C-reactive protein and high-sensitivity C-reactive protein levels in asymptomatic intestinal parasite carriers from urban and rural areas of Gabon

Abstract

AbstractBackgroundChronic carriage of intestinal parasitic infections (IPIs) can induce chronic inflammation and dysbiosis, which are risk factors for non-communicable diseases. The objective of this study was to determine the relationship between IPI carriage and inflammation in a population of volunteers living in Gabon.Methodology and Principal FindingsA cross-sectional study was conducted from September 2020 to November 2021 in asymptomatic participants aged 18 years and over residing in different areas of Gabon: Libreville (urban area) and Koula-Moutou and Bitam (rural areas). The detection of IPIs was carried out using common techniques. Inflammation markers, C-reactive protein (CRP), and high-sensitivity C-reactive protein (hsCRP) were assayed. Overall, 518 participants were included, 64.5% (n = 334) of whom resided in urban area and 35.5% (n = 184) in rural areas. The median age was 35 years [27; 46]. The prevalence of asymptomatic IPIs was 29.9% (n = 155), with a significantly higher frequency in rural areas than in urban area (adjusted OR 6.6 [CI 3.2-13.8],p< 0.01). Protozoa were more frequent than soil-transmitted helminths (STHs) in both areas: 81.6% (n = 40) in urban area and 69.8% (n = 74) in rural areas. STHs were predominant in rural areas (48.1%) than in urban area (22.4%). High concentrations of hsCRP and CRP were significantly more frequent in inhabitants of rural areas (23.4% (n = 43) and 56.5% (n = 104), respectively (p< 0.01) than those of urban area (11.1% (n = 37) and 34.5% (n = 116), respectively;p<0.01). High levels were more frequent in parasitized individuals (for hsCRP, 22.6%, n = 35,p< 0.01, for CRP, 52.9%, n = 82;p< 0.01); in particular among STH carriers (for hsCRP; 65.9%, n = 27,p <0.01, for CRP: 36.6%, n = 15;p< 0.01).Conclusions/SignificanceThis first study showed that asymptomatic IPIs, especially STHs, are associated with higher CRP and hsCRP levels. Others biomarkers of inflammation must be analyzed to confirm the relationship between asymptomatic IPIs and chronic inflammation.Author summaryRepeated or chronic parasitism can maintain local or systemic chronic inflammation, CRP and hsCRP are sensitive biomarkers of subclinical low-grade inflammation. This study assessed the serum levels of CRP and hsCRP in adults with or without intestinal parasite (IPI) carriage according to residence area and parasite species. IPI chronic carriage, especially with pathogenic protozoa and/or STH, was associated with higher levels of CRP and hsCRP. These findings suggest that intestinal parasite carriage contributes to low grade systemic inflammation which is a driver of NCD. The role of chronic carriage of other enteropathogens on chronic inflammation status as well the relationship between IPI and dysbiosis should be further analyzed in endemic countries.