THE ASSOCIATIONS BETWEEN SCHISTOSOMIASIS INFECTION, PRESENCE OF GENITAL ABNORMALITIES, AND HIV PREVALENCE, TRANSMISSION, AND ACQUISITION IN LUSAKA, ZAMBIA Public
Dinh, Cecile (2011)
Published
Abstract
Background: A reported 33.3 million people living in
Sub-Saharan Africa are infected
with HIV. In Zambia, the estimated HIV prevalence ranges from 13.5%
- 17%. An
estimated 20.7% of children in Zambia are infected with
schistosomiasis, a parasitic
infection second only to malaria in prevalence, morbidity and
mortality in Africa.
Individuals who are infected with schistosomiasis can develop
symptoms that last a
lifetime. Symptoms of schistosomiasis include genital
abnormalities, such as ulcers or
"sandy patches" that could increase the susceptibility or
transmission of HIV.
Objective: This study examines the statistical associations
between antibody to
schistosomiasis and HIV prevalence, acquisition and transmission,
and the presence of
genital abnormalities.
Methods: 2168 individuals who were followed in the
Zambia-Emory HIV Research
Project heterosexual cohort for at least three months were included
in this study. Using
banked plasma and serum samples, enzyme-linked immunosorbent assays
(ELISA) were
completed to detect schistosomiasis antibody titers. Clinical
health data were obtained
from medical history and physical exams completed at ZEHRP
enrollment visits.
Univariate logistic regressions were conducted to analyze the
associations between
antibody titer to schistosomiasis; HIV prevalence, acquisition and
transmission; and
genital abnormalities.
Results: Antibodies to schistosomiasis, overall, were not
significantly associated with
being HIV-positive at baseline or transmitting HIV. Schistosomiasis
infection was
significantly associated with the presence of some genital
abnormalities, including
inguinal adenopathy, inflammation of the cervix in women, and
gonorrhea.
Discussion: This study provides a snapshot of the possible
complications that can
arise from being previously infected with schistosomiasis, in the
context of the HIV
epidemic. Interestingly, it does not seem as if serologic evidence
of past or present
schistosomiasis infection is a significant risk factor for
transmission of HIV. Future
directions could take into account the timeline of events and
whether an individual
acquires or transmits HIV due to the presence of genital
abnormalities caused by
schistosomiasis, or if HIV exacerbates the effects of
schistosomiasis. Furthermore,
ELISA results should be followed up with Western immunoblots to
identify Schistosoma
mansoni versus S. haematobium infection, and to confirm
previous schistosomiasis
infection, particularly in individuals with intermediate
titers.
Table of Contents
TABLE OF CONTENTS
INTRODUCTION AND BACKGROUND
HIV Prevalence 1
Schistosomiasis Prevalence 2
Symptoms of Schistosomiasis Infection 2
Genital Abnormalities 3
Rwanda-Zambia HIV Research Group 4
HIV and Schistosomiasis Co-Infection 5
METHODS
Study Design 7
Study Population 7
Schistosomiasis Testing 7
HIV Acquisition and Transmission 8
Genital Abnormality Variables 8
Logistic Regression Models 10
IRB Approval 11
RESULTS 12
DISCUSSION 15
STRENGTHS AND WEAKNESSES 17
FUTURE DIRECTIONS 19
REFERENCES 21
TABLES 25
APPENDICES 32
About this Master's Thesis
| School | |
|---|---|
| Department | |
| Subfield / Discipline | |
| Degree | |
| Submission | |
| Language |
|
| Research Field | |
| Mot-clé | |
| Committee Chair / Thesis Advisor | |
| Committee Members | |
| Partnering Agencies |
Primary PDF
| Thumbnail | Title | Date Uploaded | Actions |
|---|---|---|---|
|
|
THE ASSOCIATIONS BETWEEN SCHISTOSOMIASIS INFECTION, PRESENCE OF GENITAL ABNORMALITIES, AND HIV PREVALENCE, TRANSMISSION, AND ACQUISITION IN LUSAKA, ZAMBIA () | 2018-08-28 14:53:26 -0400 |
|
Supplemental Files
| Thumbnail | Title | Date Uploaded | Actions |
|---|