Soil-transmitted helminth infection and skin prick test reactivity in children

Main Article Content

Schenny Regina Lubis
Lily lrsa
Rita Evalina
Supriatmo Supriatmo
M. Sjabaroeddin


Background Allergic diseases cause an increasingly large
burden in developed countries and in urban areas of middleincome
countries . Paras itic infections may induce allergic
responses in humans, particularly soil-transmitted helminth
(STH) infections that are prevalent in childhood in developing
countries. Although soil-transmitted helminth infec tions have
been associated with lower prevalence of allergen skin test
reactivity, study outcomes remain inconclusive.
Objective To analyze for an association between STH infections
and skin prick test reactivity in children.
Methods We conducted a cross-sectional study in August 2009
among primary school students aged 7- 12 years, at Secanggang
Subdistrict, Langkat District, North Sumatera Province. Sixty
eight children were recruited in this study consisted of 34 children
with STH infections and the other 34 children without any STH
infection. Soil-transmitted helminth infections were determined
by Kato-Katz stool examination s. All subjects underwent skin
prick tests for seven allergens. Results were con sidered to be
positive if wheal diameters 2: 3 mm and negative when wheal
diameters < 3 mm. Data was an alysed by Chi-square test.
Results Stool examinations revealed that the most common
infec tion was T. trichiura (18/34 subjects), followed by mixed
infections (T. trichiura and A lumbricoides; 12/34 subjects), and
A. lumbricoides (4134 subjects). There was a significant association
between STH infections and negative skin prick test (P= 0.002).
In addition, there were significant associations with negative skin
prick tests for each helminth type: A. lumbricoides (P=0.001) ,
T. trichiura (P=0.01) and mixed infection (P = 0.006). Severe
infection intensity was also significantly associated with negative
skin prick tests (P=0.031) .
Conclusion Children with STH infections tend to have negative
skin prick test results.

Article Details

How to Cite
Lubis S, lrsa L, Evalina R, Supriatmo S, Sjabaroeddin M. Soil-transmitted helminth infection and skin prick test reactivity in children. PI [Internet]. 28Feb.2014 [cited 23Feb.2020];54(1):52-. Available from:
Received 2016-08-16
Accepted 2016-08-16
Published 2014-02-28


1. Flohr C, Quinnell RJ, Britton J. Do helminth parasites protect against atopy and allergic disease? Clin Exp Allergy. 2009;39:20-32.
2. Cooper JP, Chico ME, Bland M, Griffin GE, Nutman TB. Allergic symptoms, atopy, and geohelminth infection s in a rural area of Ecuador. Am J Resp Crit Care Med. 2003;168:313-7.
3. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lan cet. 1998;351:1225-32.
4. Hunninghake GM, Soto-Quiros ME, Avila L, Ly NP, Liang C, Sylvia JS, et al. Sensitization to Ascaris lumbricoides and severity of childhood asthma in Costa Rica. J Allergy Clin Immunol. 2007;119:654-61.
5. Rahmawati, Punagi AQ, Savitri E. Relationship between rhinitis severity, skin prick test reactivity and mite-specific immunoglobulin E in allergic rhinitis patients in Makassar. Med J Indonesia. 2008;1:1-9.
6. Cooper PJ, Barreto ML, Rodrigues LC. Human allergy and geohelminth infections: a review of the literature and proposed conceptual model to guide the investigation of possible causal associations. Br Med Bull. 2006;79-80:203-8.
7. Rodrigues LC, Newcombe PJ, Cunha SS, Alcantara-Neves NM, Genser B, Cruz AA, et al. Early infection with Trichuris trichura and allergen skin test reactivity in later childh ood. Clin Exp Allergy. 2008;38:1769-77.
8. Morris A. Atopy, anamnesis and allergy testing. InnovAiT. 2009;2:158-65.
9. Munasir Z. Pemeriksaan penunjang klinis: uji kulit terhadap alergen. In: Akib AAP, Munasir Z, Kumiati N, editors. Buku ajar alergi imunologi anak. 2nd ed. Jakarta: Ikatan Dokter Anak Indonesia; 2007. p. 445-7.
10. Montresor A, Crompton DWI; Hall A, Bundy DAP, Savioli L. In: Guidelines for the evaluation of soil-transmitted helminthiasis and schistosomiasis of community level. Geneva: World Health Organization; 1998. p. 3-49.
11. Firmansyah I, Ginting SA, Lubis M, Lubis IZ, Pasaribu S, Lubis CP. Factors associated with the transmission of soiltransmitted helminthiasis among schoolchildren. Pediatr Indones. 2004;43:127-32.
12. Dalimunthe W, Siregar C, Lubis M, Pasaribu S, Lubis CP. Treatment of intestinal helminthiasis: mebendazole only or mebendazole-pyrantel pamoate? Paediatr Indones. 2007;47:216-20.
13. Palmer LJ, Celedon JC, Weiss ST, Wang B, Fang Z, Xu X. Ascaris lumbricoides infection is associated with increased risk of childhood asthma and atopy in rural China. Am J Resp Crit Care Med. 2002;165:1489-93.
14. Perzanowski MS, Ng'ang'a LW, Carter MC, Odhiambo J, Ngari P, Vaughan JW, et al. Atopy, asthma, and antibodies to Ascaris among rural and urban children in Kenya. J Pediatr. 2002;140:582-8.
15. Cooper PJ. Can intestinal helminth infections (geohelminths) affect the development and expression of asthma and allergic disease? Clin Exp Immunol. 2002;128:398-404.
16. Cooper PJ, Chico ME, Rodrigues LC, Ordonez M, Strachan D, Griffin GE, et al. Reduced risk ofatopy among school-agechildren infected with geohelminth parasites in a rural area of the tropics. J Allergy Clin Immunol. 2003;111:995-1000.
17. Wordemann M, Diaz RJ, Heredia LM, Collado Madurga AM, Ruiz Espinosa A, Prado RC, et al. Association of atopy, asthma, allergic rhinoconjunctivitis, atopic dermatitis and intestinal helminth infections in Cuban children. Trop Med Int Health. 2008;13:180-6.
18. Yazdanbakhsh M, Kremsner PG, van Ree R. Allergy, parasites and the hygiene hypothesis. Science. 2002;296:490-4.
19. Cooper PJ, Chico ME, Sandoval C, Nutman TB. Atopic phenotype is an important determinant of immunoglobulin E-mediated inflammation and expression of T helper cell type 2 cytokines to ascaris antigens in children exposed to ascariasis. J Infect Dis. 2004;190:1338-46.
20. Turner JD, Jackson JA, Faulkner H, Behnke J, Else KJ, Kamngo J, et al. Intensity of intestinal infection with multiple worm species is related to regulatory cytokine output and immune hyporesponsiveness. J Infect Dis. 2008;197:1204-12.
21. Van den Biggelaar A, Rodrigues LC, van Ree R, van der Zee JS, Hoeksma-Kruize YC, Souverijn JH, et al. Long-term treatment of intestinal helminths increases mite skin test reactivity in Gabonese schoolchildren. J Infect Dis. 2004;189:892-900.
22. Lynch NR, Hagel I, Perez M, Di Prisco MC, Lopez R, Alvarez N. Effect of anthelmintic treatment on the allergic reactivity of children in a tropical slum. J Allergy Clin Immunol. 1993;92:404-11.