Abstract:
Background: Fishing communities on the shores of Lake Victoria are at high risk of schistosome infections, and
at the same time, also considered at high risk of HIV infection due to factors associated with lifestyle or poor access
to health services. In the absence of targeted interventions, the burden of schistosome-HIV co-infections continues
to be high among such populations.
Methods: Fishing communities living along the shores of Lake Victoria were recruited into immunological cohort
studies investigating the host-parasite interactions in HIV-Schistosome co-infections. We assessed the prevalence
and incidence of both schistosome and HIV infections among fishing communities in western Kenya, and compared
retention rates and ease of follow-up in two completed immunological cohort studies.
Results: At least 25 busy fishing sites were identified and six beaches were selected to participate in the studies.
Up to 314 adults consented to participate in the immunological study on the role of human B cells in resistance to
reinfection with S. mansoni (Cohort 1). Only 214 were able to provide baseline blood samples, while 97 and 34 were
followed for the first and second times, respectively. Of the 191 tested for HIV, 62 (32.5%) were HIV-positive. After
one year HIV seroprevalence had risen to 36.1% among 108 participants who were screened. In the second cohort,
1040 potential participants were approached to participate. Up to 138 (13.3%) did not return after VCT. A total of 622
persons who were HIV positive were enrolled. Overall 35.8% of those eligible for the study had HIV/schistosomiasis
co-infection. The prevalence of other soil transmitted helminthes was: hookworms at 3%, Ascaris lumbricoides at
<1% and Trichuris trichiura at about 1.5%.
Abstract
Conclusions: HIV remains an important factor to consider when planning for neglected tropical diseases (NTD)
community based medical interventions in the region, and HIV interventions should also take into consideration the
endemicity of prevalent NTDs in such settings. On the other hand, fishing communities could benefit from NTD/HIV
co-infection study cohorts even though retention among these highly migrant ccmmunities is still a major issue to
consider, while contributing to research development.
