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Trippler L, Knopp S, Welsche S, Webster BL, Stothard JR, Blair L, Allan F, Ame SM, Juma S, Kabole F, Ali SM, Rollinson D, Pennance T. The long road to schistosomiasis elimination in Zanzibar: A systematic review covering 100 years of research, interventions and control milestones. ADVANCES IN PARASITOLOGY 2023; 122:71-191. [PMID: 37657854 DOI: 10.1016/bs.apar.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Zanzibar is among the few places in sub-Saharan Africa where interruption of Schistosoma transmission seems an achievable goal. Our systematic review identifies and discusses milestones in schistosomiasis research, control and elimination efforts in Zanzibar over the past 100 years. The search in online databases, libraries, and the World Health Organization Archives revealed 153 records published between May 1928 and August 2022. The content of records was summarised to highlight the pivotal work leading towards urogenital schistosomiasis elimination and remaining research gaps. The greatest achievement following 100 years of schistosomiasis interventions and research is undoubtedly the improved health of Zanzibaris, exemplified by the reduction in Schistosoma haematobium prevalence from>50% historically down to<5% in 2020, and the absence of severe morbidities. Experiences from Zanzibar have contributed to global schistosomiasis guidelines, whilst also revealing challenges that impede progression towards elimination. Challenges include: transmission heterogeneity requiring micro-targeting of interventions, post-treatment recrudescence of infections in transmission hotspots, biological complexity of intermediate host snails, emergence of livestock Schistosoma species complicating surveillance whilst creating the risk for interspecies hybridisation, insufficient diagnostics performance for light intensity infections and female genital schistosomiasis, and a lack of acceptable sanitary alternatives to freshwater bodies. Our analysis of the past revealed that much can be achieved in the future with practical implementation of integrated interventions, alongside operational research. With continuing national and international commitments, interruption of S. haematobium transmission across both islands is within reach by 2030, signposting the future demise of urogenital schistosomiasis across other parts of sub-Saharan Africa.
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Affiliation(s)
- Lydia Trippler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | | | - Bonnie L Webster
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | | | - Fiona Allan
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom; University of St Andrews, St Andrews, United Kingdom
| | - Shaali Makame Ame
- Neglected Diseases Programme, Zanzibar Ministry of Health, Lumumba, Unguja, United Republic of Tanzania
| | - Saleh Juma
- Neglected Diseases Programme, Zanzibar Ministry of Health, Mkoroshoni, Pemba, United Republic of Tanzania
| | - Fatma Kabole
- Neglected Diseases Programme, Zanzibar Ministry of Health, Lumumba, Unguja, United Republic of Tanzania
| | - Said Mohammed Ali
- Public Health Laboratory - Ivo de Carneri, Wawi, Chake Chake, Pemba, United Republic of Tanzania
| | - David Rollinson
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom; Global Schistosomiasis Alliance, London, United Kingdom
| | - Tom Pennance
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom; Western University of Health Sciences, Lebanon, OR, United States.
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Makia CM, Fesuh NB, Amabo EN, Gamba VA, Oluwole AS, Stothard R. Urogenital schistosomiasis (UGS) and female genital schistosomiasis (FGS) in Cameroon: an observational assessment of key reproductive health determinants of girls and women in the Matta Health Area. BMJ Open 2023; 13:e063392. [PMID: 36787976 PMCID: PMC9930553 DOI: 10.1136/bmjopen-2022-063392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVES AND SETTING Across sub-Saharan Africa, urogenital schistosomiasis (UGS), in particular female genital schistosomiasis (FGS), is a significant waterborne parasitic disease, with its direct burden on the sexual and reproductive health (SRH) of sufferers infrequently measured. UGS has an established control plan, which in most endemic regions as in Cameroon, still excludes FGS considerations. Highlighting existent associations between UGS and FGS could increase the management of FGS within UGS interventions. This study seeks to identify current associations among FGS and UGS with some reproductive health indicators, to provide formative information for better integrated control. PARTICIPANTS 304 females aged 5-69 years were all examined for UGS by urine filtration and microscopy. Among these, 193 women and girls were eligible for clinical FGS assessment based on age (>13). After selective questioning for FGS symptoms, a subgroup of 67 women and girls consented for clinical examination for FGS using portable colposcopy, with observed sequelae classified according to the WHO FGS pocket atlas. OUTCOME Overall UGS and FGS prevalence was measured, with FGS-related/UGS-related reproductive health symptoms recorded. Associations between FGS and UGS were investigated by univariate and multivariate logistic regression analyses. RESULTS Overall UGS prevalence was 63.8% (194/304), where FGS prevalence (subgroup) was 50.7% (34/67). FGS manifestation increased significantly with increasing age, while a significant decrease with ascending age was observed for UGS. Lower abdominal pain (LAP) vaginal itches (VI) and coital pain (CP) were identified as the main significant shared symptoms of both FGS and UGS, while LAP with menstrual irregularity (MI) appeared a strong symptomatic indicator for FGS. CONCLUSION LAP, MI, CP and VI are the potential SRH indicators that could be exploited in future for targeting of praziquantel provision to FGS sufferers within primary care, complementary with existing praziquantel distribution for UGS sufferers in Schistosoma haematobium endemic areas.
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Affiliation(s)
- Christine Masong Makia
- Social Sciences and Management, Catholic University of Central Africa, Yaounde, Centre, Cameroon
| | - Nono Betrand Fesuh
- Department of Mathematics and Physical Sciences, National Advanced School of Engineering, University of Yaoundé 1, Yaoundé, Centre, Cameroon
| | | | - Victoria A Gamba
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Nairobi, Kenya
| | - Akinola Stephen Oluwole
- Department of Pure and Applied Zoology, Federal University of Agriculture Abeokuta, Abeokuta, Ogun, Nigeria
| | - Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
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Hybridization increases genetic diversity in Schistosoma haematobium populations infecting humans in Cameroon. Infect Dis Poverty 2022; 11:37. [PMID: 35346375 PMCID: PMC8962594 DOI: 10.1186/s40249-022-00958-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Hybrids between Schistosoma haematobium (Sh) and S. bovis (Sb) have been found in several African countries as well as in Europe. Since the consequences of this hybridization are still unknown, this study aims to verify the presence of such hybrids in Cameroonian humans, to describe the structure of S. haematobium populations on a large geographic scale, and to examine the impact of these hybrids on genetic diversity and structure of these populations.
Methods From January to April 2019, urine from infected children was collected in ten geographically distinct populations. Miracidia were collected from eggs in this urine. To detect the presence of hybrids among these miracidia we genotyped both Cox1 (RD-PCR) and ITS2 gene (PCR-RFLP). Population genetic diversity and structure was assessed by genotyping each miracidium with a panel of 14 microsatellite markers. Gene diversity was measured using both heterozygosity and allelic richness indexes, and genetic structure was analyzed using paired Fst, PCA and Bayesian approaches. Results Of the 1327 miracidia studied, 88.7% were identified as pure genotypes of S. haematobium (Sh_Sh/Sh) while the remaining 11.3% were hybrids (7.0% with Sh_Sh/Sb, 3.7% with Sb_Sb/Sh and 0.4% with Sb_Sh/Sb). No miracidium has been identified as a pure genotype of S. bovis. Allelic richness ranged from 5.55 (Loum population) to 7.73 (Matta-Barrage) and differed significantly between populations. Mean heterozygosity ranged from 53.7% (Loum) to 59% (Matta Barrage) with no significant difference. The overall genetic differentiation inferred either by a principal component analysis or by the Bayesian approach shows a partial structure. Southern populations (Loum and Matta Barrage) were clearly separated from other localities but genetic differentiation between northern localities was limited, certainly due to the geographic proximity between these sites. Conclusions Hybrids between S. haematobium and S. bovis were identified in 11.3% of miracidia that hatched from eggs present in the urine of Cameroonian schoolchildren. The percentages of these hybrids are correlated with the genetic diversity of the parasite, indicating that hybridization increases genetic diversity in our sampling sites. Hybridization is therefore a major biological process that shapes the genetic diversity of S. haematobium. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00958-0.
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Bassa FK, Eze IC, Assaré RK, Essé C, Koné S, Acka F, Laubhouet-Koffi V, Kouassi D, Bonfoh B, Utzinger J, N'Goran EK. Prevalence of Schistosoma mono- and co-infections with multiple common parasites and associated risk factors and morbidity profile among adults in the Taabo health and demographic surveillance system, South-Central Côte d'Ivoire. Infect Dis Poverty 2022; 11:3. [PMID: 34983662 PMCID: PMC8728899 DOI: 10.1186/s40249-021-00925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Schistosomiasis remains an important public health problem, also among adults, and infected individuals not treated serve as a reservoir for continued transmission. Despite this fact, evidence on the epidemiology of schistosomiasis in adults in Côte d’Ivoire is scanty. This study aimed to determine the prevalence and risk factors of Schistosoma infection and co-infection with other helminth species and Plasmodium among adults in the Taabo region in the south-central part of Côte d’Ivoire. Methods A cross-sectional survey was carried out in April and May 2017 in the frame of the “Côte d’Ivoire Dual Burden of Disease Study” (CoDuBu). A total of 901 randomly selected individuals, aged 18–90 years, provided blood, stool and urine samples for the diagnosis of malaria and helminth infections. Stool samples were subjected to the Kato-Katz technique for detection of Schistosoma mansoni and soil-transmitted helminth eggs, while urine samples were examined for eggs of Schistosoma haematobium and circulating cathodic antigen of S. mansoni. Risk factors and morbidity profiles were assessed using health examination and questionnaires. Multinomial logistic regressions were employed to identify risk factors and morbidity patterns associated with S. mansoni mono- and co-infections. Results The prevalence of S. mansoni and S. haematobium was 23.2% and 1.0%, respectively. Most S. mansoni were mono-infections (81.3%). Independent determinants of S. mansoni infection were young age, low socioeconomic status (mono- and co-infection) and poor hygiene practices (co-infection) (P < 0.05). S. mansoni infection was independently associated with higher pain and symptom scores (mono-infection), poor self-rated health and low healthcare use (co-infection) (P < 0.05). Conclusions This study showed that adults represent a substantial reservoir of S. mansoni. To sustain schistosomiasis control and improve people’s wellbeing, it is important to expand preventive chemotherapy from school-aged children to adults, coupled with hygiene and health education.
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Affiliation(s)
- Fidèle K Bassa
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22, P.O. Box 582, Abidjan 22, Côte d'Ivoire.
| | - Ikenna C Eze
- Swiss Tropical and Public Health Institute, 4002, Basel, Switzerland.,University of Basel, 4003, Basel, Switzerland
| | - Rufin K Assaré
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22, P.O. Box 582, Abidjan 22, Côte d'Ivoire.,Swiss Tropical and Public Health Institute, 4002, Basel, Switzerland.,University of Basel, 4003, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01, P.O. Box 1303, Abidjan 01, Côte d'Ivoire
| | - Clémence Essé
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01, P.O. Box 1303, Abidjan 01, Côte d'Ivoire.,Institut d'Ethnosociologie, Université Félix Houphouët-Boigny, 01, P.O. Box 34,, Abidjan 01, Côte d'Ivoire
| | - Siaka Koné
- Swiss Tropical and Public Health Institute, 4002, Basel, Switzerland.,University of Basel, 4003, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01, P.O. Box 1303, Abidjan 01, Côte d'Ivoire
| | - Félix Acka
- Institut National de Santé Publique, 01, P.O. Box 47, Abidjan 01, Côte d'Ivoire
| | - Véronique Laubhouet-Koffi
- Ligue Ivoirienne Contre l'Hypertension Artérielle et les Maladies Cardiovasculaires, 17, P.O. Box 773, Abidjan 17, Côte d'Ivoire
| | - Dinard Kouassi
- Institut National de Santé Publique, 01, P.O. Box 47, Abidjan 01, Côte d'Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01, P.O. Box 1303, Abidjan 01, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, 4002, Basel, Switzerland.,University of Basel, 4003, Basel, Switzerland
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22, P.O. Box 582, Abidjan 22, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01, P.O. Box 1303, Abidjan 01, Côte d'Ivoire
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Sumbele IUN, Tabi DB, Teh RN, Njunda AL. Urogenital schistosomiasis burden in school-aged children in Tiko, Cameroon: a cross-sectional study on prevalence, intensity, knowledge and risk factors. Trop Med Health 2021; 49:75. [PMID: 34530935 PMCID: PMC8444581 DOI: 10.1186/s41182-021-00362-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed at determining urogenital schistosomiasis (UGS) prevalence, intensity, knowledge and risk factors in school-aged children (SAC) in the new endemic focus of Tiko, Cameroon. Methods A cross-sectional study including 389 SAC of both sexes aged 5–15 years was carried out between April and June 2018. A structured questionnaire was used to collect demographic data, clinical and predisposing factors. Urine sample collected was used to detect Schistosoma haematobium eggs by filtration technique and microhaematuria by Heme dipstick COMBI 11. Logistic regression model was used to determine risk factors of UGS. Results The overall prevalence of UGS was 37.0% (CI 32.4–41.9) and 32.6% (CI 28.2–37.5) were positive by egg excretion while 24.4% (CI 20.4–28.9) by haematuria. S. haematobium egg excretion and haematuria were significantly higher in males (P = 0.016; P = 0.049) and children 12–15 years old (P = 0.009; P = 0.002), respectively. The mean number of eggs per 10 mL of urine was 77.6 (10.2) and ranged from 2 to 400. The proportion of light intensity of infection was higher (67.7%, CI 59.2–75.2) with no significant differences by sex, age and residence. However, the older children were more heavily infected when compared to the younger children, who had more of light infection. Overall, the mean knowledge score 1.42 (CI 1.32–1.51) on a scale of 6, was poor and the proportion of good knowledge of the disease (23.14%, CI 19.2–27.6) was low. Stream water contact (AOR = 4.94; P = 0.001) was the only significant risk factor identified. Conclusion Urogenital schistosomiasis is of public health concern among SAC in Tiko, Cameroon. Most participants have poor knowledge about the disease, hence education on vector-borne diseases and the avoidance of stream water contact should be implemented.
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Affiliation(s)
- Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Doris Bennen Tabi
- Department of Medical Laboratory Science, University of Buea, Buea, Cameroon
| | - Rene Ning Teh
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.
| | - Anne Longdoh Njunda
- Department of Medical Laboratory Science, University of Buea, Buea, Cameroon
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6
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Sumbele IUN, Otia OV, Bopda OSM, Ebai CB, Kimbi HK, Nkuo-Akenji T. Polyparasitism with Schistosoma haematobium, Plasmodium and soil-transmitted helminths in school-aged children in Muyuka-Cameroon following implementation of control measures: a cross sectional study. Infect Dis Poverty 2021; 10:14. [PMID: 33597042 PMCID: PMC7890808 DOI: 10.1186/s40249-021-00802-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/29/2021] [Indexed: 01/04/2023] Open
Abstract
Background Despite the ubiquity of polyparasitism, its health impacts have been inadequately studied. The aim of this study was to determine the prevalence and determinants of polyparasitism with Schistosoma haematobium, Plasmodium and soil-transmitted helminths (STH) following sustained control measures, as well as evaluate the outcomes and clinical correlates of infection in school-aged children (SAC) living in the schistosomiasis endemic focus of Muyuka-Cameroon. Methods In a cross-sectional study, urine, blood and stool samples were each collected from SAC (4–14 years) selected at random between March and June 2015. Microhaematuria in urine was detected using reagent strip and S. haematobium ova by filtration/microscopy methods. Plasmodium was detected using Giemsa-stained blood films and complete blood count was obtained using an auto-haematology analyser. STH in stool was detected by the Kato-Katz method. Categorical and continuous variables were compared as required, Kappa value estimated and the adjusted odds ratio (aOR) in the multivariate analysis was used to evaluate association of the risk factors with infection. Results Out of the 638 SAC examined, single infection was prevalent in 33.4% while polyparasitism was 19.9%. Prevalence of S. haematobium + Plasmodium was 7.8%; S. haematobium + STH was 0.8%; Plasmodium + STH was 0.8%; while S. haematobium + Plasmodium + STH was 0.9%. Higher preponderance of S. haematobium + Plasmodium infection occurred in females, those from Likoko, did not use potable water, practiced bathing in stream and carried out open defecation than their equivalents. However, being female (aOR = 2.38, P = 0.009) was the only significant risk factor identified. Anaemia was a common morbidity (74.3%) with a slight agreement with microscopy in predicting S. haematobium and Plasmodium infections. The sensitivity and specificity of haematuria (13.0%) in predicting S. haematobium infection was 46.5% and 100% with a moderate agreement with microscopy. Co-infection with S. haematobium and malaria parasite was significantly associated with threefold odds of history of fever in the last three days. Conclusions Polyparasitism is a public health problem in Muyuka with females most at risk. Anaemia prevalence is exacerbated in co- and triple-infections and together with a history of fever are of value in predicting polyparasitism.![]()
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Affiliation(s)
- Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon. .,Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
| | - Ofon Vitalis Otia
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | - Orelien Sylvain Mtopi Bopda
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, University of Buea, Buea, Cameroon
| | - Calvin Bisong Ebai
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Science, University of Bamenda, Bambili, Cameroon
| | - Helen KuoKuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Science, University of Bamenda, Bambili, Cameroon
| | - Theresa Nkuo-Akenji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
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Eyre MT, Stanton MC, Macklin G, Bartoníček Z, O'Halloran L, Eloundou Ombede DR, Chuinteu GD, Stewart M, LaCourse EJ, Tchuem Tchuenté LA, Stothard JR. Piloting an integrated approach for estimation of environmental risk of Schistosoma haematobium infections in pre-school-aged children and their mothers at Barombi Kotto, Cameroon. Acta Trop 2020; 212:105646. [PMID: 32721393 DOI: 10.1016/j.actatropica.2020.105646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/27/2022]
Abstract
Within schistosomiasis control, assessing environmental risk of currently non-treated demographic groups e.g. pre-school-aged children (PSAC) and their mothers is important. We conducted a pilot micro-epidemiological assessment at the crater lake of Barombi Kotto, Cameroon with GPS tracking and infection data from 12 PSAC-mother pairs (n = 24) overlaid against environmental sampling inclusive of snail, parasite and water-use information. Several high-risk locations or 'hotspots' with elevated water contact, increased intermediate snail host densities and detectable schistosome environmental DNA (eDNA) were identified. Exposure between PSAC and mother pairs was temporally and spatially associated, suggesting interventions which can benefit both groups simultaneously might be feasible. When attempting to interrupt parasite transmission in future, overlaid maps of snail, parasite and water contact data can guide fine-scale spatial targeting of environmental interventions.
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Affiliation(s)
- M T Eyre
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom; Centre for Health Informatics, Computing, and Statistics, Lancaster University Medical School, Lancaster LA1 4YW United Kingdom
| | - M C Stanton
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom; Centre for Health Informatics, Computing, and Statistics, Lancaster University Medical School, Lancaster LA1 4YW United Kingdom
| | - G Macklin
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom
| | - Z Bartoníček
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom
| | - L O'Halloran
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom
| | | | - G D Chuinteu
- Centre for Schistosomiasis & Parasitology, P.O. Box 7244 Yaoundé, Cameroon
| | - M Stewart
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom
| | - E J LaCourse
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom
| | | | - J R Stothard
- Liverpool School of Tropical Medicine, Liverpool L3 5QA United Kingdom.
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Tchami Mbagnia MC, Melachio Tanekou TT, Kengne Fokam AC, Nguiffo Nguete D, Wondji CS, Njiokou F. PCR-based molecular identification of two intermediate snail hosts of Schistosoma mansoni in Cameroon. Parasit Vectors 2020; 13:158. [PMID: 32228678 PMCID: PMC7106826 DOI: 10.1186/s13071-020-04033-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background Snails of the genus Biomphalaria are intermediate hosts of Schistosoma mansoni, the causative agent of the human intestinal schistosomiasis. Two Biomphalaria species (Biomphalaria pfeifferi and Biomphalaria camerunensis) are involved in the transmission in Cameroon, where the disease is present nationwide. However, difficulty in the identification of both vectors impedes proper assessment of the epidemiological burden caused by each species. To overcome this issue, we designed a PCR-based molecular diagnostic tool to improve the identification of these species. Methods We analyzed the internal transcribed spacer 2 (ITS2) region of Biomphalaria ribosomal DNA (rDNA) using polymerase chain reaction amplification (PCR) and restriction fragment length polymorphism (RFLP). Results The amplification of the ITS2 region of Biomphalaria snails resulted in a 490 bp fragment and produced two profiles for each species after digestion with the restriction enzyme Hpa II. The profile 1 (Bc-HpaII-1: 212-bp and 139-bp bands) for B. camerunensis, was common in all the sampling points; the profile 2 (Bc-HpaII-2: 212-bp and 189-bp bands), was only observed in the Lake Monoun Njindoun sampling site. Biomphalaria pfeifferi profile 1 (Bpf-HpaII-1: 211-bp and 128-bp bands) was common in most of B. pfeifferi sampling points; the profile 2 (Bpf-HpaII-2: 289-bp and 128-bp bands) was only observed in Mokolo (Far North Cameroon).The second restriction enzyme TaqαI, revealed three band profiles, Bc-TaqαI-1 (243-bp, 136-bp and 118-bp bands) and Bc-TaqαI-2 (244-bp, 136-bp and 99-bp) for B. camerunensis and Bpf-TaqαI-1 (242-bp, 135-bp and 107-bp bands) for B. pfeifferi. Sequencing analysis revealed the occurrence of six haplotypes for B. camerunensis and three haplotypes for B. pfeifferi. The level of gene flow was low and the Biomphalaria populations were not in demographic expansion according to neutrality tests (Tajima’s D and Fu’s Fs). Conclusions The PCR-RFLP technique revealed genetic diversity in Biomphalaria snails, and the combination with the morphological method could improve the identification of B. pfeifferi and B. camerunensis in Cameroon. This could help focus on the infection to evaluate the transmission risk with respect of the different species and to develop efficient and cost-effective control measures.![]()
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Affiliation(s)
- Mureille Carole Tchami Mbagnia
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Tito Trésor Melachio Tanekou
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon.,Department of Biological Sciences, Faculty of Science, University of Bamenda, Bamenda, Cameroon
| | - Alvine Christelle Kengne Fokam
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Daniel Nguiffo Nguete
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon.,Research Unit of Applied Biology and Ecology, University of Dschang, Dschang, Cameroon
| | - Charles Sinclair Wondji
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon.,Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Flobert Njiokou
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon. .,Centre for Research in Infectious Diseases, Yaoundé, Cameroon.
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Influence of malaria, soil-transmitted helminths and malnutrition on haemoglobin level among school-aged children in Muyuka, Southwest Cameroon: A cross-sectional study on outcomes. PLoS One 2020; 15:e0230882. [PMID: 32226023 PMCID: PMC7105131 DOI: 10.1371/journal.pone.0230882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 03/10/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The health of school-aged children (SAC) is often compromised by malaria parasitaemia (MP), soil-transmitted helminths (STH), and malnutrition in the tropics. The aim of this study was to determine the prevalence and influence of MP, STH and malnutrition on haemoglobin (Hb) levels as well as identify its predictors. METHODS This cross-sectional study was carried out in SAC (4-14 years) in Owe, Mpundu and Meanja villages in Muyuka, Southwest Cameroon. Hb concentration was measured using a URIT-12 Hb meter while MP and STH were determined by Giemsa staining of blood films and Kato-Katz technique respectively. Anthropometric measures (weight, height and mid upper arm circumference (MUAC)) of malnutrition (z-scores of <-2 standard deviations below mean) were obtained by standard methods. Categorical and continuous variables were compared appropriately, and multiple linear regression model was used to determine predictors of Hb level. RESULTS The prevalence of MP, STH, anaemia and malnutrition in the 401 SAC examined were 33.9%, 2.2%, 75.3% and 24.4% respectively. The prevalence of MP varied significantly with locality (P = 0.031). Stunting occurred commonly (23.7%) and was significantly higher in males (28.6%), children 11-14 years old (38.3%) and those of Meanja locality (47.4%) than their counterparts. Significantly higher prevalence of anaemia was observed in children of Meanja (89.5%) and those both MP positive and malnourished (86.2%). Moderate anaemia occurred commonly (60.6%) and children ≤6 years old had significantly (P = 0.034) higher prevalence (75.0%). Mean Hb level varied significantly (P = 0.004) with age and those ≤6 years old infected with MP had significantly (P = 0.022) lower values. Significant predictors of Hb levels were the MUAC (P <0.001) and the MP status (P = 0.035). Based on the Hb level (>11g/dL) and the absence of MP, STH and malnutrition, 13.7% of the SAC were considered as healthy. CONCLUSIONS The health of a majority of SAC is compromised by malaria, helminthiasis, malnutrition and other conditions not investigated. Anaemia is of major public health concern hence, intervention programmes that integrate malaria control with improvement of educational levels especially on proper nutrition and health care practices are desirable.
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Nkengni SMM, Zoumabo ATC, Soppa NPS, Sizono ABN, Vignoles P, Tchuenté LAT, Teukeng FFD. Current decline in schistosome and soil-transmitted helminth infections among school children at Loum, Littoral region, Cameroon. Pan Afr Med J 2019; 33:94. [PMID: 31489072 PMCID: PMC6713490 DOI: 10.11604/pamj.2019.33.94.18265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 05/09/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction Soil-transmitted helminth infections (STHs) and schistosomiasis have serious consequences for the health, education and nutrition of children in developing countries. As Loum is known as a highly endemic commune for these infections, several deworming campaigns have been carried out in the past. The purpose of this study was to determine any changes that have occurred since then in the characteristics of these infections among schoolchildren in this site. Methods A cross-sectional study was conducted in October 2016 on 289 schoolchildren. Stool and urine samples were collected and examined to determine the prevalence and intensity of helminth infections. Results The highest prevalence was noted for Schistosoma haematobium (34.2%), followed by Ascaris lumbricoides (8.6%), S. mansoni (4.9%) and Trichuris trichiura (4.9%) in decreasing order. A prevalence of less than 2% was noted for each of the other two helminths. The highest mean intensity was found for S. haematobium (39.6 eggs/10 ml of urine), followed by A. lumbricoides (24.2 eggs per gram of faeces: epg), Strongyloides stercoralis (16.6 epg) and Schistosoma mansoni (12.3 epg). The prevalence of T. trichiura was significantly higher in boys and that of S. haematobium in children aged 10 years or older, while the differences between other values of prevalence or between egg burdens were not significant. Conclusion Compared with values reported in 2003, the prevalence and intensity of schistosomiases and STH infections in Loum has sharply decreased in 2016. Confirmation of this decrease in the years to come allowed to space deworming campaigns among schoolchildren.
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Affiliation(s)
| | | | - Naomi Paloma Sangue Soppa
- Faculty of Health Sciences, Campus of Banekane, Université des Montagnes, P.O. Box 208, Bangangté, Cameroon
| | - Adèle Besch Ngwem Sizono
- Faculty of Health Sciences, Campus of Banekane, Université des Montagnes, P.O. Box 208, Bangangté, Cameroon
| | - Philippe Vignoles
- INSERM U 1094, Institute of Neuroepidemiology and Tropical Neurology, 2, rue du Docteur Raymond Marcland, 87025 Limoges, France
| | - Louis-Albert Tchuem Tchuenté
- Centre for Schistosomiasis and Parasitology, Texaco Omnisport and Laboratory of Parasitology and Ecology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon
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11
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Small bowel obstruction complicating an Ascaris lumbricoides infestation in a 4-year-old male: a case report. J Med Case Rep 2019; 13:155. [PMID: 31122293 PMCID: PMC6533677 DOI: 10.1186/s13256-019-2103-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 04/28/2019] [Indexed: 11/15/2022] Open
Abstract
Background Ascariasis is the leading helminthic infection worldwide, with its peak prevalence noted in children aged 2–10 years. Although mainly asymptomatic, chronic and heavy infestation could lead to severe complications such as malnutrition, poor physical and cognitive development, as well as intestinal obstruction. We report the case of a 4-year-old boy with intestinal obstruction due to Ascaris lumbricoides infestation and discuss its public health significance. Case presentation A 4-year-old Black African boy from the Menchum Division in the Northwest Region of Cameroon, with no history of deworming since birth, presented with a 3-day history of generalized abdominal pains, vomiting and obstipation, and abdominal distention evolving over a period of 6 months. Clinical and paraclinical findings were in favor of a subacute intestinal occlusion associated with an electrolyte imbalance. An exploratory laparotomy was done after correction of the electrolyte imbalance. Perioperative findings revealed a dilated small bowel obstructed by bundles of live worms. An enterotomy of 2 cm in length was done, and the bundles of Ascaris lumbricoides worms extracted manually and by milking through the stoma. His postoperative period was unremarkable, and he was discharged on postoperative day 7. He and his entire household were dewormed with a single dose of mebendazole 500 mg administered orally. A follow-up visit 1 week after discharge revealed a healed abdominal wound and normal bowel functions. Conclusion Despite considerable progress made on the control of soil-transmitted helminthiasis in Cameroon, the program faces a number of bottlenecks. Funding is inadequate, making data acquisition and hence remapping of high-risk zones difficult. Accessibility to enclaved zones where most high-risk children live is difficult, while community sensitization on soil-transmitted helminthiasis and proper education on the right environmental hygienic practices are lacking. All these challenges once addressed could go a long way to help achieve recently set sustainable development goals.
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12
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Nono JK, Kamdem SD, Netongo PM, Dabee S, Schomaker M, Oumarou A, Brombacher F, Moyou-Somo R. Schistosomiasis Burden and Its Association With Lower Measles Vaccine Responses in School Children From Rural Cameroon. Front Immunol 2018; 9:2295. [PMID: 30356757 PMCID: PMC6189399 DOI: 10.3389/fimmu.2018.02295] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/17/2018] [Indexed: 12/19/2022] Open
Abstract
Background and Methods: Schistosomiasis is debilitating and reported to impair immune responsiveness of infected hosts. In Cameroon, mass drug administration (MDA) is used in schoolchildren to reduce transmission of S. haematobium and S. mansoni. The effects of MDA and the impact of schistosomiasis on the titers of antibodies in vaccinated children have been poorly studied. We therefore assessed the prevalence of schistosomiasis in schoolchildren, eight months after MDA, in two locations: Barombi Koto (BK), endemic for S. haematobium (N = 169) and Yoro (Y), endemic for S. mansoni (N = 356). Age, gender, residence time and frequency of contact with river water were assessed as risk factors for infection and morbidity in both localities. In 70 schoolchildren from BK and 83 from Y, ultrasound was used to assess morbidity according to the WHO guidelines. Evaluation of measles antibodies was performed in previously vaccinated schoolchildren (14 with S. haematobium and 12 egg-negative controls from BK and 47 with S. mansoni and12 egg-negative controls from Y). Principal Findings and conclusions: The prevalence of S. haematobium was 25. 4% in BK (43/169) and 34.8% for S. mansoni in Y (124/356), indicating the persistent transmission of schistosomiasis despite MDA. Older age (AOR 1.31; 95%CI 1.12–1.54) and higher frequencies of exposure to river water (AOR 1.99; 95%CI 1.03–3.86) were identified as risks for infection in BK whereas only older age (OR 1.15; 95%CI 1.04–1.27) was a risk for infection in Y. Bladder pathology (score 2 to 5) was observed in 29.2% (7/24) of egg-positive children in BK and liver pathology (pattern C) in 31.1% (19/61) of egg-positive children in Y. There was a positive correlation between S. haematobium egg burden and bladder pathology (AOR 1.01; 95% CI 0.99–1.02) and positive correlation between S. mansoni-driven liver pathology and female gender (AOR 3.01; 95% CI 0.88–10.26). Anti-measles antibodies in vaccinated children were significantly lower in S. mansoni-infected when compared to egg-negative controls (p = 0.001), which was not observed in the S. haematobium-infected group from BK. Our results demonstrate a questionable efficacy of MDA alone in halting schistosomiasis transmission and confirm a possible immunomodulatory effect of S. mansoni on response to vaccines.
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Affiliation(s)
- Justin Komguep Nono
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon.,Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | - Smritee Dabee
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Michael Schomaker
- Centre for Infectious Disease Epidemiology & Research, University of Cape Town, Cape Town, South Africa
| | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Roger Moyou-Somo
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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Association of riverine prawns and intermediate host snails and correlation with human schistosomiasis in two river systems in south-eastern Côte d'Ivoire. Parasitology 2018; 145:1792-1800. [PMID: 30246683 DOI: 10.1017/s003118201800135x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current emphasis of schistosomiasis control is placed on preventive chemotherapy using praziquantel. However, reinfection may occur rapidly in the absence of complementary interventions. Recent studies from Senegal suggest that predatory prawns might feed on intermediate host snails and thus impact on schistosomiasis transmission. We designed a study with four repeated cross-sectional surveys pertaining to prawns and snails, coupled with a single cross-sectional parasitological survey among humans. We assessed for potential associations between the presence/density of prawns and snails and correlation with Schistosoma infection in a composite sample of school-aged children and adults. The study was carried out between October 2015 and December 2016 in 24 villages located near the Agnéby and Mé coastal river systems in south-eastern Côte d'Ivoire. At each site, snails and prawns were collected, and in each village, 150 individuals were subjected to stool and urine examination for the diagnosis of Schistosoma mansoni and S. haematobium. We found peaks of relative abundance of intermediate host snails in the villages of the Agnéby River system, while predatory prawns were predominantly recorded in the Mé River system. A negative association was observed between intermediate host snail densities and riverine prawns; however, no pattern was found between this trend in the predator-prey relationship and the prevalence of human schistosomiasis.
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Tchakounté BN, Nkouayep VR, Poné JW. Soil Contamination Rate, Prevalence, Intensity of Infection of Geohelminths and Associated Risk Factors among Residents in Bazou (West Cameroon). Ethiop J Health Sci 2018; 28:63-72. [PMID: 29622908 PMCID: PMC5866290 DOI: 10.4314/ejhs.v28i1.8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Soil-transmitted helminths (STH) infections remain an important public health problem in the tropics. This study aimed to evaluate the soil contamination rate and prevalence of infestations of geohelminth among residents in Bazou. Methods Four hundred (400) soil samples and 182 stool specimens were collected respectively from four sites and from inhabitants aged 1 to 40 years and above in 12 households. A questionnaire was administered to evaluate risk factors of STH-infections. Soil samples were screened using sucrose centrifugal flotation method while stool specimens were analyzed using two techniques. Results Out of the 400 soil and 182 stool samples examined, 13(3.3%) and 9(4.95%) were positive respectively after analyses. Soil contamination rates were 2%, 1% and 0.3% for Ascaris, Trichuris and hookworm eggs respectively while 4.95% of stool samples were positive to one species nematode (Ascaris lumbricoides). The soil contamination rate observed (5%) in the rainy season was significantly different (p>0.05) from the one observed (1.5%) in the dry season. Irrespectively of the season, the most frequent parasite identified was Ascaris spp. Soils around houses were more contaminated 6(12%) as compared to those collected from markets 5(10%) and roads 2(4%) while those around classrooms were not contaminated. Participants in the age group of 1–10 were more infected. Factors such as no hand washing habit and untrimmed finger nails were found to be important risk factors for STH. Conclusion These results suggest the necessity to promote measures that could help to reduce STH infections.
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Affiliation(s)
- Blandine Ngatou Tchakounté
- Laboratory of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Vanessa Rosine Nkouayep
- Laboratory of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Josué Wabo Poné
- Laboratory of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
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15
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Bizimana P, Polman K, Van Geertruyden JP, Nsabiyumva F, Ngenzebuhoro C, Muhimpundu E, Ortu G. Capacity gaps in health facilities for case management of intestinal schistosomiasis and soil-transmitted helminthiasis in Burundi. Infect Dis Poverty 2018; 7:66. [PMID: 29970181 PMCID: PMC6030799 DOI: 10.1186/s40249-018-0447-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/31/2018] [Indexed: 12/29/2022] Open
Abstract
Background Schistosomiasis and soil-transmitted helminthiasis (STH) are endemic diseases in Burundi. STH control is integrated into health facilities (HF) across the country, but schistosomiasis control is not. The present study aimed to assess the capacity of HF for integrating intestinal schistosomiasis case management into their routine activities. In addition, the current capacity for HF-based STH case management was evaluated. Methods A random cluster survey was carried out in July 2014, in 65 HF located in Schistosoma mansoni and STH endemic areas. Data were collected by semi-quantitative questionnaires. Staff with different functions at the HF were interviewed (managers, care providers, heads of laboratory and pharmacy and data clerks). Data pertaining to knowledge of intestinal schistosomiasis and STH symptoms, human and material resources and availability and costs of diagnostic tests and treatment were collected. Findings Less than half of the 65 care providers mentioned one or more major symptoms of intestinal schistosomiasis (abdominal pain 43.1%, bloody diarrhoea 13.9% and bloody stool 7.7%). Few staff members (15.7%) received higher education, and less than 10% were trained in-job on intestinal schistosomiasis case management. Clinical guidelines and laboratory protocols for intestinal schistosomiasis diagnosis and treatment were available in one third of the HF. Diagnosis was performed by direct smear only. Praziquantel was not available in any of the HF. The results for STH were similar, except that major symptoms were more known and cited (abdominal pain 69.2% and diarrhoea 60%). Clinical guidelines were available in 61.5% of HF, and albendazole or mebendazole was available in all HF. Conclusions The current capacity of HF for intestinal schistosomiasis and STH detection and management is inadequate. Treatment was not available for schistosomiasis. These issues need to be addressed to create an enabling environment for successful integration of intestinal schistosomiasis and STH case management into HF routine activities in Burundi for better control of these diseases. Electronic supplementary material The online version of this article (10.1186/s40249-018-0447-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul Bizimana
- Global Health Institute, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Gouverneur Kinsbergencentrum, Doornstraat 331, Wilrijk, 2610, Antwerp, Belgium. .,Département des Sciences de la Santé Publique, Direction de la Formation, Institut National de Santé Publique, B.P, 6807, Bujumbura, Burundi. .,Département de Médecine Communautaire, Faculté de Médecine de Bujumbura, Université du Burundi, Bujumbura, Burundi. .,Département des Sciences de la Santé Publique, Institut Universitaire des Sciences de la Santé et de Développement Communautaire, Bujumbura, Burundi.
| | - Katja Polman
- Medical Helminthology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Gouverneur Kinsbergencentrum, Doornstraat 331, Wilrijk, 2610, Antwerp, Belgium
| | - Frédéric Nsabiyumva
- Département de Médecine Interne, Faculté de Médecine de Bujumbura, Université du Burundi, Bujumbura, Burundi
| | - Céline Ngenzebuhoro
- Département des Sciences de la Santé Publique, Institut Universitaire des Sciences de la Santé et de Développement Communautaire, Bujumbura, Burundi
| | - Elvis Muhimpundu
- Programme National Intégré de Lutte contre les Maladies Tropicales Négligées et la Cécité, Département des programmes de santé, Ministère de la Santé Publique et de la Lutte contre le Sida, Bujumbura, Burundi
| | - Giuseppina Ortu
- Department of Infectious Diseases and Epidemiology, Schistosomiasis Control Initiative, Imperial College, London, UK
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Macklin G, Stanton MC, Tchuem-Tchuenté LA, Stothard JR. A pilot study using wearable global positioning system data loggers to compare water contact levels: Schistosoma haematobium infection in pre-school-age children (PSAC) and their mothers at Barombi Kotto, Cameroon. Trans R Soc Trop Med Hyg 2018; 112:361-365. [PMID: 29992295 DOI: 10.1093/trstmh/try059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 06/27/2018] [Indexed: 12/22/2022] Open
Abstract
Background Barombi Kotto, Cameroon serves as a reference location for assessing intervention strategies against Schistosoma haematobium. Methods As part of a pilot study, the whole community was treated with praziquantel, inclusive of pre-school-age children (PSAC) and their mothers. One year later, egg-patent infections were reassessed and water contact patterns of 12 pairs of PSAC and their mothers were measured with global positioning system (GPS) data loggers. Results A substantial reduction in general infection prevalence, from 44.8% to 12.2%, was observed but certain PSAC and mothers continued to have egg-patent infections. Analysis of GPS data demonstrated similar water contact levels between the child and mother groups, although certain individuals were numerical outliers. Conclusions This study shows the potential of GPS data loggers to clarify the at-risk status of PSAC and mothers.
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Affiliation(s)
- Grace Macklin
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
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Coulibaly JT, Ouattara M, Barda B, Utzinger J, N'Goran EK, Keiser J. A Rapid Appraisal of Factors Influencing Praziquantel Treatment Compliance in Two Communities Endemic for Schistosomiasis in Côte d'Ivoire. Trop Med Infect Dis 2018; 3:tropicalmed3020069. [PMID: 30274465 PMCID: PMC6073597 DOI: 10.3390/tropicalmed3020069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/09/2018] [Accepted: 06/14/2018] [Indexed: 01/12/2023] Open
Abstract
Over the past decade, a significant reduction in the prevalence of schistosomiasis has been achieved, partially explained by the large-scale administration of praziquantel. Yet, the burden of schistosomiasis remains considerable, and factors influencing intervention coverage are important. This study aimed to deepen the understanding of low treatment coverage rates observed in two schistosomiasis-endemic villages in Côte d’Ivoire. The research was conducted in August 2015, in Moronou and Bigouin, two villages of Côte d’Ivoire that are endemic for Schistosoma haematobium and S. mansoni, respectively. After completion of a clinical trial, standard praziquantel treatment (single 40 mg/kg oral dose) was offered to all village inhabitants by community health workers using a house-to-house approach. Factors influencing treatment coverage were determined by a questionnaire survey, randomly selecting 405 individuals. The overall treatment coverage rate was only 47.6% (2730/5733) with considerable intervillage heterogeneity (27.7% in Bigouin (302/1091) versus 52.3% in Moronou (2428/4642)). Among the 200 individuals interviewed in Moronou, 50.0% were administered praziquantel, while only 19.5% of the 205 individuals interviewed in Bigouin received praziquantel. The main reasons for low treatment coverage were work-related (agricultural activities), the bitter taste of praziquantel and previous experiences with adverse events. The most suitable period for treatment campaigns was reported to be the dry season. More than three-quarter of the interviewees who had taken praziquantel (overall, 116/140; Moronou, 84/100; Bigouin, 32/40) declared that they would not participate in future treatments (p < 0.001). In order to enhance praziquantel treatment coverage, careful consideration should be given to attitudes and practices, such as prior or perceived adverse events and taste of praziquantel, and appropriate timing, harmonized with agricultural activities. Without such understanding, breaking the transmission of schistosomiasis remains a distant goal.
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Affiliation(s)
- Jean T Coulibaly
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Beatrice Barda
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
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18
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Raso G, Essé C, Dongo K, Ouattara M, Zouzou F, Hürlimann E, Koffi VA, Coulibaly G, Mahan V, Yapi RB, Koné S, Coulibaly JT, Meïté A, Guéhi-Kabran MC, Bonfoh B, N'Goran EK, Utzinger J. An Integrated Approach to Control Soil-Transmitted Helminthiasis, Schistosomiasis, Intestinal Protozoa Infection, and Diarrhea: Protocol for a Cluster Randomized Trial. JMIR Res Protoc 2018; 7:e145. [PMID: 29895511 PMCID: PMC6019843 DOI: 10.2196/resprot.9166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/05/2018] [Accepted: 03/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background The global strategy to control helminthiases (schistosomiasis and soil-transmitted helminthiasis) emphasizes preventive chemotherapy. However, in the absence of access to clean water, improved sanitation, and adequate hygiene, reinfection after treatment can occur rapidly. Integrated approaches might be necessary to sustain the benefits of preventive chemotherapy and make progress toward interruption of helminthiases transmission. Objective The aim of this study was to assess and quantify the effect of an integrated control package that consists of preventive chemotherapy, community-led total sanitation, and health education on soil-transmitted helminthiasis, schistosomiasis, intestinal protozoa infection, and diarrhea in rural Côte d’Ivoire. Methods In a first step, a community health education program was developed that includes an animated cartoon to promote improved hygiene and health targeting school-aged children, coupled with a health education theater for the entire community. In a second step, a cluster randomized trial was implemented in 56 communities of south-central Côte d’Ivoire with 4 intervention arms: (1) preventive chemotherapy; (2) preventive chemotherapy plus community-led total sanitation; (3) preventive chemotherapy plus health education; and (4) all 3 interventions combined. Before implementation of the aforementioned interventions, a baseline parasitologic, anthropometric, and hygiene-related knowledge, attitudes, practices, and beliefs survey was conducted. These surveys were repeated 18 and 39 months after the baseline cross-sectional survey to determine the effect of different interventions on helminth and intestinal protozoa infection, nutritional indicators, and knowledge, attitudes, practices, and beliefs. Monitoring of diarrhea was done over a 24-month period at 2-week intervals, starting right after the baseline survey. Results Key results from this cluster randomized trial will shed light on the effect of integrated approaches consisting of preventive chemotherapy, community-led total sanitation, and health education against infections with soil-transmitted helminths, schistosomes, an intestinal protozoa and prevention of diarrhea in a rural part of Côte d’Ivoire. Conclusions The research provided new insights into the acceptability, strengths, and limitations of an integrated community-based control package targeting helminthiases, intestinal protozoa infections, and diarrhea in rural communities of Côte d’Ivoire. In the longer term, the study will allow determining the effect of the integrated control approach on infection patterns with parasitic worms and intestinal protozoa, diarrheal incidence, anthropometric measures, and hygiene-related knowledge, attitudes, practices, and beliefs. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 53102033; http://www.isrctn.com/ISRCTN53102033 (Archived by WebCite at http://www.webcitation.org/6wpnXEiHo) Registered Report Identifier RR1-10.2196/9166
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Affiliation(s)
- Giovanna Raso
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Clémence Essé
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de l'Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Kouassi Dongo
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de Terre et des Ressources Minières, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Mamadou Ouattara
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Fabien Zouzou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,FAIRMED, Bern, Switzerland
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Veronique A Koffi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de l'Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Gaoussou Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Virginie Mahan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Sciences de Terre et des Ressources Minières, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.,UNICEF Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Richard B Yapi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jean Tenena Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Aboulaye Meïté
- Programme National de Lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministère de la Santé et de l'Hygiène Publique, Abidjan, Côte d'Ivoire
| | | | - Bassirou Bonfoh
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eliézer Kouakou N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Tian-Bi YNT, Ouattara M, Knopp S, Coulibaly JT, Hürlimann E, Webster B, Allan F, Rollinson D, Meïté A, Diakité NR, Konan CK, N'Goran EK, Utzinger J. Interrupting seasonal transmission of Schistosoma haematobium and control of soil-transmitted helminthiasis in northern and central Côte d'Ivoire: a SCORE study protocol. BMC Public Health 2018; 18:186. [PMID: 29378542 PMCID: PMC5789673 DOI: 10.1186/s12889-018-5044-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/08/2018] [Indexed: 12/19/2022] Open
Abstract
Background To achieve a world free of schistosomiasis, the objective is to scale up control and elimination efforts in all endemic countries. Where interruption of transmission is considered feasible, countries are encouraged to implement a comprehensive intervention package, including preventive chemotherapy, information, education and communication (IEC), water, sanitation and hygiene (WASH), and snail control. In northern and central Côte d’Ivoire, transmission of Schistosoma haematobium is seasonal and elimination might be achieved. In a cluster-randomised trial, we will assess different treatment schemes to interrupt S. haematobium transmission and control soil-transmitted helminthiasis over a 3-year period. We will compare the impact of (i) arm A: annual mass drug administration (MDA) with praziquantel and albendazole before the peak schistosomiasis transmission season; (ii) arm B: annual MDA after the peak schistosomiasis transmission season; (iii) arm C: two yearly treatments before and after peak schistosomiasis transmission; and (iv) arm D: annual MDA before peak schistosomiasis transmission, coupled with chemical snail control using niclosamide. Methods/design The prevalence and intensity of S. haematobium and soil-transmitted helminth infections will be assessed using urine filtration and Kato-Katz thick smears, respectively, in six administrative regions in northern and central parts of Côte d’Ivoire. Once a year, urine and stool samples will be collected and examined from 50 children aged 5–8 years, 100 children aged 9–12 years and 50 adults aged 20–55 years in each of 60 selected villages. Changes in S. haematobium and soil-transmitted helminth prevalence and intensity will be assessed between years and stratified by intervention arm. In the 15 villages randomly assigned to intervention arm D, intermediate host snails will be collected three times per year, before niclosamide is applied to the selected freshwater bodies. The snail abundance and infection rates over time will allow drawing inference on the force of transmission. Discussion This cluster-randomised intervention trial will elucidate whether in an area with seasonal transmission, the four different treatment schemes can interrupt S. haematobium transmission and control soil-transmitted helminthiasis. Lessons learned will help to guide schistosomiasis control and elimination programmes elsewhere in Africa. Trial registration ISRCTNISRCTN10926858. Registered 21 December 2016. Retrospectively registered.
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Affiliation(s)
- Yves-Nathan T Tian-Bi
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 770, Abidjan, 22, Côte d'Ivoire. .,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan, 01, Côte d'Ivoire.
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 770, Abidjan, 22, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan, 01, Côte d'Ivoire
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Jean T Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 770, Abidjan, 22, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan, 01, Côte d'Ivoire.,Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Bonnie Webster
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, United Kingdom
| | - Fiona Allan
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, United Kingdom
| | - David Rollinson
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, United Kingdom
| | - Aboulaye Meïté
- Programme National de Lutte contre les Maladies Tropicales Négligées à Chimiothérapie Préventive, Ministère de la Santé et de l'Hygiène Publique, 06 BP 6394, Abidjan, 06, Côte d'Ivoire
| | - Nana R Diakité
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 770, Abidjan, 22, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan, 01, Côte d'Ivoire
| | - Cyrille K Konan
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 770, Abidjan, 22, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan, 01, Côte d'Ivoire
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 770, Abidjan, 22, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan, 01, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
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Essé C, Koffi VA, Kouamé A, Dongo K, Yapi RB, Moro HM, Kouakou CA, Palmeirim MS, Bonfoh B, N’Goran EK, Utzinger J, Raso G. "Koko et les lunettes magiques": An educational entertainment tool to prevent parasitic worms and diarrheal diseases in Côte d'Ivoire. PLoS Negl Trop Dis 2017; 11:e0005839. [PMID: 28934198 PMCID: PMC5630154 DOI: 10.1371/journal.pntd.0005839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 10/06/2017] [Accepted: 07/31/2017] [Indexed: 11/26/2022] Open
Abstract
Background Integrated control programs, emphasizing preventive chemotherapy along with health education, can reduce the incidence of soil-transmitted helminthiasis and schistosomiasis. The aim of this study was to develop an educational animated cartoon to improve school children’s awareness regarding soil-transmitted helminthiasis, diarrheal diseases, and related hygiene practices in Côte d’Ivoire. The key messages included in the cartoon were identified through prior formative research to specifically address local knowledge gaps. Methodology In a first step, preliminary research was conducted to assess the knowledge, attitudes, practices, and beliefs of school-aged children regarding parasitic worm infections and hygiene, to identify key health messages to be included in an animated cartoon. Second, an animated cartoon was produced, which included the drafting of the script and story board, and the production of the cartoon’s initial version. Finally, the animated cartoon was pilot tested in eight selected schools and further fine-tuned. Principal findings According to the questionnaire results, children believed that the consumption of sweet food, eating without washing their hands, sitting on the floor, and eating spoiled food were the main causes of parasitic worm infections. Abdominal pain, diarrhea, lack of appetite, failure to grow, and general fatigue were mentioned as symptoms of parasitic worm infections. Most of the children knew that they should go to the hospital for treatment if they experienced symptoms of parasitic worm diseases. The animated cartoon titled “Koko et les lunettes magiques” was produced by Afrika Toon, in collaboration with a scientific team composed of epidemiologists, civil engineers, and social scientists, and the local school children and teachers. Pilot testing of the animated cartoon revealed that, in the short term, children grasped and kept key messages. Most of the children who were shown the cartoon reported to like it. Acceptance of the animated cartoon was high among children and teachers alike. The messaging was tailored to improve knowledge and practices for prevention of helminthiases and diarrheal diseases through prior identification of knowledge gaps. Integration of such education tools into the school curriculum, along with deworming campaigns, might improve sustainability of control and elimination efforts against helminthiases and diarrheal diseases. Soil-transmitted helminthiases, schistosomiasis, and diarrhea remain important public health issues in sub-Saharan Africa. Health educational animated cartoons can help raise awareness and improve hygiene practices, and thus contribute to the control and elimination of these diseases. For the development of an educational animated cartoon, we first evaluated the knowledge, attitudes, practices, and beliefs of school-aged children in Côte d’Ivoire regarding soil-transmitted helminthiases, diarrhea, and schistosomiasis in order to identify setting-specific health messages for our animated cartoon. We found that children believed that the consumption of sweet food, eating without washing their hands, sitting on the floor, and eating spoiled food were the main causes of parasitic worm infections. As a next step, the alpha version of the animated cartoon was produced and given the title: “Koko et les lunettes magiques”. The animated cartoon was pre-tested in eight schools and further developed. Our study found that children could retain most of the information provided by the animated cartoon. It is suggested that such a tool, integrated into the school curriculum, together with deworming campaigns in Côte d’Ivoire, might improve the sustainability of control and elimination efforts against soil-transmitted helminthiases, diarrhea, and schistosomiasis.
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Affiliation(s)
- Clémence Essé
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Véronique A. Koffi
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Kouassi Dongo
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Richard B. Yapi
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Honorine M. Moro
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Christiane A. Kouakou
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Marta S. Palmeirim
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Eliézer K. N’Goran
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Njunda AL, Ndzi EN, Assob JCN, Kamga HLF, Kwenti ET. Prevalence and factors associated with urogenital schistosomiasis among primary school children in barrage, Magba sub-division of Cameroon. BMC Public Health 2017; 17:618. [PMID: 28673343 PMCID: PMC5496429 DOI: 10.1186/s12889-017-4539-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 06/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the prevalence and intensity as well as the factors associated with urogenital schistosomiasis (US) in Barrage, a rural community around the Mape΄ dam, in the West region of Cameroon not previously documented for transmission. METHODS In this cross sectional parasitological survey, 382 children were enrolled from three primary schools in the study area between March and May 2016. A semi-structured questionnaire was used to collect information on demographics, clinical and predisposing factors. The syringe filtration technique was used to analyse urine samples. Samples with visible or gross haematuria were recorded prior to filtration. The Pearson chi-square, the student T-test and logistic regression were all performed as part of the statistical analyses. RESULTS The overall prevalence of US was 41.1% (95% CI: 36.1-46.2). Infection was more common in children below 10 years (p = 0.009), in males (p = 0.029), and in children who frequently come into contact with water from the dam (p < 0.001). Furthermore, US was more common in children attending Ecole Public (EP) Manbonko Bord (81.1%, p < 0.001) which is very close to the dam and in children from a fishing background (80.9%, p < 0.001). On the contrary, knowledge about schistosomiasis was not observed to be associated with prevalence. In this study, the intensity of infection was observed to be higher in children below 10 years (p < 0.001), in males (p = 0.001), and in children attending EP Manbonko Bord (p < 0.001). The intensity of infection was also highest in children presenting with haematuria (p < 0.001). Frequent contact with water from the dam and having parents whose occupation was fishing were identified as the associated factors for US. CONCLUSION A high prevalence of US was observed in school-aged children in the study area especially in those attending EP Manbonko Bord. Limiting contact with water from the dam, control of the snail intermediate host, provision of portable water and mass treatment of the entire population are proposed as some of the measures to reduce and eventually eliminate transmission in the area.
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Affiliation(s)
- Anna Longdoh Njunda
- Department of Medical Laboratory Sciences, University of Buea, P.B, 63 Buea, Cameroon
| | - Emmanuel Ngala Ndzi
- Department of Medical Laboratory Sciences, University of Buea, P.B, 63 Buea, Cameroon
| | | | | | - Emmanuel Tebit Kwenti
- Department of Medical Laboratory Sciences, University of Buea, P.B, 63 Buea, Cameroon
- Department of Microbiology and Parasitology, University of Buea, P.B, 63 Buea, Cameroon
- Department of Public Health and Hygiene, University of Buea, P.B, 63 Buea, Cameroon
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Sumbele IUN, Nkemnji GB, Kimbi HK. Soil-transmitted helminths and plasmodium falciparum malaria among individuals living in different agroecosystems in two rural communities in the mount Cameroon area: a cross-sectional study. Infect Dis Poverty 2017; 6:67. [PMID: 28302147 PMCID: PMC5353792 DOI: 10.1186/s40249-017-0266-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 02/17/2017] [Indexed: 11/30/2022] Open
Abstract
Background Soil-transmitted helminths (STHs) and Plasmodium falciparum infections remain public health problems in Cameroon. A cross-sectional study was carried out in the Mount Cameroon area to determine the prevalence and intensity of STHs and P. falciparum infections in individuals living in different agroecosystems; to assess the influence of these infections on haematological parameters; and to identify the risk factors associated with STH infections. Methods STH and malaria parasites were detected using the Kato-Katz method and Giemsa staining of blood films, respectively. Complete blood count values were obtained using an automatic haematology analyser. Soil samples were analysed using the sucrose floatation sedimentation method. Categorical and continuous variables were compared as required and logistic regression models were used to assess the risk factors for STH infections and anaemia. Results Of the 450 participants examined, STHs, P. falciparum and mixed co-infections were detected in 14.0, 33.3 and 5.6% of participants, respectively. Significantly higher prevalences of Ascaris (18.8%) and Trichuris (7.9%) infections were observed in participants from tea plantation areas compared to those from banana and palm plantation areas, with similar trends in egg density. P. falciparum prevalence and parasite density were comparable between the different agroecosystems. The overall prevalence of anaemia was 64.2%. The prevalence of haematological manifestations such as moderate (48.0%) and severe (8.0%) anaemia, leucopenia (26.9%) and microcytosis (30.8%) was significantly higher among Plasmodium-STH co-infected participants. Soil samples from plantations showed the highest prevalences of STH eggs compared to soil samples from areas around pit toilets and public water taps. Living in a tea plantation area (OR = 3.07), age (AOR = 1.49) and lack of access to potable water (OR = 2.25) were identified as risk factors for STH infections, while the age groups 15–25 years (OR = 2.928) and 26–35 years (OR = 2.832), and being female (OR = 2.671) were significant risk factors for anaemia. Conclusions STHs, malaria and anaemia are still of public health concern in plantation communities. Co-infections negatively influence haematological parameters. The tea farming agroecosystem, age and lack of access to potable water were identified as significant risk factors for STH infections. Trial registration Not applicable. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0266-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, University of Bamenda, Bamenda, Cameroon
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Campbell SJ, Stothard JR, O'Halloran F, Sankey D, Durant T, Ombede DE, Chuinteu GD, Webster BL, Cunningham L, LaCourse EJ, Tchuem-Tchuenté LA. Urogenital schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon: An epidemiological update at Barombi Mbo and Barombi Kotto crater lakes assessing prospects for intensified control interventions. Infect Dis Poverty 2017; 6:49. [PMID: 28238285 PMCID: PMC5327519 DOI: 10.1186/s40249-017-0264-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/17/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The crater lakes of Barombi Mbo and Barombi Kotto are well-known transmission foci of schistosomiasis and soil-transmitted helminthiasis having had several important control initiatives previously. To collect contemporary epidemiological information, a cross-sectional survey was undertaken inclusive of: signs and symptoms of disease, individual treatment histories, local water, sanitation and hygiene (WASH)-related factors and malacological surveillance, with molecular characterisation of specimens. METHODS At each lake, a community cross-sectional survey was undertaken using a combination of stool and urine parasitological sampling, and interview with pro-forma questionnaires. A total of 338 children and adults participated. Material from snail and parasite species were characterised by DNA methods. RESULTS Egg-patent prevalence of urogenital schistosomiasis was 8.7% at Barombi Mbo (all light-intensity infections) and 40.1% at Barombi Kotto (21.2% heavy-intensity infections). Intestinal schistosomiasis was absent. At Barombi Kotto, significantly more women reported signs and symptoms associated with female genital schistosomiasis. While there had been extensive recent improvement in WASH-related infrastructure at Barombi Mbo, water contact risk scores were higher among schistosomiasis-infected participants (P < 0.001) and at Barombi Kotto in general (P < 0.001). Across both lakes, mean prevalence of STH was very low (6.3%) evidencing an impressive decrease of 79.0% over the last decade; neither Strongyloides stercoralis nor Ascaris lumbricoides were found. A total of 29 freshwater sampling sites were inspected for snails, 13 in Barombi Mbo and 16 in Barombi Kotto; water chemistry differed significantly (P < 0.0001) between lakes for both mean pH (7.9 v. 9.6) and mean conductivity (64.3 μS v. 202.1 μS) respectively. Only two Bulinus camerunensis found on the central island of Barombi Kotto were observed to shed schistosome cercariae, but schistosome DNA was later detected in Bulinus sampled from both lakes as well as in Indoplanorbis exustus, an invasive species from Asia. CONCLUSIONS STH is currently at very low levels while urogenital schistosomiasis is of greatest concern at Barombi Kotto. This assessment highlights a unique opportunity for further study of the epidemiological dynamics at these crater lakes, to evaluate future intensified interventions both in terms of gaining and sustaining control at Barombi Kotto or in moving towards local interruption of transmission of both diseases at Barombi Mbo.
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Affiliation(s)
- Suzy J Campbell
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Faye O'Halloran
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Deborah Sankey
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Timothy Durant
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | | | | | - Bonnie L Webster
- Department of Life Sciences, Parasites and Vectors Division, Natural History Museum, London, SW7 5BD, UK
- London Centre for Neglected Tropical Disease Research, London, UK
| | - Lucas Cunningham
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - E James LaCourse
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - 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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Tchuem Tchuenté LA, Rollinson D, Stothard JR, Molyneux D. Moving from control to elimination of schistosomiasis in sub-Saharan Africa: time to change and adapt strategies. Infect Dis Poverty 2017; 6:42. [PMID: 28219412 PMCID: PMC5319063 DOI: 10.1186/s40249-017-0256-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 02/08/2017] [Indexed: 11/17/2022] Open
Abstract
Schistosomiasis is a water borne parasitic disease of global importance and with ongoing control the disease endemic landscape is changing. In sub-Saharan Africa, for example, the landscape is becoming ever more heterogeneous as there are several species of Schistosoma that respond in different ways to ongoing preventive chemotherapy and the inter-sectoral interventions currently applied. The major focus of preventive chemotherapy is delivery of praziquantel by mass drug administration to those shown to be, or presumed to be, at-risk of infection and disease. In some countries, regional progress may be uneven but in certain locations there are very real prospects to transition from control into interruption of transmission, and ultimately elimination. To manage this transition requires reconsideration of some of the currently deployed diagnostic tools used in surveillance and downward realignment of existing prevalence thresholds to trigger mass treatment. A key challenge will be maintaining and if possible, expanding the current donation of praziquantel to currently overlooked groups, then judging when appropriate to move from mass drug administration to selective treatment. In so doing, this will ensure the health system is adapted, primed and shown to be cost-effective to respond to these changing disease dynamics as we move forward to 2020 targets and beyond.
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Affiliation(s)
- Louis-Albert Tchuem Tchuenté
- National Programme for the Control of Schistosomiasis and STH, Ministry of Public Health, Yaoundé, Cameroon. .,Centre for Schistosomiasis and Parasitology, University of Yaoundé I, Yaoundé, Cameroon.
| | - David Rollinson
- Department of Life Sciences, The Natural History Museum, London, SW7 5BD, UK
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - David Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
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Bladder outlet obstruction; a rare complication of the neglected schistosome, Schistosoma haematobium: two case reports and public health challenges. BMC Res Notes 2016; 9:493. [PMID: 27876076 PMCID: PMC5120452 DOI: 10.1186/s13104-016-2303-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 11/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomiasis is a severe parasitic infestation with debilitating complications and is the third most devastating tropical disease in the world. It is one of the neglected tropical diseases (NTDs) with a high disease-burden. We present two rare cases of bladder outlet obstruction: one which led to a chronic kidney disease and ultimately death and a second which recovered after treatment with praziquantel. CASE PRESENTATIONS A 72 year old male presented with lower urinary tract symptoms which culminated in an episode of acute urinary retention. The patient had never received preventive chemotherapy with praziquantel. After suprapubic aspiration, the cause of the obstructive uropathy was found to be several mature live worms of Schistosoma haematobium. Despite treatment with praziquantel and haemodialysis; we lost the patient due to sepsis from a urinary tract infection. In the second case, a 15 year old male presented with LUTS for a 1 year duration and was diagnosed to have schistosomiasis after eggs of Schistosoma haematobium were found in his urine. He was treated with praziquantel. CONCLUSION There are several gaps in the public health policies in place to control this NTD in Cameroon as annual distribution of preventive chemotherapy is inadequate due to inaccessibility of some high-endemic zones and is based on data obtained two decades ago. Population education is insufficient leading to poor health-seeking behaviour. These gaps in public health policies need to be addressed to aid in the overall achievement of the sustainable development goals.
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Walz Y, Wegmann M, Dech S, Vounatsou P, Poda JN, N'Goran EK, Utzinger J, Raso G. Modeling and Validation of Environmental Suitability for Schistosomiasis Transmission Using Remote Sensing. PLoS Negl Trop Dis 2015; 9:e0004217. [PMID: 26587839 PMCID: PMC4654500 DOI: 10.1371/journal.pntd.0004217] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 10/15/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Schistosomiasis is the most widespread water-based disease in sub-Saharan Africa. Transmission is governed by the spatial distribution of specific freshwater snails that act as intermediate hosts and human water contact patterns. Remote sensing data have been utilized for spatially explicit risk profiling of schistosomiasis. We investigated the potential of remote sensing to characterize habitat conditions of parasite and intermediate host snails and discuss the relevance for public health. METHODOLOGY We employed high-resolution remote sensing data, environmental field measurements, and ecological data to model environmental suitability for schistosomiasis-related parasite and snail species. The model was developed for Burkina Faso using a habitat suitability index (HSI). The plausibility of remote sensing habitat variables was validated using field measurements. The established model was transferred to different ecological settings in Côte d'Ivoire and validated against readily available survey data from school-aged children. PRINCIPAL FINDINGS Environmental suitability for schistosomiasis transmission was spatially delineated and quantified by seven habitat variables derived from remote sensing data. The strengths and weaknesses highlighted by the plausibility analysis showed that temporal dynamic water and vegetation measures were particularly useful to model parasite and snail habitat suitability, whereas the measurement of water surface temperature and topographic variables did not perform appropriately. The transferability of the model showed significant relations between the HSI and infection prevalence in study sites of Côte d'Ivoire. CONCLUSIONS/SIGNIFICANCE A predictive map of environmental suitability for schistosomiasis transmission can support measures to gain and sustain control. This is particularly relevant as emphasis is shifting from morbidity control to interrupting transmission. Further validation of our mechanistic model needs to be complemented by field data of parasite- and snail-related fitness. Our model provides a useful tool to monitor the development of new hotspots of potential schistosomiasis transmission based on regularly updated remote sensing data.
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Affiliation(s)
- Yvonne Walz
- Department of Remote Sensing, Institute for Geography and Geology, University of Würzburg, Würzburg, Germany.,United Nations University-Institute for Environment and Human Security, Bonn, Germany
| | - Martin Wegmann
- Department of Remote Sensing, Institute for Geography and Geology, University of Würzburg, Würzburg, Germany
| | - Stefan Dech
- Department of Remote Sensing, Institute for Geography and Geology, University of Würzburg, Würzburg, Germany.,German Remote Sensing Data Centre, German Aerospace Centre, Oberpfaffenhofen, Germany
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jean-Noël Poda
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Eliézer K N'Goran
- 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
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Chammartin F, Houngbedji CA, Hürlimann E, Yapi RB, Silué KD, Soro G, Kouamé FN, N Goran EK, Utzinger J, Raso G, Vounatsou P. Bayesian risk mapping and model-based estimation of Schistosoma haematobium-Schistosoma mansoni co-distribution in Côte d'Ivoire. PLoS Negl Trop Dis 2014; 8:e3407. [PMID: 25522007 PMCID: PMC4270510 DOI: 10.1371/journal.pntd.0003407] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 11/10/2014] [Indexed: 12/22/2022] Open
Abstract
Background Schistosoma haematobium and Schistosoma mansoni are blood flukes that cause urogenital and intestinal schistosomiasis, respectively. In Côte d′Ivoire, both species are endemic and control efforts are being scaled up. Accurate knowledge of the geographical distribution, including delineation of high-risk areas, is a central feature for spatial targeting of interventions. Thus far, model-based predictive risk mapping of schistosomiasis has relied on historical data of separate parasite species. Methodology We analyzed data pertaining to Schistosoma infection among school-aged children obtained from a national, cross-sectional survey conducted between November 2011 and February 2012. More than 5,000 children in 92 schools across Côte d′Ivoire participated. Bayesian geostatistical multinomial models were developed to assess infection risk, including S. haematobium–S. mansoni co-infection. The predicted risk of schistosomiasis was utilized to estimate the number of children that need preventive chemotherapy with praziquantel according to World Health Organization guidelines. Principal Findings We estimated that 8.9% of school-aged children in Côte d′Ivoire are affected by schistosomiasis; 5.3% with S. haematobium and 3.8% with S. mansoni. Approximately 2 million annualized praziquantel treatments would be required for preventive chemotherapy at health districts level. The distinct spatial patterns of S. haematobium and S. mansoni imply that co-infection is of little importance across the country. Conclusions/Significance We provide a comprehensive analysis of the spatial distribution of schistosomiasis risk among school-aged children in Côte d′Ivoire and a strong empirical basis for a rational targeting of control interventions. Two types of blood-dwelling parasitic worms that cause schistosomiasis (i.e., Schistosoma haematobium and Schistosoma mansoni) are endemic in Côte d′Ivoire, West Africa. Reliable information on their geographical distribution is needed to plan and guide the national control program. Recently, control efforts have been intensified. There is a need to update risk maps that, historically, have been based on data specific to each type of parasite. In late 2011 and early 2012, we conducted a cross-sectional survey in 92 schools all over Côte d′Ivoire. We used Bayesian geostatistical multinomial models to estimate the risk for each infection, as well as co-infection. We estimated that slightly less than 10% of school-aged children are affected by schistosomiasis (5.3% with S. haematobium and 3.8% with S. mansoni). To control schistosomiasis with the deworming drug praziquantel, approximately 2 million treatments would be necessary each year. The distinct spatial patterns of S. haematobium and S. mansoni imply that co-infection with these two types of parasitic worms is rare across the country. Our results provide a detailed analysis of the spatial distribution of schistosomiasis risk among school-aged children in Côte d′Ivoire, which will inform the national control program for targeted interventions.
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Affiliation(s)
- Frédérique Chammartin
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Clarisse A Houngbedji
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche des Sciences de la Nature, Université Nangui Abrogua, Abidjan, Côte d'Ivoire
| | - Eveline Hürlimann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Richard B Yapi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Kigbafori D Silué
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Gotianwa Soro
- Programme National de Santé Scolaire et Universitaire, Abidjan, Côte d'Ivoire
| | - Ferdinand N Kouamé
- Programme National de Santé Scolaire et Universitaire, Abidjan, Côte d'Ivoire
| | - Eliézer K N Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Assaré RK, Knopp S, N'Guessan NA, Yapi A, Tian-Bi YNT, Yao PK, Coulibaly JT, Ouattara M, Meïté A, Fenwick A, N'Goran EK, Utzinger J. Sustaining control of schistosomiasis mansoni in moderate endemicity areas in western Côte d'Ivoire: a SCORE study protocol. BMC Public Health 2014; 14:1290. [PMID: 25519880 PMCID: PMC4320592 DOI: 10.1186/1471-2458-14-1290] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 12/10/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Schistosomiasis is a parasitic disease that occurs in the tropics and subtropics. The mainstay of control is preventive chemotherapy with praziquantel. In Africa, an estimated 230 million people require preventive chemotherapy. In western Côte d'Ivoire, infections with Schistosoma mansoni are widespread. To provide an evidence-base for programme decisions about preventive chemotherapy to sustain control of schistosomiasis, a 5-year multi-country study with different treatment arms has been designed by the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) and is currently being implemented in various African settings, including Côte d'Ivoire. METHODS/DESIGN We report the study protocol, including ethics statement and insight from a large-scale eligibility survey carried out in four provinces in western Côte d'Ivoire. The study protocol has been approved by the ethics committees of Basel and Côte d'Ivoire. A total of 12,110 children, aged 13-14 years, from 264 villages were screened for S. mansoni using duplicate Kato-Katz thick smears from single stool samples. Among the schools with a S. mansoni prevalence of 10-24%, 75 schools were selected and randomly assigned to one of three treatment arms. In each school, three stool samples are being collected from 100 children aged 9-12 years annually and one stool sample from 100 first-year students at baseline and in the final year and subjected to duplicate Kato-Katz thick smears. Cost and coverage data for the different intervention arms, along with environmental, political and other characteristics that might impact on the infection prevalence and intensity will be recorded in each study year, using a pretested village inventory form. DISCUSSION The study will document changes in S. mansoni infection prevalence and intensity according to different treatment schemes. Moreover, factors that determine the effectiveness of preventive chemotherapy will be identified. These factors will help to develop reasonable measures of force of transmission that can be used to make decisions about the most cost-effective means of lowering prevalence, intensity and transmission in a given setting. The gathered information and results will inform how to effectively sustain control of schistosomiasis at a low level in different social-ecological contexts. TRIAL REGISTRATION ISRCTN99401114 (date assigned: 12 November 2014).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P,O, Box, Basel, CH-4002, Switzerland.
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Koné S, Baikoro N, N'Guessan Y, Jaeger FN, Silué KD, Fürst T, Hürlimann E, Ouattara M, Séka MCY, N'Guessan NA, Esso ELJC, Zouzou F, Boti LI, Gonety PT, Adiossan LG, Dao D, Tschannen AB, von Stamm T, Bonfoh B, Tanner M, Utzinger J, N'Goran EK. Health & Demographic Surveillance System Profile: The Taabo Health and Demographic Surveillance System, Côte d'Ivoire. Int J Epidemiol 2014; 44:87-97. [PMID: 25433704 DOI: 10.1093/ije/dyu221] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The Taabo Health and Demographic Surveillance System (HDSS) is located in south-central Côte d'Ivoire, approximately 150 km north-west of Abidjan. The Taabo HDSS started surveillance activities in early 2009 and the man-made Lake Taabo is a key eco-epidemiological feature. Since inception, there has been a strong interest in research and integrated control of water-associated diseases such as schistosomiasis and malaria. The Taabo HDSS has generated setting-specific evidence on the impact of targeted interventions against malaria, schistosomiasis and other neglected tropical diseases. The Taabo HDSS consists of a small town, 13 villages and over 100 hamlets. At the end of 2013, a total population of 42 480 inhabitants drawn from 6707 households was under surveillance. Verbal autopsies have been conducted to determine causes of death. Repeated cross-sectional epidemiological surveys on approximately 5-7% of the population and specific, layered-on haematological, parasitological and questionnaire surveys have been conducted. The Taabo HDSS provides a database for surveys, facilitates interdisciplinary research, as well as surveillance, and provides a platform for the evaluation of health interventions. Requests to collaborate and to access data are welcome and should be addressed to the secretariat of the Centre Suisse de Recherches Scientifiques en Côte d'Ivoire: [secretariat@csrs.ci].
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Affiliation(s)
- Siaka Koné
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Nahoua Baikoro
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Yao N'Guessan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Fabienne N Jaeger
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Kigbafori D Silué
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Thomas Fürst
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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
| | - Eveline Hürlimann
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Mamadou Ouattara
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Marie-Chantal Y Séka
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Nicaise A N'Guessan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Emmanuel L J C Esso
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Fabien Zouzou
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Louis I Boti
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Prosper T Gonety
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Lukas G Adiossan
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Daouda Dao
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Andres B Tschannen
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Thomas von Stamm
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Marcel Tanner
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Jürg Utzinger
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
| | - Eliézer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire, Department of Epidemiology and Public Health, 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 for Health Policy, and Department of Infectious Disease Epidemiology, Imperial College London, London, UK, Fairmed, Bern, Switzerland and Hôpital Général de Taabo, Taabo Cité, Côte d'Ivoire
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Soumahoro MK, Bosson-Vanga AH, Coulibaly KJ, Sidibé S, Angora E, Kouadio K, N'Douba AK, Sissoko D, Dosso M. [Investigation of urinary schistosomiasis outbreak in the primary school of the village Guébo 2, Abidjan, Côte d'Ivoire]. BULLETIN DE LA SOCIETE DE PATHOLOGIE EXOTIQUE (1990) 2014; 107:185-7. [PMID: 24838686 DOI: 10.1007/s13149-014-0362-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 03/07/2014] [Indexed: 11/29/2022]
Abstract
We report the results of an outbreak investigation of urinary schistosomiasis in 2012 among school children at Guébo 2. Among the 250 school children, 107 (42.8%) had confirmed urinary schistosomiasis. Age ≥ 10y (OR = 2.6 [1.1 to 6.2]) and self-reported bathing in the river (OR = 14.0 [4.7 to 42.5]) were associated with the presence of S.h. in the adjusted analyses. A massive deworming of the population of Guébo-1&2 was conducted as epidemic-response.
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Affiliation(s)
- M K Soumahoro
- Institut Pasteur de Côte d'Ivoire, 01 BP 490, Abidjan 01, Côte d'Ivoire,
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Stothard JR, Sousa-Figueiredo JC, Navaratnam AMD. Advocacy, policies and practicalities of preventive chemotherapy campaigns for African children with schistosomiasis. Expert Rev Anti Infect Ther 2014; 11:733-52. [DOI: 10.1586/14787210.2013.811931] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tchuem Tchuenté LA, Dongmo Noumedem C, Ngassam P, Kenfack CM, Gipwe NF, Dankoni E, Tarini A, Zhang Y. Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of Littoral, North-West, South and South-West Cameroon and recommendations for treatment. BMC Infect Dis 2013; 13:602. [PMID: 24365046 PMCID: PMC3878270 DOI: 10.1186/1471-2334-13-602] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 12/17/2013] [Indexed: 11/19/2022] Open
Abstract
Background The previous nationwide mapping of schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon was conducted 25 years ago. Based on its results, mass drug administration (MDA) of praziquantel was limited to the three northern regions and few health districts in the southern part of Cameroon. In 2010, we started the process of updating the disease distribution in order to improve the control strategies. Three of the ten regions of Cameroon were mapped in 2010 and the data were published. In 2011, surveys were conducted in four additional regions, i.e. Littoral, North-West, South and South-West. Methods Parasitological surveys were conducted in March 2011 in selected schools in all 65 health districts of the four targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. Results The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma haematobium was the most prevalent schistosome species, with an overall prevalence of 3.2%, followed by S. mansoni (3%) and S. guineensis (1.2%). The overall prevalence of schistosomiasis across the four regions was 7.4% (95% CI: 6.7-8.3%). The prevalence for Ascaris lumbricoides was 19.5% (95% CI: 18.3-20.7%), Trichuris trichiura 18.9% (95% CI: 17.7-20.1%) and hookworms 7.6% (95% CI: 6.8-8.4%), with an overall STH prevalence of 32.5% (95% CI: 31.1-34.0%) across the four regions. STH was more prevalent in the South region (52.8%; 95% CI: 48.0-57.3%), followed by the South-West (46.2%; 95% CI: 43.2-49.3%), the North-West (35.9%; 95% CI: 33.1-38.7%) and the Littoral (13.0%; 95% CI: 11.3-14.9%) regions. Conclusions In comparison to previous data in 1985–87, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis.
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Affiliation(s)
- Louis-Albert Tchuem Tchuenté
- National Programme for the Control of Schistosomiasis and Intestinal Helminthiasis, Ministry of Public Health, Yaoundé, Cameroon.
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Abstract
In May 2012, the World Health Assembly passed resolution WHA 65.21, calling upon member states to intensify schistosomiasis control and, wherever possible, to attempt transmission interruption and initiate interventions towards local elimination. It is now clear that CONTRAST--a multidisciplinary alliance to optimize schistosomiasis control and transmission surveillance in sub-Saharan Africa--was ahead of the game. Indeed, launched in October 2006, this 4-year project funded by the European Commission made important contributions for sustainable schistosomiasis control in the selected African countries through innovation, validation and application of new tools and locally adapted intervention strategies complementary to preventive chemotherapy. Moreover, CONTRAST articulated a research agenda for schistosomiasis elimination, framed by 10 key questions. Here, we provide a rationale for CONTRAST and discuss its overarching goal, the interrelated objectives, establishment and running of a research node network across Africa, partnership configuration and modus operandi of the project. A collection of 25 articles is presented that are grouped into five main themes: molecular, biological, spatial, social and cross-cutting issues pertaining to the epidemiology and control of schistosomiasis. We summarize key achievements made by CONTRAST, many of which are featured in this special issue of Acta Tropica. Together with an independent view put forth by an eminent schistosomiasis researcher, the current piece provides an umbrella for the 25-article collection, including current gaps and remaining research needs. Finally, post-CONTRAST initiatives are discussed and a speculative viewpoint is given on how schistosomiasis control/elimination will have evolved over the next several years.
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Ruxin J, Negin J. Removing the neglect from neglected tropical diseases: the Rwandan experience 2008-2010. Glob Public Health 2012; 7:812-22. [PMID: 22812700 DOI: 10.1080/17441692.2012.699535] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
While there has been increasing recognition of the importance of neglected tropical diseases (NTDs), national scale action and funding remain limited. In 2007, a 3-year, $1 million per year programme was launched in Rwanda to address NTDs. While more than $100 million had flowed into Rwanda's health sector annually, not $1 was allocated for NTDs. This article describes the development of a national NTD strategy in Rwanda and outlines lessons learned, with particular regard to integrated approaches to NTD prevention. A baseline survey revealed that more than 65% of children had intestinal worms with high levels of concurrent multiple parasite infection. Within a year, mass treatment administration was provided for the first time. A repeat survey found that prevalence of soil-transmitted helminths and Schistosoma mansoni infection had been reduced significantly, including a reduction in prevalence of S. mansoni of 82% and of 72% in hookworm. Infection intensity and signs of early clinical morbidity also decreased significantly. Despite ongoing global neglect, the Rwandan NTD response presents a promising and unheralded success in science-based national public health action at scale. Looking forward, greater integration of the NTD response with water and sanitation activities are needed to consolidate impact and sustainably reduce the disease burden.
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Tchuem Tchuenté LA, Kamwa Ngassam RI, Sumo L, Ngassam P, Dongmo Noumedem C, Nzu DDL, Dankoni E, Kenfack CM, Gipwe NF, Akame J, Tarini A, Zhang Y, Angwafo FF. Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of centre, East and West Cameroon. PLoS Negl Trop Dis 2012; 6:e1553. [PMID: 22413029 PMCID: PMC3295801 DOI: 10.1371/journal.pntd.0001553] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2011] [Accepted: 01/18/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schistosomiasis and soil-transmitted helminthiasis (STH) are widely distributed in Cameroon. Although mass drug administration (MDA) of mebendazole is implemented nationwide, treatment with praziquantel was so far limited to the three northern regions and few health districts in the southern part of Cameroon, based on previous mapping conducted 25 years ago. To update the disease distribution map and determine where treatment with praziquantel should be extended, mapping surveys were conducted in three of the seven southern regions of Cameroon, i.e. Centre, East and West. METHODOLOGY Parasitological surveys were conducted in April-May 2010 in selected schools in all 63 health districts of the three targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. PRINCIPAL FINDINGS The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma mansoni was the most prevalent schistosome species, with an overall prevalence of 5.53%, followed by S. haematobium (1.72%) and S. guineensis (0.14%). The overall prevalence of schistosomiasis across the three regions was 7.31% (95% CI: 6.86-7.77%). The prevalence for Ascaris lumbricoides was 11.48 (95% CI: 10.93-12.04%), Trichuris trichiura 18.22% (95% CI: 17.56-18.90%) and hookworms 1.55% (95% CI: 1.35-1.78%), with an overall STH prevalence of 24.10% (95% CI: 23.36-24.85%) across the three regions. STH was more prevalent in the East region (46.57%; 95% CI: 44.41-48.75%) in comparison to the Centre (25.12; 95% CI: 24.10-26.17%) and West (10.49%; 95% CI: 9.57-11.51%) regions. CONCLUSIONS/SIGNIFICANCE In comparison to previous data, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis.
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Affiliation(s)
- Louis-Albert Tchuem Tchuenté
- National Programme for the Control of Schistosomiasis and Intestinal Helminthiasis, Ministry of Public Health, Yaoundé, Cameroon
- Laboratory of Parasitology and Ecology, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- * E-mail:
| | | | - Laurentine Sumo
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Pierre Ngassam
- Laboratory of Parasitology and Ecology, University of Yaoundé I, Yaoundé, Cameroon
| | | | | | - Esther Dankoni
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | | | | | - Julie Akame
- Helen Keller International, Yaoundé, Cameroon
| | - Ann Tarini
- Helen Keller International, Yaoundé, Cameroon
| | - Yaobi Zhang
- Helen Keller International, Regional Office for Africa, Dakar, Senegal
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Kihara J, Mwandawiro C, Waweru B, Gitonga CW, Brooker S. Preparing for national school-based deworming in Kenya: the validation and large-scale distribution of school questionnaires with urinary schistosomiasis. Trop Med Int Health 2011; 16:1326-33. [PMID: 21767334 PMCID: PMC3558801 DOI: 10.1111/j.1365-3156.2011.02829.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE School questionnaires of self-reported schistosomiasis provide a rapid and simple approach for identifying schools at high risk of Schistosoma haematobium and requiring mass treatment. This study investigates the reliability of school questionnaires to identify such schools and infected children within the context of a national school-based deworming programme in Kenya. METHODS Between November 2008 and March 2009, 6182 children from 61 schools in Coast Province, Kenya were asked by an interviewer whether they had blood in urine or urinary schistosomiasis (kichocho), and their results were compared with results from microscopic examination of urine samples. Subsequently, in 2009, a school-based questionnaire survey for self-reported schistosomiasis was distributed by the Ministry of Education to all schools in Coast Province, and its results were compared against results from the parasitological survey. The questionnaire survey results were linked to a schools database and mapped. RESULTS Prevalence of self-reported blood in urine was lower among girls than boys among all ages. The use of a 30% threshold of reported blood in urine was both highly sensitive (91.7%) and specific (100%) in identifying high (>50%) prevalence schools in Coast Province. Questionnaires were however less reliable in diagnosing S. haematobium infection in individuals, particularly among young girls. Comparable levels of reliability were observed when the questionnaire was distributed through the existing education systems and administered by class teachers. CONCLUSIONS The results confirm that blood in urine questionnaires can be reliably used to target mass treatment with praziquantel at national scales. The mapped results of the Ministry of Education survey serve to describe the spatial variation of urinary schistosomiasis and identify schools requiring mass treatment.
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Affiliation(s)
- Jimmy Kihara
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
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Acka CA, Raso G, N'Goran EK, Tschannen AB, Bogoch II, Séraphin E, Tanner M, Obrist B, Utzinger J. Parasitic worms: knowledge, attitudes, and practices in Western Côte d'Ivoire with implications for integrated control. PLoS Negl Trop Dis 2010; 4:e910. [PMID: 21200423 PMCID: PMC3006135 DOI: 10.1371/journal.pntd.0000910] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 11/10/2010] [Indexed: 11/23/2022] Open
Abstract
Background In the developing world where parasitic worm infections are pervasive, preventive chemotherapy is the key strategy for morbidity control. However, local knowledge, attitudes, and practices (KAP) of parasitic worms are poorly understood, although such information is required for prevention and sustainable control. Methods We carried out KAP surveys in two rural communities of Côte d'Ivoire that were subjected to school-based and community-based research and control activities. We used qualitative and quantitative methods. The former included observations, in-depth interviews with key informants, and focus group discussions with school children and adults. Quantitative methods consisted of a structured questionnaire administered to household heads. Principal Findings Access to clean water was lacking in both communities and only a quarter of the households had functioning latrines. There was a better understanding of soil-transmitted helminthiasis than intestinal schistosomiasis, but community-based rather than school-based interventions appeared to improve knowledge of schistosomiasis. In the villages with community-based interventions, three-quarters of household interviewees knew about intestinal schistosomiasis compared to 14% in the village where school-based interventions were implemented (P<0.001). Whereas two-thirds of respondents from the community-based intervention village indicated that the research and control project was the main source of information, only a quarter of the respondents cited the project as the main source. Conclusions/Significance Preventive chemotherapy targeting school-aged children has limitations, as older population segments are neglected, and hence lack knowledge about how to prevent and control parasitic worm infections. Improved access to clean water and sanitation is necessary, along with health education to make a durable impact against helminth infections. There is a need to better understand communities' knowledge, attitudes, and practices (KAP) of neglected tropical diseases to improve prevention and control efforts. We studied the socio-cultural aspects of parasitic worm infections in two villages (Mélapleu and Zouatta II) of western Côte d'Ivoire, where research and control activities have been implemented. Zouatta II was exposed to a community-based approach, while school-based interventions were implemented in Mélapleu. KAP surveys were carried out using qualitative and quantitative methods. Although there was some knowledge of parasitic worm infections in both villages, we found important differences between the two villages regarding intestinal schistosomiasis: there was a better understanding of this disease in Zouatta II. However, even the community-based research and control efforts implemented in Zouatta II were ineffective in transforming the information conveyed into preventive behavior related to water contact. Our results suggest that KAP of parasitic worm infections conveyed by research and control activities targeting only school-aged children have shortcomings as older population groups are left out. Hence, for effective control of parasitic worms, children and adults must be educated and interventions should include access to deworming drugs, clean water and sanitation.
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Affiliation(s)
- Cinthia A. Acka
- Unité de Formation et de Recherche (UFR) Sciences Sociales, Université de Cocody-Abidjan, Abidjan, Côte d'Ivoire
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Giovanna Raso
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Eliézer K. N'Goran
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Unité de Formation et de Recherche (UFR) Biosciences, Université de Cocody-Abidjan, Abidjan, Côte d'Ivoire
| | - Andres B. Tschannen
- Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Isaac I. Bogoch
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Essane Séraphin
- Unité de Formation et de Recherche (UFR) Sciences Sociales, Université de Cocody-Abidjan, Abidjan, Côte d'Ivoire
| | - Marcel Tanner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Brigit Obrist
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Institute of Social Anthropology, University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Fürst T, Tschannen AB, Raso G, Acka CA, de Savigny D, Girardin O, N'Goran EK, Utzinger J. Effect of an armed conflict on relative socioeconomic position of rural households: case study from western Côte d'Ivoire. Emerg Themes Epidemiol 2010; 7:6. [PMID: 20807398 PMCID: PMC2945336 DOI: 10.1186/1742-7622-7-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 08/31/2010] [Indexed: 11/16/2022] Open
Abstract
Background Current conceptual frameworks on the interrelationship between armed conflict and poverty are based primarily on aggregated macro-level data and/or qualitative evidence and usually focus on adherents of warring factions. In contrast, there is a paucity of quantitative studies about the socioeconomic consequences of armed conflict at the micro-level, i.e., noncommitted local households and civilians. Methods We conducted a secondary analysis of data pertaining to risk factors for malaria and neglected tropical diseases. Standardized questionnaires were administered to 182 households in a rural part of western Côte d'Ivoire in August 2002 and again in early 2004. Between the two surveys, the area was subject to intensive fighting in the Ivorian civil war. Principal component analysis was applied at the two time points for constructing an asset-based wealth-index and categorizing the households in wealth quintiles. Based on quintile changes, the households were labeled as 'worse-off', 'even' or 'better-off'. Statistical analysis tested for significant associations between the socioeconomic fates of households and head of household characteristics, household composition, village characteristics and self-reported events associated with the armed conflict. Most-poor/least-poor ratios and concentration indices were calculated to assess equity changes in households' asset possession. Results Of 203 households initially included in the first survey, 21 were lost to follow-up. The population in the remaining 182 households shrunk from 1,749 to 1,625 persons due to migration and natural population changes. However, only weak socioeconomic dynamics were observed; every seventh household was defined as 'worse-off' or 'better-off' despite the war-time circumstances. Analysis of other reported demographic and economic characteristics did not clearly identify more or less resilient households, and only subtle equity shifts were noted. However, the results indicate significant changes in livelihood strategies with a significant return to agricultural production and a decrease in the diversity of socioeconomic activities. Conclusion Situational constraints and methodological obstacles are inherent in conflict settings and hamper conflict-related socioeconomic research. Furthermore, sensitive methods to assess and meaningfully interpret longitudinal micro-level wealth data from low-income countries are lacking. Despite compelling evidence of socioeconomic dynamics triggered by armed conflicts at the macro-level, we could not identify similar effects at the micro-level. A deeper understanding of household profiles that are more resilient to armed conflict could help to better prevent and/or alleviate adverse conflict-related and increasingly civilian-borne socioeconomic effects.
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Affiliation(s)
- Thomas Fürst
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Andres B Tschannen
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia.,School of Population Health, University of Queensland, Brisbane, Australia
| | - Cinthia A Acka
- Département de Sociologie, Université de Cocody-Abidjan, Abidjan, Côte d'Ivoire
| | - Don de Savigny
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Olivier Girardin
- Fondation Rurale Interjurassienne, Courtemelon, Courtételle, Switzerland
| | - Eliézer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,UFR Biosciences, Université de Cocody-Abidjan, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution. Parasitology 2010; 136:1859-74. [PMID: 19906318 DOI: 10.1017/s0031182009991600] [Citation(s) in RCA: 277] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In May 2001, the World Health Assembly (WHA) passed a resolution which urged member states to attain, by 2010, a minimum target of regularly administering anthelminthic drugs to at least 75% and up to 100% of all school-aged children at risk of morbidity. The refined global strategy for the prevention and control of schistosomiasis and soil-transmitted helminthiasis was issued in the following year and large-scale administration of anthelminthic drugs endorsed as the central feature. This strategy has subsequently been termed 'preventive chemotherapy'. Clearly, the 2001 WHA resolution led the way for concurrently controlling multiple neglected tropical diseases. In this paper, we recall the schistosomiasis situation in Africa in mid-2003. Adhering to strategic guidelines issued by the World Health Organization, we estimate the projected annual treatment needs with praziquantel among the school-aged population and critically discuss these estimates. The important role of geospatial tools for disease risk mapping, surveillance and predictions for resource allocation is emphasised. We clarify that schistosomiasis is only one of many neglected tropical diseases and that considerable uncertainties remain regarding global burden estimates. We examine new control initiatives targeting schistosomiasis and other tropical diseases that are often neglected. The prospect and challenges of integrated control are discussed and the need for combining biomedical, educational and engineering strategies and geospatial tools for sustainable disease control are highlighted. We conclude that, for achieving integrated and sustainable control of neglected tropical diseases, a set of interventions must be tailored to a given endemic setting and fine-tuned over time in response to the changing nature and impact of control. Consequently, besides the environment, the prevailing demographic, health and social systems contexts need to be considered.
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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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