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1000
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Abstract/Summary
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<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>The Gran Chaco ecoregion is a well-known hotspot of several neglected tropical diseases (NTDs) including Chagas disease, soil-transmitted helminthiasis and multiparasitic infections. Interspecific interactions between parasite species can modify host susceptibility, pathogenesis and transmissibility through immunomodulation. Our objective was to test the association between human co-infection with intestinal parasites and host parasitaemia, infectiousness to the vector and immunological profiles in <jats:italic>Trypanosoma cruzi</jats:italic>-seropositive individuals residing in an endemic region of the Argentine Chaco.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>We conducted a cross-sectional serological survey for <jats:italic>T. cruzi</jats:italic> infection along with an intestinal parasite survey in two adjacent rural villages. Each participant was tested for <jats:italic>T. cruzi</jats:italic> and <jats:italic>Strongyloides stercoralis</jats:italic> infection by serodiagnosis, and by coprological tests for intestinal parasite detection. <jats:italic>Trypanosoma cruzi</jats:italic> bloodstream parasite load was determined by quantitative PCR (qPCR), host infectiousness by artificial xenodiagnosis and serum human cytokine levels by flow cytometry.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>The seroprevalence for <jats:italic>T. cruzi</jats:italic> was 16.1% and for <jats:italic>S. stercoralis</jats:italic> 11.5% (<jats:italic>n</jats:italic> = 87). We found 25.3% of patients with <jats:italic>Enterobius vermicularis</jats:italic>. The most frequent protozoan parasites were <jats:italic>Blastocystis</jats:italic> spp. (39.1%), <jats:italic>Giardia lamblia</jats:italic> (6.9%) and <jats:italic>Cryptosporidium</jats:italic> spp. (3.4%). Multiparasitism occurred in 36.8% of the examined patients. Co-infection ranged from 6.9% to 8.1% for <jats:italic>T. cruzi</jats:italic>-seropositive humans simultaneously infected with at least one protozoan or helminth species, respectively. The relative odds of being positive by qPCR or xenodiagnosis (i.e. infectious) of 28 <jats:italic>T. cruzi</jats:italic>-seropositive patients was eight times higher in people co-infected with at least one helminth species than in patients with no such co-infection. <jats:italic>Trypanosoma cruzi</jats:italic> parasite load and host infectiousness were positively associated with helminth co-infection in a multiple regression analysis. Interferon-gamma (IFN-γ) response, measured in relation to interleukin (IL)-4 among humans infected with <jats:italic>T. cruzi</jats:italic> only, was 1.5-fold higher than for <jats:italic>T. cruzi</jats:italic>-seropositive patients co-infected with helminths. The median concentration of IL-4 was significantly higher in <jats:italic>T. cruzi</jats:italic>-seropositive patients with a positive qPCR test than in qPCR-negative patients.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Our results show a high level of multiparasitism and suggest that co-infection with intestinal helminths increased <jats:italic>T. cruzi</jats:italic> parasitaemia and upregulated the Th2-type response in the study patients.</jats:p>
</jats:sec><jats:sec>
<jats:title>Graphical Abstract</jats:title>
</jats:sec>
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Hinweis
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DeepGreen-ID: d8cda242b7bb4bc2a276a295df07ac1f ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
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