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dc.contributor.authorvan Soelen, Neldaen_US
dc.contributor.authorMandalakas, Anna Men_US
dc.contributor.authorKirchner, H Lesteren_US
dc.contributor.authorWalzl, Gerharden_US
dc.contributor.authorGrewal, Harleen M. S.en_US
dc.contributor.authorJacobsen, Marcen_US
dc.contributor.authorHesseling, Anneke C.en_US
dc.date.accessioned2014-10-28T13:36:26Z
dc.date.available2014-10-28T13:36:26Z
dc.date.issued2012-09-11eng
dc.identifier.issn1471-2334
dc.identifier.urihttps://hdl.handle.net/1956/8691
dc.description.abstractBackground: 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. Methods: We 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. Results: Of 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. Conclusions: Our 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_US
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/2.0eng
dc.subjectTuberculosiseng
dc.subjectHelminth infectioneng
dc.subjectAscariseng
dc.subjectM.tb infectioneng
dc.subjectImmune polarizationeng
dc.subjectPaediatric tuberculosiseng
dc.titleEffect of Ascaris Lumbricoides specific IgE ontuberculin skin test responses in children in a high-burdensetting: a cross-sectional community-based studyen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2013-08-23T09:08:18Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2012 van Soelen et al.; licensee BioMed Central Ltd
dc.rights.holderNelda van Soelen et al.; licensee BioMed Central Ltd.
dc.source.articlenumber211
dc.identifier.doihttps://doi.org/10.1186/1471-2334-12-211
dc.identifier.cristin995000
dc.source.journalBMC Infectious Diseases
dc.source.4012


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