title: Rates and intensity of re-infection with human helminths after treatment and the influence of individual, household, and environmental factors in a Brazilian community.
abstract: 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.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK. bonnie.cundill@lshtm.ac.uk
authors.forename: Bonnie
authors.initials: B
authors.lastname: Cundill
authors.forename: Neal
authors.initials: N
authors.lastname: Alexander
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Bethony
authors.forename: David
authors.initials: D
authors.lastname: Diemert
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Pullan
authors.forename: Simon
authors.initials: S
authors.lastname: Brooker
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000368:Aged; D000723:Ancylostomatoidea / Q000502:physiology*; D000818:Animals; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005243:Feces / Q000469:parasitology; D005260:Female; D006725:Hookworm Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010270:Parasite Egg Count; D015995:Prevalence; D012008:Recurrence; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D012550:Schistosoma mansoni / Q000502:physiology*; D012555:Schistosomiasis mansoni / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission