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Folefac LN, Nde-Fon P, Verla VS, Tangye MN, Njunda AL, Luma HN. Knowledge, attitudes and practices regarding urinary schistosomiasis among adults in the Ekombe Bonji Health Area, Cameroon. Pan Afr Med J 2018; 29:161. [PMID: 30050625 PMCID: PMC6057561 DOI: 10.11604/pamj.2018.29.161.14980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 02/24/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Urinary schistosomiasis (US) is endemic in Cameroon. Knowledge, attitudes and practices (KAP) are important aspects for control of the disease. However, data on these remain scanty. We aimed at evaluating knowledge, attitudes and practices regarding urinary schistosomiasis among adults in households in the Ekombe Bonji health area. Methods A community-based, cross-sectional study was carried out at Ekombe Bonji health area from February to March, 2017, involving all 12 communities. A pre-tested questionnaire was used to assess knowledge, attitudes and practices regarding urinary schistosomiasis among 198 adults and to record their socio-demographic, environmental and clinical variables. Data were stored in Excel version 2013 and analysed using Stata version 14.2. Results Of the 198 adults interviewed, only 35.4% had prior knowledge about urinary schistosomiasis. Among these, 94.3%, 74.3%, 57.7% knew the signs and symptoms, modes of transmission and preventive measures respectively. Only 14.3% knew the cause and treatment. 81.2% considered urinary schistosomiasis a serious disease and 77.1% believed it could be prevented, albeit, their practices to prevent infection were inadequate. Conclusion Knowledge, attitudes and practices regarding urinary schistosomiasis among adults are inadequate, since most of them are not aware of the disease. Therefore, there is need for community-based interventions especially health education to effectively reduce the disease burden.
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Affiliation(s)
- Laura Ngolere Folefac
- Department of Medicine, Faculty of Health Sciences, University of Buea, South West Region, Cameroon
| | - Peter Nde-Fon
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, South West Region, Cameroon
| | - Vincent Siysi Verla
- Department of Medicine, Faculty of Health Sciences, University of Buea, South West Region, Cameroon
| | - Michael Nkemanjong Tangye
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, South West Region, Cameroon
| | - Anna Longdoh Njunda
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, South West Region, Cameroon
| | - Henry Namme Luma
- Department of Microbiology, Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Central Region, Cameroon
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A centenary of Robert T. Leiper's lasting legacy on schistosomiasis and a COUNTDOWN on control of neglected tropical diseases. Parasitology 2016; 144:1602-1612. [PMID: 27363810 PMCID: PMC5964474 DOI: 10.1017/s0031182016000998] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Part of Robert T. Leiper's (1881–1969) lasting legacy in medical helminthology is grounded on his pioneering work on schistosomiasis (Bilharzia). Having undertaken many expeditions to the tropics, his fascination with parasite life cycles typically allowed him to devise simple preventive measures that curtailed transmission. Building on his formative work with others in Africa and Asia, and again in Egypt in 1915, he elucidated the life cycles of African schistosomes. His mandate, then commissioned by the British War Office, was to prevent and break transmission of this disease in British troops. This he did by raising standing orders based on simple water hygiene measures. Whilst feasible in military camp settings, today their routine implementation is sadly out of reach for millions of Africans living in poverty. Whilst we celebrate the centenary of Leiper's research we draw attention to some of his lesser known colleagues, then focus on schistosomiasis in Uganda discussing why expanded access to treatment with praziquantel is needed now. Looking to WHO 2020 targets for neglected tropical diseases, we introduce COUNTDOWN, an implementation research consortium funded by DFID, UK, which fosters the scale-up of interventions and confirm the current relevance of Leiper's original research.
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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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Mbanefo EC, Huy NT, Wadagni AA, Eneanya CI, Nwaorgu O, Hirayama K. Host determinants of reinfection with schistosomes in humans: a systematic review and meta-analysis. PLoS Negl Trop Dis 2014; 8:e3164. [PMID: 25211227 PMCID: PMC4161334 DOI: 10.1371/journal.pntd.0003164] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 08/04/2014] [Indexed: 12/12/2022] Open
Abstract
Background Schistosomiasis is still a major public health burden in the tropics and subtropics. Although there is an effective chemotherapy (Praziquantel) for this disease, reinfection occurs rapidly after mass drug administration (MDA). Because the entire population do not get reinfected at the same rate, it is possible that host factors may play a dominant role in determining resistance or susceptibility to reinfection with schistosomes. Here, we systematically reviewed and meta-analyzed studies that reported associations between reinfection with the principal human-infecting species (S. mansoni, S. japonicum and S. haematobium) and host socio-demographic, epidemiological, immunological and genetic factors. Methodology/Principal Findings PubMed, Scopus, Google Scholar, Cochrane Review Library and African Journals Online public databases were searched in October 2013 to retrieve studies assessing association of host factors with reinfection with schistosomes. Meta-analysis was performed to generate pooled odds ratios and standardized mean differences as overall effect estimates for dichotomous and continuous variables, respectively. Quality assessment of included studies, heterogeneity between studies and publication bias were also assessed. Out of the initial 2739 records, 109 studies were included in the analyses, of which only 32 studies with 37 data sets were eligible for quantitative data synthesis. Among several host factors identified, strong positive association was found with age and pre-treatment intensity, and only slightly for gender. These factors are major determinants of exposure and disease transmission. Significant positive association was found with anti-SWA IgG4 level, and a negative overall effect for association with IgE levels. This reconfirmed the concept that IgE/IgG4 balance is a major determinant of protective immunity against schistosomiasis. Other identified determinants were reported by a small number of studies to enable interpretation. Conclusions Our data contribute to the understanding of host-parasite interaction as it affects reinfection, and is a potential tool to guide planning and tailoring of community interventions to target high-risk groups. One of the major challenges of schistosomiasis control is that disease prevalence reverts to baseline levels after mass drug administration due to high rate of reinfection. Host factors play a major role in determining resistance or susceptibility to reinfection with schistosomiasis and other diseases. We systematically searched and analyzed studies that identified potential host determinants of reinfection with schistosomes. Among demographic variables, age but not gender was strongly associated with reinfection with schistosomes. Pretreatment infection intensity was also identified as a major determinant of reinfection. Positive association with IgG4 levels and negative association with IgE levels reconfirmed the notion that IgE/IgG4 balance is the major factor controlling protective immunity against schistosomiasis. Other factors were reported by few studies to allow correct inferences. These results contribute to our understanding of host-parasite relationship as it affects reinfection, and will be useful for planning and targeting the limited resources for intervention on high-risk groups.
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Affiliation(s)
- Evaristus Chibunna Mbanefo
- Department of Parasitology and Entomology, Faculty of Bioscience, Nnamdi Azikiwe University, Awka, Nigeria
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan
- * E-mail: ,
| | - Nguyen Tien Huy
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Anita Akpeedje Wadagni
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan
| | - Christine Ifeoma Eneanya
- Department of Parasitology and Entomology, Faculty of Bioscience, Nnamdi Azikiwe University, Awka, Nigeria
| | - Obioma Nwaorgu
- Department of Parasitology and Entomology, Faculty of Bioscience, Nnamdi Azikiwe University, Awka, Nigeria
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Sakamoto, Nagasaki, Japan
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Musuva RM, Awiti A, Omedo M, Ogutu M, Secor WE, Montgomery SP, Alaii J, Mwinzi PNM. Community knowledge, attitudes and practices on schistosomiasis in western Kenya--the SCORE Project. Am J Trop Med Hyg 2014; 90:646-52. [PMID: 24534810 DOI: 10.4269/ajtmh.13-0488] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In an effort to improve intervention strategies, community knowledge, attitudes, and practices on schistosomiasis were evaluated using focus group discussions involving 237 participants, in eight Schistosoma mansoni high prevalence districts in rural Nyanza Province, Kenya. The majority of participants reported having heard about schistosomiasis through schools, posters, radio announcements, and community gatherings. Participants had a variety of beliefs about contracting schistosomiasis, including associating it with dirty drinking water and uncooked or contaminated food. Avenues for seeking treatment included health centers, spiritual intervention, herbal treatments, and medicine shops, with health centers receiving the most mention. Barriers to schistosomiasis control included attitudes of community members toward the infection, especially misconceptions that lead to stigma and the perception that diagnosis and treatment are expensive. Schools were the most common avenue for receiving information, suggesting that the existing education infrastructure can be used for health education and improved sensitization about schistosomiasis control programs.
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Affiliation(s)
- Rosemary M Musuva
- Neglected Tropical Diseases Branch, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Atlanta, Georgia; ContextFACTOR Solutions, Nairobi, Kenya
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Advances in our understanding of the epidemiology of Plasmodium and schistosome infection: informing coinfection studies. Curr Opin HIV AIDS 2012; 7:225-30. [PMID: 22327411 DOI: 10.1097/coh.0b013e328351b9fb] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Schistosomes and Plasmodium parasites have complex patterns of transmission, leading to differing dynamics of host-parasite interactions across study sites and a bias of studying differing age groups in monoinfection studies. Combined, these infections lead to difficulties in conducting and interpreting human coinfection studies. RECENT FINDINGS Interactions between the two parasites may affect morbidity associated with either infection; both by influencing mechanisms directly associated with the development of those morbidities and by influencing mechanisms associated with resistance or susceptibility to the other infection. However, conflicting results are reported due to inherent difficulties in studying coinfections. More studies with stringent designs are required to clarify interactions between the two parasites. Recent monoinfection studies indicate that further coinfection studies may need to have a wider age range than previously studied. These studies also need to harness new techniques, both for data collection and analysis that are being developed for modern epidemiological studies. These techniques will allow an essential multidisciplinary approach to be taken. SUMMARY Coinfection with Plasmodium and schistosome infection has implications for the health of children of all ages in sub-Saharan Africa. It is important to gain further understanding of the interactions between the two parasites in all age groups.
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