TY - JOUR
T1 - Does treatment of intestinal helminth infections influence malaria? Background and methodology of a longitudinal study of clinical, parasitological and immunological parameters in Nangapanda, Flores, Indonesia (ImmunoSPIN Study)
AU - Wiria, Aprilianto E.
AU - Prasetyani, Margaretta A.
AU - Hamid, Firdaus
AU - Wammes, Linda J.
AU - Lell, Bertrand
AU - Ariawan, Iwan
AU - Uh, Hae W.
AU - Wibowo, Heri
AU - Djuardi, Yenny
AU - Wahyuni, Sitti
AU - Sutanto, Inge
AU - May, Linda
AU - Luty, Adrian J F
AU - Verweij, Jaco J.
AU - Sartono, Erliyani
AU - Yazdanbakhsh, Maria
AU - Supali, Taniawati
N1 - Funding Information:
This study is funded by The Royal Netherlands Academy of Arts and Science (KNAW), Ref.KNAW-05-PP-35, European Commission contracts INCO-CT-2006-031714 and INCO-CT-2006-032436 The authors thank Drg Dominggus Minggu Mere as the former Head of Ende Health District for his support to initiate the study. Health staff in district as well as in the Puskesmas Primary Health center and community workers, Aurelius I Data as data entry person, Markus Rubu and Maksima as field worker, mostly help from UI team (Maria Kaisar, Sudirman, Suwarto, Heni Sitompul, Rosidi) and LUMC team (Yvonne Kruize), Awal Setiawan and Agus Rahmat (NAMRU-Two) who help and assist the mapping process, and last most of all inhabitants of Nangapanda (Ndeturea, Ndorurea1, Ndorurea).
PY - 2010/3/25
Y1 - 2010/3/25
N2 - Background: Given that helminth infections are thought to have strong immunomodulatory activity, the question whether helminth infections might affect responses to malaria antigens needs to be addressed. Different cross-sectional studies using diverse methodologies have reported that helminth infections might either exacerbate or reduce the severity of malaria attacks. The same discrepancies have been reported for parasitemia.Methods/Design: To determine the effect of geohelminth infections and their treatment on malaria infection and disease outcome, as well as on immunological parameters, the area of Nangapanda on Flores Island, Indonesia, where malaria and helminth parasites are co-endemic was selected for a longitudinal study. Here a Double-blind randomized trial will be performed, incorporating repeated treatment with albendazole (400 mg) or placebo at three monthly intervals. Household characteristic data, anthropometry, the presence of intestinal helminth and Plasmodium spp infections, and the incidence of malaria episodes are recorded. In vitro cultures of whole blood, stimulated with a number of antigens, mitogens and toll like receptor ligands provide relevant immunological parameters at baseline and following 1 and 2 years of treatment rounds. The primary outcome of the study is the prevalence of Plasmodium falciparum and P. vivax infection. The secondary outcome will be incidence and severity of malaria episodes detected via both passive and active follow-up. The tertiary outcome is the inflammatory cytokine profile in response to parasite antigens. The project also facilitates the transfer of state of the art methodologies and technologies, molecular diagnosis of parasitic diseases, immunology and epidemiology from Europe to Indonesia.Discussion: The study will provide data on the effect of helminth infections on malaria. It will also give information on anthelminthic treatment efficacy and effectiveness and could help develop evidence-based policymaking.
AB - Background: Given that helminth infections are thought to have strong immunomodulatory activity, the question whether helminth infections might affect responses to malaria antigens needs to be addressed. Different cross-sectional studies using diverse methodologies have reported that helminth infections might either exacerbate or reduce the severity of malaria attacks. The same discrepancies have been reported for parasitemia.Methods/Design: To determine the effect of geohelminth infections and their treatment on malaria infection and disease outcome, as well as on immunological parameters, the area of Nangapanda on Flores Island, Indonesia, where malaria and helminth parasites are co-endemic was selected for a longitudinal study. Here a Double-blind randomized trial will be performed, incorporating repeated treatment with albendazole (400 mg) or placebo at three monthly intervals. Household characteristic data, anthropometry, the presence of intestinal helminth and Plasmodium spp infections, and the incidence of malaria episodes are recorded. In vitro cultures of whole blood, stimulated with a number of antigens, mitogens and toll like receptor ligands provide relevant immunological parameters at baseline and following 1 and 2 years of treatment rounds. The primary outcome of the study is the prevalence of Plasmodium falciparum and P. vivax infection. The secondary outcome will be incidence and severity of malaria episodes detected via both passive and active follow-up. The tertiary outcome is the inflammatory cytokine profile in response to parasite antigens. The project also facilitates the transfer of state of the art methodologies and technologies, molecular diagnosis of parasitic diseases, immunology and epidemiology from Europe to Indonesia.Discussion: The study will provide data on the effect of helminth infections on malaria. It will also give information on anthelminthic treatment efficacy and effectiveness and could help develop evidence-based policymaking.
UR - http://www.scopus.com/inward/record.url?scp=77952281296&partnerID=8YFLogxK
U2 - 10.1186/1471-2334-10-77
DO - 10.1186/1471-2334-10-77
M3 - Article
C2 - 20338054
AN - SCOPUS:77952281296
SN - 1471-2334
VL - 10
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
M1 - 77
ER -
