Association between allergic sensitization and intestinal parasite infection in schoolchildren in Gqeberha, South Africa. Issue 5 (2nd March 2022)

• Record Type: Journal Article
• Authors: Brandt, Oliver; Wegenstein, Benjamin; Müller, Ivan; Smith, Danielle; Nqweniso, Siphesihle; Adams, Larissa; Müller, Simon; du Randt, Rosa; Pühse, Uwe; Gerber, Markus; Navarini, Alexander A.; Utzinger, Jürg; Labhardt, Niklaus D.; Schindler, Christian; Walter, Cheryl
• Is Part Of: Clinical & experimental allergy. Volume 52:Issue 5(2022)
• Page Start: 670
• Page End: 683
• Publication Date: 2022-03-02
• Subjects: Allergy -- Periodicals; Immunology -- Periodicals; 616.97
• DOI: 10.1111/cea.14100
• Languages: English
• ISSNs: 0954-7894

Abstract

Abstract: Background: Inconsistent data exist regarding the influence of parasitic infection on the prevalence of allergic sensitization and disorders. Objective: To investigate the impact of geohelminth and protozoan infections on sensitization patterns and allergic symptoms of children living in low‐income communities in Gqeberha, South Africa. Methods: In a cross‐sectional study, 587 schoolchildren aged 8–12 years were recruited in June 2016 and screened for reactivity to common allergens by skin prick tests (SPTs) and for parasitic infections by stool examination. Additionally, questionnaires were completed to record allergic symptoms the children may have experienced. Results: Positive SPTs were found in 237/587 children (40.4%), and about one‐third of whom were polysensitized. Sensitizations were most frequently detected against the house dust mites (HDM) Dermatophagoides spp. (31.9%) and Blomia tropicalis (21.0%). Infections with geohelminths ( Ascaris lumbricoides, Trichuris trichiura ) were found in 26.8% and protozoan infections ( Giardia intestinalis, Cryptosporidia spp.) in 13.9% of study participants. Mixed logistic regression analyses revealed negative associations between parasite infection and sensitization to Blomia tropicalis (OR: 0.54, 95% CI 0.33–0.89) and to Dermatophagoides spp. (OR 0.65, 95% CI 0.43–0.96), and between protozoan infection and allergic sensitization to any aeroallergen, although these associations were not significant when adjusted for false discovery. Geohelminth infection and intensity of geohelminth infection were both associated with reduced risk of polysensitization (OR 0.41, 95% CI 0.21–0.86), and this association remained significant with adjustment for false discovery. Reported respiratory symptoms were associated with HDM sensitization (ORs from 1.54 to 2.48), but not with parasite infection. Conclusions and clinical relevance: Our data suggest that geohelminth infection and high geohelminth infection intensity are associated with a reduced risk of polysensitization. Abstract : Schoolchildren from low‐income communities in Gqeberha, South Africa, were investigated for intestinal parasite infections and its impact on allergic sensitization. A questionnaire was used to report previous and current allergic symptoms. About 40% exhibited at least one sensitization with HDMs being the most prevalent allergen. While helminth infections were associated with a reduced risk of polysensitization, inverse associations between sensitization in general and protozoa infection were found.