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Effects of co-distribution of Plasmodium and intestinal helminth infections on clinical outcomes and self-rated quality of life

English title Effects of co-distribution of Plasmodium and intestinal helminth infections on clinical outcomes and self-rated quality of life
Applicant Raso Giovanna
Number 132949
Funding scheme Project funding (Div. I-III)
Research institution Department of Epidemiology and Public Health Swiss Tropical and Public Health Institute Universität Basel
Institution of higher education University of Basel - BS
Main discipline Infectious Diseases
Start/End 01.10.2010 - 30.06.2014
Approved amount 331'000.00
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All Disciplines (2)

Discipline
Infectious Diseases
Tropical Medicine

Keywords (11)

Polyparasitism; Malaria; Schistosomiasis; Soil-transmitted helminthiasis; Geographical information system; Bayesian geostatistical modelling; Morbidity; Quality of life; Co-morbidity; Bayesian geostatistics; Disability weights

Lay Summary (English)

Lead
Lay summary
In developing countries, the spatial and temporal distribution of different parasitic infections often overlaps, and hence infections with multiple parasite species (polyparasitism) are a common phenomenon. There is growing interest to further elucidate the issue of polyparasitism because this will allow harnessing programmatic similarities for cost-effective and sustainable control. At present, morbidity implications of polyparasitism are poorly understood. For example, some studies suggest that the co-occurrence of helminths (parasitic worms) and Plasmodium (parasite causing malaria) might worsen the clinical outcome of malaria, whereas no interaction between these parasites was found in other studies. The aim of this project is to generate new knowledge on the spatial distribution and burden of polyparasitism in Côte d'Ivoire, placing emphasis on malaria and intestinal helminth infections, to investigate interactions between parasites and how these interactions affect morbidity and self-rated quality of life in different age groups. We will carry out surveys in 100 schools across Côte d'Ivoire and in 6 entire communities to examine study participants for parasitic infections, anaemia, and spleen and liver pathology. We will also measure their weight and height. Furthermore, we will use questionnaires to assess socio-economic status and self-reported morbidity and ask every participant to rate their quality of life. Satellite images, geographical information system and statistical models will be used to analyse risk factors that influence the spatial distribution of polyparasitism and to produce maps that display the modelled risk for co-infections. Further statistical analyses will be used to determine how different parasite species interact together to affect anaemia, spleen and liver pathology, nutritional status and self-reported morbidity and quality of life in different age groups. This knowledge will deepen our understanding of parasite-parasite interactions at individual and community level and provide a basis for the control of polyparasitism in Côte d'Ivoire and elsewhere. The produced risk maps will serve to guide control interventions against these infections.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Effect of deworming on school-aged children's physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic area of Côte d'Ivoire.
Hürlimann Eveline, Houngbedji Clarisse A, N'Dri Prisca B, Bänninger Dominique, Coulibaly Jean T, Yap Peiling, Silué Kigbafori D, N'Goran Eliézer K, Raso Giovanna, Utzinger Jürg (2014), Effect of deworming on school-aged children's physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic area of Côte d'Ivoire., in BMC infectious diseases, 14(1), 411-411.
Infection and co-infection with helminths and Plasmodium among school children in Côte d'Ivoire: results from a National Cross-Sectional Survey.
Yapi Richard B, Hürlimann Eveline, Houngbedji Clarisse A, Ndri Prisca B, Silué Kigbafori D, Soro Gotianwa, Kouamé Ferdinand N, Vounatsou Penelope, Fürst Thomas, N'Goran Eliézer K, Utzinger Jürg, Raso Giovanna (2014), Infection and co-infection with helminths and Plasmodium among school children in Côte d'Ivoire: results from a National Cross-Sectional Survey., in PLoS neglected tropical diseases, 8(6), 2913-2913.
Plasmodium falciparum infection and clinical indicators in relation to net coverage in central Côte d'Ivoire.
Ouattara Allassane F, Dagnogo Mamadou, Olliaro Piero L, Raso Giovanna, Tanner Marcel, Utzinger Jürg, Koudou Benjamin G (2014), Plasmodium falciparum infection and clinical indicators in relation to net coverage in central Côte d'Ivoire., in Parasites & vectors, 7(1), 306-306.
The epidemiology of polyparasitism and implications for morbidity in two rural communities of Côte d'Ivoire.
Hürlimann Eveline, Yapi Richard B, Houngbedji Clarisse A, Schmidlin Thomas, Kouadio Bernadette A, Silué Kigbafori D, Ouattara Mamadou, N'Goran Eliézer K, Utzinger Jürg, Raso Giovanna (2014), The epidemiology of polyparasitism and implications for morbidity in two rural communities of Côte d'Ivoire., in Parasites & vectors, 7, 81-81.
Transmission of malaria in relation to distribution and coverage of long-lasting insecticidal nets in central Côte d'Ivoire.
Ouattara Allassane F, Dagnogo Mamadou, Constant Edi A V, Koné Moussa, Raso Giovanna, Tanner Marcel, Olliaro Piero L, Utzinger Jürg, Koudou Benjamin G (2014), Transmission of malaria in relation to distribution and coverage of long-lasting insecticidal nets in central Côte d'Ivoire., in Malaria journal, 13, 109-109.
Effects of hygiene and defecation behavior on helminths and intestinal protozoa infections in Taabo, Côte d'Ivoire.
Schmidlin Thomas, Hürlimann Eveline, Silué Kigbafori D, Yapi Richard B, Houngbedji Clarisse, Kouadio Bernadette A, Acka-Douabélé Cinthia A, Kouassi Dongo, Ouattara Mamadou, Zouzou Fabien, Bonfoh Bassirou, N'Goran Eliézer K, Utzinger Jürg, Raso Giovanna (2013), Effects of hygiene and defecation behavior on helminths and intestinal protozoa infections in Taabo, Côte d'Ivoire., in PloS one, 8(6), 65722-65722.
Mapping malaria risk among children in Cote d'Ivoire using Bayesian geo-statistical models.
Raso Giovanna, Schur Nadine, Utzinger Jürg, Koudou Benjamin G, Tchicaya Emile S, Rohner Fabian, N'goran Eliézer K, Silué Kigbafori D, Matthys Barbara, Assi Serge, Tanner Marcel, Vounatsou Penelope (2012), Mapping malaria risk among children in Cote d'Ivoire using Bayesian geo-statistical models., in Malaria journal, 11(1), 160-160.
Willingness to use a rapid diagnostic test for malaria in a rural area of central Côte d'Ivoire.
Comoé Colombe Coffie, Ouattara Allassane F, Raso Giovanna, Tanner Marcel, Utzinger Jürg, Koudou Benjamin G (2012), Willingness to use a rapid diagnostic test for malaria in a rural area of central Côte d'Ivoire., in BMC public health, 12, 1089-1089.
Malaria knowledge and long-lasting insecticidal net use in rural communities of central Côte d’Ivoire
Ouattara Allassane F, Raso Giovanna, Edi Constant VA, Utzinger Jürg, Tanner Marcel, Dagnogo Mamadou, Koudou Benjamin G (2011), Malaria knowledge and long-lasting insecticidal net use in rural communities of central Côte d’Ivoire, in Malaria Journal, 10, 288-12.
Research in a war zone
Bonfoh Bassirou, Raso Giovanna, Koné Inza, Dao Daouda, Girardin Olivier, Cissé Gueladio, Zinsstag Jakob, Utzinger Jürg, Tanner Marcel (2011), Research in a war zone, in Nature, 474(7353), 569-571.
Risk factors for helminth infections in a rural and a peri-urban setting of the Dongting Lake area, People's Republic of China.
Balen Julie, Raso Giovanna, Li Yue-Sheng, Zhao Zheng-Yuan, Yuan Li-Ping, Williams Gail M, Luo Xin-Song, Shi Meng-Zhi, Yu Xin-Ling, Utzinger Jürg, McManus Donald P (2011), Risk factors for helminth infections in a rural and a peri-urban setting of the Dongting Lake area, People's Republic of China., in International journal for parasitology, 41(11), 1165-73.

Collaboration

Group / person Country
Types of collaboration
Centre Suisse de Recherches Scientifiques en Côte d'Ivoire Ivory Coast (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Université de Cocody-Abidjan Ivory Coast (Africa)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Programme National de Santé Scolaire et Universitaire Ivory Coast (Africa)
- Exchange of personnel

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
ParaTrop 2014 Individual talk Disparities of malaria preventive measures and treatment in Côte d'Ivoire 19.07.2014 Zürich, Switzerland Vounatsou Penelope; Hürlimann Eveline; Raso Giovanna; Utzinger Jürg;
ParaTrop 2014 - Joint Society Meeting on Parasitology and Tropical Medicine Individual talk Effects on anaemia in plasmodium-helmimnth co-infected children and adults from rural settings in southern Côte d’Ivoire 14.07.2014 Zürich, Switzerland Utzinger Jürg; Hürlimann Eveline; Raso Giovanna;
Africa 2013 Ecohealth conference Poster Effects on anaemia in plasmodium-helmimnth co-infected children and adults from rural settings in southern Côte d’Ivoire 07.10.2013 Grand Bassam, Ivory Coast Vounatsou Penelope; Utzinger Jürg; Raso Giovanna; Hürlimann Eveline;
Africa 2013 Ecohealth conference Individual talk Malaria and helminth co-infection among school-aged children in Côte d’Ivoire: a national cross sectional survey 07.10.2013 Grand Bassam, Ivory Coast Utzinger Jürg; Raso Giovanna; Hürlimann Eveline; Vounatsou Penelope;
Africa 2013 Ecohealth conference Individual talk Ecological pattern of anaemia and malnutrtion among school-aged children in Côte d'Ivoire 07.10.2013 Grand Bassam, Ivory Coast Hürlimann Eveline; Utzinger Jürg; Vounatsou Penelope; Raso Giovanna;
Challenges in Malaria Research: Progress Towards Elimination Poster Concomitant Plasmodium falciparum and intestinal helminth infections in a rural community of southern Côte d’Ivoire 10.10.2012 Basel, Switzerland Hürlimann Eveline; Vounatsou Penelope; Utzinger Jürg; Raso Giovanna;


Communication with the public

Communication Title Media Place Year
Print (books, brochures, leaflets) Bulletin d'information du CSRS N°3, Enquête nationale sur le polyparasitisme en milieu scolaire International 2012

Abstract

Background: In developing countries, the spatial and temporal distribution of different parasitic infections often overlaps, and hence polyparasitism is a common phenomenon. Whilst most research has concentrated on single species parasite infections, there is growing interest to further elucidate the issue of polyparasitism. A deeper understanding of polyparasitism is not only relevant from a fundamental point of view, but also to harness programmatic similarities for integrated, cost-effective and sustainable control. At present, morbidity implications of polyparasitism are poorly understood, as are synergistic or antagonistic effects of polyparasite infections and consequences for control. For example, some studies suggest that the co-occurrence of helminths and Plasmodium might worsen the clinical outcome of malaria, whereas no interaction between these parasites was found in other studies.Hypotheses: (1) Polyparasitism is pervasive among school-aged children and entire rural communities of Côte d’Ivoire and the spatial and temporal distribution of polyparasitic infections is governed by an array of determinants, including behavioural, climatic, environmental, intervention-related and socio-economic factors. We conjecture that the importance of each factor differs depending on the spatial scale. (2) The effect resulting from an interaction between parasite species on morbidity and self-rated quality of life may be additive or multiplicative. Depending on the parasite interaction and the intensity of infection, synergistic or antagonistic effects may prevail between parasite species.Aim: To generate new knowledge on the spatial distribution and burden of polyparasitism in Côte d’Ivoire, placing emphasis on malaria and intestinal helminth infections at different spatial scales, to investigate interactions between parasites and how these interactions affect morbidity and self-rated quality of life, including the assessment of age-specific disability weights.Methods: We will carry out cross-sectional surveys, combining clinical, parasitological and questionnaire surveys to gather the necessary data in selected schools and entire communities, across Côte d’Ivoire. Remote sensing, geographical information system and Bayesian geostatistical modelling will be used to analyse spatial determinants of polyparasitism at community and regional level and to produce risk maps for the spatial distribution of co-infections. We will use statistical analyses to measure the association of morbidity and self-rated quality of life with polyparasitism. Interactions between different parasite species will be determined, and the effects of infection intensity on anaemia, organ pathology, nutritional status and self-reported morbidity and quality of life revealed. Age-specific disability weights for parasitic infections will be determined.Expected results and significance: A comprehensive, spatially-explicit database on polyparasitism, morbidity and self-rated quality of life will be generated for Côte d’Ivoire and probed for parasite associations and impact of single- and multiple species infections on morbidity and self-rated quality of life. This knowledge will deepen our understanding of parasite-parasite interactions at individual and community level and provides a basis for the control of polyparasitism in Côte d’Ivoire and elsewhere.
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