Advances in our understanding of the epidemiology of Plasmodium and schistosome infection:  informing coinfection studies.
OBJECTIVE
Schistosomes and Plasmodium parasites have complex patterns of transmission, leading to differing dynamics of host-parasite interactions across study sites and a bias of studying differing age groups in monoinfection studies. Combined, these infections lead to difficulties in conducting and interpreting human coinfection studies.


RESULTS
Interactions between the two parasites may affect morbidity associated with either infection; both by influencing mechanisms directly associated with the development of those morbidities and by influencing mechanisms associated with resistance or susceptibility to the other infection. However, conflicting results are reported due to inherent difficulties in studying coinfections. More studies with stringent designs are required to clarify interactions between the two parasites. Recent monoinfection studies indicate that further coinfection studies may need to have a wider age range than previously studied. These studies also need to harness new techniques, both for data collection and analysis that are being developed for modern epidemiological studies. These techniques will allow an essential multidisciplinary approach to be taken.


CONCLUSIONS
Coinfection with Plasmodium and schistosome infection has implications for the health of children of all ages in sub-Saharan Africa. It is important to gain further understanding of the interactions between the two parasites in all age groups.
Department of Pathology, University of Cambridge, Cambridge, UK. sw320@cam.ac.uk
Shona
S
Wilson
David W
DW
Dunne
D017954:Africa South of the Sahara / Q000453:epidemiology; D017677:Age Distribution; D000818:Animals; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology* / Q000469:parasitology; D006790:Host-Parasite Interactions; D006801:Humans; D007223:Infant; D008288:Malaria / Q000150:complications* / Q000453:epidemiology* / Q000469:parasitology; D010961:Plasmodium; D012547:Schistosoma; D012552:Schistosomiasis / Q000150:complications* / Q000453:epidemiology* / Q000469:parasitology