than in group MD5 (65 days
p.i.). The chronobiological emergence pattern revealed a circadian rhythm with one shedding peak at mid-day. Comparisons
are made with the vectorial capacity of the sympatric combination of B.
[Show abstract][Hide abstract] ABSTRACT: The importance of the increase in irrigated land on the perimeters of the Middle and Upper Valleys of the Senegal River basin, on the prevalence and intensity of urinary schistosomiasis, was investigated. Surveys were conducted, in May-June 1997, to determine the prevalence and intensity of Schistosoma haematobium infection among 1445 children aged 7-14 years: 1011 in 10 villages near Matam, and 434 in four villages near Bakel. Macrohaematuria was present in seven of the study villages (four near Matan and three near Bakel), whereas microhaematuria was present in all the villages, with prevalences of 10%-73%. A second survey, conducted, in June 1999, on 755 children from nine of the study villages near Matam, demonstrated significant increases in the prevalences of both micro- and macro-haematuria in three of the villages, all of which were adjacent to the Senegal River and practising irrigated agriculture. None of the other study villages re-surveyed was irrigating any of its agricultural land. A longitudinal survey was also carried out, between May 1997 and November 1998, on about 10% of the population (2272 subjects) of Nguidjilone, north of Matam; selective treatment with praziquantel (40 mg/kg) was given in May 1997, and mass treatment in May 1998. The data analysed were those relating to the 125 individuals who provided samples at each survey. Very severe infections (> 1000 eggs/10 ml urine) were seen in five subjects in May 1997. One year later (i.e. 1 year after the selective treatment), the prevalence of urinary schistosomiasis had increased in every age-group. Although prevalence had decreased slightly by November 1998 (6 months after the mass treatment), the intensity of the infections seen had increased in every age-group. At the end of the dry season (May-June 1997), Bulinus truncalus infected with schistosome cercariae were recovered from the Senegal River. However, immediately after the next rainy season (November 1997), no snails were found at any collection site on the river.
Pathogens and Global Health 09/2000; 94(6):581-90. DOI:10.1080/00034980050152012 · 1.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Snail-infection experiments were carried out with a number of different species and populations of Bulinus and isolates of Schistosoma haematobium. The parasites came from six localities in the Senegal River basin (SRB), in the Lower Valley (Mbodiene), Middle Valley (Podor, Diatar and Nguidjilone), and Upper Valley (Aroundou and Galladé). Isolates of S. haematobium from the Middle and Upper Valleys all showed some compatibility with laboratory-bred B. truncatus from Mali, but none of these isolates was compatible with laboratory-bred B. truncatus originating from Senegal. Schistosoma haematobium from Diatar (Middle Valley) was compatible with B. senegalensis, whereas S. haematobium from Mbodiene (Lower Valley), which is naturally transmitted by B. globosus, was incompatible with B. senegalensis and B. truncatus. These data demonstrate that different isolates of S. haematobium from different regions of the SRB exhibit distinct intermediate-host specificities, which in turn will have an effect on the epidemiology of the disease, including the periods of transmission. It is apparent that, in addition to B. senegalensis and B. globosus, B. truncatus, the most widespread bulinid snail in the SRB, may be playing a role in the epidemiology of urinary schistosomiasis. This conclusion has obvious implications for the future spread of urinary schistosomiasis in the SRB. Chemical and physical measurements from assorted habitats along the SRB, including pH, temperature, salinity, conductivity, and resistivity, are also reported.
Pathogens and Global Health 04/2000; 94(2):157-64. DOI:10.1080/00034980057491 · 1.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The first cases of Schistosoma mansoni infection were reported in the Senegal River Basin ten years ago. Today endemicity is so high that prevalence rates exceed 90 p. 100 in some areas. Schistosomiasis sometimes goes undiagnosed until the occurrence of portal hypertension with rupture of esophageal varices. Endoscopy is the gold standard for detection of esophageal varices but it is impractical in remote areas. Ultrasonography has been proposed as a non-invasive alternative. The purpose of this study is to describe the results of simultaneous endoscopic and ultrasonographic assessment in 101 subjects from the Richard-Toll area of the Senegal River Basin. Findings showed that severe forms of schistosomiasis complicated by portal hypertension were already present in the region less 10 years after description of the first case. This study also proposes a diagnostic score for portal hypertension based on ultrasonographic findings. The features included in this score are thickening of portal vessel walls, portal vessel diameter, and collapsed appearance of the splenic vein during inspiration. In our hands this score allowed reliable prediction of the development of esophageal varices. Ultrasonography is a good tool for identifying severe forms of schistosomiasis. It should be useful for routine screening in recently established endemic zones.
Médecine tropicale: revue du Corps de santé colonial 02/2000; 60(1):42-6.
[Show abstract][Hide abstract] ABSTRACT: A village with mixed Schistosoma mansoni and S. haematobium infections (probably in a early endemic phase) was identified around the Lac de Guiers in the Senegal River Basin. In documenting the epidemiology of both schistosomes, we focused on prevalence and intensity of infection, transmission patterns and the impact of treatment. S. mansoni prevalences (near 100%) and egg counts (overall geometric mean eggs per gram of faeces (epg) of 589 were high in all age groups, with 35% of individuals excreting > 1000 epg, and showing a slow decline in egg output only after the age of 30 years. The overall prevalence (28%) and egg counts (2% > 50 eggs/10 ml) of S. haematobium were low, with mean counts of 6.3 eggs/10 ml. Maximal mean S. mansoni egg counts were found in 5-9 year-old boys and in 15-19 year-old girls; S. haematobium maximal counts in 1-4 year-old boys and in girls aged 5-9. Extremely high Biomphalaria pfeifferi infection ratios were recorded over the whole year. Following a single treatment, re-infection was rapid with prevalences and mean egg counts of both Schistosoma species reaching pretreatment levels within 7 months.
Tropical Medicine & International Health 09/1999; 4(8):544-50. DOI:10.1046/j.1365-3156.1999.00444.x · 2.30 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The construction of the Diama dam on the Senegal River and the ensuing ecological changes have led to a massive outbreak of Schistosoma mansoni infection in Northern Senegal, associated with very high intensity of infections, due to extremely intense transmission. The vectorial capacity of Biomphalaria pfeifferi from Ndombo, near Richard-Toll was investigated in order to assess the role of the snail-parasite relationship in this particular epidemiological situation. The results revealed an unusually high compatibility between the Senegalese S. mansoni strain and its local snail intermediate host, B. pfeifferi. The snail infection rate after exposure to a single miracidium per snail was 87%. The cercarial production of infected snails was very high, with a mean total production of 50,456 cercariae per snail. No significant difference was found in the total cercarial output between snails exposed to 1 miracidium and those exposed to 5 miracidia. The increase in the rate of cercarial output was significantly greater in snails exposed to 5 miracidia, but there was a higher mortality in this group. The chronobiological cercarial production pattern showed a peak around mid-day. The implications of these findings on the epidemiology of schistosomiasis in Northern Senegal are discussed.
[Show abstract][Hide abstract] ABSTRACT: The construction of the Diama dam on the Senegal River and the ensuing ecological changes have led to a massive outbreak
mansoni infection in Northern Senegal, associated with very high intensity of infections, due to extremely
intense transmission. The vectorial capacity of Biomphalaria
pfeifferi from Ndombo, near Richard-Toll was investigated
in order to assess the role of the snail–parasite relationship in this particular epidemiological situation. The results revealed
an unusually high compatibility between the Senegalese S.
mansoni strain and its local snail intermediate host, B.
The snail infection rate after exposure to a single miracidium per snail was 87%. The cercarial production of infected
snails was very high, with a mean total production of 50456 cercariae per snail. No significant difference was found in the
total cercarial output between snails exposed to 1 miracidium and those exposed to 5 miracidia. The increase in the rate
of cercarial output was significantly greater in snails exposed to 5 miracidia, but there was a higher mortality in this group.
The chronobiological cercarial production pattern showed a peak around mid-day. The implications of these findings on
the epidemiology of schistosomiasis in Northern Senegal are discussed.
[Show abstract][Hide abstract] ABSTRACT: This paper describes the present epidemiological situation of Schistosoma haematobium in 4 villages in the middle valley of the Senegal River Basin, in terms of level and intensity of infection, seasonality of transmission, and intermediate hosts, and the effect of different treatment schedules with praziquantel on the overall infection levels and re-infection rates. The longitudinal study involving 7 surveys was carried out between June 1995 and March 1997 in Diatar, Guia, Donaye and Niandane. The prevalence and intensity of infection remained low throughout the survey (< 55% and < 12 eggs/10 mL urine), and there were no systematic differences in the prevalence or intensity of infection between men and women. Before treatment, infections were highly aggregated in individuals and were concentrated in children (aged < 15 years) with 85% of the potential contamination; no individual aged > 24 years produced > 50 eggs/10 mL urine. Using WHO guidelines mass treatment was given to all Diatar and Guia villagers in December 1995, whereas in Donaye and Niandane only individuals positive for eggs were treated. Six weeks post-treatment cure rates in all villages were > 80%, with marked declines in levels of infection (< 20% and < 4.5 eggs/10 mL). By March 1997 infection levels in Donaye and Niandane had returned to pre-treatment levels, whereas in the 2 mass-treated villages (Diatar and Guia) infection levels were still markedly reduced compared to pre-treatment levels. Rates of conversion were very low between all surveys; however, there was an apparent high level of reversion (> 20%), due to the alternation of individuals apparently positive and negative between surveys. Water and infected snails were present from June to March. Therefore, owing to the high aggregation of infections in children, the low overall infection levels and the transmission period, it is suggested that in this area the best treatment schedule would be selective treatment of school-aged children in March/April, probably on an annual basis.
Transactions of the Royal Society of Tropical Medicine and Hygiene 03/1999; 93(2):142-50. DOI:10.1016/S0035-9203(99)90288-2 · 1.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Seven years after the completion of two dams in the Senegal River basin, 203 individuals from four villages around Podor in the middle valley, where Schistosoma haematobium infections were present, were examined in June 1995. In December 1995 a single dose of praziquantel (40 mg/kg) was given to each of these subjects, who were re-examined in April 1996. Clinical and parasitological signs of infection were investigated at both examinations, and ultrasonography was performed to check for lesions of the urinary tract induced by S. haematobium. As uninfected controls, 200 people from four villages where S. haematobium was absent were similarly examined, in November 1995. Prior to treatment, bladder irregularities were observed in 43% of the subjects from Podor but only 6% of the uninfected controls. The severity of the bladder lesions visible by ultrasonography was significantly associated with intensity of infection, despite the generally low levels of infection in the subjects mean = 13.1 eggs/10 ml urine). Four months after treatment, however, the frequency of bladder irregularities among the subjects (11%) was similar to that in the uninfected controls and intensities of infection and other clinical signs of disease had also significantly declined. The prevalence of haematuria, for example, fell from 35% pre-treatment to 10% post-treatment. The results indicate that the onset of S. haematobium morbidity can be relatively rapid even in areas with seasonal and low levels of transmission, and demonstrate that treatment to reduce morbidity in such areas is important and could be relatively simple and very effective.
Pathogens and Global Health 11/1998; 92(7):775-83. · 1.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Four hundred and seventy villagers of Ndombo, a village with recently established intensive transmission of Schistosoma mansoni in the Senegal River Basin, were enrolled in a study with the intention to assess hepatosplenic morbidity. All patients were examined parasitologically and by ultrasound. Hepatic fibrosis serum markers were determined in 153 adult patients (aminoterminal propeptide of procollagen type III, hyaluronan and laminin). By ultrasound, about 60% of the patients showed early stages of hepatic involvement, 3% of the patients unequivocally showed severe hepatosplenic pathology (grade 3 according to the Managil classification), whereas in another study performed in the same village 3 years earlier, no patients with severe hepatosplenic pathology had been found. No correlation between the aminoterminal propeptide of procollagen type III, hyaluronan or laminin and the ultrasound findings could be established. These hepatic fibrosis serum markers do not seem to be a sensitive method to detect early hepatic fibrosis in schistosomiasis.
Tropical Medicine & International Health 04/1998; 3(3):234-41. · 2.30 Impact Factor