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Dances with worms: the ecological and evolutionary impacts of deworming on coinfecting pathogens

机译：与蠕虫共舞：驱虫对共感染病原体的生态和进化影响

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SUMMARY Parasitic helminths are ubiquitous in most host, including human, populations. Helminths often alter the likelihood of infection and disease progression of coinfecting microparasitic pathogens (viruses, bacteria, protozoa), and there is great interest in incorporating deworming into control programmes for many major diseases (e.g. HIV, tuberculosis, malaria). However, such calls are controversial; studies show the consequences of deworming for the severity and spread of pathogens to be highly variable. Hence, the benefits of deworming, although clear for reducing the morbidity due to helminth infection per se, are unclear regarding the outcome of coinfections and comorbidities. I develop a theoretical framework to explore how helminth coinfection with other pathogens affects host mortality and pathogen spread and evolution under different interspecific parasite interactions. In all cases the outcomes of coinfection are highly context-dependent, depending on the mechanism of helminth-pathogen interaction and the quantitative level of helminth infection, with the effects of deworming potentially switching from beneficial to detrimental depending on helminth burden. Such context-dependency may explain some of the variation in the benefits of deworming seen between studies, and highlights the need for obtaining a quantitative understanding of parasite interactions across realistic helminth infection ranges. However, despite this complexity, this framework reveals predictable patterns in the effects of helminths that may aid the development of more effective, integrated management strategies to combat pathogens in this coinfected world.
机译：小结寄生虫蠕虫在包括人在内的大多数宿主中无处不在。蠕虫通常会改变同时感染微寄生病原体（病毒，细菌，原生动物）的感染和疾病进展的可能性，因此人们非常希望将驱虫纳入许多主要疾病（例如HIV，结核病，疟疾）的控制程序中。但是，这种呼吁是有争议的。研究表明，驱虫对病原体的严重程度和传播的影响是高度可变的。因此，驱虫的好处，尽管很明显可以减少由蠕虫感染引起的发病率，但对于合并感染和合并症的结果尚不清楚。我建立了一个理论框架，探讨蠕虫与其他病原体的共感染如何在不同种间寄生虫相互作用下影响宿主死亡率以及病原体的传播和进化。在所有情况下，合并感染的结果在很大程度上取决于上下文，具体取决于蠕虫-病原体相互作用的机制和蠕虫感染的定量水平，根据蠕虫的负担，驱虫的效果可能会从有益变为有害。这种上下文相关性可以解释研究之间在驱虫益处上的某些差异，并强调需要获得对现实蠕虫感染范围内寄生虫相互作用的定量了解。然而，尽管如此复杂，但该框架揭示了蠕虫作用的可预测模式，这可能有助于开发更有效的综合管理策略来对抗这个共同感染的世界中的病原体。

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