| Popis: |
In Africa, polyparasitism is the rule rather than the exception. The aim of this thesis was to get a detailed insight into the micro-geographical distribution and patterns of S. mansoni and S. haematobium co-infections, and how this affects host morbidity. A community-wide study was carried out in a co-endemic focus in the north of Senegal, combining epidemiological, ecological, immunological, and geographical analyses. This multidisciplinary approach led to several new insights. Spatial analyses showed significant clustering of Schistosoma infection and morbidity even on a micro scale; S. mansoni and S. haematobium hotspots were found in different sections of one community. Another major finding was that the presence of S. mansoni in co-infections might protect against S. haematobium-specific urinary tract morbidity. Furthermore, it was observed that S. haematobium antigens induced stronger cytokine responses than those of S. mansoni, indicating that the first species may be more immunogenic. The results of this thesis provide new leads for further research on disease etiology and underlying mechanisms in Schistosoma co-infections. Such knowledge is key to rationalizing and optimizing current schistosomiasis control strategies in co-endemic areas and to developing successful elimination strategies in the future. |
