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Co-infection and Nutrition: Integrating Ecological and Epidemiological Perspectives

Abstract
Concurrent infection (or co-infection) is the norm rather than the exception in real-world populations where most host individuals are infected by more than one parasite species simultaneously. Likewise, nutritional deficiencies are also common, and co-infection and multiple nutritional deficiencies frequently co-occur in the same populations. Despite the coincidence of these two phenomena, however, only a small fraction of studies on infection and malnutrition address the issue of co-infection. This chapter explores how the integration of ecological and epidemiological perspectives can be used to draw insight into the interactions between co-infection and nutrition. Specifically, I examine whether applying an ecological framework that accounts for feeding or “trophic” relationships between species can help advance our understanding of how co-infection affects nutrition (helminths and malaria) and, reciprocally, how nutrition affects co-infection (helminths and tuberculosis). I also consider the practicalities of applying a trophic approach to studying co-infection and nutrition in terms of specific methods that can be incorporated into epidemiological studies and the clinical value of considering trophic links. The chapter ends by highlighting the potential value of integrating ideas and approaches across disciplines for addressing the complex problem posed by coincident co-infection and malnutrition.

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Type
Book Chapter