Observations on possible immunity to reinfection among Kenyan schoolchildren after treatment for Schistosoma mansoni

In February 1977, 306 out of 409 six- to 16-year-old Kenyan schoolchildren were found to be infected with Schistosoma mansoni. Prevalence and intensity were directly related to age and indirectly to the distance between the child's home and the transmission site, but were not related to the child's sex. Most children were treated with hycanthone in July 1977. Pretreatment blood samples were taken from 100 study children for eosinophil counts and measurements of cytotoxic anti-schistosomular antibody levels. Blood and faecal samples were re-examined five times between November 1977 and July 1979. Whole school resurveys in July 1978 and 1979 confirmed the continuation of transmission after chemotherapy. 'Reinfection' rates in the study children, incorporating both failed treatment and true reinfections, were significantly reduced in children, with both detectable antibody and eosinophil counts above 400/mm3, compared with children with neither. Children with either detectable antibodies or high eosinophil counts (mainly the latter) had intermediate reinfection rates. Neither sex, age nor pretreatment intensities influenced reinfection rates, but location of dwelling did: children from distant homes had lower rates. However, the effects of residence and 'protection' were not directly linked. The implication of these results, namely that infection can confer immune protection to reinfection after treatment, is being explored in further studies.