Martial L Ndeffo Mbah1, Eric M Poolman2, Paul K Drain3,4, Megan P Coffee5, Marieke J van der Werf6,7, Alison P Galvani1. 1. School of Public Health, Yale University, New Haven, Connecticut. 2. Department of Family Medicine, Oregon Health & Science University, Portland, Oregon. 3. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 4. Department of Medicine and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts. 5. Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. 6. KNCV Tuberculosis Foundation, The Hague, The Netherlands. 7. CINIMA, University of Amsterdam, Amsterdam, The Netherlands.
Abstract
OBJECTIVE: Epidemiological studies have observed that genital schistosomiasis increases the risk of HIV infection in Africa. We analysed the correlation between Schistosoma haematobium prevalence and HIV prevalence across sub-Saharan African countries. DESIGN: Regression analysis of prevalence of HIV and S. haematobium across sub-Saharan African countries. METHODS: Using compiled country-level S. haematobium prevalence, HIV prevalence and other demographic and economic data from published sources, we applied univariate and multivariate regression models to assess the correlations between S. haematobium prevalence and HIV prevalence while controlling for risk factors associated with each infection. RESULTS: In 43 sub-Saharan African countries, the mean prevalence of S. haematobium was 22.4% [standard deviation (SD): 9.8%] and for HIV was 6.21% (SD: 5.71%). In multivariate analysis, adjusted for prevalence of male circumcision, years since a country's first HIV/AIDS diagnosis, geographical region and immunization coverage, each S. haematobium infection per 100 individuals was associated with a 2.9% (95% CI: 0.2-5.8%) relative increase in HIV prevalence. S. haematobium was not associated with Schistosoma mansoni, HSV-2, hepatitis C, malaria or syphilis. CONCLUSIONS: Schistosoma haematobium prevalence was associated with HIV prevalence in sub-Saharan Africa. Controlling S. haematobium may be an effective means of reducing HIV transmission in sub-Saharan Africa.
OBJECTIVE: Epidemiological studies have observed that genital schistosomiasis increases the risk of HIV infection in Africa. We analysed the correlation between Schistosoma haematobium prevalence and HIV prevalence across sub-Saharan African countries. DESIGN: Regression analysis of prevalence of HIV and S. haematobium across sub-Saharan African countries. METHODS: Using compiled country-level S. haematobium prevalence, HIV prevalence and other demographic and economic data from published sources, we applied univariate and multivariate regression models to assess the correlations between S. haematobium prevalence and HIV prevalence while controlling for risk factors associated with each infection. RESULTS: In 43 sub-Saharan African countries, the mean prevalence of S. haematobium was 22.4% [standard deviation (SD): 9.8%] and for HIV was 6.21% (SD: 5.71%). In multivariate analysis, adjusted for prevalence of male circumcision, years since a country's first HIV/AIDS diagnosis, geographical region and immunization coverage, each S. haematobium infection per 100 individuals was associated with a 2.9% (95% CI: 0.2-5.8%) relative increase in HIV prevalence. S. haematobium was not associated with Schistosoma mansoni, HSV-2, hepatitis C, malaria or syphilis. CONCLUSIONS:Schistosoma haematobium prevalence was associated with HIV prevalence in sub-Saharan Africa. Controlling S. haematobium may be an effective means of reducing HIV transmission in sub-Saharan Africa.
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