Validez de los estudios de asociación entre geohelmintos e incidencia de malaria: ¿Debería impactar las políticas de salud?

Abstract

Introduction: The global distribution of malaria and soil-transmitted helminths is widely overlapped. Some studies suggest a possible association between helminth infection and incidence of malaria. Objectives: To identify the available epidemiologic evidence and to assess the validity of these studies. Methods: A systematic review was carried out in specialized databases. The studies identified were critically analyzed and ranked according to the U.S. Preventive Services Task Force's classification. The major methodological limitations of each study were identified. Results: Six studies on the topic were found. Only two studies had a high evidence level (level I), three had level II-2, and one had level III-3. There are important methodological limitations for clarifying the association between soiltransmitted helminths and the incidence of malaria. Conclusion: It is too early to discuss the potential public health implications of these findings, given the lack of studies and limited validity of the evidence available. Further studies with new methodological considerations could improve the knowledge on the association. However, it is more important to carry out actions on structural determinants to control and prevent the occurrence of both diseases.

Correlación entre la incidencia de malaria y la prevalencia de las geohelmintiasis en Colombia: enfoque ecológico

“…This implies that the ecological risk of acquiring both diseases may not be the same in all cases. The fact that some of the previous studies did not strictly control for confounding variables may allow confounding to operate in single level studies as it does in ecological ones (26). Given the characteristics of ecologic studies as hypotheses generators, we cannot go far beyond in concluding about this particular aspect.…”

“…Overlapping and co-determination are mainly population phenomena with individual effects although certainly they also represent some equivalent common causes on an individual level. Some co-determinants could be individual, others ecological and some could work at both levels (26). Co-morbidity is originated from a population event but has a clinical individual representation.…”