title: Slaving and release in co-infection control.
abstract: BACKGROUND
  Animal and human infection with multiple parasite species is the norm rather than the exception, and empirical studies and animal models have provided evidence for a diverse range of interactions among parasites. We demonstrate how an optimal control strategy should be tailored to the pathogen community and tempered by species-level knowledge of drug sensitivity with use of a simple epidemiological model of gastro-intestinal nematodes.
  
  
  METHODS
  We construct a fully mechanistic model of macroparasite co-infection and use it to explore a range of control scenarios involving chemotherapy as well as improvements to sanitation.
  
  
  RESULTS
  Scenarios are presented whereby control not only releases a more resistant parasite from antagonistic interactions, but risks increasing co-infection rates, exacerbating the burden of disease. In contrast, synergisms between species result in their becoming epidemiologically slaved within hosts, presenting a novel opportunity for controlling drug resistant parasites by targeting co-circulating species.
  
  
  CONCLUSIONS
  Understanding the effects on control of multi-parasite species interactions, and vice versa, is of increasing urgency in the advent of integrated mass intervention programmes.
authors.affiliation: Infectious Disease Epidemiology Unit, School of Population Health, University of Queensland, Herston, Brisbane, QLD 4006, Australia. laith.yakob@uq.edu.au
authors.forename: Laith
authors.initials: L
authors.lastname: Yakob
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
authors.forename: Darren J
authors.initials: DJ
authors.lastname: Gray
authors.forename: Kate
authors.initials: K
authors.lastname: Halton
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Solon
authors.forename: Archie C A
authors.initials: AC
authors.lastname: Clements
mesh_terms: D000818:Animals; D060085:Coinfection / Q000188:drug therapy / Q000469:parasitology* / Q000662:veterinary*; D004358:Drug Therapy / Q000379:methods*; D006801:Humans; D008962:Models, Theoretical; D009348:Nematoda / Q000187:drug effects / Q000254:growth & development*; D009349:Nematode Infections / Q000188:drug therapy / Q000469:parasitology* / Q000662:veterinary*