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Poague KIHM, Mingoti SA, Heller L. Water, sanitation and schistosomiasis mansoni: a study based on the Brazilian National Prevalence Survey (2011-2015). CIENCIA & SAUDE COLETIVA 2023; 28:363-372. [PMID: 36651392 DOI: 10.1590/1413-81232023282.09692022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 07/23/2022] [Indexed: 01/18/2023] Open
Abstract
This study aimed to explore the association between water, sanitation, and the prevalence of schistosomiasis mansoni in students aged 7 to 17 years from all 27 federative units in Brazil. It was a cross-sectional study conducted based on data on the prevalence of schistosomiasis mansoni referring to 197,567 students from 521 Brazilian municipalities, who participated in the National Survey on the Prevalence of Schistosomiasis Mansoni and Soil-transmitted Helminth Infections (2011-2015). Univariable and multivariable generalized linear models of the negative binomial type were adjusted using 25 and 5% significance levels, respectively, considering municipalities as the unit of analysis. While a protective association was found between access to filtered water in schools and schistosomiasis mansoni prevalence, sanitation in schools was indicated as a risk factor. The collection of wastewater through a network is not universal in Brazil, and even when present, it is not necessarily carried out by the treatment of collected effluents, thus often resulting in the direct discharge of raw sewage into water resources. Regarding septic tanks, only the presence of infrastructure alone does not guarantee its correct use by the population.
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Affiliation(s)
| | | | - Léo Heller
- Instituto René Rachou, Fundação Oswaldo Cruz em Minas Gerais. Belo Horizonte MG Brasil
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2
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Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study. BMC Public Health 2021; 21:1064. [PMID: 34088297 PMCID: PMC8178865 DOI: 10.1186/s12889-021-11106-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Understanding the health behavior of the target population is crucial for sustainable schistosomiasis control. The aim of this study was to assess schistosomiasis related levels of knowledge, attitude, and practices of communities in lowland areas of western Ethiopia, where schistosomiasis is endemic. Methods A community-based multilevel triangulation mixed-methods design was conducted in three schistosomiasis endemic villages in the Abbey and Didessa valleys of the Benishangul Gumuz Region of Western Ethiopia, where mass drug administration (MDA) was done 30 years back and again the last 5 years. A structured survey questionnaire, in-depth interviews, focused group discussions, and observation was conducted to assess levels of knowledge, attitude, and practices related to schistosomiasis in the communities. Results Among the survey participants, 13% reported having heard of schistosomiasis, locally called Pecka (meaning worm). The majority of this 13% believe that schistosomiasis is caused by the biting of the worm Pecka, while others say drinking dirty water is the cause of infection, or they didn’t know what the cause is. A majority of respondents answered “I don’t know” to most of the questions about established knowledge of schistosomiasis. Male participants and students were more aware of schistosomiasis than their counterparts, and awareness increased with the educational level. Only one participant perceived that schistosomiasis was a serious disease. There were negative attitudes and misconceptions about the drug used in the mass treatment and many complaints were raised related to the size of the tablet and its side effects. There was no local budget and specific plan to prevent and control the disease. Local health personnel had insufficient knowledge about schistosomiasis, and the diagnosis and treatment capacities of local health institutions were poor. Conclusion In the current research area, schistosomiasis prevention and control recommendations should be redesigned to change the knowledge, attitudes, and practices of the community and local health workers. It is also necessary to have the local budget and trained manpower in order to diagnose and treat schistosomiasis locally. There is a great need to have a safer Praziquantel pediatric formulation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11106-y.
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Lund AJ, Rehkopf DH, Sokolow SH, Sam MM, Jouanard N, Schacht AM, Senghor S, Fall A, Riveau G, De Leo GA, Lopez-Carr D. Land use impacts on parasitic infection: a cross-sectional epidemiological study on the role of irrigated agriculture in schistosome infection in a dammed landscape. Infect Dis Poverty 2021; 10:35. [PMID: 33745442 PMCID: PMC7983278 DOI: 10.1186/s40249-021-00816-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/05/2021] [Indexed: 01/20/2023] Open
Abstract
Background Water resources development promotes agricultural expansion and food security. But are these benefits offset by increased infectious disease risk? Dam construction on the Senegal River in 1986 was followed by agricultural expansion and increased transmission of human schistosomes. Yet the mechanisms linking these two processes at the individual and household levels remain unclear. We investigated the association between household land use and schistosome infection in children. Methods We analyzed cross-sectional household survey data (n = 655) collected in 16 rural villages in August 2016 across demographic, socio-economic and land use dimensions, which were matched to Schistosoma haematobium (n = 1232) and S. mansoni (n = 1222) infection data collected from school-aged children. Mixed effects regression determined the relationship between irrigated area and schistosome infection presence and intensity. Results Controlling for socio-economic and demographic risk factors, irrigated area cultivated by a household was associated with an increase in the presence of S. haematobium infection (odds ratio [OR] = 1.14; 95% confidence interval [95% CI]: 1.03–1.28) but not S. mansoni infection (OR = 1.02; 95% CI: 0.93–1.11). Associations between infection intensity and irrigated area were positive but imprecise (S. haematobium: rate ratio [RR] = 1.05; 95% CI: 0.98–1.13, S. mansoni: RR = 1.09; 95% CI: 0.89–1.32). Conclusions Household engagement in irrigated agriculture increases individual risk of S. haematobium but not S. mansoni infection. Increased contact with irrigated landscapes likely drives exposure, with greater impacts on households relying on agricultural livelihoods.![]() Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00816-5.
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Affiliation(s)
- Andrea J Lund
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, 473 Via Ortega Suite 226, Stanford, CA, USA.
| | - David H Rehkopf
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford University, 1701 Page Mill Road Room 229, Palo Alto, CA, USA
| | - Susanne H Sokolow
- Woods Institute for the Environment, Stanford University, 473 Via Ortega, Stanford, CA, USA.,Hopkins Marine Station, Stanford University, 120 Ocean View Blvd, Pacific Grove, CA, USA
| | - M Moustapha Sam
- Centre de Recherche Biomédicale-Espoir Pour La Sante, 263 Route de la Corniche, BP 226, Saint-Louis, Sénégal
| | - Nicolas Jouanard
- Station d'Innovation Aquacole, UGB Cote Cite SAED, BP 524, Saint-Louis, Sénégal.,Center for Infection and Immunology of Lille, Institut Pasteur de Lille, 1 Rue du Professeur Calmette, 59800, Lille, France
| | - Anne-Marie Schacht
- Centre de Recherche Biomédicale-Espoir Pour La Sante, 263 Route de la Corniche, BP 226, Saint-Louis, Sénégal.,Center for Infection and Immunology of Lille, Institut Pasteur de Lille, 1 Rue du Professeur Calmette, 59800, Lille, France
| | - Simon Senghor
- Centre de Recherche Biomédicale-Espoir Pour La Sante, 263 Route de la Corniche, BP 226, Saint-Louis, Sénégal
| | - Assane Fall
- Centre de Recherche Biomédicale-Espoir Pour La Sante, 263 Route de la Corniche, BP 226, Saint-Louis, Sénégal
| | - Gilles Riveau
- Centre de Recherche Biomédicale-Espoir Pour La Sante, 263 Route de la Corniche, BP 226, Saint-Louis, Sénégal.,Center for Infection and Immunology of Lille, Institut Pasteur de Lille, 1 Rue du Professeur Calmette, 59800, Lille, France
| | - Giulio A De Leo
- Hopkins Marine Station, Stanford University, 120 Ocean View Blvd, Pacific Grove, CA, USA
| | - David Lopez-Carr
- Department of Geography, University of California, 4836 Ellison Hall, Santa Barbara, CA, USA
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Archer J, O’Halloran L, Al-Shehri H, Summers S, Bhattacharyya T, Kabaterine NB, Atuhaire A, Adriko M, Arianaitwe M, Stewart M, LaCourse EJ, Webster BL, Bustinduy AL, Stothard JR. Intestinal Schistosomiasis and Giardiasis Co-Infection in Sub-Saharan Africa: Can a One Health Approach Improve Control of Each Waterborne Parasite Simultaneously? Trop Med Infect Dis 2020; 5:E137. [PMID: 32854435 PMCID: PMC7558413 DOI: 10.3390/tropicalmed5030137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022] Open
Abstract
Both intestinal schistosomiasis and giardiasis are co-endemic throughout many areas of sub-Saharan Africa, significantly impacting the health of millions of children in endemic areas. While giardiasis is not considered a neglected tropical disease (NTD), intestinal schistosomiasis is formally grouped under the NTD umbrella and receives significant advocacy and financial support for large-scale control. Although there are differences in the epidemiology between these two diseases, there are also key similarities that might be exploited within potential integrated control strategies permitting tandem interventions. In this review, we highlight these similarities and discuss opportunities for integrated control of giardiasis in low and middle-income countries where intestinal schistosomiasis is co-endemic. By applying new, advanced methods of disease surveillance, and by improving the provision of water, sanitation and hygiene (WASH) initiatives, (co)infection with intestinal schistosomiasis and/or giardiasis could not only be more effectively controlled but also better understood. In this light, we appraise the suitability of a One Health approach targeting both intestinal schistosomiasis and giardiasis, for if adopted more broadly, transmission of both diseases could be reduced to gain improvements in health and wellbeing.
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Affiliation(s)
- John Archer
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK; (J.A.); (B.L.W.)
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.O.); (H.A.-S.); (M.S.); (E.J.L.)
| | - Lisa O’Halloran
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.O.); (H.A.-S.); (M.S.); (E.J.L.)
| | - Hajri Al-Shehri
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.O.); (H.A.-S.); (M.S.); (E.J.L.)
- Department of Tropical Infectious Diseases, Ministry of Health, Asir District, Abha 61411, Saudi Arabia
| | - Shannan Summers
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (S.S.); (T.B.); (A.L.B.)
| | - Tapan Bhattacharyya
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (S.S.); (T.B.); (A.L.B.)
| | - Narcis B. Kabaterine
- Vector Control Division, Ministry of Health, Kampala 759125, Uganda; (N.B.K.); (A.A.); (M.A.); (M.A.)
| | - Aaron Atuhaire
- Vector Control Division, Ministry of Health, Kampala 759125, Uganda; (N.B.K.); (A.A.); (M.A.); (M.A.)
| | - Moses Adriko
- Vector Control Division, Ministry of Health, Kampala 759125, Uganda; (N.B.K.); (A.A.); (M.A.); (M.A.)
| | - Moses Arianaitwe
- Vector Control Division, Ministry of Health, Kampala 759125, Uganda; (N.B.K.); (A.A.); (M.A.); (M.A.)
| | - Martyn Stewart
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.O.); (H.A.-S.); (M.S.); (E.J.L.)
| | - E. James LaCourse
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.O.); (H.A.-S.); (M.S.); (E.J.L.)
| | - Bonnie L. Webster
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK; (J.A.); (B.L.W.)
| | - Amaya L. Bustinduy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (S.S.); (T.B.); (A.L.B.)
| | - J. Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (L.O.); (H.A.-S.); (M.S.); (E.J.L.)
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Collyer BS, Turner HC, Hollingsworth TD, Keeling MJ. Vaccination or mass drug administration against schistosomiasis: a hypothetical cost-effectiveness modelling comparison. Parasit Vectors 2019; 12:499. [PMID: 31647019 PMCID: PMC6813092 DOI: 10.1186/s13071-019-3749-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/11/2019] [Indexed: 08/21/2023] Open
Abstract
Background Schistosomiasis is a neglected tropical disease, targeted by the World Health Organization for reduction in morbidity by 2020. It is caused by parasitic flukes that spread through contamination of local water sources. Traditional control focuses on mass drug administration, which kills the majority of adult worms, targeted at school-aged children. However, these drugs do not confer long-term protection and there are concerns over the emergence of drug resistance. The development of a vaccine against schistosomiasis opens the potential for control methods that could generate long-lasting population-level immunity if they are cost-effective. Methods Using an individual-based transmission model, matched to epidemiological data, we compared the cost-effectiveness of a range of vaccination programmes against mass drug administration, across three transmission settings. Health benefit was measured by calculating the heavy-intensity infection years averted by each intervention, while vaccine costs were assessed against robust estimates for the costs of mass drug administration obtained from data. We also calculated a critical vaccination cost, a cost beyond which vaccination might not be economically favorable, by benchmarking the cost-effectiveness of potential vaccines against the cost-effectiveness of mass drug administration, and examined the effect of different vaccine protection durations. Results We found that sufficiently low-priced vaccines can be more cost-effective than traditional drugs in high prevalence settings, and can lead to a greater reduction in morbidity over shorter time-scales. MDA or vaccination programmes that target the whole community generate the most health benefits, but are generally less cost-effective than those targeting children, due to lower prevalence of schistosomiasis in adults. Conclusions The ultimate cost-effectiveness of vaccination will be highly dependent on multiple vaccine characteristics, such as the efficacy, cost, safety and duration of protection, as well as the subset of population targeted for vaccination. However, our results indicate that if a vaccine could be developed with reasonable characteristics and for a sufficiently low cost, then vaccination programmes can be a highly cost-effective method of controlling schistosomiasis in high-transmission areas. The population-level immunity generated by vaccination will also inevitably improve the chances of interrupting transmission of the disease, which is the long-term epidemiological goal.
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Affiliation(s)
- Benjamin S Collyer
- Zeeman Institute (SBIDER), Mathematics Institute, University of Warwick, Coventry, UK.
| | - Hugo C Turner
- Oxford University Clinical Research Unit, Wellcome Trust Overseas Programme, Ho Chi Minh City, Vietnam.,Centre for Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Matt J Keeling
- Zeeman Institute (SBIDER), Mathematics Institute, University of Warwick, Coventry, UK.,School of Life Sciences, University of Warwick, Coventry, UK
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Stothard JR, Campbell SJ, Osei-Atweneboana MY, Durant T, Stanton MC, Biritwum NK, Rollinson D, Ombede DRE, Tchuem-Tchuenté LA. Towards interruption of schistosomiasis transmission in sub-Saharan Africa: developing an appropriate environmental surveillance framework to guide and to support 'end game' interventions. Infect Dis Poverty 2017; 6:10. [PMID: 28088239 PMCID: PMC5237522 DOI: 10.1186/s40249-016-0215-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 12/12/2016] [Indexed: 01/03/2023] Open
Abstract
Schistosomiasis is a waterborne parasitic disease in sub-Saharan Africa, particularly common in rural populations living in impoverished conditions. With the scale-up of preventive chemotherapy, national campaigns will transition from morbidity- to transmission-focused interventions thus formal investigation of actual or expected declines in environmental transmission is needed as 'end game' scenarios arise. Surprisingly, there are no international or national guidelines to do so in sub-Saharan Africa. Our article therefore provides an introduction to key practicalities and pitfalls in the development of an appropriate environmental surveillance framework. In this context, we discuss how strategies need to be adapted and tailored to the local level to better guide and support future interventions through this transition. As detection of egg-patent infection in people becomes rare, careful sampling of schistosome larvae in freshwater and in aquatic snails with robust species-specific DNA assays will be required. Appropriate metrics, derived from observed prevalence(s) as compared with predetermined thresholds, could each provide a clearer insight into contamination- and exposure-related dynamics. Application could be twofold, first to certify areas currently free from schistosomiasis transmission or second to red-flag recalcitrant locations where extra effort or alternative interventions are needed.
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Affiliation(s)
- J. Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Suzy J. Campbell
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Mike Y. Osei-Atweneboana
- Department of Environmental Biology and Health, Council for Scientific and Industrial Research-Water Research Insitute, P.O. Box M 32, Accra, Ghana
| | - Timothy Durant
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - Michelle C. Stanton
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | | | - David Rollinson
- Department of Life Sciences; Natural History Museum, Cromwell Road, London, SW7 5BD UK
| | - Dieudonné R. Eloundou Ombede
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- Laboratory of Parasitology and Ecology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Louis-Albert Tchuem-Tchuenté
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- Laboratory of Parasitology and Ecology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
- National Programme for the Control of Schistosomiasis and Intestinal Helminthiasis, Ministry of Public Health, Yaoundé, Cameroon
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7
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Assaré RK, Hürlimann E, Ouattara M, N'Guessan NA, Tian-Bi YNT, Yapi A, Yao PK, Coulibaly JT, Knopp S, N'Goran EK, Utzinger J. Sustaining the Control of Schistosoma mansoni in Western Côte d'Ivoire: Baseline Findings Before the Implementation of a Randomized Trial. Am J Trop Med Hyg 2015; 94:352-60. [PMID: 26598571 DOI: 10.4269/ajtmh.15-0530] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 10/19/2015] [Indexed: 12/22/2022] Open
Abstract
We report baseline findings before the implementation of a 4-year intervention trial designed to assess the impact of three different school-based treatment schedules with praziquantel to sustain the control of intestinal schistosomiasis. The baseline survey was conducted in 75 schools of western Côte d'Ivoire previously identified with moderate Schistosoma mansoni endemicity (prevalence: 10-24% in children aged 13-14 years). Three stool samples collected over consecutive days were subjected to duplicate Kato-Katz thick smears each. A questionnaire was administered to collect village-specific information that is relevant for schistosomiasis transmission. Overall, 4,953 first graders (aged 5-8 years) and 7,011 school children (aged 9-12 years) had complete parasitologic data. The overall prevalence of S. mansoni was 5.4% among first graders and 22.1% in 9- to 12-year-old children. Open defecation was practiced in all villages. The current baseline findings will be important to better understand the dynamics of S. mansoni prevalence and intensity over the course of this trial that might be governed by village characteristics and specific treatment interventions.
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Affiliation(s)
- Rufin K Assaré
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Mamadou Ouattara
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Nicaise A N'Guessan
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Yves-Nathan T Tian-Bi
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Ahoua Yapi
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Patrick K Yao
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Jean T Coulibaly
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Eliézer K N'Goran
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
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Abstract
Mass drug administration with praziquantel is the mainstay of programs for the control of schistosomiasis morbidity. However, there is a growing recognition that treatment alone will not be sufficient for eventually effecting elimination and that additional measures will be required to interrupt transmission. In the absence of a safe and an effective vaccine for human schistosomiasis, the strategies to reduce infection levels will necessarily involve some interventions that affect the water-related stages of the schistosome life cycle: by reducing exposure to infectious water, by moderating availability of the intermediate snail host, or by decreasing contamination of water with egg-containing excreta. While much research on the importance of water on schistosomiasis has been performed, advances in these areas have perhaps languished with the ready availability of a cost-effective treatment. As some endemic areas near a shift to an elimination goal, a better understanding of water-based interventions that can be used alone or in concert with treatment will be needed. Reinvigoration of laboratory, field, and human behavioral aspects of this research now will ensure that the appropriate strategies are available by the time their implementation becomes necessary.
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Grimes JET, Croll D, Harrison WE, Utzinger J, Freeman MC, Templeton MR. The roles of water, sanitation and hygiene in reducing schistosomiasis: a review. Parasit Vectors 2015; 8:156. [PMID: 25884172 PMCID: PMC4377019 DOI: 10.1186/s13071-015-0766-9] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/18/2015] [Indexed: 11/10/2022] Open
Abstract
Schistosomiasis is a disease caused by infection with blood flukes of the genus Schistosoma. Transmission of, and exposure to, the parasite result from faecal or urinary contamination of freshwater containing intermediate host snails, and dermal contact with the same water. The World Health Assembly resolution 65.21 from May 2012 urges member states to eliminate schistosomiasis through preventive chemotherapy (i.e. periodic large-scale administration of the antischistosomal drug praziquantel to school-aged children and other high-risk groups), provision of water, sanitation and hygiene (WASH) and snail control. However, control measures focus almost exclusively on preventive chemotherapy, while only few studies made an attempt to determine the impact of upgraded access to safe water, adequate sanitation and good hygiene on schistosome transmission. We recently completed a systematic review and meta-analysis pertaining to WASH and schistosomiasis and found that people with safe water and adequate sanitation have significantly lower odds of a Schistosoma infection. Importantly though, the transmission of schistosomiasis is deeply entrenched in social-ecological systems, and hence is governed by setting-specific cultural and environmental factors that determine human behaviour and snail populations. Here, we provide a comprehensive review of the literature, which explores the transmission routes of schistosomes, particularly focussing on how these might be disrupted with WASH-related technologies and human behaviour. Additionally, future research directions in this area are highlighted.
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Affiliation(s)
- Jack E T Grimes
- Department of Civil and Environmental Engineering, Imperial College London, London, SW7 2AZ, UK.
| | - David Croll
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
| | - Wendy E Harrison
- Schistosomiasis Control Initiative, Imperial College London, London, SW7 2AZ, UK.
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
| | - Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
| | - Michael R Templeton
- Department of Civil and Environmental Engineering, Imperial College London, London, SW7 2AZ, UK.
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Grimes JET, Croll D, Harrison WE, Utzinger J, Freeman MC, Templeton MR. The relationship between water, sanitation and schistosomiasis: a systematic review and meta-analysis. PLoS Negl Trop Dis 2014; 8:e3296. [PMID: 25474705 PMCID: PMC4256273 DOI: 10.1371/journal.pntd.0003296] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/24/2014] [Indexed: 11/26/2022] Open
Abstract
Background Access to “safe” water and “adequate” sanitation are emphasized as important measures for schistosomiasis control. Indeed, the schistosomes' lifecycles suggest that their transmission may be reduced through safe water and adequate sanitation. However, the evidence has not previously been compiled in a systematic review. Methodology We carried out a systematic review and meta-analysis of studies reporting schistosome infection rates in people who do or do not have access to safe water and adequate sanitation. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to 31 December 2013, without restrictions on year of publication or language. Studies' titles and abstracts were screened by two independent assessors. Papers deemed of interest were read in full and appropriate studies included in the meta-analysis. Publication bias was assessed through the visual inspection of funnel plots and through Egger's test. Heterogeneity of datasets within the meta-analysis was quantified using Higgins' I2. Principal Findings Safe water supplies were associated with significantly lower odds of schistosomiasis (odds ratio (OR) = 0.53, 95% confidence interval (CI): 0.47–0.61). Adequate sanitation was associated with lower odds of Schistosoma mansoni, (OR = 0.59, 95% CI: 0.47–0.73) and Schistosoma haematobium (OR = 0.69, 95% CI: 0.57–0.84). Included studies were mainly cross-sectional and quality was largely poor. Conclusions/Significance Our systematic review and meta-analysis suggests that increasing access to safe water and adequate sanitation are important measures to reduce the odds of schistosome infection. However, most of the studies were observational and quality was poor. Hence, there is a pressing need for adequately powered cluster randomized trials comparing schistosome infection risk with access to safe water and adequate sanitation, more studies which rigorously define water and sanitation, and new research on the relationships between water, sanitation, hygiene, human behavior, and schistosome transmission. Schistosomiasis is a serious disease in many developing countries, and the control of schistosomiasis relies on the large-scale administration of praziquantel. However, this strategy fails to address the root causes of schistosomiasis, which people acquire during contact with freshwater bodies that contain infected snails. It is suggested that improving access to clean water and sanitation reduces the risk of schistosomiasis transmission. Moreover, the use of soap, detergent, and endod (a berry sometimes used as a substitute for soap) might kill snails and the parasite larvae they excrete. We systematically reviewed the literature and performed a meta-analysis to study the association between people's access to clean water, sanitation, and good hygiene and the risk of schistosomiasis. People with access to clean water and adequate sanitation were at lower risks of schistosomiasis. No studies were found to explore the relationship between hygiene and risk of schistosomiasis. The difference in infection rates between people with and without access to clean water and sanitation varies widely between studies, suggesting that the impact of water and sanitation on schistosomiasis transmission is mediated by many other social and environmental factors. Further research is needed on the impact of water, sanitation and hygiene interventions for schistosomiasis control.
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Affiliation(s)
- Jack E. T. Grimes
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
- * E-mail:
| | - David Croll
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Wendy E. Harrison
- Schistosomiasis Control Initiative, Imperial College London, London, United Kingdom
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Matthew C. Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Michael R. Templeton
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
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Panchin AY, Tuzhikov AI, Panchin YV. Midichlorians--the biomeme hypothesis: is there a microbial component to religious rituals? Biol Direct 2014; 9:14. [PMID: 24990702 PMCID: PMC4094439 DOI: 10.1186/1745-6150-9-14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 06/23/2014] [Indexed: 01/08/2023] Open
Abstract
Background Cutting edge research of human microbiome diversity has led to the development of the microbiome-gut-brain axis concept, based on the idea that gut microbes may have an impact on the behavior of their human hosts. Many examples of behavior-altering parasites are known to affect members of the animal kingdom. Some prominent examples include Ophiocordyceps unilateralis (fungi), Toxoplasma gondii (protista), Wolbachia (bacteria), Glyptapanteles sp. (arthropoda), Spinochordodes tellinii (nematomorpha) and Dicrocoelium dendriticum (flat worm). These organisms belong to a very diverse set of taxonomic groups suggesting that the phenomena of parasitic host control might be more common in nature than currently established and possibly overlooked in humans. Presentation of the hypothesis Some microorganisms would gain an evolutionary advantage by encouraging human hosts to perform certain rituals that favor microbial transmission. We hypothesize that certain aspects of religious behavior observed in the human society could be influenced by microbial host control and that the transmission of some religious rituals could be regarded as the simultaneous transmission of both ideas (memes) and parasitic organisms. Testing the hypothesis We predict that next-generation microbiome sequencing of samples obtained from gut or brain tissues of control subjects and subjects with a history of voluntary active participation in certain religious rituals that promote microbial transmission will lead to the discovery of microbes, whose presence has a consistent and positive association with religious behavior. Our hypothesis also predicts a decline of participation in religious rituals in societies with improved sanitation. Implications of the hypothesis If proven true, our hypothesis may provide insights on the origin and pervasiveness of certain religious practices and provide an alternative explanation for recently published positive associations between parasite-stress and religiosity. The discovery of novel microorganisms that affect host behavior may improve our understanding of neurobiology and neurochemistry, while the diversity of such organisms may be of interest to evolutionary biologists and religious scholars. Reviewers This article was reviewed by Prof. Dan Graur, Dr. Rob Knight and Dr. Eugene Koonin
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Affiliation(s)
- Alexander Y Panchin
- Institute for Information Transmission Problems, Moscow, Russian Federation.
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Knopp S, Becker SL, Ingram KJ, Keiser J, Utzinger J. Diagnosis and treatment of schistosomiasis in children in the era of intensified control. Expert Rev Anti Infect Ther 2013; 11:1237-58. [PMID: 24127662 DOI: 10.1586/14787210.2013.844066] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the current era of intensified and integrated control against schistosomiasis and other neglected tropical diseases, there is a need to carefully rethink and take into consideration disease-specific issues pertaining to the diagnosis, prevention, control and local elimination. Here, we present a comprehensive overview about schistosomiasis including recent trends in the number of people treated with praziquantel and the latest developments in diagnosis and control. Particular emphasis is placed on children. Identified research needs are offered for consideration; namely, expanding our knowledge about schistosomiasis in preschool-aged children, assessing and quantifying the impact of schistosomiasis on infectious and noncommunicable diseases, developing new antischistosomal drugs and child-friendly formulations, designing and implementing setting-specific control packages and developing highly sensitive, but simple diagnostic tools that are able to detect very light infections in young children and in people living in areas targeted for schistosomiasis elimination.
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Affiliation(s)
- Stefanie Knopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
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Affiliation(s)
- Joe Brown
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Sandy Cairncross
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jeroen H J Ensink
- Environmental Health Group, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Santos ADM, Melo ACFL. [Schistosomiasis prevalence in Tutóia village, Maranhão, Brazil]. Rev Soc Bras Med Trop 2011; 44:97-9. [PMID: 21340417 DOI: 10.1590/s0037-86822011000100021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 08/04/2010] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Schistosomiasis mansoni is an endemic disease in underdeveloped or developing countries. The study aimed to define schistosomiasis prevalence in Bom Gosto village, Tutóia, Maranhão, in 2008 and detect intermediate host occurrence. METHODS A survey of data from stool samples examined by the Municipal Department of Health and National Health Foundation was conducted. Next, 60 snails were collected and analyzed. Mollusk analysis was achieved by the crushing process. The Kato-Katz method was used to evaluate fecal sediment. RESULTS According to data from the Municipal Department of Health and FUNASA, schistosomiasis prevalence in the village was 3.2%. The 60 snails were identified as Biomphalaria glabrata and five (8.3%) were parasitized by Schistosoma mansoni. CONCLUSIONS The Bom Gosto village is a low prevalence region of schistosomiasis mansoni. The study area has all the components of the epidemiological chain of S. mansoni, which explains the occurrence of disease in the region.
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Affiliation(s)
- Ana de Matos Santos
- Departamento de Biomedicina, Setor de Parasitologia, Universidade Federal do Piauí, Parnaíba, PI
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Sow S, de Vlas SJ, Stelma F, Vereecken K, Gryseels B, Polman K. The contribution of water contact behavior to the high Schistosoma mansoni Infection rates observed in the Senegal River Basin. BMC Infect Dis 2011; 11:198. [PMID: 21767372 PMCID: PMC3160997 DOI: 10.1186/1471-2334-11-198] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Accepted: 07/18/2011] [Indexed: 11/29/2022] Open
Abstract
Background Schistosomiasis is one of the major parasitic diseases in the world in terms of people infected and those at risk. Infection occurs through contact with water contaminated with larval forms of the parasite, which are released by freshwater snails and then penetrate the skin of people. Schistosomiasis infection and human water contact are thus essentially linked, and more knowledge about their relationship will help us to develop appropriate control measures. So far, only few studies have related water contact patterns to infection levels. Methods We have conducted detailed direct water contact observations in a village in Northern Senegal during the first years of a massive Schistosoma mansoni outbreak to determine the role of human water contact in the extent of the epidemic. We quantified water contact activities in terms of frequency and duration, and described how these vary with age and sex. Moreover, we assessed the relationship between water contact- and infection intensity patterns to further elucidate the contribution of exposure to the transmission of schistosomiasis. Results This resulted in over 120,000 recorded water contacts for 1651 subjects over 175 observation days. Bathing was the main activity, followed by household activities. Frequency and duration of water contact depended on age and sex rather than season. Water contacts peaked in adolescents, women spent almost twice as much time in the water as men, and water contacts were more intense in the afternoon than in the morning, with sex-specific intensity peaks. The average number of water contacts per person per day in this population was 0.42; the average time spent in the water per person per day was 4.3 minutes. Conclusions The observed patterns of water contact behavior are not unusual and have been described before in various other settings in sub-Saharan Africa. Moreover, water contact levels were not exceptionally high and thus cannot explain the extremely high S. mansoni infection intensities as observed in Northern Senegal. Comparison with fecal egg counts in the respective age and sex groups further revealed that water contact levels did not unambiguously correspond with infection levels, indicating that factors other than exposure also play a role in determining intensity of infection.
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Affiliation(s)
- Seydou Sow
- Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium
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Moné H, Ibikounlé M, Massougbodji A, Mouahid G. Human Schistosomiasis in the Economic Community of West African States. ADVANCES IN PARASITOLOGY 2010. [DOI: 10.1016/s0065-308x(10)71001-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Social science perspectives on schistosomiasis control in Africa: past trends and future directions. Parasitology 2009; 136:1747-58. [DOI: 10.1017/s0031182009006404] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYNew ways of integrating and scaling up control of neglected tropical diseases (including schistosomiasis) are presently underway. In this context consideration of social science perspectives is essential. In this article, we review social science publications of relevance to sustained control of schistosomiasis in Africa including diagnosis and screening, treatment, supply of clean water and improved sanitation, as well as health communication. Studies of community involvement and links between schistosomiasis control programmes and broader health care systems are also explored. Directions for future social science of relevance to sustainable schistosomiasis control are outlined, including ways of ensuring equitable access to health services as well as involvement of endemic communities and local health care systems based on equal partnership.
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