The Impact of Intensive Versus Standard Anthelminthic Treatment on Allergy-related Outcomes, Helminth Infection Intensity, and Helminth-related Morbidity in Lake Victoria Fishing Communities, Uganda: Results From the LaVIISWA Cluster-randomized Trial

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dc.contributor.authorSanya, Richard E.
dc.contributor.authorNkurunungi, Gyaviira
dc.contributor.authorHoek Spaans, Remy
dc.contributor.authorNampijja, Margaret
dc.contributor.authorO’Hara, Geraldine
dc.contributor.authorKizindo, Robert
dc.contributor.authorOduru, Gloria
dc.contributor.authorKabuubi Nakawungu, Prossy
dc.contributor.authorNiwagaba, Emmanuel
dc.contributor.authorAbayo, Elson
dc.contributor.authorKabagenyi, Joyce
dc.contributor.authorZziwa, Christopher
dc.contributor.authorTumusiime, Josephine
dc.contributor.authorNakazibwe, Esther
dc.contributor.authorKaweesa, James
dc.contributor.authorMuwonge Kakooza, Fred
dc.contributor.authorAkello, Mirriam
dc.contributor.authorLubyayi, Lawrence
dc.contributor.authorVerweij, Jaco
dc.contributor.authorNash, Stephen
dc.contributor.authorRee, Ronald van
dc.contributor.authorMpairwe, Harriet
dc.contributor.authorTukahebwa, Edridah
dc.contributor.authorWebb, Emily L.
dc.contributor.authorElliott, Alison M.
dc.date.accessioned2022-10-31T19:51:02Z
dc.date.available2022-10-31T19:51:02Z
dc.date.issued2019
dc.description.abstractThe prevalence of allergy-related diseases is increasing in low-income countries. Parasitic helminths, common in these settings, may be protective. We hypothesized that intensive, community-wide, anthelminthic mass drug administration (MDA) would increase allergy-related diseases, while reducing helminth-related morbidity. Methods. In an open, cluster-randomized trial (ISRCTN47196031), we randomized 26 high-schistosomiasis-transmission fishing villages in Lake Victoria, Uganda, in a 1:1 ratio to receive community-wide intensive (quarterly single-dose praziquantel plus albendazole daily for 3 days) or standard (annual praziquantel plus 6 monthly single-dose albendazole) MDA. Primary outcomes were recent wheezing, skin prick test positivity (SPT), and allergen-specific immunoglobulin E (asIgE) after 3 years of intervention. Secondary outcomes included helminths, haemoglobin, and hepatosplenomegaly. Results. The outcome survey comprised 3350 individuals. Intensive MDA had no effect on wheezing (risk ratio [RR] 1.11, 95% confidence interval [CI] 0.64–1.93), SPT (RR 1.10, 95% CI 0.85–1.42), or asIgE (RR 0.96, 95% CI 0.82–1.12). Intensive MDA reduced Schistosoma mansoni infection intensity: the prevalence from Kato Katz examinations of single stool samples from each patient was 23% versus 39% (RR 0.70, 95% CI 0.55–0.88), but the urine circulating cathodic antigen test remained positive in 85% participants in both trial arms. Hookworm prevalence was 8% versus 11% (RR 0.55, 95% CI 0.31–1.00). There were no differences in anemia or hepatospenomegaly between trial arms. Conclusions. Despite reductions in S. mansoni intensity and hookworm prevalence, intensive MDA had no effect on atopy, allergy- related diseases, or helminth-related pathology. This could be due to sustained low-intensity infections; thus, a causal link between helminths and allergy outcomes cannot be discounted. Intensive community-based MDA has a limited impact in high-schistosomiasis- transmission fishing communities, in the absence of other interventions.en_US
dc.identifier.citationSanya, R. E., Nkurunungi, G., Hoek Spaans, R., Nampijja, M., O’Hara, G., Kizindo, R., ... & Elliott, A. M. (2019). The impact of intensive versus standard anthelminthic treatment on allergy-related outcomes, helminth infection intensity, and Helminth-related morbidity in lake Victoria fishing communities, Uganda: results from the LaVIISWA cluster-randomized trial. Clinical infectious diseases, 68(10), 1665-1674. DOI: 10.1093/cid/ciy761en_US
dc.identifier.other10.1093/cid/ciy761
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/5083
dc.language.isoenen_US
dc.publisherClinical infectious diseasesen_US
dc.subjectHelminthsen_US
dc.subjectSchistosoma mansonien_US
dc.subjectMass drug administrationen_US
dc.subjectAllergy-related diseaseen_US
dc.subjectAfricaen_US
dc.titleThe Impact of Intensive Versus Standard Anthelminthic Treatment on Allergy-related Outcomes, Helminth Infection Intensity, and Helminth-related Morbidity in Lake Victoria Fishing Communities, Uganda: Results From the LaVIISWA Cluster-randomized Trialen_US
dc.typeArticleen_US
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