Effect of Ascaris Lumbricoides specific IgE on tuberculin skin test responses in children in a high-burdensetting : a cross-sectional community-based study

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dc.contributor.authorVan Soelen, Nelda
dc.contributor.authorMandalakas, Anna M.
dc.contributor.authorKirchner, H. L.
dc.contributor.authorWalzl, Gerhard
dc.contributor.authorGrewal, Harleen M. S.
dc.contributor.authorJacobsen, Marc
dc.contributor.authorHesseling, Anneke C.
dc.date.accessioned2013-06-26T13:37:09Z
dc.date.available2013-06-26T13:37:09Z
dc.date.issued2012-09
dc.date.updated2012-10-28T16:07:15Z
dc.descriptionThe original publication is available at http://www.biomedcentral.com/1471-2334/12/211en_ZA
dc.descriptionBibliography
dc.description.abstractABSTRACT:M.tuberculosis (M.tb) is associated with enhanced T helper cell type 1 (Th1) immune responses while helminth infection is associated with T helper cell type 2 (Th2) immune responses. Our aim was to investigate whether helminth infection could influence the ability to generate an appropriate Th1 immune response that is characterized by a positive tuberculin skin test (TST), in M.tb exposed children.MethodsWe completed a community-based, cross sectional household contact tracing study, using matched enrolment of HIV negative children with and without documented household M.tb exposure. We documented demographics, clinical characteristics, HIV status, M.tb exposure (using a standard contact score) and M.tb infection status (TST > = 10 mm). Ascaris lumbricoides-specific IgE was used as proxy for Ascaris infection/exposure.ResultsOf 271 children (median age 4 years (range: 4 months to 15 years)) enrolled, 65 participants (24%) were serum positive for Ascaris IgE. There were 168 (62%) children with a documented household tuberculosis contact and 107 (40%) were (TST) positive overall.A positive TST was associated with increasing age (Odds Ratio (OR) =1.17, p < 0.001), increasing M.tb contact score (OR = 1.17, p < 0.001), previous tuberculosis treatment (OR = 4.8, p = 0.06) and previous isoniazid preventive treatment (OR = 3.16, p = 0.01). A visible bacillus Calmette-Guérin (BCG) scar was associated with reduced odds of being TST positive (OR = 0.42, p = 0.01).Ascaris IgE was not associated with TST status in univariate analysis (OR = 0.9, p = 0.6), but multivariable logistic regression analysis suggested an inverse association between Ascaris IgE status and a positive TST (OR = 0.6, p = 0.08), when adjusted for age, and M.tb contact score. The addition of an age interaction term to the model suggested that the age effect was stronger among Ascaris IgE positive children; the effect of being Ascaris IgE positive significantly reduced the odds of being TST positive amongst younger children while this effect weakened with increasing age.ConclusionsOur preliminary findings highlight a high prevalence of both Ascaris exposure/infection and M.tb infection in children in an urban setting. Helminth exposure/infection may reduce the immune response following M.tb exposure when controlling for epidemiological and clinical covariates. These findings might be relevant to the interpretation of immunological tests of M.tb infection in children.en_ZA
dc.description.sponsorshipNorwegian Cooperation for Higher Education (NUFUPRO-2007/10183), National Institute of Allergy and Infectious Disease at the National Institutes of Health [R01A076199] and the German Research Foundation (DFG) (JA 1479/3-1).en_ZA
dc.description.sponsorshipNational Institute of Allergy and Infectious Disease at the National Institutes of Healthen_ZA
dc.description.sponsorshipGerman Research Foundationen_ZA
dc.description.sponsorship
dc.description.versionPublishers' Versionen_ZA
dc.format.extent8 p.
dc.identifier.citationVan Soelen, N. et al. 2012. Effect of Ascaris Lumbricoides specific IgE on tuberculin skin test responses in children in a high-burdensetting : a cross-sectional community-basedstudy. BMC Infectious Diseases, 12(1):211, doi:10.1186/1471-2334-12-211.en_ZA
dc.identifier.issn1471-2334 (online)
dc.identifier.otherdoi.org/10.1186/1471-2334-12-211
dc.identifier.urihttp://hdl.handle.net/10019.1/80944
dc.language.isoen_ZAen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.rights.holderNelda van Soelen et al.; licensee BioMed Central Ltd.en_ZA
dc.subjectAscaris lumbricoidesen_ZA
dc.subjectAscaris lumbricoides -- Diagnosisen_ZA
dc.subjectPediatric respiratory diseases -- Diagnosisen_ZA
dc.subjectChildren in urban areas -- Susceptibility -- Tuberculosisen_ZA
dc.subjectHelminth infections in childrenen_ZA
dc.titleEffect of Ascaris Lumbricoides specific IgE on tuberculin skin test responses in children in a high-burdensetting : a cross-sectional community-based studyen_ZA
dc.typeArticleen_ZA
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