Make New Friends and Keep the Old? Parasite Coinfection and Comorbidity in Homo sapiens

  • Melanie Martin
  • Aaron D. Blackwell
  • Michael Gurven
  • Hillard Kaplan
Part of the Developments in Primatology: Progress and Prospects book series (DIPR)


Hosts are commonly infected with multiple species of parasites and pathogens. These species may interact both directly, through competition for resources and establishment, and indirectly, by eliciting immune responses that may be agonistic or synergistic. During human evolution, hominin ancestors harbored multiple species of symbiotic microorganisms, including helminths. As proposed by the “hygiene hypothesis,” continuous exposure to these organisms may have favored the evolution of “tolerant” immune phenotypes. Conversely, in the absence of these organisms, immunodysregulation may become increasingly common, leading to inflammation, allergies, and autoimmune disorders. At the same time, coinfection resulting in increased infection susceptibility and morbidity is costly to host fitness. Understanding the consequences of multiple-species infection is therefore important for understanding human health in modern environments, as well as past selective pressures on human immune function.

In this chapter we discuss our studies examining interactions between parasites and pathogens among the Tsimane, a subsistence population in lowland Bolivia. Over three-quarters of Tsimane harbor at least one parasitic species at any given moment, with especially high prevalences of hookworm (50.8 %), Giardia lamblia (36.8 %), and Ascaris lumbricoides (15.0 %). While Tsimane infected with one helminth species are significantly more likely to be infected with another, they are significantly less likely to be infected with G. lamblia. Moreover, treatment with antihelmintics is associated with increased odds of G. lamblia infection 1 year later (OR = 1.29, p = 0.03), suggesting an agonistic relationship between these organisms. Helminth infection in children is also significantly associated with increased risk of respiratory illnesses (OR = 1.33, p = 0.04), but is associated with decreased risk of arthritis (OR = 0.68, p = 0.04) and muscle or back pain in adults (OR = 0.72, p < 0.001). The studies with the Tsimane illustrate some of the complex interactions between hosts, parasites, and pathogens that impact human health and immune function, both past and present.


Helminth Infection Infection Intensity Ascaris Lumbricoides Helminth Species Hookworm Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Melanie Martin
    • 1
  • Aaron D. Blackwell
    • 1
  • Michael Gurven
    • 1
  • Hillard Kaplan
    • 2
    • 3
  1. 1.Department of AnthropologyUniversity of California Santa BarbaraSanta BarbaraUSA
  2. 2.Department of AnthropologyUniversity of New MexicoAlbuquerqueUSA
  3. 3.Tsimane Health and Life History ProjectBoliviaSouth America

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