DIDE, School of Public Health, Imperial College, London, UK.
Acta Trop. 2013 Nov;128(2):309-17. doi: 10.1016/j.actatropica.2013.01.001. Epub 2013 Jan 10.
Two schistosome species--Schistosoma haematobium and S. mansoni--with two very different pathological profiles (urogenital versus intestinal), are responsible for the majority of human schistosomiasis infections across sub-Saharan Africa. The aim of this study was to determine whether coinfections have an impact on species-specific morbidity measures when compared to single species infections. Children from two neighbouring schools in Taveta, Kenya were grouped by infection status, i.e. uninfected, single species infections or coinfected. Clinical examination of the liver and spleen by palpation was performed and urinary albumin levels were recorded at baseline and at 12 months after praziquantel administration. Additional ultrasonographic profiles of the children's liver, spleen and bladder were incorporated at follow-up. It was found that S. haematobium-associated urogenital morbidity was lower in the coinfected group relative to single S. haematobium infections, even when infection intensities were taken into account. We also observed an association between S. haematobium infection and liver (intestinal-associated) morbidity regardless of coinfections. The findings reported here suggest that further research should be performed on the impact of S. haematobium infections on liver morbidity as well as to determine the impact of mixed schistosome species infections on human morbidity outcomes across different endemic settings.
两种血吸虫物种——曼氏血吸虫和埃及血吸虫——具有两种非常不同的病理特征（泌尿生殖道与肠道），它们在撒哈拉以南非洲造成了大多数人类血吸虫病感染。本研究旨在确定与单一物种感染相比，合并感染是否会对特定物种的发病率衡量产生影响。肯尼亚塔韦塔的两所相邻学校的儿童按感染状况分组，即未感染、单一物种感染或合并感染。通过触诊对肝脏和脾脏进行临床检查，并在吡喹酮给药后 12 个月记录尿白蛋白水平。在随访中还纳入了儿童肝脏、脾脏和膀胱的额外超声图像。结果发现，与单一埃及血吸虫感染相比，合并感染组的埃及血吸虫相关泌尿生殖道发病率较低，即使考虑到感染强度也是如此。我们还观察到埃及血吸虫感染与肝脏（肠道相关）发病率之间存在关联，而不管是否存在合并感染。这里报告的结果表明，应该进一步研究埃及血吸虫感染对肝脏发病率的影响，以及确定混合血吸虫物种感染对不同流行地区人类发病率结果的影响。
