Background/Objectives: Helminth infections, particularly prevalent in low- and middle-income countries, have been extensively studied for their effects on human health. With the emergence of new infectious diseases like SARS-CoV-2 and Ebola, their impact on disease outcomes become more apparent. While individual studies have explored the impact of helminth co-infections on disease severity and vaccine efficacy, the findings are often inconsistent and context-dependent. Furthermore, the long-term effects of helminth-mediated immunosuppression on vaccine efficacy and its broader implications for co-infections in endemic regions remain not fully understood. Methods: This systematic review conducted in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines synthesizes the current evidence, identifies patterns, and highlights areas needing further research, offering a cohesive understanding of the topic. PubMed, Scopus, Google Scholar, and Cochrane Library were searched to include studies published from 2003 to February 2025. Results: Co-infection reveals a dual role of helminths in modulating immune responses, with both beneficial and detrimental interactions reported across studies. It may confer benefits against respiratory viral infections by muting hyper-inflammation associated with the severity of conditions like COVID-19, Influenza, and RSV. However, they can exacerbate disease outcomes in most bacteria and blood-borne viral conditions by impairing immune functions, such as neutrophil recruitment and antibody response, leading to more severe infections and higher viral loads. The stage of helminth infection also appears critical, with early-stage infections sometimes offering protection, while late-stage infections may worsen disease outcomes. Helminth infection can also negatively impact vaccine efficacy by suppressing B cell activity, reducing antibody levels, and decreasing vaccine effectiveness against infectious diseases. This immunosuppressive effect may persist after deworming, complicating efforts to restore vaccine efficacy. Maternal helminth infections also significantly influence neonatal immunity, affecting newborn vaccine responses. Conclusions: There is a need for targeted interventions and further research in helminth-endemic regions to mitigate the adverse effects on vaccine efficacy and improve public health outcomes.

Background/Objectives: The COVID-19 pandemic has significantly impacted global health. However, Africa has reported relatively low numbers of cases and fatalities. Although the pandemic has largely receded, the reasons for its milder course on the African continent have not yet been fully clarified. This study explored the hypothesis that helminth co-infections may have contributed to these observations. Methods: A retrospective cohort study was conducted using 104 plasma samples collected during the third wave of the pandemic in the Ashanti Region of Ghana. Luminex assays were used to measure SARS-CoV-2-specific IgA and IgG, neutralizing antibodies, systemic cytokines and helminth-specific IgG. Results: The results indicated that the highest cumulative seroprevalence of helminths (61.5%) was observed in asymptomatic COVID-19 patients. In comparison, mild and moderate patients had helminth seropositivity rates of 43.8% and 34.5%, respectively, which were 1.4 and 1.8 times lower than those of the asymptomatic group, respectively. Notably, the two severe COVID-19 cases investigated were seronegative for all three of the helminths tested. Strikingly, co-exposure resulted in lower SARS-CoV-2-specific IgA/IgG expression and reduced neutralization potential. However, co-seropositive individuals for helminths and SARS-CoV-2 exhibited a higher expression of Th2 cytokines and IL-10 over Th1 cytokines compared to SARS-CoV-2-positive individuals alone. Conclusion: These data suggest that co-exposure to helminths could mitigate the severity of COVID-19 outcomes by reducing the Th1 and Th17 responses; this highlights the potential protective role of helminthiasis against severe COVID-19. These findings provide valuable insights for the development of public health policies in helminth-endemic regions and underscore the importance of considering helminth co-infections in managing viral infections. It also offers a plausible explanation for the milder disease severity observed in helminth-endemic regions while raising critical considerations regarding vaccine efficacy, as helminth-induced immune modulation may influence the magnitude and quality of vaccine-induced immune responses.

The accurate detection of SARS-CoV-2 through respiratory sampling is critical for the prevention of further transmission and timely initiation of treatment. There is a diverse range of SARS-CoV-2 detection rates in reported studies, with uncertainty regarding the optimal sampling method for COVID-19 diagnosis and monitoring. Oropharyngeal sampling (OPS) is one of the most commonly used methods of respiratory sampling in Ghana and other parts of the world for the detection of SARS-CoV-2 viral RNA. However, this sampling technique has a number of drawbacks, which include difficulty in obtaining high-quality swab samples, increased risk of infection to healthcare workers, and increased cost from a regular supply of swabs, transport media, and personal protective equipment (PPE). This study, therefore, sought to evaluate the diagnostic performance of sputum specimens in the diagnosis of COVID-19. This was a cross-sectional analytical study conducted in two health facilities in Kumasi, Ghana, between April and September 2021. Paired samples (an oropharyngeal swab and sputum) were taken from each recruited patient and run concurrently for the detection of SARS-CoV-2 genes (the N and ORF1ab genes) using RT-qPCR. Of the 317 patients recruited, 50.8% were males, and 60.4% were young adults aged 20–39 years. A significant proportion (65.9%) of the patients did not have any co-morbidity, and the majority were with symptoms; predominantly cough (36.3%), headache (31.5%), general weakness (24.0%), fever (20.2%), and sore throat (16.1%). Being symptomatic (p = 0.003), having comorbidity (p = 0.001), and the reporting facility (p = 0.010) were significantly associated with the COVID-19 status. The sputum samples yielded more COVID-positive, 120/317 (37.9%), as compared to OPS, 83/317 (26.2%). The sputum samples were 85.5% (95% CI, 76.4–91.5) sensitive, 79.1% (95% CI, 73.4–83.7) specific, and with positive and negative predictive values of 59.2% and 93.9%, respectively, when compared with OPS. The overall median of the SARS-CoV-2 viral loads for sputum (3.70 × 10³ copies/mL) were significantly higher than in OPS (1.18 × 10² copies/mL) (p = 0.003). Findings from the study suggest self-collected sputum as a useful alternative to OPS for the diagnosis of COVID-19, providing a comparable diagnostic performance and, thereby, easing the uncomfortable process and mitigating risk of aerosol transmission to healthcare workers.

The COVID-19 pandemic has significantly impacted global health. However, Africa has reported relatively low numbers of cases and fatalities. Although the pandemic has largely receded, the reasons for its milder course on the African continent have not yet been fully clarified. This study explored the hypothesis that helminth co-infections may have contributed to these observations. A retrospective cohort study was conducted using 104 archived plasma samples collected during the third wave of the pandemic in the Ashanti Region of Ghana. ELISA and Luminex assays were used to measure SARS-CoV-2-specific IgA and IgG, neutralizing antibodies, and helminth-specific IgG levels. The results indicated that the highest cumulative seroprevalence of helminths (61.5%) was observed in asymptomatic SARS-CoV-2-infected individuals. In comparison, mild and moderate COVID-19 patients had helminth seropositivity rates of 43.8% and 34.5%, respectively, which were 1.4 and 1.8 times lower than those of the asymptomatic group, respectively. Notably, the two severe COVID-19 cases investigated were seronegative for all three helminths tested. Strikingly, co-exposure resulted in lower SARS-CoV-2-specific IgA/IgG expression and reduced neutralization potential. However, in the plasma of individuals co-seropositive for helminths and SARS-CoV-2, a significantly higher expression of Th2 cytokines and IL-10 over Th1 was observed compared to those who were SARS-CoV-2 positive alone. These data suggest that co-exposure to helminths could mitigate severe COVID-19 outcomes by reducing the Th1 and Th17 responses. Our study highlights the potential protective role of helminth co-infection against severe COVID-19, suggesting that helminth-induced immune modulation may improve clinical outcomes. These findings provide valuable insights for public health policies in helminth-endemic regions and underscore the importance of considering helminth co-infections in managing viral infections.

Background: Africa seemed to have had low SARS-CoV-2 infection and COVID-19 morbidity and mortality. While several studies reported high SARS-CoV-2 seropositivity among healthy Africans, others hypothesized that this could have resulted from pre-existing cross-reactive antibodies. Our study tracks trends in seropositivity across three West African countries during the Delta and Omicron pandemic waves using a validated test kit with 98.9% predictive accuracy, 97% sensitivity, and 99% specificity.Methods: Cross-sectional studies were conducted across three West African countries (Burkina Faso, Ghana, and Nigeria) with study sites conveniently selected in each country. Using the validated immunoassay kits, with already published validation procedures, SARS-CoV-2 antibodies were detected in peripheral blood during the ‘Delta’ and ‘Omicron’ waves. Participants' demographic and clinical data were obtained using a semi-structured questionnaire, and the primary outcome was the proportion of each population with SARS-CoV-2 antibodies.Findings: Across the 3 countries, 20,748 participants were recruited, and the results showed SARS-CoV-2 IgG seropositivity ranging between 24.1% to 77.0%, which increased during the Omicron wave. All sites showed low self-reported vaccination rates, delinking seropositivity and vaccination. While there was a significant positive association between seropositivity and age across all sites, the association with other demographic factors was country-dependent, and most participants expressed positive opinions of vaccination.Interpretation: This is one of the largest population-based SARS-CoV-2 seroepidemiology studies in Africa, confirming widespread mild SARS-CoV-2 infection in West Africa. This confirms a marked disconnect between high population exposure and low reported clinical burden, underscoring the need for strengthened community surveillance.

Background: Ghana exhibits geographic variation across northern and southern regions alongside differences between urban and rural communities, which may influence SARS-CoV-2 exposure and immune response. This study aimed to assess the differences in seroprevalence, and seroconversion status after exposure to SARS-CoV-2 in selected urban and rural Ghanaian communities. Methods: A longitudinal study design was employed. Serum samples (n = 987) were collected during a baseline survey (August 2023–February 2024) with longitudinal follow-up (n = 212) sampling after one year (August 2024-February 2025) among consenting community participants aged ≥10 years selected through household-based sampling in urban and rural settings. Socio-demographic data, clinical symptoms, and vaccination status were collected using structured questionnaires. Serum samples were inactivated and tested with semi-quantitative Anti-SARS-CoV-2 IgG ELISA assays targeting spike (S) and nucleocapsid (N) proteins. Presence of SARS-CoV-2 neutralizing antibodies in serum was determined by a surrogate virus neutralization assay. Results: Of 987 participants aged 10–88 years (67.3% female), SARS-CoV-2 seroprevalence was comparable between urban (47.4%) and rural (47.7%) areas. Among the 212 participants followed longitudinally, 50.9% (108 participants) had both infection or vaccine-induced anti-spike and infection-induced anti-nucleocapsid antibodies after one year, indicating sustained immune responses from prior exposure or vaccination. There was a significant increase in paired spike and nucleocapsid antibody responses between baseline and follow-up (McNemar’s test, χ²(1) = 104.00, p < 0.0001), reflecting ongoing immune boosting despite evidence of antibody waning. Neutralizing antibodies, were detected in 147/148 (99.3%) individuals at timepoint-1 and in all 12 (100%) selected individuals for follow-up at timepoint-2, demonstrating robust functional immunity. Conclusion: This study demonstrates widespread serological evidence of prior SARS-CoV-2 exposure and vaccine-induced immunity in both urban and rural Ghana. Functional neutralising antibodies were detected in a longitudinal subset, suggesting persistence of antibody-mediated protection in some individuals. Larger longitudinal studies with repeated functional immune assessments are needed to better define durable protection in West African settings.