Department of Biology, Imperial College of Science, Technology and Medicine, Department of Pathology, University of Cambridge, Division of Vector-Borne Diseases, Ministry of Health, Biomedical Sciences Research Centre, Kenya Medical Research Institute, Laboratory for Parasitology, University of Leiden, Department of Medical Parasitology, London School of Tropical Medicine and Hygiene, Danish Bilharziasis Laboratory, London, United Kingdom
Understanding the dynamics of schistosome infections is problematic because direct measurements of worm burden are not possible. Hitherto, the relative intensity of infection has been estimated by the number of parasite eggs excreted. Egg excretion is assumed to have a consistent relationship with worm burden with duration of infection. We have tested this assumption in Schistosoma mansoni- and S. haematobium-infected populations by looking at the relationships between a circulating parasite antigen, egg excretion level, host age, and parasite density. The study was carried out in two populations because experimental models suggested that S. haematobium but not S. mansoni suffers immune-mediated reduction of fecundity. The results were consistent with this observation, showing that S. mansoni egg output remains stable irrespective of host age or infection intensity while S. haematobium has a substantially reduced egg production with host age. This information is fundamental to understanding the immunology and epidemiology of human schistosomiasis and thus practical approaches to disease control.