A longitudinal study of allergy and intestinal helminth infections in semi urban and rural areas of Flores, Indonesia (ImmunoSPIN Study)

This study was designed to assess how intestinal helminth infections can influence the immune response and atopic and allergic disorders in children in Indonesia. The relations between allergic outcomes and infection and lifestyle factors will be addressed. This study was set up among school-age children in semi urban and rural areas, located in Ende District of Flores Island, Indonesia. A randomized placebo-controlled anthelmintic treatment trial to elucidate the impact of helminth infections on the prevalence of skin prick test (SPT) reactivity and symptoms of allergic diseases will be performed. The children living in these semi-urban and rural areas will be assessed for SPT to allergens before and after 1 and 2 years of treatment as the primary outcome of the study; the secondary outcome is symptoms (asthma and atopic dermatitis); while the tertiary outcome is immune responses (both antibody levels to allergens and cellular immune responses).The study will provide information on the influence of helminth infections and anthelmintic treatment on immune response, atopy and allergic disorders.Current Controlled Trials ISRCTN: ISRCTN83830814Helminth infections are highly prevalent worldwide, with more than two billion people chronically infected by soil transmitted helminths such as Ascaris lumbricoides, Trichuris trichiura and/or hookworms (Necator americanus or Ancylostoma duodenale) [1]. These enteric infections affect populations living in subtropical and tropical regions of low-middle income countries, where access to hygiene, sanitation and source of clear water is limited [2]. The immune responses mounted to helminth infections is characterized by T-helper type 2 (Th2), which are thought to be protective [3]. However, there is also evidence that these parasites might enhance their own survival by modulating the immune responses of their host by inducing regulatory responses that dampen activity of effector cells [4]. Whether all different helminths are equall