Parasitic diseases of the global poor: from understanding complex host-parasite interactions to sustainable control

• Forschungsstelle: TPH
• Projektnummer: 6.11
• Projekttitel Englisch: Parasitic diseases of the global poor: from understanding complex host-parasite interactions to sustainable control

Schlüsselwörter (Englisch)

Parasitic diseases; host-parasite interactions; malaria; schistosomiasis; soil-transmitted helminthiasis; food-borne trematodiasis; integration and sustainability; diagnosis and prognosis; NMR-based metabonomics; epidemiology

Projektziele (Englisch)

The two main objectives of my research programme include:

(1) To enhance fundamental knowledge of the complex host-to-parasite cross-talk, facilitated through an iterative process, integrating large-scale longitudinal community-based surveys with modern laboratory investigations and innovative spatial statistical approaches.

(2) To develop and validate innovative tools for assessment and prediction of communities at risk of single and multiple parasitic infections and disease-attributable morbidity, and to evaluate the impact and sustainability of control strategies in the broadest possible manner, including social wellbeing and equity.

Abstract (Englisch)

The focus of my research programme is on parasitic diseases of the global poor, with an emphasis on malaria, schistosomiasis, soil-transmitted helminthiasis (STH) and food-borne trematodiasis. Some of the most intriguing questions are the understanding of the complex host-parasite interactions. This implies fundamental investigations of the host-to-parasite cross-talk, and the interplay between the diseases and risk factors operating at different scales. Recognising the challenges of addressing these issues, I pursue four main research questions:
(1) How can the dynamics of multiple species parasitic infections and disease-attributable morbidity be captured and what is the scope and limitation of NMR-based metabonomics for individual diagnosis and prognosis, and monitoring of morbidity control programmes?
(2) What are key ecological and socio-economic determinants of infection risk, and how does the combination of epidemiological sample surveys with remotely sensed environmental data and innovative Bayesian spatial statistical modelling improve predictions?
(3) To what extent do demographic and ecological transformations change the frequency and transmission dynamics of parasitic diseases, and what can mitigation strategies achieve?
(4) What is the feasibility and cost-effectiveness of integrated parasitic disease control, and what are social and economic benefits of sustaining these interventions?

My research programme will be facilitated through an iterative process, integrating large-scale community-based longitudinal surveys with modern laboratory investigations and innovative spatial statistical approaches.After these four years of research, we shall enhance, at the individual/community level, knowledge of host-parasite interactions, and establish to what extent NMR-based metabonomics can become a tool for diagnosis and prognosis of multiple parasitic infections and the monitoring of disease control programmes. At the community/regional level, innovative approaches for risk assessment and prediction of disease are developed and validated. At the regional/ecosystem level, connections between demographic/ecological transformation and transmission dynamics of parasitic diseases are quantified. The proposed research will establish unique databases for integrated economic and social policy analyses and the tailoring of strategies for cost-effective and sustainable control of parasitic diseases. We anticipate that our analytical and intervention strategies will guide studies of similar character carried out elsewhere, hence will inspire global control programmes.

Publikationen / Ergebnisse (Englisch)

1. Balen J, Stothard JR, Kabatereine NB, Tukahebwa EM, Kazibwe F, Whawell S, Webster JP, Utzinger J & Fenwick A (2006). Morbidity due to Schistosoma mansoni: an epidemiological assessment of distended abdomen syndrome in Ugandan schoolchildren with observations on 1-year post-treatment follow-up. Transactions of the Royal Society of Tropical Medicine and Hygiene (in press).
2. Betsi NA, Koudou BG, Cissé G, Tschannen AB, Pignol AM, Ouattara Y, Madougou Z, Tanner M & Utzinger J (2006). Effect of an armed conflict on human resources and health systems in Côte d’Ivoire: prevention of and care for people with HIV/AIDS. AIDS Care (in press).
3. Keiser J, Brun R, Fried B & Utzinger J (2006). Trematocidal activity of praziquantel and artemisinin derivatives: in vitro and in vivo investigations on adult Echinostoma caproni. Antimicrobial Agents and Chemotherapy (in press).
4. Wang Y, Utzinger J, Xiao SH, Xue J, Nicholson JK, Tanner M, Singer BH, Holmes E (2006). System level metabolic effects of a Schistosoma japonicum infection in the Syrian hamster. Molecular and Biochemical Parasitology (in press).
5. Keiser J, Engels, Büscher G & Utzinger J (2005). Triclabendazole for the treatment of fascioliasis and paragonimiasis. Expert Opinion on Investigational Drugs 14: 1513-1526.
6. Keiser J, Singer BH & Utzinger J (2005). Reducing the burden of malaria in different eco-epidemiological settings with environmental management: a systematic review. Lancet Infectious Diseases 5: 695-708.
7. Guo JG, Vounatsou P, Cao CL, Utzinger J, Zhu HQ, Anderegg D, Zhu R, He ZY, Li D, Hu F, Chen MG & Tanner M. (2005). A geographic information and remote sensing based model for prediction of Oncomelania hupensis habitats in the Poyang Lake area, China. Acta Tropica 96: 213-222.
8. Zhou XN, Wang LY, Chen MG, Wu XH, Jiang QW, Chen XY, Zheng J, Utzinger J (2005). The public health significance and control of schistosomiasis in China – then and now. Acta Tropica 96: 97-105.
9. Utzinger J, Zhou XN, Chen MG & Bergquist R (2005). Conquering schistosomiasis in China: the long march. Acta Tropica 96: 69-96.
10. Keiser J & Utzinger J (2005). Emerging foodborne trematodiasis. Emerging Infectious Diseases 11: 1507-1514.
11. Erlanger TE, Keiser J, Castro MC, Bos R, Singer BH, Tanner M & Utzinger J (2005). Effect of water resource development and management on lymphatic filariasis, and estimates of populations at risk. American Journal of Tropical Medicine and Hygiene 73: 523-533.
12. Keiser J, Maltese MF, Erlanger TE, Bos R, Tanner M, Singer BH & Utzinger J (2005). Effect of irrigated rice agriculture on Japanese encephalitis, including challenges and opportunities for integrated vector management. Acta Tropica 95: 40-57.
13. Keiser J, Castro MC, Maltese MF, Bos R, Tanner M, Singer BH & Utzinger J (2005). Effect of irrigation and large dams on the burden of malaria on a global and regional scale. American Journal of Tropical Medicine and Hygiene 72: 392-406.
14. Xiao SH, Wu HM, Tanner M, Utzinger J & Wang C (2005). Tribendimidine: a promising, safe and broad-spectrum anthelmintic agent from China. Acta Tropica 94: 1-14.
15. Koudou BG, Tano Y, Doumbia M, Nsanzabana C, Cissé G, Girardin O, Dao D, N’Goran EK, Vounatsou P, Bordmann G, Keiser J, Tanner M & Utzinger J (2005). Malaria transmission dynamics in central Côte d’Ivoire: the influence of changing patterns of irrigated rice agriculture. Medical and Veterinary Entomology 19: 27-37.
16. Keiser J & Utzinger J (2005). Trends in the core literature on tropical medicine: a bibliometric analysis from 1952-2002. Scientometrics 62: 351-365.
17. Ezzati M, Utzinger J, Cairncross S, Cohen AJ & Singer BH (2005). Environmental risks in the developing world: exposure indicators for evaluating interventions, programmes, and policies. Journal of Epidemiology and Community Health 59: 15-22.
18. Utzinger J, Wyss K, Moto DD, N’Diekhor Y, Tanner M & Singer BH (2005). Assessing health impacts of the Chad-Cameroon petroleum development and pipeline project: challenges and a way forward. Environmental Impact Assessment Review 25: 63-93.
19. Bergquist R, Utzinger J, Chollet J, Xiao SH, Weiss NA & Tanner M (2004). Triggering of high-level resistance against Schistosoma mansoni reinfection by artemether in the mouse model. American Journal of Tropical Medicine and Hygiene 71: 774-777.
20. Wang Y, Holmes E, Nicholson JK, Cloarec O, Chollet J, Tanner M, Singer BH & Utzinger J (2004). Metabonomic investigations in mice infected with Schistosoma mansoni: an approach for biomarker identification. Proceedings of the National Academy of Sciences USA 101: 12676-12681.
21. Castro MC, Yamagata Y, Mtasiwa D, Tanner M, Utzinger J, Keiser J & Singer BH (2004). Integrated urban malaria control: a case study in Dar es Salaam, Tanzania. American Journal of Tropical Medicine and Hygiene 71 (Suppl. 2): 103-117.
22. Keiser J, Utzinger J, Castro MC, Smith TA, Tanner M & Singer BH (2004). Urbanization in sub-Saharan Africa and implication for malaria control. American Journal of Tropical Medicine and Hygiene 71 (Suppl. 2): 118-127.
23. Keiser J & Utzinger J (2004). Chemotherapy for major food-borne trematodes: a review. Expert Opinion on Pharmacotherapy 5: 1711-1726.
24. Xiao SH, Guo J, Chollet J, Wu JT, Tanner M & Utzinger J (2004). Effect of artemether on Schistosoma mansoni: dose-efficacy relationship, and changes in worm morphology and histopathology. Chinese Journal of Parasitology and Parasitic Diseases 22: 148-153.
25. Keiser J, Utzinger J, Tanner M & Singer BH (2004). Representation of authors and editors from countries with different human development indexes in the leading literature on tropical medicine: survey of current evidence. BMJ 328: 1229-1232.
26. Utzinger J, Wyss K, Moto DD, Tanner M & Singer BH (2004). Community health outreach program of the Chad-Cameroon petroleum development and pipeline project. Clinics in Occupational and Environmental Medicine 4: 9-26.
27. Xiao SH, Yao JM, Utzinger J, Cai Y, Chollet J & Tanner M (2004). Selection and reversal of Plasmodium berghei resistance in the mouse model following repeated high doses of artemether. Parasitology Research 92: 215-219.
28. Utzinger J & Keiser J (2004). Schistosomiasis and soil-transmitted helminthiasis: common drugs for treatment and control. Expert Opinion on Pharmacotherapy 5: 263-285.
29. Girardin O, Dao D, Koudou BG, Essé C, Cissé G, Yao T, N’Goran EK, Tschannen AB, Bordmann G, Lehmann B, Nsabimana C, Keiser J, Killeen GF, Singer BH, Tanner M & Utzinger J (2004). Opportunities and limiting factors of intensive vegetable farming in malaria endemic Côte d’Ivoire. Acta Tropica 89: 109-123.