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Mazigo HD, Kayange N, Ambrose EE, Zinga MM, Mugassa S, Ruganuza D, Mwingira UJ, Uisso C, Mutapi F. Efficacy of praziquantel drug against Schistosoma haematobium and performance of urine reagent strips among pre-and-school aged children during the high transmission season in North-Western Tanzania. Acta Trop 2024; 256:107232. [PMID: 38729329 DOI: 10.1016/j.actatropica.2024.107232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/18/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
The World Health Organization calls for schistosomiasis endemic countries to regularly monitor the efficacy of Praziquantel (PZQ) drug, the only antischistosomal drug used for four decades in Tanzania. In response to that call, the current study investigated the efficacy of single dose of PZQ against Schistosoma haematobium during the high transmission season and further assessed, the sensitivity and specificity of urine reagent strips before and after treatment. The study recruited a total of 2,498 -children aged (4 -17 years old) who provided a single urine sample that was visually examined for macro-haematuria, then using urine dipstick and urine filtration technique for microhaematuria and the presence of S. haematobium eggs. The baseline prevalence of S. haematobium eggs positive based on urine filtration test was 29.2 % (95 %CI:27.5-31.0) and that of microhaematuria was 43.1 % (95 %CI:41.1-45.0). Of the infected participants, 40.9 % (95 %CI:37.4-44.6) had a heavy intensity of infection and the geometrical mean intensity (GMI) of infection was 33.7 eggs/10mls of urine. A single dose of PZQ reduced the prevalence of infection to 16.2 %, the GMI of infection to 18.8eggs/10mls of urine and that of microhaematuria to 27.9 %. Cure rate and egg reduction rates (ERR) were 83.8 % and 44.3 % respectively. At baseline, the sensitivity and specificity of the urine reagent strips were 59.7 % and 93.8 %, whereas at post-treatment they were 16.7 % and 93.6 %. When PZQ drug is administered during the high transmission season, its efficacy in term of ERR is poor. The urine reagent strips had low sensitivity but high specificity at pre-and-post PZQ treatment.
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Affiliation(s)
- Humphrey D Mazigo
- Tackling Infections to Benefit Africa Partnership and School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania; Tackling Infections to Benefit Africa Partnership, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom.
| | - Neema Kayange
- Tackling Infections to Benefit Africa Partnership and Department of Paediatrics and Child Health, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania
| | - Emmanuela E Ambrose
- Tackling Infections to Benefit Africa Partnership and Department of Paediatrics and Child Health, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania
| | - Maria M Zinga
- Tackling Infections to Benefit Africa Partnership and School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stella Mugassa
- Tackling Infections to Benefit Africa Partnership and School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Deodatus Ruganuza
- Tackling Infections to Benefit Africa Partnership and School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Upendo J Mwingira
- National Neglected Tropical Diseases Control Programme, National Institute for Medical Research, P.O. Box 9653, 3 Barack Obama Drive, 11101 Dar-Es-Salaam, Tanzania
| | - Cecilia Uisso
- National Neglected Tropical Diseases Control Programme, National Institute for Medical Research, P.O. Box 9653, 3 Barack Obama Drive, 11101 Dar-Es-Salaam, Tanzania
| | - Francesca Mutapi
- Tackling Infections to Benefit Africa Partnership, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom; Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
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Lim RM, Arme TM, Pedersen AB, Webster JP, Lamberton PHL. Defining schistosomiasis hotspots based on literature and shareholder interviews. Trends Parasitol 2023; 39:1032-1049. [PMID: 37806786 DOI: 10.1016/j.pt.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023]
Abstract
The World Health Organization (WHO) recently proposed a new operational definition which designates communities with ≥10% prevalence of Schistosoma spp. infection as a persistent hotspot, when, after at least two rounds of high-coverage annual preventive chemotherapy, there is a lack of appropriate reduction. However, inconsistencies and challenges from both biological and operational perspectives remain, making the prescriptive use of this definition difficult. Here, we present a comprehensive analysis of the use of the term 'hotspot' across schistosomiasis research over time, including both literature searches and opinions from a range of stakeholders, to assess the utility and generalisability of the new WHO definition of a persistent hotspot. Importantly, we propose an updated definition based on our analyses.
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Affiliation(s)
- Rivka M Lim
- Institute of Evolution and Ecology, School of Biological Sciences, Ashworth Laboratories, University of Edinburgh, Edinburgh, UK.
| | - Thomas M Arme
- School of Biodiversity, One Health and Veterinary Medicine, Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, UK
| | - Amy B Pedersen
- Institute of Evolution and Ecology, School of Biological Sciences, Ashworth Laboratories, University of Edinburgh, Edinburgh, UK
| | - Joanne P Webster
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield, Herts, UK
| | - Poppy H L Lamberton
- School of Biodiversity, One Health and Veterinary Medicine, Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, UK
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Senghor B, Mathieu-Begné E, Rey O, Doucouré S, Sow D, Diop B, Sène M, Boissier J, Sokhna C. Urogenital schistosomiasis in three different water access in the Senegal river basin: prevalence and monitoring praziquantel efficacy and re-infection levels. BMC Infect Dis 2022; 22:968. [PMID: 36581796 PMCID: PMC9801593 DOI: 10.1186/s12879-022-07813-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/26/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Urogenital schistosomiasis is a neglected tropical disease most prevalent in sub-Saharan Africa. In the Senegal river basin, the construction of the Diama dam led to an increase and endemicity of schistosomiasis. Since 2009, praziquantel has frequently been used as preventive chemotherapy in the form of mass administration to Senegalese school-aged children without monitoring of the treatment efficacy and the prevalence after re-infection. This study aims to determine the current prevalence of urogenital schistosomiasis (caused by Schistosoma haematobium), the efficacy of praziquantel, and the re-infection rates in children from five villages with different water access. METHODS The baseline prevalence of S. haematobium was determined in August 2020 in 777 children between 5 and 11 years old and a single dose of praziquantel (40 mg/kg) was administered to those positive. The efficacy of praziquantel and the re-infection rates were monitored 4 weeks and 7 months after treatment, respectively, in 226 children with a high intensity of infection at baseline. RESULTS At the baseline, prevalence was low among children from the village of Mbane who live close to the Lac de Guiers (38%), moderate among those from the villages of Dioundou and Khodit, which neighbor the Doue river (46%), and very high at Khodit (90.6%) and Guia (91.2%) which mainly use an irrigation canal. After treatment, the observed cure rates confirmed the efficacy of praziquantel. The lowest cure rate (88.5%) was obtained in the village using the irrigation canal, while high cure rates were obtained in those using the lake (96.5%) and the river (98%). However, high egg reduction rates (between 96.7 and 99.7%) were obtained in all the villages. The re-infection was significantly higher in the village using the canal (42.5%) than in the villages accessing the Lac de Guiers (18.3%) and the Doue river (14.8%). CONCLUSION Praziquantel has an impact on reducing the prevalence and intensity of urogenital schistosomiasis. However, in the Senegal river basin, S. haematobium remains a real health problem for children living in the villages near the irrigation canals, despite regular treatment, while prevalence is declining from those frequenting the river and the Lac de Guiers. Trial registration ClinicalTrials.gov, NCT04635553. Registered 19 November 2020 retrospectively registered, https://www. CLINICALTRIALS gov/ct2/show/NCT04635553?cntry=SN&draw=2&rank=4.
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Affiliation(s)
- Bruno Senghor
- grid.418291.70000 0004 0456 337XCampus International IRD-UCAD de Hann, Vectors-Tropical and Mediterranean Infections (VITROME) Laboratory, 1386 Dakar, Senegal
| | - Eglantine Mathieu-Begné
- grid.121334.60000 0001 2097 0141Host Pathogen Environments Interactions (IHPE) Laboratory, CNRS, IFREMER, University of Montpellier, University of Perpignan via Domitia, Perpignan, France
| | - Olivier Rey
- grid.121334.60000 0001 2097 0141Host Pathogen Environments Interactions (IHPE) Laboratory, CNRS, IFREMER, University of Montpellier, University of Perpignan via Domitia, Perpignan, France
| | - Souleymane Doucouré
- grid.418291.70000 0004 0456 337XCampus International IRD-UCAD de Hann, Vectors-Tropical and Mediterranean Infections (VITROME) Laboratory, 1386 Dakar, Senegal
| | - Doudou Sow
- grid.442784.90000 0001 2295 6052Department of Parasitology-Mycology, UFR of Health Sciences, University Gaston Berger, 234, Saint-Louis, Senegal
| | - Bocar Diop
- grid.442784.90000 0001 2295 6052Laboratory of Biological and Agronomic Sciences and Modelling of Complex Systems, UFRS2ATA, Gaston Berger University of Saint-Louis, Saint-Louis, Senegal
| | - Mariama Sène
- National Schistosomiasis Control Program (NSCP), Ministry of Health, Dakar, Senegal
| | - Jérôme Boissier
- grid.121334.60000 0001 2097 0141Host Pathogen Environments Interactions (IHPE) Laboratory, CNRS, IFREMER, University of Montpellier, University of Perpignan via Domitia, Perpignan, France
| | - Cheikh Sokhna
- grid.418291.70000 0004 0456 337XCampus International IRD-UCAD de Hann, Vectors-Tropical and Mediterranean Infections (VITROME) Laboratory, 1386 Dakar, Senegal ,grid.5399.60000 0001 2176 4817VITROME, IRD, SSA, AP-HM, IHU-Mediterranean Infection, Aix-Marseille Univ, Marseille, France
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Gender-related differences in prevalence, intensity and associated risk factors of Schistosoma infections in Africa: A systematic review and meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009083. [PMID: 34788280 PMCID: PMC8635327 DOI: 10.1371/journal.pntd.0009083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 12/01/2021] [Accepted: 09/29/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosomiasis remains a global-health problem with over 90% of its burden concentrated in Africa. Field studies reflect the complex ways in which socio-cultural and socio-economic variables, affect the distribution of Schistosoma infections across different populations. This review set out to systematically investigate and quantify the differences in Schistosoma infection burdens between males and females in Africa for two of the most prevalent Schistosoma species-Schistosoma mansoni and Schistosoma haematobium. METHODOLOGY We searched (from inception to 11th March 2020) Embase, MEDLINE, PubMed, and Web of Science for relevant studies on schistosomiasis. We included studies that report S. mansoni and/or S. haematobium prevalence and/or intensity data distributed between males and females. We conducted meta-analyses on the male to female (M:F) prevalence of infection ratios. Subgroup analyses were performed according to study baseline prevalence, sample size and the lower and upper age limit of study participants. We also present a descriptive analysis of differential risk and intensity of infection across males and females. Evidence for differences in the prevalence of schistosomiasis infection between males and females is presented, stratified by Schistosoma species. RESULT We identified 128 relevant studies, with over 200,000 participants across 23 countries. Of all the reported differences in the prevalence of infection between males and females, only 41% and 34% were statistically significant for S. mansoni and S. haematobium, respectively. Similar proportions of studies (27% and 34% for for S. haematobium and S. mansoni, respectively) of the reported differences in intensity of infection between males and females were statistically significant. The meta-analyses summarized a higher prevalence of infection in males; pooled random-effects weighted M:F prevalence of infection ratios were 1.20 (95% CI 1.11-1.29) for S. haematobium and 1.15 (95% CI 1.08-1.22) for S. mansoni. However, females are underrespresented in some of the studies. Additionally, there was significant heterogeneity across studies (Higgins I2 statistic (p-values < 0.001, I2values>95%)). Results of the subgroup analysis showed that the baseline prevalence influenced the M:F prevalence ratios for S. haematobium and S. mansoni, with higher M:F prevalence of infection ratios in settings with a lower baseline prevalence of infection. Across the studies, we identified four major risk factors associated with infection rates: occupational and recreational water contact, knowledge, socio-economic factors and demographic factors. The effect of these risk factors on the burden of infection in males and females varied across studies. CONCLUSIONS We find evidence of differences in prevalence of infection between males and females which may reflect differences in gender norms and water contact activities, suggesting that policy changes at the regional level may help ameliorate gender-related disparities in schistosomiasis infection burden. Collecting, robustly analysing, and reporting, sex-disaggregated epidemiological data, is currently lacking, but would be highly informative for planning effective treatment programmes and establishing those most at risk of schistosomiasis infections.
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Impact of seven years of mass drug administration and recrudescence of Schistosoma haematobium infections after one year of treatment gap in Zanzibar: Repeated cross-sectional studies. PLoS Negl Trop Dis 2021; 15:e0009127. [PMID: 33577601 PMCID: PMC7880478 DOI: 10.1371/journal.pntd.0009127] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background Considerable progress towards the elimination of urogenital schistosomiasis was made by the Zanzibar Elimination of Schistosomiasis Transmission project from 2012 till 2016, when biannual praziquantel mass drug administration (MDA) alone or with additional snail control or behaviour change interventions were implemented. Annual MDA was continued in 2017 and 2018, but not in 2019, imposing a 16-month treatment gap. We monitored the Schistosoma haematobium prevalence from 2012 till 2020 and assessed recrudescence patterns with focus on 2020. Methodology Repeated cross-sectional surveys were conducted from 2011/12 till 2020 in 90 communities and 90 schools in Zanzibar. Annually, around 4,500 adults and up to 20,000 schoolchildren were surveyed. The S. haematobium prevalence was detected by urine filtration and reagent strips. In 2020, risk factors for infection were investigated using generalized estimated equation models. Principal findings In adults, the apparent S. haematobium prevalence was 3.9% in 2011 and 0.4% in 2020. In schoolchildren, the prevalence decreased from 6.6% in 2012 to 1.2% in 2019 with vicissitudes over the years. Prominent recrudescence of infection from 2.8% in 2019 to 9.1% (+225%) in 2020 was observed in 29 schools with historically moderate prevalences (≥10%). Compared with 2019, reinfection in 2020 was particularly striking in boys aged 9–16 years. Being male was a risk factor for infection in 2020 (adults: odds ratio (OR): 6.24, 95% confidence interval (95% CI): 1.96–19.60; schoolchildren: OR: 2.06, 95% CI: 1.52–2.78). Living near to a natural freshwater body significantly increased the odds of infection in adults (OR: 2.90, CI: 1.12–7.54). Conclusions/Significance After 11 rounds of MDA over 7 years and a 16-month treatment gap, the urogenital schistosomiasis prevalence considerably rebounded in hotspot areas. Future elimination efforts in Zanzibar should focus on re-intensifying MDA plus additional interventions in hotspot areas. In low-prevalence areas, the strategy might be adapted from MDA to targeted surveillance-response. Schistosomiasis is a neglected tropical disease caused by parasitic blood flukes of the genus Schistosoma. On the Zanzibar islands, United Republic of Tanzania, interventions to eliminate urogenital schistosomiasis commenced in 2012. From 2012 to 2016, the population was treated biannually with praziquantel and, additionally, some areas received mollusciciding against the intermediate host snail, or educational measures for behavior change. Mass drug administration (MDA) with praziquantel was continued annually in 2017 and 2018, but not in 2019. As a result of the interventions, the overall S. haematobium prevalence was reduced to 0.4% in adults and 3.4% in schoolchildren in 2020. However, in some areas, the MDA gap in 2019 resulted in a considerable rebound of infections. The recrudescence in 2020 was particularly striking for boys aged 9–16 years. In general, in 2020, male participants had higher odds of infection than females. Adults living near to a natural freshwater body also showed an increased risk of S. haematobium infection. Future elimination efforts in Zanzibar should focus on re-intensifying elimination interventions, including MDA, snail control and behavior change in hotspot areas. In low-prevalence areas, the strategy might be adapted from MDA to targeted interventions, such as surveillance-response.
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Baseline and Impact of First-Year Intervention on Schistosoma haematobium Infection in Seasonal Transmission Foci in the Northern and Central Parts of Côte d'Ivoire. Trop Med Infect Dis 2021; 6:tropicalmed6010007. [PMID: 33429843 PMCID: PMC7838999 DOI: 10.3390/tropicalmed6010007] [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: 11/26/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 11/25/2022] Open
Abstract
In order to assess the impact of different control strategies against Schistosoma haematobium in seasonal transmission foci in Côte d’Ivoire, a three-year cluster randomized trial was implemented. The decrease in S. haematobium prevalence among children aged 9−12 years was the primary outcome. In the first step, an eligibility survey was conducted, subjecting 50 children aged 13−14 years to a single urine filtration. Sixty-four villages with a prevalence of S. haematobium of ≥4% were selected and randomly assigned to four intervention arms consisting of annual mass drug administration (MDA) before (arm 1) and after (arm 2) the peak transmission, biannual treatment with praziquantel before and after the peak transmission season (arm 3), and annual MDA before the peak transmission season, coupled with focal chemical snail control using molluscicides (arm 4). At baseline, we observed a prevalence of 24.8%, 10.1%, 13.9%, and 15.9% in study arms 1, 2, 3, and 4, respectively. One year after the first intervention, the prevalence decreased in all study arms by about two-thirds or more. The prevalence in arm 2 was lower than in arm 1 (3.5% vs. 8.1%), but the difference was not statistically significant (odds ratio (OR) = 0.42, 95% confidence interval (CI) = 0.10−1.80). After adjusting for baseline prevalence, arms 1 and 2 performed roughly similarly (adjusted odds ratio (aOR) = 1.03, 95% CI = 0.34−3.07). The prevalence in arms 3 and 4 (1.9% and 2.2%) were significantly lower compared to arm 1 in the unadjusted and the adjusted models (arm 3 vs. arm 1, OR = 0.22, 95% CI = 0.05−0.95, aOR = 0.19, 95% CI = 0.08−0.48; arm 4 vs. arm 1, OR = 0.26, 95% CI = 0.08−0.85, aOR = 0.23, 95% CI = 0.06−0.87). The initial intervention showed a significant impact on the prevalence of S. haematobium. It will be interesting to monitor the comparative impact of the different intervention arms and to determine whether the interruption of seasonal transmission of S. haematobium can be achieved in this epidemiological setting within three years.
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Zacharia A, Mushi V, Makene T. A systematic review and meta-analysis on the rate of human schistosomiasis reinfection. PLoS One 2020; 15:e0243224. [PMID: 33270752 PMCID: PMC7714137 DOI: 10.1371/journal.pone.0243224] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/17/2020] [Indexed: 11/19/2022] Open
Abstract
While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity of information on the global reinfection rate of schistosomiasis. This systematic review and meta-analysis aimed at summarizing studies that estimated the reinfection rate of human schistosomiasis. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on reinfection rate of human schistosomiasis. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted using statistical R version 3.6.2 and R Studio using "meta" and "metafor" packages. Random effect model was employed to estimate pooled reinfection rates. Heterogeneity was determined using Cochran's Q (chi-square)-test and Higgins I2 statistics. A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5-9 scores) quality. The overal mean and pooled reinfection rates of schistosomiasis were 36.1% (±23.3%) and 33.2% (95% CI, 26.5-40.5%) respectively. For intestinal schistosomiasis, the mean and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8-51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3%- 29.2%) respectively. Cochran's Q (chi-square)-test and Higgins I2 statistic indicated significant heterogeneity across studies (p-values < 0.001, I2 values > 95%). Results of subgroup analysis showed that, the type of Schistosoma species, participants' age group, sample size and geographical area had influence on disparity variation in reinfection rate of schistosomiasis (p < 0.1). Despite the control measures in place, the re-infection rate is still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing intensive programmatic strategies for schistosomiasis elimination should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six months, intensive snails control and health education.
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Affiliation(s)
- Abdallah Zacharia
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Vivian Mushi
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Twilumba Makene
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Mogeni P, Vandormael A, Cuadros D, Appleton C, Tanser F. Impact of community piped water coverage on re-infection with urogenital schistosomiasis in rural South Africa. eLife 2020; 9:54012. [PMID: 32178761 PMCID: PMC7108860 DOI: 10.7554/elife.54012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/10/2020] [Indexed: 12/15/2022] Open
Abstract
Previously, we demonstrated that coverage of piped water in the seven years preceding a parasitological survey was strongly predictive of Schistosomiasis haematobium infection in a nested cohort of 1976 primary school children (Tanser, 2018). Here, we report on the prospective follow up of infected members of this nested cohort (N = 333) for two successive rounds following treatment. Using a negative binomial regression fitted to egg count data, we found that every percentage point increase in piped water coverage was associated with 4.4% decline in intensity of re-infection (incidence rate ratio = 0.96, 95% CI: 0.93–0.98, p=0.004) among the treated children. We therefore provide further compelling evidence in support of the scaleup of piped water as an effective control strategy against Schistosoma haematobium transmission.
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Affiliation(s)
- Polycarp Mogeni
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,KwaZulu-Natal Innovation and Sequencing Platform (KRISP), University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Alain Vandormael
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,KwaZulu-Natal Innovation and Sequencing Platform (KRISP), University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Diego Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, United States.,Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, United States
| | - Christopher Appleton
- School of Life Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Frank Tanser
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa.,Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, United Kingdom
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Tetteh-Quarcoo PB, Forson PO, Amponsah SK, Ahenkorah J, Opintan JA, Ocloo JEY, Okine EN, Aryee R, Afutu E, Anang AK, Ayeh-Kumi PF. Persistent Urogenital Schistosomiasis and Its Associated Morbidity in Endemic Communities within Southern Ghana: Suspected Praziquantel Resistance or Reinfection? Med Sci (Basel) 2020; 8:E10. [PMID: 32050572 PMCID: PMC7151560 DOI: 10.3390/medsci8010010] [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: 12/20/2019] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND schistosomiasis is a neglected tropical disease caused by helminths of the genus Schistosoma. The disease has a worldwide distribution, with more cases occurring in Africa. Urogenital schistosomiasis caused by S. haematobium with its associated morbidity is prevalent in many areas of Ghana. Praziquantel is still the recommended drug of choice for schistosomiasis treatment, although a number of studies have reported sub-therapeutic effects and associated treatment failure. The current study, therefore, assessed whether persistent schistosomiasis, with its associated morbidity among children living in endemic areas within the Greater Accra Region of Ghana, is as a result of reinfection or suspected praziquantel resistance. METHODOLOGY this was a longitudinal study involving a baseline and follow-up sampling after praziquantel treatment. Urine samples were collected from school children (whose parents had also consented) for the detection of S. haematobium ova using a sedimentation technique. The morbidity parameters were examined with urine chemistry strips, as well as microscopy. Viability was assessed using a modified hatchability technique, vital staining (0.4% trypan blue and 1% neutral red) and fluorescent (Hoechst 33258) microscopy. Infected individuals were treated with a single dose of praziquantel (40mg/kg). Resampling to determine reinfection was done sixth months post-treatment, after evidence of total egg clearance. For possible resistance assessment, egg counts and viability testing were conducted on the positive samples at the baseline, as well as weekly post-treatment follow-ups for 12 weeks. RESULTS out of the 420 school children sampled, 77 were initially positive but, after the sixth month sampling for reinfection assessment, eight out of the initial positives were infected again, giving a reinfection percentage of 10.4%. No suspected praziquantel resistance was recorded in the 21 positives detected out of the 360 sampled for suspected resistance assessment. The egg reduction rate increased weekly in the follow-up samples with a gradual reduction in the egg count. The study also recorded a gradual decrease in the percentage of live eggs after the first week; with all viability testing methods used complimenting each other. The morbidity parameters (proteinuria, haematuria and pyuria) changed between the baseline and post-treatment samples, eventually reducing to zero. CONCLUSIONS the outcome of this study suggests that the persistent schistosomiasis, with its associated morbidity observed in these endemic communities, is not likely to be as a result of praziquantel resistance, but reinfection. Even though there was no suspected resistance observed in the study, there remains the need to continuously intensify the monitoring of praziquantel in other endemic communities.
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Affiliation(s)
- Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana; (P.O.F.); (J.A.O.); (R.A.); (E.A.); (P.F.A.-K.)
| | - Peter O. Forson
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana; (P.O.F.); (J.A.O.); (R.A.); (E.A.); (P.F.A.-K.)
| | - Seth K. Amponsah
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health Sciences, University of Ghana, Accra 233, Ghana;
| | - John Ahenkorah
- Department of Anatomy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana;
| | - Japheth A. Opintan
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana; (P.O.F.); (J.A.O.); (R.A.); (E.A.); (P.F.A.-K.)
| | - Janet E. Y. Ocloo
- Department of Pathology, Korle-Bu Teaching Hospital, Korle-Bu, Accra 233, Ghana;
| | - Esther N. Okine
- Central Laboratory Services, Korle-Bu Teaching Hospital, Korle-Bu, Accra 233, Ghana;
| | - Robert Aryee
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana; (P.O.F.); (J.A.O.); (R.A.); (E.A.); (P.F.A.-K.)
- Department of Physiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana
| | - Emmanuel Afutu
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana; (P.O.F.); (J.A.O.); (R.A.); (E.A.); (P.F.A.-K.)
| | - Abraham K. Anang
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra 233, Ghana;
| | - Patrick F. Ayeh-Kumi
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra 233, Ghana; (P.O.F.); (J.A.O.); (R.A.); (E.A.); (P.F.A.-K.)
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10
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Dejon-Agobé JC, Edoa JR, Honkpehedji YJ, Zinsou JF, Adégbitè BR, Ngwese MM, Mangaboula A, Lell B, Grobusch MP, Mordmüller B, Adegnika AA. Schistosoma haematobium infection morbidity, praziquantel effectiveness and reinfection rate among children and young adults in Gabon. Parasit Vectors 2019; 12:577. [PMID: 31823806 PMCID: PMC6905022 DOI: 10.1186/s13071-019-3836-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/03/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa carries most of the global burden of schistosomiasis. To optimize disease control and reduce morbidity, precise data are needed for control measures adapted to the local epidemiological situation. The objective of this study is to provide baseline information on schistosomiasis dynamics, including praziquantel (PZQ) treatment outcome in children and young adults living in the vicinity of Lambaréné, Gabon. METHODS Eligible volunteers were included into a prospective longitudinal study. Urine filtration technique was used to detect eggs in urine for schistosomiasis diagnosis. Subjects were treated with 60 mg of PZQ once per month for three consecutive months, and the outcome was assessed by cure rate (CR) and egg reduction rate (ERR). RESULTS A total of 328 volunteers were enrolled in the study with a mean (± SD) age of 12.2 ± 4.7 years-old. The female-to-male ratio was 0.99. Out of 258 participants in total, 45% had schistosomiasis during the survey and 43% presented with heavy infections. The incidences of haematuria and schistosomiasis were 0.11 and 0.17 person-years, respectively. After the first and third dose of PZQ, overall ERR of 93% and 95% were found, respectively; while the CR were 78% and 88%, respectively. Both ERR (100 vs 88%) and CR (90 vs 68%) were higher among females than males after the first dose. The CR increased for both groups after the third dose to 95% and 80%, respectively. After the first PZQ dose, ERR was higher for heavy compared to light infections (94 vs 89%), while the CR was higher for light than for heavy infections (87 vs 59%). After the third PZQ dose, ERR increased only for light infections to 99%, while CR increased to 98% and 75% for light and for heavy infections, respectively. The reinfection rate assessed at a mean of 44.6 weeks post-treatment was 25%. CONCLUSIONS The prevalence of schistosomiasis is moderate in communities living in the vicinity of Lambaréné, where a subpopulation with a high risk of reinfection bears most of the burden of the disease. To improve schistosomiasis control in this scenario, we suggest education of these high-risk groups to seek themselves a one-year PZQ treatment. Trial registration clinicaltrials.gov Identifier NCT02769103. Registered 11 May 2016, retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02769013.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Ance Mangaboula
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany
- German Center for Infection Research, Tübingen, Germany
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Woldegerima E, Bayih AG, Tegegne Y, Aemero M, Jejaw Zeleke A. Prevalence and Reinfection Rates of Schistosoma mansoni and Praziquantel Efficacy against the Parasite among Primary School Children in Sanja Town, Northwest Ethiopia. J Parasitol Res 2019; 2019:3697216. [PMID: 31179124 PMCID: PMC6507171 DOI: 10.1155/2019/3697216] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/25/2019] [Accepted: 04/02/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Schistosomiasis is among the most widespread chronic infections in the world. The magnitude of the infection may show variations across different areas with respect to time. Praziquantel is a first line drug of choice for the treatment of schistosomiasis although its low cure rate has been reported in different parts of the world. Thus, an assessment of the magnitude of the diseases, the efficacy of currently available drugs, and reinfection rates is crucial. OBJECTIVE Our principal objective is to determine the prevalence and reinfection rates of Schistosoma mansoni and to evaluate the efficacy of PZQ against Schistosoma mansoni. METHOD A school-based cross-sectional study was conducted on Sanja Elementary Schools, Sanja town, northwest Ethiopia. Stool specimens were examined using Kato-Katz method. Schoolchildren who tested positive for intestinal schistosomiasis and fulfilled the inclusion criteria took part in the efficacy and reinfection study. Positive participants were treated with 40 mg/kg of Praziquantel. Cure and egg reduction rates were evaluated three weeks after treatment. The intensity of infection was determined following the WHO's guideline. Moreover, the reinfection rate of those who were cured was evaluated after a six-month posttreatment period. Data were analyzed using SPSS version 20. RESULTS At baseline, 130 (35%) of the 372 schoolchildren were found infected with Schistosoma mansoni. Out of the 130 infected schoolchildren, 112 (86.2%) had moderate infection intensity. Among the S. mansoni positive schoolchildren, 80 were included as study participants for the evaluation of PZQ efficacy, based on the inclusion criteria established by WHO. The cure and egg reduction rates were found to be 90% (72/80) and 99.5%, respectively. Of the seventy-two schoolchildren considered for the determination of reinfection rate, after 6 months of posttreatment, 13.9% were found to be reinfected. CONCLUSION The schoolchildren in the three primary schools of Sanja are at moderate risk of the infection caused by S. mansoni. Although the therapeutic potency of PZQ at 40 mg/kg was efficient against S. mansoni, a high rate of reinfection was reported in the study site, suggesting the need for integrated schistosomiasis control measures.
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Affiliation(s)
- Eden Woldegerima
- University of Gondar Referral Hospital, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Genetu Bayih
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Yalewayker Tegegne
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Aemero
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayalew Jejaw Zeleke
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Atalabi TE, Adubi TO. The epidemiology and chemotherapeutic approaches to the control of urinary schistosomiasis in school-age children (SAC): a systematic review. BMC Infect Dis 2019; 19:73. [PMID: 30658583 PMCID: PMC6339440 DOI: 10.1186/s12879-018-3647-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 12/21/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Human schistosomiases are acute and chronic infectious diseases of poverty. Currently, epidemiological data of urinary schistosomiasis (US) in school-age children (SAC) and adults are often reported together making it difficult to ascertain the true status of the disease. Based on this premise, we set out to carry out this review. METHOD To achieve this aim, we carried out a computer-aided search of PubMed, Web of Science, Science Direct, African Journals OnLine (AJOL) and the database of World Health Organization. However, the information obtained from these sources was supplemented with additional literatures from Mendeley, Research Gate, and Google. RESULTS The search yielded 183 literatures of which 93 full text research, review and online articles were deemed fit for inclusion. Our key findings showed that: (1) of all World Health Organization (WHO) Regions, Africa is the most endemic zone for US, with Kenya and Senegal recording the highest prevalence and mean intensity respectively; (2) SAC within the range of 5-16 years contribute most significantly to the transmission cycle of US globally; (3) gender is a factor to watch out for, with male often recording the highest prevalence and intensity of infection; (4) contact with open, potentially infested water sources contribute significantly to transmission; (5) parental factors (occupation and education status) predispose SAC to US; (6) economic vis a vis ecological factors play a key role in infection transmission; and (7) in the last decade, a treatment coverage of 45% was never achieved globally for SAC or non-SAC treatment category for urinary schistosomiasis. CONCLUSION In view of the WHO strategic plan to eliminate schistosomiasis by 2020 and the findings from this review, it is obvious that this goal, in the face of realities, might not be achieved. It is imperative that annual control programmes be scaled up marginally, particularly in the African region of WHO. While US-based researches should be sponsored at the grass-root level to unveil hidden endemic foci, adequate facilities for Water, Sanitation, and Hygiene (WASH) should be put in place in all schools globally.
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Affiliation(s)
- Tolulope Ebenezer Atalabi
- Department of Biological Sciences, Federal University, Dutsin-Ma, Km 65, P.M.B. 5001, Dutsin-Ma, Katsina State Nigeria
| | - Taiwo Oluwakemi Adubi
- Department of Biological Sciences and Biotechnology, College of Pure and Applied Sciences, Caleb University, Imota, Lagos State Nigeria
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Mutsaka-Makuvaza MJ, Matsena-Zingoni Z, Tshuma C, Ray S, Zhou XN, Webster B, Midzi N. Reinfection of urogenital schistosomiasis in pre-school children in a highly endemic district in Northern Zimbabwe: a 12 months compliance study. Infect Dis Poverty 2018; 7:102. [PMID: 30268157 PMCID: PMC6162945 DOI: 10.1186/s40249-018-0483-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/04/2018] [Indexed: 12/19/2022] Open
Abstract
Background In light of the shift to aiming for schistosomiasis elimination, the following are needed: data on reinfection patterns, participation, and sample submission adherence of all high-risk age groups to intervention strategies. This study was conducted to assess prevalence, reinfections along with consecutive participation, sample submission adherence, and effect of treatment on schistosomiasis prevalence in children aged five years and below in an endemic district in Zimbabwe, over one year. Methods The study was conducted from February 2016–February 2017 in Madziwa area, Shamva district. Following community mobilisation, mothers brought their children aged 5 years and below for recruitment at baseline and also urine sample collection at baseline, 3, 6, 9 and 12 months follow up surveys. At each time point, urine was tested for urogenital schistosomiasis by urine filtration and children found positive received treatment. Schistosoma haematobium prevalence, reinfections as well as children participation, and urine sample submission at each visit were assessed at each time point for one year. Results Of the 535 children recruited from the five communities, 169 (31.6%) participated consecutively at all survey points. The highest mean number of samples submitted was 2.9 among communities and survey points. S. haematobium prevalence significantly reduced from 13.3% at baseline to 2.8% at 12 months for all participants and from 24.9% at baseline to 1.8% at 12 months (P < 0.001) for participants coming at all- time points. Among the communities, the highest baseline prevalence was found in Chihuri for both the participants coming consecutively (38.5%, 10/26) and all participants (20.4%, 21/103). Reinfections were significantly high at 9 months follow up survey (P = 0.021) and in Mupfure (P = 0.003). New infections significantly decreased over time (P < 0.001). Logistic regression analysis showed that the risk of acquiring schistosomiasis was high in some communities (P < 0.05). Conclusions S. haematobium infections and reinfections are seasonal and depend on micro-geographical settings. The risk of being infected with schistosomes in pre-school aged children increases with increasing age. Sustained treatment of infected individuals in a community reduces prevalence overtime. Participation compliance at consecutive visits and sample submission adherence are important for effective operational control interventions. Electronic supplementary material The online version of this article (10.1186/s40249-018-0483-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masceline Jenipher Mutsaka-Makuvaza
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, P. O. Box A178, Avondale, Harare, Zimbabwe.,National Institute of Health Research, Ministry of Health and Child Care, P.O. Box CY573, Causeway, Harare, Zimbabwe
| | - Zvifadzo Matsena-Zingoni
- National Institute of Health Research, Ministry of Health and Child Care, P.O. Box CY573, Causeway, Harare, Zimbabwe.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, 27 St Andrews' Road, Parktown, Johannesburg, 2193, South Africa
| | - Cremance Tshuma
- Mashonaland Central Provincial Health Office, Ministry of health and Child Care, Bindura, Zimbabwe
| | - Sunanda Ray
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, P. O. Box A178, Avondale, Harare, Zimbabwe
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Bonnie Webster
- Parasites and Vectors Division, National History Museum, London, UK
| | - Nicholas Midzi
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, P. O. Box A178, Avondale, Harare, Zimbabwe.
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Kabuyaya M, Chimbari MJ, Mukaratirwa S. Efficacy of praziquantel treatment regimens in pre-school and school aged children infected with schistosomiasis in sub-Saharan Africa: a systematic review. Infect Dis Poverty 2018; 7:73. [PMID: 29986763 PMCID: PMC6036702 DOI: 10.1186/s40249-018-0448-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 06/06/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Schistosomiasis is a serious public health burden in sub-Saharan Africa. Praziquantel is the only drug recommended by the World Health Organization to treat both urogenital and intestinal schistosomiasis. The reliance on a single drug to treat a disease with such a huge burden has raised concerns of possible drug resistance mainly in endemic areas. This systematic review was conducted to identify gaps and recent progress on the efficacy of different regimens of praziquantel in treating schistosomiasis among children in sub-Saharan Africa where Schistosoma mansoni and S. haematobium are endemic. MAIN TEXT A literature search of peer-reviewed journals was done on Google Scholar, MEDLINE (under EBSCOhost) and PubMed databases using pre-defined search terms and Boolean operators. The search included studies published from 2008 to 2017 (August) with emphasis on the efficacy of praziquantel on S. haematobium and S. mansoni infections among preschool and school children. Nineteen publications satisfied the inclusion criteria for the review. The studies reviewed were from 10 sub-Saharan African countries and 7/19 of the studies (37%) were conducted in Uganda. Seven studies (37%) focused on Schistosoma mansoni, 6/19 (31.5%) on S. haematobium and another 6 on mixed infection. A single standard dose of 40 mg/kg body weight was the most used regimen (9) followed by the repeated single standard dose assessed for efficacy at 3-4 weeks post-treatment. CONCLUSIONS A repeated standard dose of 40 mg/kg achieved satisfactory efficacy compared to a single dose against both parasite species. However, findings on efficacy of repeated doses in co-infection of S. mansoni and S. haematobium were not conclusive. Praziquantel administrated at 60 mg/kg was slightly more efficacious than the 40 mg/kg standard dose. Minor and transitory side-effects were reported for both regimens. The review indicates that further investigations are necessary to conclusively determine efficacy of praziquantel on coinfection of S. haematobium and S. mansoni to formulate concrete guidelines on the use of repeated doses at 40 or 60 mg/kg for treating schistosomiasis. We recommend the use of the egg reduction rate (ERR) formula recommended by the WHO for assessing praziquantel efficacy in order for the results to be comparable for different regions.
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Affiliation(s)
- Muhubiri Kabuyaya
- Discipline of Public Health Medicine, Howard College, University of KwaZulu-Natal, P.O Box 4041, Durban, South Africa
| | - Moses John Chimbari
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Samson Mukaratirwa
- School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
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15
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Shehata MA, Chama MF, Funjika E. Prevalence and intensity of Schistosoma haematobium infection among schoolchildren in central Zambia before and after mass treatment with a single dose of praziquantel. Trop Parasitol 2018; 8:12-17. [PMID: 29930901 PMCID: PMC5991037 DOI: 10.4103/tp.tp_32_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2017] [Indexed: 12/21/2022] Open
Abstract
Introduction Urinary schistosomiasis caused by Schistosoma haematobium is common in some parts of Lusaka Province, Zambia, where water contact activity is high and sanitation is poor. We conducted a longitudinal study in Ng'ombe Compound of Lusaka, between 2007 and 2015, to observe the prevalence and intensity of S. haematobium infection among community primary school children, before and after receiving a single dose of praziquantel. Materials and Methods A total of 975 (445 females and 530 males) pupils, aged 9-16 years, were tested for S. haematobium at baseline. After mass treatment with praziquantel in 2010, 1570 pupils (785 females and 785 males), aged 9-15 years, were examined for S. haematobium eggs, from 2011 to 2015. Results At baseline, 279 out of 975 of the children were infected, with light infections constituting 84.9% and 15.1% classified as heavy infection. After mass treatment with praziquantel, the prevalence rate dropped, slightly, to 20.3% (63 out of 310) in 2011. However, it increased the following years up to 38% (133 out of 350) in 2015, with prevalence rates higher in males than females. The average number of heavy infection cases increased to 24.3% (120 out of 494) after treatment, reducing cases of light infections to 75.7% (374 out of 494). Conclusion This study revealed that mass treatment with a single dose of praziquantel was not sufficient to significantly reduce the transmission of schistosomiasis. Further studies will need to evaluate whether multiple praziquantel treatments will be more therapeutically effective in limiting future incidences.
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Affiliation(s)
- Mohamed A Shehata
- Department of Biological Sciences, The University of Zambia, Zambia, United Kingdom
| | - Mubanga F Chama
- Department of Chemistry, School of Natural Sciences, The University of Zambia, Zambia, United Kingdom.,Tropical Gastroenterology and Nutrition Group, School of Medicine, The University of Zambia, Zambia, United Kingdom
| | - Evelyn Funjika
- Department of Chemistry, School of Natural Sciences, The University of Zambia, Zambia, United Kingdom.,Tropical Gastroenterology and Nutrition Group, School of Medicine, The University of Zambia, Zambia, United Kingdom.,Faculty of Life Sciences, The University of Manchester, Manchester, United Kingdom
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Sokhna C, Gaye O, Doumbo O. Developing Research in Infectious and Tropical Diseases in Africa: The Paradigm of Senegal. Clin Infect Dis 2018; 65:S64-S69. [PMID: 28859342 DOI: 10.1093/cid/cix347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Infectious diseases represent one of the greatest potential barriers to achievement of the third Sustainable Development Goals in African countries and around the world because they continue to pose major public health challenges. The surveillance of infectious diseases has recently assumed greater importance in most African countries, both because of the emergence of infectious diseases and because strains of pathogens that cause tuberculosis, malaria, cholera, dysentery, and pneumonia have developed resistance to common and inexpensive antimicrobial drugs. However, data on the pathogen-specific causes of infectious diseases are limited. Developing research in infectious and tropical diseases in Africa is urgently needed to better describe the distribution of pathogen-borne diseases and to know which pathogens actually cause fever. This research is critical for guiding treatment and policies in Africa. More effective diagnostics are also needed for these diseases, which often are misdiagnosed or diagnosed too late. A comprehensive review of this type of research is presented here.
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Affiliation(s)
- Cheikh Sokhna
- Aix-Marseille Univ, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut Hospitlao-Universitaire (IHU)Méditerranée-Infection
| | - Oumar Gaye
- Service Parasitologie, Université Cheikh Anta Diop, Dakar, Senegal
| | - Ogobara Doumbo
- Department of Epidemiology of Infectious Diseases, Faculty of Medicine, Pharmacy and Dentistry, University of Techniques and Technologies of Bamako, Mali
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Nyarko R, Torpey K, Ankomah A. Schistosoma haematobium, Plasmodium falciparum infection and anaemia in children in Accra, Ghana. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2018; 4:3. [PMID: 29721329 PMCID: PMC5907294 DOI: 10.1186/s40794-018-0063-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/11/2018] [Indexed: 11/10/2022]
Abstract
Background Urinary Schistosomiasis and malaria are endemic in Sub-Saharan Africa. There are public health concerns and implications of these parasites. This study sought to assess the prevalence of malaria, urinary schistosomiasis, and anaemia in children of school going age in two municipalities in Ghana. Methods A cross-sectional study design was used to investigate the prevalence of S. haematobium, P. falciparum infection and the haemoglobin concentration of respondents. A total of 404 (231 males and 173 females) school children between ages 9 - 14 years (mean age 11.8 ± 1.4 years) were recruited for the survey. Urine and blood samples were collected using standard operating procedures for urinary schistosomiasis and malaria diagnosis. Haemoglobin concentration was measured using a Hemocue® Hb 201 m. Results The prevalence of mono-infection was 4.7 and 12.9% for S. haematobium and P. falciparum respectively with a small proportion (0.9%) of the respondents infected with both parasites. The prevalence of anaemia in the study population was 59.9%. The risk of developing anaemia was not associated with being infected with any of the parasites. All co-infected children had anaemia. Conclusion High prevalence of anaemia was observed within the study population. Prevalence of malaria was higher compared to schistosomiasis. Interventions to address the high levels of anaemia is required within the community. Electronic supplementary material The online version of this article (10.1186/s40794-018-0063-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ruth Nyarko
- School of Public Health, University of Ghana, P. O Box LG 13, Legon, Accra Ghana
| | - Kwasi Torpey
- School of Public Health, University of Ghana, P. O Box LG 13, Legon, Accra Ghana
| | - Augustine Ankomah
- School of Public Health, University of Ghana, P. O Box LG 13, Legon, Accra Ghana
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Kabuyaya M, Chimbari MJ, Manyangadze T, Mukaratirwa S. Efficacy of praziquantel on Schistosoma haematobium and re-infection rates among school-going children in the Ndumo area of uMkhanyakude district, KwaZulu-Natal, South Africa. Infect Dis Poverty 2017; 6:83. [PMID: 28385154 PMCID: PMC5383960 DOI: 10.1186/s40249-017-0293-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 03/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite its low cure rates and possible resistance, praziquantel (PZQ) is the only drug available for schistosomiasis treatment. Hence, monitoring its efficacy is crucial. This study assessed the efficacy of PZQ, determined re-infection and incidence rates of Schistosoma haematobium infection among school-going children in the Ndumo area, KwaZulu-Natal. METHODS A cohort of 320 school-going children (10 - 15 years) in 10 primary schools was screened for S. haematobium infection using the filtration technique. Infected children were treated at different times and hence were divided into two sub-cohorts; A1 and A2. Non-infected children constituted the sub-cohort B. Children who continued excreting viable eggs 4 weeks post-treatment received a second dose of PZQ. Re-infection rates were determined in sub-cohort A1 and A2 at 28 and 20 weeks post-treatment, respectively. Cure rates (CR) and egg reduction rates (ERR) were calculated. Incidence rate was assessed 28 weeks post baseline survey using children that were negative for schistosome eggs at that survey. Analysis of data was done using the Chi square and the Wilcoxon rank test. A 95% confidence interval with a P-value < 0.05 determined significance. RESULTS At baseline, 120 (37.5%) of the 320 study participants were found infected with Schistosoma haematobium. Heavy infections accounted for 36.7%. The calculated cure rates were 88.07% and 82.92% for females and males, respectively. Egg Reduction Rates of 80% and 64% for females and males were observed 4 weeks after the initial treatment. After the second treatment, CR was 100% in females and 50% in males with an ERR of 100% in females and 70% in males. At 20 and 28 weeks post treatment, reinfection rates of 8.03% and 8.00% were observed, respectively, giving an overall rate of 8.1%. An incidence rate of 4.1% was observed 28 weeks after the baseline screening. CONCLUSIONS The study indicated high CR while the ERR was low suggesting a reduced PZQ efficacy. The efficacy improved among females after the second dose. Re-infection rates at 20 and 28 weeks post-treatment were low. The study also indicated a low incidence rate for the 28 weeks period.
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Affiliation(s)
- Muhubiri Kabuyaya
- Discipline of Public Health Medicine, Howard College, University of KwaZulu-Natal, Durban, P.O Box, 4041 South Africa
| | - Moses John Chimbari
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Tawanda Manyangadze
- Discipline of Public Health Medicine, Howard College, University of KwaZulu-Natal, Durban, P.O Box, 4041 South Africa
| | - Samson Mukaratirwa
- School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
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19
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Mewabo AP, Moyou RS, Kouemeni LE, Ngogang JY, Kaptue L, Tambo E. Assessing the prevalence of urogenital schistosomaisis and transmission risk factors amongst school-aged children around Mapé dam ecological suburbs in Malantouen district, Cameroon. Infect Dis Poverty 2017; 6:40. [PMID: 28260525 PMCID: PMC5338087 DOI: 10.1186/s40249-017-0257-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 02/10/2017] [Indexed: 12/01/2022] Open
Abstract
Background Urogenital schistosomiasis is a parasitic infection of public health importance that affects over 112 million people worldwide. The study aimed at assessing the urogenital schistosomiasis prevalence and risk factors of transmission around Mape dam suburds in Malantouen district, West, Cameroon. Methods The study was conducted using semi-structured pretested questionnaires to collect socio-demographic and ecological data. Urine samples were also collected and used to confirm the prevalence of schistosomiasis in consented school-aged children in four primary schools between March – July 2014. Snails’ samples around the dam surburbs were also collected for taxonomy characterization and species identification. Data were compiled and quality control assessed and analysed using SPSS version 17 and Epiinfo data 3.1. P < 0.05 was considered statistical significance. Results Questionnaires were administered to 229 pupils, with gender ratio of 1.04 (m/f). The prevalence of schistosomiasis haematobium was 16.6%. Mambonko school site, which is the closest to the dam suburbs, registered the greatest prevalence rate of 40%. The age group beween 10–13 years was the most infected (18.3%) and boys were more infested than girls (21.0% vs. 15.5%). Haematuria, urination pain, school absentiesm and poor performance were the major recorded complications in 39.5 and 26.3% males to female respectively. Infection rate gender disparity documented is still poorly understood and Bulinus truncatus collected from Mambonko suburb as potential snail intermediate host requires further studies. Conclusions Authors advocated that schools and dam suburds sustained and innovative community-based surveillance and response targeted interventions implementation are needed to inform and support decision-making policy, but also in improving effective contextual behavioural communication changes and MDA improved uptake measures on national schistosomiasis control and elimination in Cameroon. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0257-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adeline P Mewabo
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Roger S Moyou
- Institut de Recherches Médicales et d'Etudes des Plantes Médicinale-Centre de Recherches Médicales (IMPM-CRM), Yaoundé, Cameroon
| | - Lysette E Kouemeni
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Jeanne Y Ngogang
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Lazare Kaptue
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Ernest Tambo
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon. .,Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Institute, Yaoundé, Cameroon.
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Dawaki S, Al-Mekhlafi HM, Ithoi I, Ibrahim J, Abdulsalam AM, Ahmed A, Sady H, Atroosh WM, Al-Areeqi MA, Elyana FN, Nasr NA, Surin J. PREVALENCE AND RISK FACTORS OF SCHISTOSOMIASIS AMONG HAUSA COMMUNITIES IN KANO STATE, NIGERIA. Rev Inst Med Trop Sao Paulo 2017; 58:54. [PMID: 27410914 PMCID: PMC4964323 DOI: 10.1590/s1678-9946201658054] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/07/2016] [Indexed: 12/17/2022] Open
Abstract
Schistosomiasis remains one of the most prevalent neglected tropical diseases especially in Nigeria which has the greatest number of infected people worldwide. A cross-sectional study was conducted among 551 participants from Kano State, North Central Nigeria. Fecal samples were examined for the presence of Schistosoma mansoni eggs using the formalin-ether sedimentation method while the urine samples were examined using the filtration technique for the presence of S. haematobium eggs. Demographic, socioeconomic and environmental information was collected using a pre-validated questionnaire. The overall prevalence of schistosomiasis was 17.8%, with 8.9% and 8.3% infected with S. mansoni and S. haematobium, respectively and 0.5% presenting co-infection with both species. The multiple logistic regression analysis revealed that age < 18 years (OR = 2.13; 95% CI; 1.34- 3.41), presence of infected family members (OR = 3.98; 95% CI; 2.13-7.46), and history of infection (OR = 2.87; 95% CI; 1.87- 4.56) were the significant risk factors associated with schistosomiasis in these communities. In conclusion, this study revealed that schistosomiasis is still prevalent among Hausa communities in Nigeria. Mass drug administration, health education and community mobilization are imperative strategies to significantly reduce the prevalence and morbidity of schistosomiasis in these communities.
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Affiliation(s)
- Salwa Dawaki
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Hesham Mahyoub Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ; .,Endemic and Tropical Diseases Unit, Medical Research Center, Jazan University, Jazan, Saudi Arabia. E-mail:
| | - Init Ithoi
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Jamaiah Ibrahim
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Awatif Mohammed Abdulsalam
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Abdulhamid Ahmed
- Department of Biology, Faculty of Natural and Applied Sciences, Umaru Musa Yar'adua University. Katsina, Katsina State, Nigeria. E-mail:
| | - Hany Sady
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Wahib Mohammed Atroosh
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Mona Abdullah Al-Areeqi
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Fatin Nur Elyana
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Nabil Ahmed Nasr
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
| | - Johari Surin
- Department of Parasitology, Faculty of Medicine, University of Malaya. 50603 Kuala Lumpur, Malaysia. E-mails: ; ; ; ; ; ; ; ; ; ;
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Zwang J, Olliaro P. Efficacy and safety of praziquantel 40 mg/kg in preschool-aged and school-aged children: a meta-analysis. Parasit Vectors 2017; 10:47. [PMID: 28126024 PMCID: PMC5270314 DOI: 10.1186/s13071-016-1958-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 12/27/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Children carry most of the schistosomiasis burden. While school-aged children are the principal target group of preventive chemotherapy with praziquantel, limited information on efficacy and safety exists for preschool-aged children. METHODS Here, we conducted a meta-analysis of clinical trials of praziquantel for treating children with any form of schistosomiasis. Efficacy was reported as cure rate (CR) and egg reduction rates (ERR); statistical corrections were applied based on methodological disparities across trials to derive the predicted geometrical mean ERR (pERRgm). Safety was reported as frequencies of adverse events. RESULTS Forty-seven comparative and non-comparative studies were identified, enrolling 15,549 children of whom 14,340 (92%) were assessed between 3 and 8 weeks post-treatment with praziquantel 40 mg/kg (the WHO-recommended treatment, n = 8,380, 56%) or comparators (n = 5,960, 44%). The median age was 10 years (range 1-19), 11% (n = 1,694) were preschool-aged. The CR and pERRgm with praziquantel 40 mg/kg were respectively: S. haematobium, 73.6% (95% CI: 63.5-81.40, 25 study arms) and 94.7% (95% CI: 92.7-96.4); S. mansoni, 76.4% (95% CI: 71.5-81.0, 34 arms) and 95.3% (95% CI: 94.2-96.2); S. mansoni/S. haematobium, 67.6% (95% CI: 54.1-80.7, 5 arms) and 93.4% (95% CI: 89.9-96.2); S. japonicum, 94.7% (95% CI: 92.2-98.0) and 98.7% (95% CI: 98.3-99.2). Mixed-effect multivariate analysis found no significant difference between preschool- and school-aged children for CR or pERRgm in S. haematobium (P = 0.309 and P = 0.490, respectively) or S. mansoni (P = 0.982 and P = 0.895) after controlling for time of assessment, formulation, intensity of infection and detection method. Praziquantel was reportedly safe at all ages, with only mild reported adverse events which cleared rapidly after treatment. CONCLUSIONS Praziquantel 40 mg/kg was effective at reducing infection intensity in all Schistosoma species without differences between preschool- and school-aged children. However, conclusions should be tempered because of the limited number of preschool-aged children enrolled, disparities in study procedures and limited information made available in publications, as well as the current imperfect test-of-cure. Also, although reportedly well-tolerated, safety was inconsistently assessed. Studies in target groups, individual-data meta-analysis and standardised methodologies are needed for more robust evidence-base.
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Affiliation(s)
| | - Piero Olliaro
- UNICEF/UNDP/World Bank/WHO Special Programme for Research & Training in Tropical Diseases (TDR), Geneva, Switzerland
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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22
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Elyana FN, Al-Mekhlafi HM, Ithoi I, Abdulsalam AM, Dawaki S, Nasr NA, Atroosh WM, Abd-Basher MH, Al-Areeqi MA, Sady H, Subramaniam LR, Anuar TS, Lau YL, Moktar N, Surin J. A tale of two communities: intestinal polyparasitism among Orang Asli and Malay communities in rural Terengganu, Malaysia. Parasit Vectors 2016; 9:398. [PMID: 27422533 PMCID: PMC4947346 DOI: 10.1186/s13071-016-1678-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/01/2016] [Indexed: 12/19/2022] Open
Abstract
Background Intestinal parasitic infections (IPIs) are still major health problems in many developing countries including Malaysia, particularly in the poor and socioeconomically deprived rural and remote communities in Peninsular Malaysia. This study was conducted to determine the prevalence of IPIs and to identify the key factors associated with intestinal polyparasitism as well as to evaluate the knowledge, attitude and practices (KAP) on IPIs among rural Orang Asli and Malay communities in Terengganu, Malaysia. Methods A cross-sectional study was conducted among 340 participants (165 Orang Asli and 175 Malay) aged ≤ 15 years from the Hulu Terengganu and Kemaman districts of Terengganu. Faecal samples were examined for the presence of intestinal parasites by using direct smear, formalin-ether sedimentation, trichrome stain, modified Ziehl Neelsen stain, in vitro cultivation in Jones’ medium, Kato Katz and Harada Mori techniques. Demographic, socioeconomic, environmental and behavioural information of the participants and their KAP for IPIs were collected by using a pre-tested questionnaire. Results Overall, 149 (90.3 %) Orang Asli and 43 (24.6 %) Malay children were infected by at least one parasite species. The overall prevalences of intestinal polyparasitism among the Orang Asli and Malay were 68.5 % (113/165) and 14.3 % (25/175), respectively. Multiple logistic regression analysis showed that using unsafe water supply as a source for drinking water, the presence of domestic animals, not wearing shoes when outside, not washing vegetables before consumption, not washing hands after playing with soil, indiscriminate defecation and the low level of mother’s education were the key risk factors for intestinal polyparasitism among the Orang Asli, while working mothers and the presence of domestic animals were the risk factors among the Malay children. Almost all the Malays were well aware about the IPIs while Orang Asli respondents had a poor level of related awareness. Conclusions This study demonstrates that IPIs are highly prevalent in rural Terengganu, Malaysia. Community awareness about IPIs was found to be imperative in protecting Malay children from these infections. An integrated control programme for the prevention and control of IPIs is highly recommended for these communities, with a special emphasis on the Orang Asli population.
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Affiliation(s)
- Fatin Nur Elyana
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hesham M Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. .,Endemic and Tropical Diseases Unit, Medical Research Center, Jazan University, Jazan, Kingdom of Saudi Arabia. .,Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
| | - Init Ithoi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Awatif M Abdulsalam
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Salwa Dawaki
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Nabil A Nasr
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Wahib M Atroosh
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamad Hafiz Abd-Basher
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mona A Al-Areeqi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hany Sady
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Lahvanya R Subramaniam
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Tengku Shahrul Anuar
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Puncak Alam Campus, 42300, Selangor, Malaysia.,Department of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, 42300, Selangor, Malaysia
| | - Yee Ling Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Norhayati Moktar
- Department of Parasitology and Medical Entomology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000, Kuala Lumpur, Malaysia
| | - Johari Surin
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.,Centre for Research and Innovation, Taylor's University, Subang Jaya, 47500, Selangor, Malaysia
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Senghor B, Diaw OT, Doucoure S, Seye M, Diallo A, Talla I, Bâ CT, Sokhna C. Impact of Annual Praziquantel Treatment on Urogenital Schistosomiasis in a Seasonal Transmission Focus in Central Senegal. PLoS Negl Trop Dis 2016; 10:e0004557. [PMID: 27015646 PMCID: PMC4807842 DOI: 10.1371/journal.pntd.0004557] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/27/2016] [Indexed: 11/18/2022] Open
Abstract
In Sub-Saharan Africa, urogenital schistosomiasis remains a significant public health problem, causing 150.000 deaths/year with approximately 112 million cases diagnosed. The Niakhar district is a disease hotspot in central Senegal where transmission occurs seasonally with high prevalences. The aim of this study was to determine the effect of annual treatment over 3 years on the seasonal transmission dynamics of S. haematobium in 9 villages in the Niakhar district. Adults and children aged between 5 and 60 years were surveyed from 2011 to 2014. Urine samples were collected door-to-door and examined for S. haematobium eggs at baseline in June 2011, and all participants were treated in August 2011 with PZQ (40 mg/kg). After this initial examination, evaluations were conducted at 3 successive time points from September 2011 to March 2014, to measure the efficacy of the annual treatments and the rates of reinfection. Each year, during the transmission period, from July to November-December, malacological surveys were also carried out in the fresh water bodies of each village to evaluate the infestation of the snail intermediate hosts. At baseline, the overall prevalence of S. haematobium infection was 57.7%, and the proportion of heavy infection was 45.3%, but one month after the first treatment high cure rates (92.9%) were obtained. The overall infection prevalence and proportion of heavy infection intensities were drastically reduced to 4.2% and 2.3%, respectively. The level of the first reinfection in February-March 2012 was 9.5%. At follow-up time points, prevalence levels varied slightly between reinfection and treatment from 9.5% in June 2012 to 0.3% in March 2013, 11.2 in June 2013, and 10.1% April 2014. At the end of the study, overall prevalence was significantly reduced from 57.7% to 10.1%. The overall rate of infested Bulinid snails was reduced after repeated treatment from 0.8% in 2012 to 0.5% in 2013. Repeated annual treatments are suggested to have a considerable impact on the transmission dynamics of S. haematobium in Niakhar, due to the nature of the epidemiological system with seasonal transmission. Thus, to maintain this benefit and continue to reduce the morbidity of urogenital schistosomiasis, other approaches should be integrated into the strategy plans of the National program to achieve the goal of urogenital schistosomiasis elimination in seasonal foci in Senegal. Urogenital schistosomiasis represents a serious cause of morbidity and mortality in S. haematobium endemic countries. Treatment with praziquantel (PZQ) is effective at reducing or eliminating active infection, but does not prevent reinfection that remains a continuing problem in high-risk communities, especially in areas where contacts with infested water are inevitable. The efficacy of PZQ treatment is challenged by regular re-infection in high risk communities due to frequent contact with water infested with snails carrying the larvae of S. haematobium. A large number of countries have initiated schistosomiasis control and elimination programs based on repeated PZQ mass drug administration (MDA). However, little information is available on the impact of repeated treatment on S. haematobium transmission dynamics in areas where transmission occurs seasonally in temporary water bodies. This observational study assessed the effect of annual repeated cohort treatment with PZQ over 3 years on the seasonal transmission dynamics of S. haematobium in nine villages in Niakhar district, District. Repeated annual treatments have a considerable impact on the transmission dynamics of S. haematobium in Niakhar. The prevalence of S. haematobium was dramatically reduced from 57.7% in 2011 to 10.1% in 2014. The reinfection rate did not exceed 10% from 2012 to 2014. Also, the rate of infested Bulinid snails decreased from 0.8% in 2012 to 0.5% in 2013. These results suggest that it may be possible to implement urogenital schistosomiasis elimination strategies in the Niakhar district and other seasonal transmission areas in Senegal if praziquantel MDAs are carried out in combination with other measures such as health education, improvement of access to clean water and snail control.
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Affiliation(s)
- Bruno Senghor
- Institute Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, Dakar, Sénégal
- Université Cheikh Anta Diop de Dakar, Département de Biologie Animale, laboratoire d’écologie et de Biologie évolutive, Dakar, Senegal
| | - Omar Talla Diaw
- Institut Sénégalais de Recherches Agricoles, ISRA, Dakar, Senegal
| | - Souleymane Doucoure
- Institute Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, Dakar, Sénégal
| | - Mouhamadane Seye
- Institut Sénégalais de Recherches Agricoles, ISRA, Dakar, Senegal
| | - Adiouma Diallo
- Institute Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, Dakar, Sénégal
| | - Idrissa Talla
- Programme national de lutte contre les bilharzioses et les géo-helminthiases, Ministère de la Santé et de l'Action sociale (MSAS), Dakar, Sénégal
| | - Cheikh T. Bâ
- Université Cheikh Anta Diop de Dakar, Département de Biologie Animale, laboratoire d’écologie et de Biologie évolutive, Dakar, Senegal
| | - Cheikh Sokhna
- Institute Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, Dakar, Sénégal
- * E-mail:
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Senghor B, Diaw OT, Doucoure S, Seye M, Talla I, Diallo A, Bâ CT, Sokhna C. Study of the snail intermediate hosts of urogenital schistosomiasis in Niakhar, region of Fatick, West central Senegal. Parasit Vectors 2015; 8:410. [PMID: 26246374 PMCID: PMC4527339 DOI: 10.1186/s13071-015-1030-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/02/2015] [Indexed: 11/17/2022] Open
Abstract
Background Schistosoma haematobium is the most widespread schistosome species in Senegal and occurs in several regions of the country especially in the Sudan-Sahelian zone. The aims of the study were i) to determine the freshwater species ii) to ascertain the role of the identified snail species in the transmission of S. haematobium and iii) to study the impact of drought on the snails. Methods Snails were sampled each year in 17 sites from July to November-December 2012 and 2013. At each snail survey, snails were grouped by village, counted, identified according to shell morphology and the rates of schistosome cercarial shedding recorded. The shell height of the snails collected in July was measured and classified into four groups according to their size in order to determine those that are open to aestivation. Results B. senegalensis and B. umbilicatus were the only snails intermediate hosts collected in the Niakhar study area. B. senegalensis is found in all the 17 sampling sites while B. umbilicatus was only found in one site out of the many surveyed. The total number of B. senegalensis collected in 2012 and 2013 was 1032 and 8261 respectively. A total of 901 and 6432 B. senegalensis were tested for Schistosoma spp. infestation in 2012 and 2013 respectively. For B. umbilicatus, 58 snails were collected and tested in 2012. In 2013, 290 were collected and 281 tested. The overall rates of schistosome cercarial shedding were 0 % in 2012 and 0.12 % in 2013 for B. senegalensis and 13.79 and 4.98 % in 2012 and 2013 respectively for B. umbilicatus. For both species collected in July, size group 3 individuals (7–9.9 mm) were the most numerous, 63.6 and 57.8 % for B. senegalensis and B. umbilicatus respectively. B. umbilicatus was reported for the first time in the region of Fatick located in the old ecological zone of Sine-Saloum, is able to maintain Schistosoma spp. larvae during 7 months of drought and may transmit the disease in early July, increasing the period and the risk of transmission. Conclusion This study recommends an adaptation of snail control strategies at pond cycles and ecology of the snails in these seasonal foci. Malacological control strategies must take into account these phenomena of drought resistance and the capacity of some snails to maintain parasite during aestivation. The treatment of ponds with Bayluscide at the end of the rainy season in November and upon onset of rains in July would be more advantageous to the control of snails thereby reducing transmission of urogenital schistosomiasis in the Niakhar area.
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Affiliation(s)
- Bruno Senghor
- Institut de Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, BP 1386, CP 18524, Dakar, Sénégal. .,Département de Biologie Animale, laboratoire d'écologie et de Biologie évolutive, Université Cheikh Anta Diop de Dakar, BP 5005, Dakar, Senegal.
| | - Omar Talla Diaw
- Institut Sénégalais de Recherches Agricoles, ISRA, route des Hydrocarbures, Bel Air, BP 3120, Dakar, Senegal.
| | - Souleymane Doucoure
- Institut de Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, BP 1386, CP 18524, Dakar, Sénégal.
| | - Mouhamadane Seye
- Institut Sénégalais de Recherches Agricoles, ISRA, route des Hydrocarbures, Bel Air, BP 3120, Dakar, Senegal.
| | - Idrissa Talla
- Programme national de lutte contre les bilharzioses et les géo-helminthiases, ministère de la santé et de l'action sociale, Dakar, Sénégal.
| | - Adiouma Diallo
- Institut de Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, BP 1386, CP 18524, Dakar, Sénégal.
| | - Cheikh Tidiane Bâ
- Département de Biologie Animale, laboratoire d'écologie et de Biologie évolutive, Université Cheikh Anta Diop de Dakar, BP 5005, Dakar, Senegal.
| | - Cheikh Sokhna
- Institut de Recherche pour le Développement, UMR 198 (URMITE), Campus International de Hann, IRD, BP 1386, CP 18524, Dakar, Sénégal.
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