Health outcomes evaluation of children with gastrointestinal parasitic - Chagas Disease co-infection
Melissa Nolan, PhD, MPH
BACKGROUND: Infection from GI parasites and T. cruzi parasite (Chagas disease) is largely nonspecific in children, resulting in chronic infections that sub-clinically progress until advanced morbidity has occurred. Infection with more than one GI parasite type has been shown to hamper the host immunologic response, creating a greater susceptibility to acquiring new infections and having greater overall parasite count burden; however, the host mediated response to co-infection between T. cruzi parasite (Chagas Disease) and GI parasites has yet to be elucidated.
GAP: It is unknown if co-infection results in an alteration of the Th1 v Th2 immunologic polarization, resulting in a higher GI parasitic load and subsequently worse clinical outcomes in children.
HYPOTHESIS: Co-infected children will have statistically significant worse health outcomes, defined by four specific clinical measurements in scientific summary, than singularly infected and seronegative children. Co-infected children will have significantly reduced Th1 cytokine levels than their comparison groups, reflective of their overall impaired ability to clear GI parasitic infections, resulting in higher total parasitic burden (egg count) and establishment of chronic infection despite history of past anti-parasitic treatment.
METHODS: From children concurrently enrolling in our Chagas disease surveillance study, we will collect fecal samples for MP-qPCR testing of 8 common GI parasites, collect sera samples for Th1/Th2 cytokine profiling, and collect clinical data from a study health survey and medical chart records.
IMPACT: We will evaluate post-treatment parasite clearance (Chagas disease and GI parasite), as we hypothesize that co-infected children will have higher parasite loads and will need different therapeutic regimens to clear both infections. The results of this study has the potential to improve the current therapies available for kids worldwide suffering from GI parasites and Chagas disease.