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

ELIANA A. G. REIS Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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MITERMAYER G. REIS Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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RITA DE CÁSSIA R. SILVA Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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THEOMIRA M. A. CARMO Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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ANA MARLÚCIA O. ASSIS Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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MAURÍCIO L. BARRETO Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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ISABEL M. PARRAGA Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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MONICA LEILA P. SANTANA Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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RONALD E. BLANTON Oswaldo Cruz Foundation, Fiocruz, Salvador, Bahia, Brazil; School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil; Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

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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.

Author Notes

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