Schistosoma-Salmonella co-infection in Africa: Epidemiology, biological mechanisms, and antimicrobial resistance: A systematic review and meta analysis.
Brhane Berhe, Hadush Negash, Tesfay Abadi et al.
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In 30 seconds
This systematic review and meta-analysis synthesized evidence on the epidemiology, proposed biological mechanisms, and antimicrobial resistance associated with Schistosoma–Salmonella co-infection in Africa. Using a random-effects model, the authors estimated an overall pooled co-infection prevalence of 9%. Prevalence differed by Schistosoma species: 4% for S. mansoni–Salmonella and 12% for S. haematobium–Salmonella. Country-level estimates also varied. The review describes immune modulation, tissue pathology, and parasite–bacterium interactions as mechanisms that may support persistent infection and compromise treatment efficacy.
Key findings
- Pooled prevalence of Schistosoma–Salmonella co-infection in Africa was 9%.
- Species-specific pooled prevalence was 4% for S. mansoni–Salmonella and 12% for S. haematobium–Salmonella co-infection.
- Country estimates varied; S. haematobium–Salmonella prevalence was 0% in Ethiopia, 25% in Sudan, and 8% in Nigeria.
Why it matters
The pooled estimate and variation by parasite species and country indicate that co-infection is a relevant, though potentially unevenly distributed, public health concern. The proposed interactions between the parasite and bacterium may help explain persistent infection and reduced therapeutic efficacy. Recognising this overlap can inform surveillance and research on diagnosis and integrated control.