Association of deworming with reduced eosinophilia : implications for HIV/AIDS and co-endemic diseases

Fincham, J. E. ; Markus, M. B. ; Adams, V. J. ; Lombard, C. J. ; Bentwich, Z. ; Mansvelt, E. P. G. ; Dhansay, M. A. ; Schoeman, S. E. (2003-04)

Please cite as follows:

Fincham, J. E. et al. 2003. Association of deworming with reduced eosinophilia: Implications for HIV/AIDS and co-endemic diseases. South African Journal of Science , 99(3&4):182-184.

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Eosinophil counts in venous blood were monitored during a randomized controlled deworming trial (n = 155 children) that lasted for a year, and in a whole-school deworming programme (range 174-256 children) of 2 years' duration. Mean eosinophil counts (x109/I) decreased from 0.70 in the randomized trial, and 0.61 in the whole-school study, to well within the normal paediatric range of 0.05-0.45 (P < 0.05). The prevalence of eosinophilia declined from 57% to 37% in the randomized trial (mean for 400, 800 and 1200 mg albendazole doses); and from 47% to 24% in the whole-school study (500 mg stat mebendazole). Benzimidazole anthelminthics were highly effective against Ascaris but less so against Trichuris. Activated eosinophils are effector and immunoregulatory leucocytes of the T-helper cell type 2 (Th2) immune response to parasitic helminths and atopic disorders. Under conditions of poverty where soil-transmitted helminths are hyperendemic, Th2 polarization of the immune profile is characteristic. Regular anthelminthic treatment should reduce contact with worm antigens, and this may contribute to re-balancing of the immune profile. Suppression of eosinophil recruitment and activation, together with related cellular and molecular immunological changes, might have positive implications for prevention and treatment of co-endemic diseases, including HIV/AIDS, cholera, tuberculosis and atopic disorders.

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