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BIOCHEMICAL AND IMMUNOLOGIC PREDICTORS OF EFFICACY OF TREATMENT OR REINFECTION RISK FOR SCHISTOSOMA MANSONI

Most Schistosoma mansoni infections are egg-negative after a single dose of oxamniquine. A cohort of 661 infected children was treated at 6-month intervals and assessed for nutritional and parasitological status. Initial biochemical and immunologic markers were measured in a subset of 84 children. All were treated at the start of therapy and at 6 months. Immunoglobulins only served as markers for active infection. No markers were predictive of cure or reinfection, except initial infection intensity and serum low-density lipoprotein. Ten percent were persistently infected and had no change in infection intensity at any time-point. Several factors suggest that this group was biologically different. In addition to failing to reduce their worm burden, they had significantly higher initial intensity of infection (100 versus 65 eggs/g, P = 0.001) and significantly lower initial serum low-density lipoprotein (72 versus 104 mg/dL, P = 0.045). The biologic plausibility of this observation is discussed.

Received August 10, 2005. Accepted for publication April 12, 2006.

Financial support: This work was supported by a grant from the Nestle Foundation, CNPq (Brazilian National Research Counsel), and Pronex (Centers of Excellence Program–Brazilian Ministry of Science and Technology).

^* Address correspondence to Ronald Blanton, Center for Global Health and Disease, Case Western Reserve University, Cleveland, OH 44106. E-mail reb6{at}case.edu

Authors’ addresses: Eliana A. G. Reis, E-mail: ereis{at}cpqgm.fiocruz.br. Mitermayer G. Reis, E-mail: miter{at}cpqgm.fiocruz.br. Rita de Cássia R. Silva, E-mail: rcsilva{at}ufba.br. Theomira M. A. Carmo, Oswaldo Cruz Foundation, Fiocruz, Rua Waldemar Falcão, 121 Brotas, Salvador, Bahia, Brazil, CEP–40296-710. Telephone: 71-3176-2205, Fax: 71-3176-2289. E-mail: theo{at}cpqgm.fiocruz.br. Ana Marlúcia O. Assis, E-mail: amos{at}ufba.br. Maurício L. Barreto, Institute of Collective Health, Federal University of Bahia, Rua Basilio da Gama s/N°, Canela, Salvador-Bahia, Brasil Salvador, Bahia, Brazil 40-110-170. Telephone: 71-3263-7445, Fax: 71-3263-7460, E-mail: mauricio{at}ufbar.br. Isabel M. Parraga, Department of Nutrition, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106-4906. Telephone: 216-368-6626, Fax: 216-368-6644, E-mail: isabel.parraga{at}case.edu. Mnica Leila P. Santana, School of Nutrition, Federal University of Bahia, Rua Padre Feijó, 29/4° andar, Canela, Salvador, Bahia, Brazip CEP–40.110-170. Telephone: 71-3245-0544, Fax: 71-3237-5856, E-mail: monicalp{at}ufba.br. Ronald E. Blanton, Center for Global Health and Diseases, Case Western Reserve University, 2103 Cornell Road, 4th floor, Wolstein Research Building, Cleveland, Ohio 44106-7286. Telephone: 216-368-4814, Fax: 216-368-4825, E-mail: reb6{at}case.edu.