Relationship between different species of helminths and atopy: a study in a population living in helminth-endemic area in Sulawesi, Indonesia.

BACKGROUND

The association between allergen skin sensitization and helminth infection has been debated for years. Here, we sought to estimate the prevalence of atopic sensitization of residents living in area endemic for lymphatic filariasis and intestinal helminths and to investigate the association between these different species of helminths with allergen skin test reactivity to allergens.

METHODS

Five hundred and eighty-three individuals living in an area endemic for Brugia malayi and for intestinal helminths were skin prick tested using 3 allergens. Microfilariae were enumerated by filtration of 1 ml nocturnally collected blood, and 442 stool samples were examined for the presence of intestinal helminth eggs.

RESULTS

The prevalence of skin prick test positivity to any allergen was 23.5% (to cockroach 20.6%, to house dust mite 6.2% and to grass pollen 1.2%). Individuals with B. malayi infection had a significantly reduced risk for atopic reactivity to cockroach (adjusted odds ratio 0.56, 95% CI 0.35-0.88). In the same population, no association was found between the presence of intestinal helminths and any skin test reactivity.

CONCLUSIONS

In a general population, across all ages in a rural area of Indonesia, the prevalence of skin test reactivity to house dust mite is as low as in other non-affluent countries, and infection with B. malayi appears to reduce the risk of skin reactivity to cockroach. On the other hand, we found no association between infection with intestinal helminths and skin test reactivity to aeroallergens.