Helminth infections on Flores Island, Indonesia : associations with communicable and non-communicable diseases

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Helminth infections on Flores Island, Indonesia : associations with communicable and non-communicable diseases

Title: Helminth infections on Flores Island, Indonesia : associations with communicable and non-communicable diseases
Author: Wiria, Aprilianto Eddy
Publisher: Department of Parasitology, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Issue Date: 2013-06-13
Keywords: Helminth
Hyporesponsiveness
Immune modulation
Albendazole
Insulin sensitivity
Atherosclerosis
Metabolic syndrome
Epidemiologic transition
Allergy
Indonesia
Abstract: In this thesis we reported our investigations of the relationship between soil-transmitted helminths (STH) and a number of outcomes, in particular malaria, insulin resistance (a marker for type-2 diabetes (T2D)) and atherosclerosis (a marker for cardiovascular diseases (CVD)) on Flores island, Indonesia. In the study on Flores Island, the use of albendazole as a single dose at three monthly intervals decreased helminth infections significantly. However, this intensive deworming could not eliminate helminth infections. Despite no effect on malaria parasitemia and clinical symptoms was found, we noted that in vitro immune responses were improved after albendazole treatment and significant increases in malaria-specific and mitogen-induced tumor necrosis factor and interferon γ cytokine production were observed. We also reported that helminth infections are associated with improved insulin sensitivity and lower risk factors for CVD. A possible approach to confirm our results will be a long-term, well-powered, placebo controlled (adequate) anthelminthic trials to investigate asymptomatic malaria (in area where clinical malaria is highly prevalent); as well as to study whether alleviation of helminthic pressure is inversely correlated with anti-inflammation, lipid levels and insulin sensitivity, and therefore leads to an accelerated development of T2D and CVD.
Description: Promotor: M. Yazdanbakhsh, Co-Promotores: T. Supali, E. Sartono
With Summary in Dutch
Faculty: LUMC
Citation: Wiria, A.E., 2013, Doctoral Thesis, Leiden University
ISBN: 9789461822765
Sponsor: The Royal Netherlands Academy of Arts and Science (KNAW), Ref.KNAW-05-PP-35, European Commission contracts INCO-CT-2006-031714 and INCO-CT-2006-032436, and the Prof. Dr. P.C. Flu Foundation
Handle: http://hdl.handle.net/1887/20945
 

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