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Rates and intensity of re-infection with human helminths after treatment and the influence of individual, household, and environmental factors in a Brazilian community

Published online by Cambridge University Press:  08 August 2011

BONNIE CUNDILL ,
NEAL ALEXANDER ,
JEFF M. BETHONY ,
DAVID DIEMERT ,
RACHEL L. PULLAN  and
SIMON BROOKER
BONNIE CUNDILL*
Affiliation:
London School of Hygiene and Tropical Medicine, London, UK
NEAL ALEXANDER
Affiliation:
London School of Hygiene and Tropical Medicine, London, UK The George Washington University, Washington D.C., USA
JEFF M. BETHONY
Affiliation:
The George Washington University, Washington D.C., USA Centro de Pesquisas René Rachou (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
DAVID DIEMERT
Affiliation:
The George Washington University, Washington D.C., USA Sabin Vaccine Institute, Washington D.C., USA
RACHEL L. PULLAN
Affiliation:
London School of Hygiene and Tropical Medicine, London, UK
SIMON BROOKER
Affiliation:
London School of Hygiene and Tropical Medicine, London, UK Kenya Medical Research Institute – Wellcome Trust Research Programme, Nairobi, Kenya
*
*Corresponding author: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Tel: +44 207 927 2111. E-mail: [email protected]
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Summary

This study quantifies the rate and intensity of re-infection with human hookworm and Schistosoma mansoni infection 12 months following successful treatment, and investigates the influence of socio-economic, geographical and environmental factors. A longitudinal study of 642 individuals aged over 5 years was conducted in Minas Gerais State, Brazil from June 2004 to March 2006. Risk factors were assessed using interval censored regression for the rate and negative binomial regression for intensity. The crude rate and intensity of hookworm re-infection was 0·21 per year (95% confidence interval (CI) 0·15–0·29) and 70·9 epg (95% CI 47·2–106·6). For S. mansoni the rate was 0·06 per year (95% CI 0·03–0·10) and intensity 6·51 epg (95% CI 3·82–11·11). Rate and intensity of re-infection with hookworm were highest among males and positively associated with previous infection status, absence of a toilet and house structure. Rate and intensity of S. mansoni re-infection were associated with previous infection status as well as geographical, environmental and socio-economic factors. The implications of findings for the design of anti-helminth vaccine trials are discussed.

Keywords

Necator americanushookwormSchistosoma mansonirisk factorsre-infectionnegative binomial
Type
Research Article
Information
Parasitology , Volume 138 , Issue 11 , September 2011 , pp. 1406 - 1416
Copyright
Copyright © Cambridge University Press 2011

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