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Background   Schistosoma  infection is associated with immune modulation that can influence responses to non-schistosome antigens. Vaccine responses may be impaired in  S .  mansoni -infected individuals. We investigated effects of  S .  mansoni  infection on responses to childhood measles catch-up immunisation and of praziquantel treatment on this outcome in a randomised trial.    Methodology  The Immune Modulation and Childhood Immunisation (IMoChI) study was based in Entebbe, Uganda. Children aged 3–5 years (193  S .  mansoni -infected and 61 uninfected) were enrolled. Infected children were randomised in a 1:1:1 ratio to receive praziquantel 2 weeks before, at time of, or 1 week after, measles catch-up immunisation. Plasma anti-measles IgG was measured at enrolment, 1 week and 24 weeks after measles immunisation. Primary outcomes were IgG levels and percentage of participants with levels considered protective against measles.    Results  Anti-measles IgG levels increased following immunisation, but at 1 week post-immunisation  S .  mansoni -infected, compared to uninfected, children had lower levels of anti-measles IgG (adjusted geometric mean ratio (aGMR) 0.4 [95% CI 0.2–0.7]) and the percentage with protective antibody levels was also lower (adjusted odds ratio 0.1 [0–0.9]). Among  S .  mansoni -infected children, anti-measles IgG one week post-immunisation was higher among those treated with praziquantel than among those who were not yet treated (treatment before immunisation, aGMR 2.3 [1.5–4.8]; treatment at immunisation aGMR 1.8 [1.1–3.5]). At 24 weeks post-immunisation, IgG levels did not differ between the trial groups, but tended to be lower among previously-infected children who were still  S mansoni  stool-positive than among those who became stool-negative.    Conclusions and significance  Our findings suggest that  S .  mansoni  infection among pre-school children is associated with a reduced antibody response to catch-up measles immunisation, and that praziquantel treatment improves the response.  S .  mansoni  infection may contribute to impaired vaccine responses in endemic populations; effective schistosomiasis control may be beneficial for vaccine efficacy. This should be further explored.    Trial registration   ISRCTN87107592 .

plos neglected tropical diseases

Effect of Schistosoma mansoni infection and its treatment on antibody responses to measles catch-up immunisation in pre-school children: A randomised trial