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Immuno-epidemiology of human geohelminthiasis: ecological and immunological determinants of worm burden

Published online by Cambridge University Press:  06 April 2009

D. A. P. Bundy  and
G. F. Medley
D. A. P. Bundy
Affiliation:
Welcome Trust Research Centre for Parasitic Infections, Imperial College, Prince Consort Road, London
G. F. Medley
Affiliation:
Welcome Trust Research Centre for Parasitic Infections, Imperial College, Prince Consort Road, London
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Summary

The morbidity and transmission dynamics of geohelminthiases are determined by the patterns of infection intensity in the community. Understanding the determinants of these patterns requires a combination of field, laboratory and theoretical study. Studies of age-specific reinfection, and of the phenomenon of predisposition, indicate that the major determinant of convex age-intensity profiles and of heterogeneity in infection intensity is the rate of establishment of infection, rather than the rate of adult worm mortality. The rate of establishment is, in turn, determined by exposure to, and protection from, infection. The evidence indicates that exposure, at least to the orally-transmitted geohelminths, varies with age and is highly heterogeneous between hosts. The immune response in geohelminthiasis is vigorous, parasite-specific, hetero geneous between hosts, and both age and infection dose dependent, but has yet to be convincingly shown to be protective. Since the immune response is itself a function of exposure, unravelling the interaction between ecology and immunology as determinants of geohelminth worm burden will require simultaneous assessment of both processes via immuno epidemiological study.

Type
Geohelminthiasis
Information
Parasitology , Volume 104 , Issue S1: Symposia of the British Society for Parasitology Volume 29:Human parasitic disease: the complementory roles of field and laboratory studies , June 1992 , pp. S105 - S119
Copyright
Copyright © Cambridge University Press 1992

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