Completed Pregnancy, Children & Inherited Conditions Infection & Immunity

Helminths and Allergy in Uganda.

Funder Wellcome Charity-funded
Recipient organisation London School of Hygiene & Tropical Medicine
Funding £3.2M
Period Sept 2011 — Jul 2019

In plain English

AI plain-English summary

In Uganda, researchers are treating 3,000 households for parasitic worms to see if that triggers a surge in allergies. The project tackles a long-standing puzzle: in wealthy countries, allergies are common, but in many low-income regions with widespread helminth infections, allergies are rare. Animal experiments suggest worms suppress allergic immune responses, but whether this holds true in humans—and what happens when you remove the worms—remains unknown. This study directly tests that by comparing island communities with high worm prevalence against a mainland area where infections have recently dropped. If the hypothesis is correct, mass deworming programmes—a major public health success—could inadvertently unleash a wave of asthma, eczema, and hay fever in previously protected populations. The research also tracks children from before birth to school age, asking whether early-life worm exposure permanently shapes the immune system. Molecular analysis will identify the specific immune pathways involved. This is fundamental science with immediate practical stakes. The findings could reshape how global health agencies balance deworming campaigns against the risk of rising allergic disease, particularly in sub-Saharan Africa.

View original technical description
There is strong evidence from animal models that helminth infections can protect against allergic disease. Our key goal is to determine whether this is important in humans and, if so, to determine the implications for public health, and for development of interventions against allergic conditions. This programme, in Entebbe and the nearby islands of Lake Victoria, Uganda, will study interactions between helminths and allergy among 3000 households, and in an established birth cohort, the Ent ebbe Mother and Baby Study (EMaBS). Through a cluster-randomised trial of standard versus intensive anthelminthic intervention in the island communities (where helminth prevalence is still high), and an observational study of standard intervention in Entebbe (where helminth prevalence has recently declined sharply), we will address the hypothesis that effective anthelminthic treatment will result in an epidemic of allergy in low-income countries. By examining effects of interventions in ut ero and in under-fives on allergy outcomes at school-age in EMaBS, we will investigate the hypothesis that helminth exposure early in life is critical. We will apply cutting-edge molecular techniques to determine immunological pathways involved in effects of helminths on responses to allergens in humans, and to determine whether long-term effects on these pathways are established in early life.

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Researchers

Alison Elliott (EPMC Awardee)

Related Research

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Original classification

Residual Award

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