Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.

<h4>Background</h4>Individuals living in areas endemic for helminths are commonly infected with multiple species. Despite increasing emphasis given to the potential health impacts of polyparasitism, few studies have investigated the relative importance of household and environmental fact...

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Autores principales:	Rachel L Pullan, Jeffrey M Bethony, Stefan M Geiger, Bonnie Cundill, Rodrigo Correa-Oliveira, Rupert J Quinnell, Simon Brooker
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2008
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/41f107e8a307471884e088c03208c7f6
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spelling	oai:doaj.org-article:41f107e8a307471884e088c03208c7f62021-12-02T20:23:54ZHuman helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.1935-27271935-273510.1371/journal.pntd.0000352https://doaj.org/article/41f107e8a307471884e088c03208c7f62008-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19104658/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Individuals living in areas endemic for helminths are commonly infected with multiple species. Despite increasing emphasis given to the potential health impacts of polyparasitism, few studies have investigated the relative importance of household and environmental factors on the risk of helminth co-infection. Here, we present an investigation of exposure-related risk factors as sources of heterogeneity in the distribution of co-infection with Necator americanus and Schistosoma mansoni in a region of southeastern Brazil.<h4>Methodology</h4>Cross-sectional parasitological and socio-economic data from a community-based household survey were combined with remotely sensed environmental data using a geographical information system. Geo-statistical methods were used to explore patterns of mono- and co-infection with N. americanus and S. mansoni in the region. Bayesian hierarchical models were then developed to identify risk factors for mono- and co-infection in relation to community-based survey data to assess their roles in explaining observed heterogeneity in mono and co-infection with these two helminth species.<h4>Principal findings</h4>The majority of individuals had N. americanus (71.1%) and/or S. mansoni (50.3%) infection; 41.0% of individuals were co-infected with both helminths. Prevalence of co-infection with these two species varied substantially across the study area, and there was strong evidence of household clustering. Hierarchical multinomial models demonstrated that relative socio-economic status, household crowding, living in the eastern watershed and high Normalized Difference Vegetation Index (NDVI) were significantly associated with N. americanus and S. mansoni co-infection. These risk factors could, however, only account for an estimated 32% of variability between households.<h4>Conclusions</h4>Our results demonstrate that variability in risk of N. americanus and S. mansoni co-infection between households cannot be entirely explained by exposure-related risk factors, emphasizing the possible role of other household factors in the heterogeneous distribution of helminth co-infection. Untangling the relative contribution of intrinsic host factors from household and environmental determinants therefore remains critical to our understanding of helminth epidemiology.Rachel L PullanJeffrey M BethonyStefan M GeigerBonnie CundillRodrigo Correa-OliveiraRupert J QuinnellSimon BrookerPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 2, Iss 12, p e352 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Rachel L Pullan Jeffrey M Bethony Stefan M Geiger Bonnie Cundill Rodrigo Correa-Oliveira Rupert J Quinnell Simon Brooker Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.
description	<h4>Background</h4>Individuals living in areas endemic for helminths are commonly infected with multiple species. Despite increasing emphasis given to the potential health impacts of polyparasitism, few studies have investigated the relative importance of household and environmental factors on the risk of helminth co-infection. Here, we present an investigation of exposure-related risk factors as sources of heterogeneity in the distribution of co-infection with Necator americanus and Schistosoma mansoni in a region of southeastern Brazil.<h4>Methodology</h4>Cross-sectional parasitological and socio-economic data from a community-based household survey were combined with remotely sensed environmental data using a geographical information system. Geo-statistical methods were used to explore patterns of mono- and co-infection with N. americanus and S. mansoni in the region. Bayesian hierarchical models were then developed to identify risk factors for mono- and co-infection in relation to community-based survey data to assess their roles in explaining observed heterogeneity in mono and co-infection with these two helminth species.<h4>Principal findings</h4>The majority of individuals had N. americanus (71.1%) and/or S. mansoni (50.3%) infection; 41.0% of individuals were co-infected with both helminths. Prevalence of co-infection with these two species varied substantially across the study area, and there was strong evidence of household clustering. Hierarchical multinomial models demonstrated that relative socio-economic status, household crowding, living in the eastern watershed and high Normalized Difference Vegetation Index (NDVI) were significantly associated with N. americanus and S. mansoni co-infection. These risk factors could, however, only account for an estimated 32% of variability between households.<h4>Conclusions</h4>Our results demonstrate that variability in risk of N. americanus and S. mansoni co-infection between households cannot be entirely explained by exposure-related risk factors, emphasizing the possible role of other household factors in the heterogeneous distribution of helminth co-infection. Untangling the relative contribution of intrinsic host factors from household and environmental determinants therefore remains critical to our understanding of helminth epidemiology.
format	article
author	Rachel L Pullan Jeffrey M Bethony Stefan M Geiger Bonnie Cundill Rodrigo Correa-Oliveira Rupert J Quinnell Simon Brooker
author_facet	Rachel L Pullan Jeffrey M Bethony Stefan M Geiger Bonnie Cundill Rodrigo Correa-Oliveira Rupert J Quinnell Simon Brooker
author_sort	Rachel L Pullan
title	Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.
title_short	Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.
title_full	Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.
title_fullStr	Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.
title_full_unstemmed	Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.
title_sort	human helminth co-infection: analysis of spatial patterns and risk factors in a brazilian community.
publisher	Public Library of Science (PLoS)
publishDate	2008
url	https://doaj.org/article/41f107e8a307471884e088c03208c7f6
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Human helminth co-infection: analysis of spatial patterns and risk factors in a Brazilian community.

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