human helminth co-infection analysis of spatial patterns and risk factors in a brazilian community合并感染人类寄生虫的空间模式和风险因素分析巴西的社区.pdfVIP

Human Helminth Co-Infection: Analysis of Spatial Patterns and Risk Factors in a Brazilian Community 1 2,3 2,3 1 2 Rachel L. Pullan *, Jeffrey M. Bethony , Stefan M. Geiger , Bonnie Cundill , Rodrigo Correa-Oliveira , Rupert J. Quinnell4, Simon Brooker1 ´ 1 London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 Rene Rachou Research Centre FIOCRUZ, Belo Horizonte, Brazil, 3 The George Washington University, Washington D.C., United States of America, 4 University of Leeds, Leeds, United Kingdom Abstract Background: Individuals living in areas endemic for helminths are commonly infected with multiple species. Despite increasing emphasis given to the potential health impacts of polyparasitism, few studies have investigated the relative importance of household and environmental factors on the risk of helminth co-infection. Here, we present an investigation of exposure-related risk factors as sources of heterogeneity in the distribution of co-infection with Necator americanus and Schistosoma mansoni in a region of southeastern Brazil. Methodology: Cross-sectional parasitological and socio-economic data from a community-based household survey were combined with remotely sensed environmental data using a geographical information system. Geo-statistical methods were used to explore patterns of mono- and co-infection with N. americanus and S. mansoni in the region. Bayesian hierarchical models were then developed to identify risk factors for mono- and co-infection in relation to community-based survey data to assess their roles in explaining observed heterogeneity in mono and co-i