Epidemiology of polyparasitism with Taenia solium, schistosomes and soil-transmitted helminths in the co-endemic village of Malanga, Democratic Republic of Congo.
Helminth co-infections are common in sub-Saharan Africa. However, little is known about the distribution and determinants of co-infections with Taenia solium taeniasis/cysticercosis. Building on a previous community-based study on human cysticercosis in Malanga village, we investigated co-infections with Taenia solium, soil-transmitted helminths (STHs) and Schistosoma spp and associated risk factors in a random subsample of 330 participants. Real time PCR assays were used to detect DNA of soil-transmitted helminths (STHs), T. solium and Schistosoma in stool samples and Schistosoma DNA in urine samples. Serum samples were tested for T. solium cysticercosis using the B158/B60 monoclonal antibody-based antigen ELISA. Bivariate analysis and logistic regression were applied to assess associations of single and co-infections with common risk factors (age, sex, area, hygiene) as well as pair wise associations between helminth species. Overall, 240 (72.7%) participants were infected with at least one helminth species; 128 (38.8%) harbored at least two helminth species (16.1% with STHs-Schistosoma, 14.5% with STHs-T. solium taeniasis/cysticercosis and 8.2% with Schistosoma-T. solium taeniasis/cysticercosis co-infections). No significant associations were found between Schistosoma-T. solium taeniasis/cysticercosis co-infection and any of the risk factors studied. Males (OR=2 (95%CI=1.1-5), p=0.03) and open defecation behavior (OR=3.8 (95%CI=1.1-6.5), p=0.04) were associated with higher odds of STHs-T. solium taeniasis/cysticercosis co-infection. Village districts that were found at high risk of T. solium taeniasis/cysticercosis were also at high risk of co-infection with STHs and T. solium taeniasis/cysticercosis (OR=3.2 (95%CI=1.1-7.8), p=0.03). Significant pair-wise associations were found between T. solium cysticerci and Necator americanus (OR=2.2 (95%CI=1.2-3.8), p<0.01) as well as Strongyloides stercoralis (OR=2.7 (95%CI=1.1-6.5), p=0.02). These findings show that co-infections with T. solium are common in this polyparasitic community in DRC. Our results on risk factors of helminth co-infections and specific associations between helminths may contribute to a better integration of control within programmes that target more than one NTD.
Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: jmadinga@yahoo.fr.
Joule
J
Madinga
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: kpolman@itg.be.
Katja
K
Polman
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: KIKA@iwt.be.
Kirezi
K
Kanobana
Departement of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: E.A.van_Lieshout@lumc.nl.
Lisette
L
van Lieshout
Departement of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: E.A.T.Brienen@lumc.nl.
Eric
E
Brienen
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: nicolas.x.praet@gsk.com.
Nicolas
N
Praet
Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo. Electronic address: kako_kabwe@yahoo.fr.
Constantin
C
Kabwe
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: sgabriel@itg.be.
Sarah
S
Gabriël
Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: pdorny@itg.be.
Pierre
P
Dorny
Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Tropical Medicine, University of Kinshasa, Democratic Republic of the Congo. Electronic address: pascal_lutumba@yahoo.fr.
Pascal
P
Lutumba
Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium. Electronic address: niko.speybroeck@uclouvain.be.
Niko
N
Speybroeck
D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D060085:Coinfection; D003223:Congo; D003551:Cysticercosis / Q000453:epidemiology* / Q000469:parasitology; D003552:Cysticercus; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012547:Schistosoma; D012552:Schistosomiasis / Q000453:epidemiology* / Q000469:parasitology; D012987:Soil / Q000469:parasitology*; D041201:Taenia solium; D013622:Taeniasis / Q000453:epidemiology* / Q000469:parasitology
D000909:Antibodies, Helminth; D012987:Soil
Co-infection; Democratic Republic of Congo; Helminths; Polyparasitism; Schistosoma; Soil-transmitted helminths; Taenia solium