Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis?
In light of multinational efforts to reduce helminthiasis, we evaluated whether there exist high-risk subpopulations for helminth infection. Such individuals are not only at risk of morbidity, but may be important parasite reservoirs and appropriate targets for disease control interventions.We follo...
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ftdoajarticles:oai:doaj.org/article:101bbcc201a24fed819f8672b1d55343 2023-05-15T15:13:54+02:00 Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? Elizabeth J Carlton Alan Hubbard Shuo Wang Robert C Spear 2013-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002098 https://doaj.org/article/101bbcc201a24fed819f8672b1d55343 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3591324?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002098 https://doaj.org/article/101bbcc201a24fed819f8672b1d55343 PLoS Neglected Tropical Diseases, Vol 7, Iss 3, p e2098 (2013) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2013 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002098 2022-12-30T21:57:33Z In light of multinational efforts to reduce helminthiasis, we evaluated whether there exist high-risk subpopulations for helminth infection. Such individuals are not only at risk of morbidity, but may be important parasite reservoirs and appropriate targets for disease control interventions.We followed two longitudinal cohorts in Sichuan, China to determine whether there exist persistent human reservoirs for the water-borne helminth, Schistosoma japonicum, in areas where treatment is ongoing. Participants were tested for S. japonicum infection at enrollment and two follow-up points. All infections were promptly treated with praziquantel. We estimated the ratio of the observed to expected proportion of the population with two consecutive infections at follow-up. The expected proportion was estimated using a prevalence-based model and, as highly exposed individuals may be most likely to be repeatedly infected, a second model that accounted for exposure using a data adaptive, machine learning algorithm. Using the prevalence-based model, there were 1.5 and 5.8 times more individuals with two consecutive infections than expected in cohorts 1 and 2, respectively (p<0.001 in both cohorts). When we accounted for exposure, the ratio was 1.3 (p = 0.013) and 2.1 (p<0.001) in cohorts 1 and 2, respectively.We found clustering of infections within a limited number of hosts that was not fully explained by host exposure. This suggests some hosts may be particularly susceptible to S. japonicum infection, or that uncured infections persist despite treatment. We propose an explanatory model that suggests that as cercarial exposure declines, so too does the size of the vulnerable subpopulation. In low-prevalence settings, interventions targeting individuals with a history of S. japonicum infection may efficiently advance disease control efforts. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 7 3 e2098 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Elizabeth J Carlton Alan Hubbard Shuo Wang Robert C Spear Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
In light of multinational efforts to reduce helminthiasis, we evaluated whether there exist high-risk subpopulations for helminth infection. Such individuals are not only at risk of morbidity, but may be important parasite reservoirs and appropriate targets for disease control interventions.We followed two longitudinal cohorts in Sichuan, China to determine whether there exist persistent human reservoirs for the water-borne helminth, Schistosoma japonicum, in areas where treatment is ongoing. Participants were tested for S. japonicum infection at enrollment and two follow-up points. All infections were promptly treated with praziquantel. We estimated the ratio of the observed to expected proportion of the population with two consecutive infections at follow-up. The expected proportion was estimated using a prevalence-based model and, as highly exposed individuals may be most likely to be repeatedly infected, a second model that accounted for exposure using a data adaptive, machine learning algorithm. Using the prevalence-based model, there were 1.5 and 5.8 times more individuals with two consecutive infections than expected in cohorts 1 and 2, respectively (p<0.001 in both cohorts). When we accounted for exposure, the ratio was 1.3 (p = 0.013) and 2.1 (p<0.001) in cohorts 1 and 2, respectively.We found clustering of infections within a limited number of hosts that was not fully explained by host exposure. This suggests some hosts may be particularly susceptible to S. japonicum infection, or that uncured infections persist despite treatment. We propose an explanatory model that suggests that as cercarial exposure declines, so too does the size of the vulnerable subpopulation. In low-prevalence settings, interventions targeting individuals with a history of S. japonicum infection may efficiently advance disease control efforts. |
format |
Article in Journal/Newspaper |
author |
Elizabeth J Carlton Alan Hubbard Shuo Wang Robert C Spear |
author_facet |
Elizabeth J Carlton Alan Hubbard Shuo Wang Robert C Spear |
author_sort |
Elizabeth J Carlton |
title |
Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? |
title_short |
Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? |
title_full |
Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? |
title_fullStr |
Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? |
title_full_unstemmed |
Repeated Schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? |
title_sort |
repeated schistosoma japonicum infection following treatment in two cohorts: evidence for host susceptibility to helminthiasis? |
publisher |
Public Library of Science (PLoS) |
publishDate |
2013 |
url |
https://doi.org/10.1371/journal.pntd.0002098 https://doaj.org/article/101bbcc201a24fed819f8672b1d55343 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 7, Iss 3, p e2098 (2013) |
op_relation |
http://europepmc.org/articles/PMC3591324?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002098 https://doaj.org/article/101bbcc201a24fed819f8672b1d55343 |
op_doi |
https://doi.org/10.1371/journal.pntd.0002098 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
7 |
container_issue |
3 |
container_start_page |
e2098 |
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1766344415812517888 |