Open Access Highly Accessed Study protocol

A longitudinal study of allergy and intestinal helminth infections in semi urban and rural areas of Flores, Indonesia (ImmunoSPIN Study)

Firdaus Hamid12, Aprilianto E Wiria23, Linda J Wammes2, Maria MM Kaisar23, Bertrand Lell4, Iwan Ariawan5, Hae Won Uh6, Heri Wibowo3, Yenny Djuardi3, Sitti Wahyuni7, Robert Schot8, Jaco J Verweij2, Ronald van Ree9, Linda May2, Erliyani Sartono2, Maria Yazdanbakhsh2* and Taniawati Supali3*

Author Affiliations

1 Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia

2 Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands

3 Department of Parasitology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia

4 Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany

5 Department of Biostatistics, School of Public Health, University of Indonesia, Jakarta, Indonesia

6 Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands

7 Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia

8 Department of Pulmonology, Leiden University Medical Center, Leiden. The Netherlands

9 Department of Experimental Immunology and Department of Otorhinolaryngology, Academic Medical Center, Amsterdam University, Amsterdam, The Netherlands

For all author emails, please log on.

BMC Infectious Diseases 2011, 11:83  doi:10.1186/1471-2334-11-83

Published: 1 April 2011



The prevalence of asthma and atopic disease has been reported to be low in low income countries, however helminth infections are likely to be high among these communities. The question of whether helminth infections play a role in allergic diseases can best be addressed by intervention studies. None of the studies so far have been based on a large scale placebo-controlled trial.


This study was designed to assess how intestinal helminth infections can influence the immune response and atopic and allergic disorders in children in Indonesia. The relations between allergic outcomes and infection and lifestyle factors will be addressed. This study was set up among school-age children in semi urban and rural areas, located in Ende District of Flores Island, Indonesia. A randomized placebo-controlled anthelmintic treatment trial to elucidate the impact of helminth infections on the prevalence of skin prick test (SPT) reactivity and symptoms of allergic diseases will be performed. The children living in these semi-urban and rural areas will be assessed for SPT to allergens before and after 1 and 2 years of treatment as the primary outcome of the study; the secondary outcome is symptoms (asthma and atopic dermatitis); while the tertiary outcome is immune responses (both antibody levels to allergens and cellular immune responses).


The study will provide information on the influence of helminth infections and anthelmintic treatment on immune response, atopy and allergic disorders.

Trial registration

Current Controlled Trials ISRCTN: ISRCTN83830814