The relative contribution of co-infection to focal infection risk in children

Joanne Lello*, Stefanie Knopp, Khalfan A. Mohammed, I. Simba Khamis, Juerg Utzinger, Mark E. Viney

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

21 Citations (Scopus)

Abstract

Co-infection is ubiquitous in people in the developing world but little is known regarding the potential for one parasite to act as a risk factor for another. Using generalized linear mixed modelling approaches applied to data from school-aged children from Zanzibar, Tanzania, we determined the strength of association between four focal infections (i.e. Ascaris lumbricoides, Trichuris trichiura, hookworm and self-reported fever, the latter used as a proxy for viral, bacterial or protozoal infections) and the prevalence or intensity of each of the helminth infections. We compared these potential co-infections with additional risk factors, specifically, host sex and age, socioeconomic status and physical environment, and determined what the relative contribution of each risk factor was. We found that the risk of infection with all four focal infections was strongly associated with at least one other infection, and that this was frequently dependent on the intensity of that other infection. In comparison, no other incorporated risk factor was associated with all focal infections. Successful control of infectious diseases requires identification of infection risk factors. This study demonstrates that co-infection is likely to be one of these principal risk factors and should therefore be given greater consideration when designing disease-control strategies. Future work should also incorporate other potential risk factors, including host genetics which were not available in this study and, ideally, assess the risks via experimental manipulation.

Original languageEnglish
Article numberARTN 20122813
Pages (from-to)1-7
Number of pages7
JournalProceedings of the Royal Society B: Biological Sciences
Volume280
Issue number1754
DOIs
Publication statusPublished - 7 Mar 2013

Keywords

  • infection risk
  • SUB-SAHARAN AFRICA
  • HOST GENETICS
  • MALARIA
  • COTE-DIVOIRE
  • HETEROGENEITY
  • HELMINTH INFECTIONS
  • fever
  • soil-transmitted helminthiasis
  • childhood infection
  • SOUTH-AFRICA
  • infection heterogeneity
  • co-infection
  • IMMUNE-RESPONSES
  • NEONATAL INFECTIONS
  • CONTROL PROGRAMS

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  • Why is infection unequal?

    Viney, M. (Principal Investigator)

    1/05/101/03/11

    Project: Research

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