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Trippler L, Taylor L, Ali MN, Najim SO, Khamis KS, Hattendorf J, Juma S, Ame SM, Kabole F, Ali SM, Knopp S. Test-treat-track-test-treat (5T) approach for Schistosoma haematobium elimination on Pemba Island, Tanzania. BMC Infect Dis 2024; 24:661. [PMID: 38956479 PMCID: PMC11218394 DOI: 10.1186/s12879-024-09549-w] [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: 11/29/2023] [Accepted: 06/21/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND After decades of praziquantel mass drug administration (MDA), several countries approach schistosomiasis elimination. Continuing MDA in largely uninfected populations no longer seems justified. Alternative interventions to maintain the gains or accelerate interruption of transmission are needed. We report results, strengths, and shortcomings of novel test-treat-track-test-treat (5T) interventions in low Schistosoma haematobium prevalence areas on Pemba, Tanzania. METHODS School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area. RESULTS The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive. CONCLUSIONS The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination. TRIAL REGISTRATION ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493 .
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Affiliation(s)
- Lydia Trippler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Lyndsay Taylor
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Sarah Omar Najim
- Ivo de Carneri, Wawi, Chake Chake, Pemba, United Republic of Tanzania
| | | | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Saleh Juma
- Neglected Diseases Program, Zanzibar Ministry of Health, Mkoroshoni, Pemba, United Republic of Tanzania
| | - Shaali Makame Ame
- Neglected Diseases Program, Zanzibar Ministry of Health, Lumumba, Unguja, United Republic of Tanzania
| | - Fatma Kabole
- Neglected Diseases Program, Zanzibar Ministry of Health, Lumumba, Unguja, United Republic of Tanzania
| | - Said Mohammed Ali
- Ivo de Carneri, Wawi, Chake Chake, Pemba, United Republic of Tanzania
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
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Mathieu-Bégné E, Kincaid-Smith J, Chaparro C, Allienne JF, Rey O, Boissier J, Toulza E. Schistosoma haematobium and Schistosoma bovis first generation hybrids undergo gene expressions changes consistent with species compatibility and heterosis. PLoS Negl Trop Dis 2024; 18:e0012267. [PMID: 38954732 PMCID: PMC11249247 DOI: 10.1371/journal.pntd.0012267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/15/2024] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
When two species hybridize, the two parental genomes are brought together and some alleles might interact for the first time. To date, the extent of the transcriptomic changes in first hybrid generations, along with their functional outcome constitute an important knowledge gap, especially in parasite species. Here we explored the molecular and functional outcomes of hybridization in first-generation hybrids between the blood fluke parasites Schistosoma haematobium and S. bovis. Through a transcriptomic approach, we measured gene expression in both parental species and hybrids. We described and quantified expression profiles encountered in hybrids along with the main biological processes impacted. Up to 7,100 genes fell into a particular hybrid expression profile (intermediate between the parental expression levels, over-expressed, under-expressed, or expressed like one of the parental lines). Most of these genes were different depending on the direction of the parental cross (S. bovis mother and S. haematobium father or the reverse) and depending on the sex. For a given sex and cross direction, the vast majority of genes were hence unassigned to a hybrid expression profile: either they were differentially expressed genes but not typical of any hybrid expression profiles or they were not differentially expressed neither between hybrids and parental lines nor between parental lines. The most prevalent profile of gene expression in hybrids was the intermediate one (24% of investigated genes). These results suggest that transcriptomic compatibility between S. haematobium and S. bovis remains quite high. We also found support for an over-dominance model (over- and under-expressed genes in hybrids compared to parental lines) potentially associated with heterosis. In females in particular, processes such as reproductive processes, metabolism and cell interactions as well as signaling pathways were indeed affected. Our study hence provides new insight on the biology of Schistosoma hybrids with evidences supporting compatibility and heterosis.
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Affiliation(s)
| | - Julien Kincaid-Smith
- IHPE, Université de Montpellier, CNRS, Ifremer, Université Perpignan Via Domitia, Perpignan, France
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Université de Montpellier, Montpellier, France
| | - Cristian Chaparro
- IHPE, Université de Montpellier, CNRS, Ifremer, Université Perpignan Via Domitia, Perpignan, France
| | - Jean-François Allienne
- IHPE, Université de Montpellier, CNRS, Ifremer, Université Perpignan Via Domitia, Perpignan, France
| | - Olivier Rey
- IHPE, Université de Montpellier, CNRS, Ifremer, Université Perpignan Via Domitia, Perpignan, France
| | - Jérôme Boissier
- IHPE, Université de Montpellier, CNRS, Ifremer, Université Perpignan Via Domitia, Perpignan, France
| | - Eve Toulza
- IHPE, Université de Montpellier, CNRS, Ifremer, Université Perpignan Via Domitia, Perpignan, France
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Kapour Kieng Katsang G, Wambui CW, Madinga J, Huyse T, Mitashi P. Mapping of intermediate host snails for schistosomiasis in the Democratic Republic of Congo: a systematic review. Folia Parasitol (Praha) 2024; 71:2024.010. [PMID: 38841845 DOI: 10.14411/fp.2024.010] [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: 10/05/2023] [Accepted: 01/25/2024] [Indexed: 06/07/2024]
Abstract
Schistosomiasis is a snail-borne disease that has a considerable impact on human and animal health, particularly in sub-Saharan Africa. The intermediate hosts of the schistosome parasites are freshwater snails of the genera Biomphalaria Preston, 1910 and Bulinus Müller, 1781. In order to identify existing gaps in the spread of the disease in the Democratic Republic of Congo (DRC), this study compiled the available knowledge of the distribution, population dynamics and ecology of the intermediate hosts of schistosomiasis. A systematic literature search was conducted in PubMed, Embase and Scopus for all malacological studies on schistosoma intermediate hosts in DRC published between 1927 and October 2022. A total of 55 records were found, of which 31 met the inclusion criteria: these were published field and experimental studies conducted in the DRC and focused on snails as intermediate hosts of schistosomes. The analysis of these studies revealed that more up-to-date data on the distribution of snail intermediate hosts in the DRC are needed. Moreover, ecological factors have been less studied for Bulinus species than for Biomphalaria species. These factors play a crucial role in determining suitable snail habitats, and the lack of comprehensive information poses a challenge in snail control. This review makes it clear that there are no current malacological data in the DRC. There is a clear need for molecular and ecological research to update the exact species status and population dynamics of all potential intermediate host species. This will facilitate targeted snail control measures that complement drug treatment in the control of schistosomiasis in the country.
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Affiliation(s)
| | | | - Joule Madinga
- National Institutes for Biomedical Research, Kinshasa, the Democratic Republic of Congo
- Biomedical Department, University of Kikwit, Kikwit, Democratic Republic of the Congo
| | - Tine Huyse
- Department of Biology Royal Museum for Central Africa, Tervuren, Belgium
| | - Patrick Mitashi
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Vere M, ten Ham-Baloyi W, Melariri PE. Effects of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic review. PLoS One 2024; 19:e0301464. [PMID: 38696510 PMCID: PMC11065241 DOI: 10.1371/journal.pone.0301464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 03/17/2024] [Indexed: 05/04/2024] Open
Abstract
Preventive chemotherapy by mass drug administration is globally recommended as the primary method of reaching the elimination of schistosomiasis, especially in the high risk-paediatric population. This systematic review provides a summary of the effects of paediatric schistosomiasis control programs on eliminating schistosomiasis in sub-Saharan Africa. A systematic search was conducted in PubMed, EBSCOhost, and other databases to obtain studies regarding the effects of paediatric schistosomiasis control programmes in sub-Saharan Africa. 3455 studies were screened for eligibility, included articles reported on both paediatrics control programmes and schistosomiasis, and articles were excluded when they did not report on schistosomiasis control programmes in paediatrics exclusively. 40 selected studies were critically appraised using the JBI critical appraisal tools for relevance and 30 studies were included in the study. An in-depth quantitative descriptive analysis was conducted, and a comprehensive narrative summary explained the results within the scope of the review questions. The results show that despite preventive chemotherapy lowering schistosomiasis prevalence, chances of re-infection are high in endemic areas. Preventive chemotherapy without complementary interventions including safe water provision and proper sanitation, snail control and health education on the aetiology of schistosomiasis, transmission pattern and control practices might not eliminate schistosomiasis.
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Affiliation(s)
- Maryline Vere
- Faculty of Health Sciences, Department of Environmental Health, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
| | - Wilma ten Ham-Baloyi
- Faculty of Health Sciences, Department of Environmental Health, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
- Faculty of Health Sciences, Department of Nursing Science, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
| | - Paula Ezinne Melariri
- Faculty of Health Sciences, Department of Nursing Science, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
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Rakotozandrindrainy R, Rakotoarivelo RA, Kislaya I, Marchese V, Rasamoelina T, Solonirina J, Ratiaharison EF, Razafindrakoto R, Razafindralava NM, Rakotozandrindrainy N, Radomanana M, Andrianarivelo MR, Klein P, Lorenz E, Jaeger A, Hoekstra PT, Corstjens PLAM, Schwarz NG, van Dam GJ, May J, Fusco D. Schistosome infection among pregnant women in the rural highlands of Madagascar: A cross-sectional study calling for public health interventions in vulnerable populations. PLoS Negl Trop Dis 2024; 18:e0011766. [PMID: 38626192 PMCID: PMC11051649 DOI: 10.1371/journal.pntd.0011766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/26/2024] [Accepted: 03/26/2024] [Indexed: 04/18/2024] Open
Abstract
INTRODUCTION Schistosomiasis is a parasitic infection highly prevalent in sub-Saharan Africa (SSA) with Madagascar being among the countries with highest burden of the disease worldwide. Despite WHO recommendations, suggesting treatment of pregnant women after the first trimester, this group is still excluded from Mass Drug Administration programs. Our study, had the objective to measure the prevalence of schistosome infection among pregnant women in Madagascar in order to inform public health policies for treatment in this vulnerable population. METHODS Women were recruited for this cross-sectional study between April 2019 and February 2020 when attending Antenatal Care Services (ANCs) at one of 42 included Primary Health Care Centers. The urine-based upconverting reporter particle, lateral flow (UCP-LF) test detecting circulating anodic antigen was used for the detection of schistosome infections. To identify factors associated with the prevalence of schistosome infection crude and adjusted prevalence ratios and 95% CIs were estimated using mixed-effect Poisson regression. RESULTS Among 4,448 participating women aged between 16 and 47 years, the majority (70.4%, 38 n = 3,133) resided in rural settings. Overall, the prevalence of schistosome infection was 55.9% (n = 2486, CI 95%: 53.3-58.5). A statistically significant association was found with age group (increased prevalence in 31-47 years old, compared to 16-20 years old (aPR = 1.15, CI 95%: 1.02-1.29) and with uptake of antimalaria preventive treatment (decreased prevalence, aPR = 0.85, CI 95%: 0.77-0.95). No other associations of any personal characteristics or contextual factors with schistosome infection were found in our multivariate regression analysis. DISCUSSION AND CONCLUSION The high prevalence of schistosome infection in pregnant women supports the consideration of preventive schistosomiasis treatment in ANCs of the Malagasy highlands. We strongly advocate for adapting schistosomiasis programs in highly endemic contexts. This, would contribute to both the WHO and SDGs agendas overall to improving the well-being of women and consequently breaking the vicious cycle of poverty perpetuated by schistosomiasis.
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Affiliation(s)
| | | | - Irina Kislaya
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Valentina Marchese
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | | | | | | | | | | | | | - Mickael Radomanana
- Infectious diseases service, University Hospital Tambohobe, Fianarantsoa, Madagascar
| | | | - Philipp Klein
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Eva Lorenz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Anna Jaeger
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | | | | | - Norbert Georg Schwarz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | | | - Jürgen May
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Daniela Fusco
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
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Archer J, Yeo SM, Gadd G, Pennance T, Cunningham LJ, Juhàsz A, Jones S, Chammudzi P, Kapira DR, Lally D, Namacha G, Mainga B, Makaula P, LaCourse JE, Kayuni SA, Musaya J, Stothard JR, Webster BL. Development, validation, and pilot application of a high throughput molecular xenomonitoring assay to detect Schistosoma mansoni and other trematode species within Biomphalaria freshwater snail hosts. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2024; 5:100174. [PMID: 38618156 PMCID: PMC11010794 DOI: 10.1016/j.crpvbd.2024.100174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/27/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024]
Abstract
Schistosomiasis is a neglected tropical disease (NTD) caused by infection with parasitic trematodes of the genus Schistosoma that can lead to debilitating morbidity and mortality. The World Health Organization recommend molecular xenomonitoring of Biomphalaria spp. freshwater snail intermediate hosts of Schistosoma mansoni to identify highly focal intestinal schistosomiasis transmission sites and monitor disease transmission, particularly in low-endemicity areas. A standardised protocol to do this, however, is needed. Here, two previously published primer sets were selected to develop and validate a multiplex molecular xenomonitoring end-point PCR assay capable of detecting S. mansoni infections within individual Biomphalaria spp. missed by cercarial shedding. The assay proved highly sensitive and highly specific in detecting and amplifying S. mansoni DNA and also proved highly sensitive in detecting and amplifying non-S. mansoni trematode DNA. The optimised assay was then used to screen Biomphalaria spp. collected from a S. mansoni-endemic area for infection and successfully detected S. mansoni infections missed by cercarial shedding as well as infections with non-S. mansoni trematodes. The continued development and use of molecular xenomonitoring assays such as this will aid in improving disease control efforts, significantly reducing disease-related morbidities experienced by those in schistosomiasis-endemic areas.
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Affiliation(s)
- John Archer
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London, SW7 5HD, UK
| | - Shi Min Yeo
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London, SW7 5HD, UK
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Grace Gadd
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London, SW7 5HD, UK
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Tom Pennance
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London, SW7 5HD, UK
- College of Osteopathic Medicine of the Pacific – Northwest, Western University of Health Sciences, Lebanon, OR, 97355, USA
| | - Lucas J. Cunningham
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Alexandra Juhàsz
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Institute of Medical Microbiology, Semmelweis University, Budapest, H-1089, Hungary
| | - Sam Jones
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Priscilla Chammudzi
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, P.O. Box 30096, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, 360, Malawi
| | - Donales R. Kapira
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, P.O. Box 30096, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, 360, Malawi
| | - David Lally
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, P.O. Box 30096, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, 360, Malawi
| | - Gladys Namacha
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, P.O. Box 30096, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, 360, Malawi
| | - Bright Mainga
- Laboratory Department, Mangochi District Hospital, Mangochi, P.O. Box 42, Malawi
| | - Peter Makaula
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, P.O. Box 30096, Malawi
| | - James E. LaCourse
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Sekeleghe A. Kayuni
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, P.O. Box 30096, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, 360, Malawi
| | - Janelisa Musaya
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, P.O. Box 30096, Malawi
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, 360, Malawi
| | - J. Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Bonnie L. Webster
- Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London, SW7 5HD, UK
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Mathewson JD, van der Spek L, Mazigo HD, Kabona G, de Vlas SJ, Nshala A, Rood EJJ. Enabling targeted mass drug administration for schistosomiasis in north-western Tanzania: Exploring the use of geostatistical modeling to inform planning at sub-district level. PLoS Negl Trop Dis 2024; 18:e0011896. [PMID: 38227610 PMCID: PMC10817176 DOI: 10.1371/journal.pntd.0011896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/26/2024] [Accepted: 01/02/2024] [Indexed: 01/18/2024] Open
Abstract
INTRODUCTION Schistosomiasis is a parasitic disease in Tanzania affecting over 50% of the population. Current control strategies involve mass drug administration (MDA) campaigns at the district level, which have led to problems of over- and under-treatment in different areas. WHO guidelines have called for more targeted MDA to circumvent these problems, however a scarcity of prevalence data inhibits decision makers from prioritizing sub-district areas for MDA. This study demonstrated how geostatistics can be used to inform planning for targeted MDA. METHODS Geostatistical sub-district (ward-level) prevalence estimates were generated through combining a zero-inflated poisson model and kriging approach (regression kriging). To make predictions, the model used prevalence survey data collected in 2021 of 17,400 school children in six regions of Tanzania, along with several open source ecological and socio-demographic variables with known associations with schistosomiasis. RESULTS The model results show that regression kriging can be used to effectively predict the ward level parasite prevalence of the two species of Schistosoma endemic to the study area. Kriging was found to further improve the regression model fit, with an adjusted R-squared value of 0.51 and 0.32 for intestinal and urogenital schistosomiasis, respectively. Targeted treatment based on model predictions would represent a shift in treatment away from 193 wards estimated to be over-treated to 149 wards that would have been omitted from the district level MDA. CONCLUSIONS Geostatistical models can help to support NTD program efficiency and reduce disease transmission by facilitating WHO recommended targeted MDA treatment through provision of prevalence estimates where data is scarce.
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Affiliation(s)
- Jake D. Mathewson
- Kit-Royal Tropical Institute, Epidemiology, Center for Applied Spatial Epidemiology (CASE), Amsterdam, The Netherlands
| | - Linda van der Spek
- Kit-Royal Tropical Institute, Epidemiology, Center for Applied Spatial Epidemiology (CASE), Amsterdam, The Netherlands
| | - Humphrey D. Mazigo
- School of Medicine, Department of Medical Parasitology & Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - George Kabona
- Ministry of Health, National Neglected Tropical Diseases Control Programme, Dodoma, Tanzania
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Ente J. J. Rood
- Kit-Royal Tropical Institute, Epidemiology, Center for Applied Spatial Epidemiology (CASE), Amsterdam, The Netherlands
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Ngwa AF, Tanyi Bobga P, Nsongmayi ED, Yememe Yememe GS, Ngong Nyeme J, Isah M, Ashu EC, Ebai CB. Prevalence and Predictors Associated to Schistosoma mansoni Infection among Patients Attending the Saint Jean de Malte Hospital, Njombe, Littoral Region, Cameroon. J Parasitol Res 2023; 2023:8674934. [PMID: 37901676 PMCID: PMC10613114 DOI: 10.1155/2023/8674934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/31/2023] Open
Abstract
Background Schistosomiasis remains a major public health concern in sub-Saharan Africa. It has been associated to morbidity and mortality in developing countries including Cameroon, and Njombe-Penja health district is an endemic area. This study is aimed at determining the prevalence and risk factors of Schistosoma mansoni infection among patients attending the Saint Jean de Malte Hospital, Njombe. Methods A cross-sectional study design was employed, with the enrolment of 300 participants using convenience sampling technique. Data were collected using a structured questionnaire. Stool specimens were collected and examined using direct microscopy, Kato-Katz's method, and formol ether concentration technique. Data were analyzed using SPSS, and chi-square test was used to assess the association. Risk factors for S. mansoni infection were assessed using multivariable logistic regression, and a p < 0.05 was considered significant. Results The overall prevalence of Schistosoma mansoni infection was 13%. Schistosoma mansoni infection was mostly frequent among patients < 20 years and males. Stream usage (AOR = 2.15, 95% CI. 1.32-3.50), always visiting the stream (AOR = 11.35, 95% CI 2.33-55.33), always swimming and washing clothes in the stream (AOR = 7 : 10, 95% CI 2.31-21.80), age group < 20 years (AOR = 3.7, 95% CI 1.1-12.2), and age group 20-29 years (AOR = 2.58, 95% CI 1.14-18.42) were significantly associated with increased risk of S. mansoni infection. Conclusion These findings suggest that Schistosoma mansoni infection is of public health concern in Njombe and its environs. Age of <20 years and between 20 and 29 years, stream usage, always visiting the stream, and always swimming and washing clothes in the stream were the main risk factors of S. mansoni infection. Thus, mass drug administration and health education are required.
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Affiliation(s)
- Ambe Fabrice Ngwa
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Cameroon
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Cameroon
- International School for Nurses and Technico-Sanitary Personnels, Douala, Cameroon
- School of Medical and Biomedical Sciences, Fomic Polytechnic University, PO Box 123, Buea, Cameroon
| | - Pride Tanyi Bobga
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Cameroon
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Cameroon
| | - Ekwi Damian Nsongmayi
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Cameroon
- School of Medical and Biomedical Sciences, Fomic Polytechnic University, PO Box 123, Buea, Cameroon
| | | | - Judith Ngong Nyeme
- International School for Nurses and Technico-Sanitary Personnels, Douala, Cameroon
| | - Mohamed Isah
- Department of Public Health, Faculty of Medicine and Pharmaceutical Science, University of Dschang, Cameroon
| | - Ebai Christabel Ashu
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Buea, Cameroon
- Department of Public Health, Faculty of Medicine and Pharmaceutical Science, University of Douala, Cameroon
| | - Calvin Bisong Ebai
- Department of Medical Laboratory Sciences, Faculty Health Sciences, University of Bamenda, Cameroon
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Siama A, Eteme Enama S, Kalmobe J, Abah S, Foutchou A, Njan Nloga AM. Abundance, Distribution, and Diversity of Freshwater Snail and Prevalences of Their Infection by Cercaria of Fasciola gigantica and Schistosoma spp at Mayo-Vreck River, Far North Region of Cameroon. J Trop Med 2023; 2023:9527349. [PMID: 37900305 PMCID: PMC10611546 DOI: 10.1155/2023/9527349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/14/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Malacological and parasitological studies were conducted from April 2020 to March 2021 to determine the abundance and distribution of molluscs and cercariae of Schistosoma spp and Fasciola gigantica. Collected molluscs are exposed to strong light to induce cercarial release. Mollusc densities were higher at station 1 (Gamak) than in station 8 (Patakai), with Bellamya unicolor and Biomphalaria pfeifferi more abundant and Bulinus truncatus, B. tropicus, and B. globosus less abundant. The overall prevalence of cercariae (19.87%) is higher in station 3 (Yaye orchard), station 9 (Gougni), station 4 (Madiogo), station 5 (Madiogo pasture), and station 6 (Ziam 3). It varies significantly between 15.76% in station 8 and 25.77% in station 3, between 8.48% in B. truncatus and 25.53% in B. globosus, and between 19.27% for cercariae of Schistosoma spp and 21.60% for those of F. gigantica. Cercarial emissions in L. natalensis and B. pfeifferi were higher in hot and cold dry seasons; on the other hand, cercarial emissions in B. globosus were higher in hot dry seasons (31.48%) and rainy seasons (23.38%). Emissions of cercariae from S. haematobium are related to areas of human activity and defecation, while those of F. gigantica in L. natalensis, Schistosoma haematobium in B. tropicus, and S. mansoni in B. pfeifferi are related to grazing areas. Mayo-Vreck is a site that favors the endemicity of fascioliasis and human schistosomiasis.
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Affiliation(s)
- Augustin Siama
- Department of Parasitology and Parasitic Pathology, School of Sciences and Veterinary Medicine, University of Ngaoundere, Ngaoundere, Cameroon
| | - Serges Eteme Enama
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaounde I, Yaounde, Cameroon
| | - Justin Kalmobe
- Department of Parasitology and Parasitic Pathology, School of Sciences and Veterinary Medicine, University of Ngaoundere, Ngaoundere, Cameroon
| | - Samuel Abah
- Special Mission of Tse-Tse Flies Eradication, Ngaoundere, Cameroon
| | - Angele Foutchou
- Department of Biological Sciences, Faculty of Science, University of Ngaoundere, Ngaoundere, Cameroon
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Kutz JM, Rausche P, Rasamoelina T, Ratefiarisoa S, Razafindrakoto R, Klein P, Jaeger A, Rakotomalala RS, Rakotomalala Z, Randrianasolo BS, McKay-Chopin S, May J, Rakotozandrindrainy R, Puradiredja DI, Sicuri E, Hampl M, Lorenz E, Gheit T, Rakotoarivelo RA, Fusco D. Female genital schistosomiasis, human papilloma virus infection, and cervical cancer in rural Madagascar: a cross sectional study. Infect Dis Poverty 2023; 12:89. [PMID: 37749705 PMCID: PMC10518971 DOI: 10.1186/s40249-023-01139-3] [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: 06/19/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Women's health in resource-limited settings can benefit from the integrated management of high-burden diseases, such as female genital schistosomiasis (FGS) and human papilloma virus (HPV)-related cervical cancer. In schistosomiasis-endemic countries such as Madagascar, data on FGS and HPV prevalence are lacking as well as preventive measures for both conditions. This study aims to estimate the prevalence of FGS and HPV in rural Madagascar, and to examine associated risk factors to identify opportunities for improving women's health. METHODS After initial community outreach activities, interested women aged 18-49 years were recruited consecutively in 2021 at three primary health care centers in the district of Marovoay. FGS was detected by colposcopy. Colposcopy images were double-blind reviewed by two independent specialists. A Luminex bead-based assay was performed on cervical vaginal lavage specimens for HPV typing. Crude (CPR) and adjusted prevalence ratios (APR) of associations between selected factors and FGS and HPV positivity were estimated using univariable and multivariable binary Poisson regression with 95% confidence intervals (CIs). RESULTS Among 500 women enrolled, 302 had complete information on FGS and HPV diagnosis, and were thus eligible for analysis. Within the sample, 189 (62.6%, 95% CI: 56.9-68.1) cases of FGS were detected. A total of 129 women (42.7%, 95% CI: 37.1-48.5) tested positive for HPV. In total, 80 women (26.5%, 95% CI: 21.6-31.8]) tested positive for both conditions. No association was observed between FGS and HPV positivity, while previous pregnancy (APR = 0.65, 95% CI: 0.43-0.78) and older age (APR = 0.59, 95% CI: 0.42-0.81) are showing a negative association with HPV infection compared to no previous pregnancy and younger age groups. CONCLUSIONS The results of the study show that FGS and HPV are highly prevalent in rural Madagascar. The concurrent prevalence of these two conditions requires urgent adaptations of public health strategies to improve women's health, such as integrated services at primary level of care.
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Affiliation(s)
- Jean-Marc Kutz
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Pia Rausche
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | | | | | | | - Philipp Klein
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Anna Jaeger
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | | | - Zoly Rakotomalala
- Centre Hospitalier Universitaire (CHU) Androva, Mahajanga, Madagascar
| | | | | | - Jürgen May
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
- University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Dewi Ismajani Puradiredja
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Elisa Sicuri
- Barcelona Institute for Global Health (IS Global), Barcelona, Spain
| | | | - Eva Lorenz
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Tarik Gheit
- International Agency for Research on Cancer (IARC), Lyon, France
| | | | - Daniela Fusco
- Department of Infectious Disease Epidemiology, Bernhard-Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany.
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany.
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11
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Isaiah PM, Sólveig Palmeirim M, Steinmann P. Epidemiology of pediatric schistosomiasis in hard-to-reach areas and populations: a scoping review. Infect Dis Poverty 2023; 12:37. [PMID: 37069632 PMCID: PMC10108517 DOI: 10.1186/s40249-023-01088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/24/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Schistosomiasis affects over 250 million people worldwide. Despite children and the poor being key risk groups, limited research and control activities target pre-school aged children (PSAC) and hard-to-reach populations. As endemic countries shift the goals of their schistosomiasis programs from morbidity control to disease elimination, there is a need for inclusive planning to cover all affected age groups from all geographical areas and populations to achieve sustainable impact and health equity. METHODS We conducted searches in MEDLINE, Web of Science, Embase (Ovid), and LILACS per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) guidelines. Quality assessment of identified articles was done using the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Relevant study data were extracted from the articles and entered into Microsoft Excel 2016 for descriptive analysis. RESULTS From the 17,179 screened articles, we identified 13 eligible studies on schistosomiasis in PSAC living in hard-to-reach areas and populations. All identified studies were from sub-Saharan Africa. The mean sample size of the retained studies was 572, with a balanced sex distribution among the young children sampled in each study. Ten studies investigated Schistosoma mansoni, one investigated Schistosoma haematobium, while two covered both S. mansoni and S. haematobium in the target population. The prevalence of S. mansoni among PSAC in the included studies was estimated at 12.9% in Ghana, 80.3-90.5% in Kenya, 35.0% in Madagascar, 9.6-78.0% in Senegal, 11.2-35.4% in Sierra Leone, 44.4-54.9% in Tanzania and 39.3-74.9% in Uganda. Out of the three studies that investigated S. haematobium, the presence of the infection was reported in only one study carried out in Nigeria. Schistosome infections reported in nearly all studies included in this review were of light intensity. Only one study conducted in Nigeria documented visible hematuria in 17.7% of the PSAC studied. CONCLUSIONS The findings document the high prevalence of schistosomiasis among PSAC in hard-to-reach populations and underscore the need to consider this population subgroup when designing the expansion of preventive chemotherapy and schistosomiasis control activities.
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Affiliation(s)
- Phyllis Munyiva Isaiah
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Marta Sólveig Palmeirim
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Huguenin A, Kincaid-Smith J, Depaquit J, Boissier J, Ferté H. MALDI-TOF: A new tool for the identification of Schistosoma cercariae and detection of hybrids. PLoS Negl Trop Dis 2023; 17:e0010577. [PMID: 36976804 PMCID: PMC10081743 DOI: 10.1371/journal.pntd.0010577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 04/07/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
Schistosomiasis is a neglected water-born parasitic disease caused by Schistosoma affecting more than 200 million people. Introgressive hybridization is common among these parasites and raises issues concerning their zoonotic transmission. Morphological identification of Schistosoma cercariae is difficult and does not permit hybrids detection. Our objective was to assess the performance of MALDI-TOF (Matrix Assistated Laser Desorption-Ionization–Time Of Flight) mass spectrometry for the specific identification of cercariae in human and non-human Schistosoma and for the detection of hybridization between S. bovis and S. haematobium. Spectra were collected from laboratory reared molluscs infested with strains of S. haematobium, S. mansoni, S. bovis, S. rodhaini and S. bovis x S. haematobium natural (Corsican hybrid) and artificial hybrids. Cluster analysis showed a clear separation between S. haematobium, S. bovis, S. mansoni and S. rodhaini. Corsican hybrids are classified with those of the parental strain of S. haematobium whereas other hybrids formed a distinct cluster. In blind test analysis the developed MALDI-TOF spectral database permits identification of Schistosoma cercariae with high accuracy (94%) and good specificity (S. bovis: 99.59%, S. haematobium 99.56%, S. mansoni and S. rodhaini: 100%). Most misidentifications were between S. haematobium and the Corsican hybrids. The use of machine learning permits to improve the discrimination between these last two taxa, with accuracy, F1 score and Sensitivity/Specificity > 97%. In multivariate analysis the factors associated with obtaining a valid identification score (> 1.7) were absence of ethanol preservation (p < 0.001) and a number of 2–3 cercariae deposited per well (p < 0.001). Also, spectra acquired from S. mansoni cercariae are more likely to obtain a valid identification score than those acquired from S. haematobium (p<0.001). MALDI-TOF is a reliable technique for high-throughput identification of Schistosoma cercariae of medical and veterinary importance and could be useful for field survey in endemic areas.
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Affiliation(s)
- Antoine Huguenin
- Université de Reims Champagne Ardenne, EA7510 ESCAPE, Reims, France
- Laboratoire de Parasitologie-Mycologie, pôle de Biopathologie, CHU de Reims, Reims, France
- * E-mail:
| | - Julien Kincaid-Smith
- IHPE, Université de Montpellier, CNRS, Ifremer, Université de Perpignan, Perpignan, France
- CBGP, IRD, CIRAD, INRAE, Institut Agro, Université de Montpellier, Montpellier, France
| | - Jérôme Depaquit
- Université de Reims Champagne Ardenne, EA7510 ESCAPE, Reims, France
- Laboratoire de Parasitologie-Mycologie, pôle de Biopathologie, CHU de Reims, Reims, France
| | - Jérôme Boissier
- IHPE, Université de Montpellier, CNRS, Ifremer, Université de Perpignan, Perpignan, France
| | - Hubert Ferté
- Université de Reims Champagne Ardenne, EA7510 ESCAPE, Reims, France
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Chala B. Advances in Diagnosis of Schistosomiasis: Focus on Challenges and Future Approaches. Int J Gen Med 2023; 16:983-995. [PMID: 36967838 PMCID: PMC10032164 DOI: 10.2147/ijgm.s391017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/07/2023] [Indexed: 03/20/2023] Open
Abstract
Schistosomiasis is the second most devastating parasite prevalent in the tropical region of the world, posing significant public health impacts in endemic areas. Presently, several disease mitigation measures have shown a decline in transmission of the infection rate in risk localities using mass drug administration (MDA) of school-based or community-wide treatments. Despite all the endeavors made, the decline in transmission of infection rate has not been attained in the entire medicated segment of the population. Perhaps the current challenges of control of the disease appear to be strongly associated with a lack of appropriate diagnostic tools. It's well known that the current diagnosis of schistosomiasis greatly relies on conventional methods. On the other hand, minor symptoms of schistosomiasis and low sensitivity and specificity of diagnostic methods are still unresolved diagnostic challenges to clinicians. Numerous scholars have reviewed various diagnostic methods of schistosomiasis and attempted to identify their strengths and weaknesses, currently on function. As a result of the known limitations of the existing diagnostic tools, the need to develop new and feasible diagnostic methods and diagnostic markers is unquestionable for more precise detection of the infection. Hence, advances in diagnostic methods have been considered part of the solution for the control and eventual elimination strategy of the disease in endemic areas. As of today, easy, cheap, and accurate diagnostics for schistosomiasis are difficult to get, and this limits the concerted efforts towards full control of schistosomiasis. While looking for new diagnostic methods and markers, it is important to simultaneously work on improving the existing diagnostic methods for better results. This review tries to give new insights to the status of the existing diagnostic methods of schistosomiasis from conventional to modern via summarizing the strengths and limitations of the methods. It also tries to recommend new, sensitive and feasible diagnostic methods for future approaches.
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Affiliation(s)
- Bayissa Chala
- Department of Applied Biology, School of Applied Natural Science, Adama Science and Technology University, Adama, Ethiopia
- Correspondence: Bayissa Chala, Email ;
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14
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A retrospective analysis of schistosomiasis related literature from 2011-2020: Focusing on the next decade. Acta Trop 2023; 238:106750. [PMID: 36372254 DOI: 10.1016/j.actatropica.2022.106750] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Schistosomiasis, an ancient and neglected tropical disease, which poses a huge threat to over 200 million people globally. It is necessary to have a general summary of schistosomiasis research after the new roadmap 2021-2030 issued by WHO. This study analyzes the current status of schistosomiasis research from the perspective of the One Health concept by analyzing important research literature published from 2011 to 2020, while further highlighting research priorities, difficulties, and research directions in order to propose suggestions for tropical disease studies research. METHODS Published literature related to schistosomiasis was searched from the Web of Science Core Collection (WoSCC) database. Focusing on a visual analysis of the main research literature in the field of schistosomiasis, CiteSpace software was used to conduct co-occurrence analysis with keywords, countries, institutions, and authors. Moreover, clustering and burst analyses of keywords and co-citation analysis of authors, publications, and journals were performed. RESULTS A total of 6638 schistosomiasis-related articles were published from 2011 to 2020, all of which can be sourced from the WoSCC database. The publication of schistosomiasis research has remained stable over the past 10 years, and contains studies in the area of human epidemiology, animal surveillance and the environment. The top five high-frequency keywords included Schistosoma mansoni, schistosomiasis, infection, praziquantel, and Schistosoma japonicum. The keywords formed nine clusters, including praziquantel, epidemiology, Schistosoma japonicum, helminths, protein, diagnosis, schistosomiasis, response, and haematobium. In recent years, most research studies focused on the mechanism of liver fibrosis, eliminating schistosomiasis, controlling risk factors, and the relationship between schistosomiasis infection and host immunity. The most productive countries include the United States, China, and Brazil, and the most productive institutions are the University of Basel, the Swiss Tropical and Public Health Institute, and the University of São Paulo. Highly productive authors include Jürg Utzinger and Donald P. McManus. At the time of writing, the author with the highest co-citation frequency (993 times) was Peter Hotez, and the journal with the highest co-citation frequency (3,720 times) was PLoS Neglected Tropical Diseases. Human schistosomiasis, published by Colley et al. (2014), was the most frequently co-cited publication (494 times). CONCLUSIONS This study provides a preliminary description of the current status of schistosomiasis research and an initial exploration of future research directions. The One Health concept was applied in the field of schistosomiasis control, as confirmed by this bibliometric analysis. Our study provides guidance for the development of research on schistosomiasis and other neglected tropical diseases.
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15
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Boateng EM, Dvorak J, Ayi I, Chanova M. A literature review of schistosomiasis in Ghana: a reference for bridging the research and control gap. Trans R Soc Trop Med Hyg 2023:6997900. [PMID: 36688317 DOI: 10.1093/trstmh/trac134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/13/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023] Open
Abstract
Schistosomiasis is endemic in most sub-Saharan African countries, including Ghana, where the need for effective control involving preventive chemotherapy was indicated by the WHO. Mass drug administration commenced in 2008 and has continued since then in Ghana, but the country remains highly endemic. Here, we review the literature on schistosomiasis to identify research and knowledge gaps potentially affecting disease control. A total of 100 Ghana-related schistosomiasis literature sources were reviewed, showing that most studies were conducted on epidemiology, control of transmission and diagnosis. By contrast, many aspects of this disease remain neglected, including livestock schistosomiasis and its zoonotic potential, recent distribution of disease vectors or widely overlooked genital schistosomiasis. Stratified by region, the highest number of studies focus on Greater Accra, while studies are limited or absent for several other regions. Although this review shows apparent progress in terms of schistosomiasis research and control, a considerable amount of work remains to achieve at least a reduction in the prevalence of the disease, which affects a significant proportion of the population. National epidemiological data based on a nationwide survey, integrated control and improved monitoring and evaluation must be ensured.
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Affiliation(s)
- Enoch Mensah Boateng
- Department of Zoology and Fisheries, Center of Infectious Animal Diseases, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences in Prague, Kamycka 129, 16500 Prague, Czech Republic.,Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studnickova 7, 128 00 Prague, Czech Republic
| | - Jan Dvorak
- Department of Zoology and Fisheries, Center of Infectious Animal Diseases, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences in Prague, Kamycka 129, 16500 Prague, Czech Republic.,Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo namesti 2, 16000 Prague, Czech Republic.,Faculty of Environmental Sciences, Czech University of Life Sciences in Prague, Kamycka 129, 16500 Prague, Czech Republic
| | - Irene Ayi
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, LG 1181, Legon, Accra, Ghana
| | - Marta Chanova
- Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studnickova 7, 128 00 Prague, Czech Republic
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Isaiah PM, Palmeirim MS, Steinmann P. Epidemiology of pediatric schistosomiasis in hard-to-reach areas and populations: A scoping review protocol. F1000Res 2023; 11:1203. [PMID: 36761831 PMCID: PMC9898687 DOI: 10.12688/f1000research.126884.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
Background: Schistosomiasis is a neglected tropical disease (NTD) that affects millions of people. Children are the most vulnerable group to developing overt disease. An estimated 779 million people are at risk of schistosomiasis and 50 million preschool-age children (PSAC) need treatment. PSAC are not currently targeted by national chemotherapy campaigns due to a lack of suitable pediatric formulations of praziquantel. The Pediatric Praziquantel Consortium has developed an orally dispersible praziquantel formulation (arpraziquantel) and is facilitating its adoption for schistosomiasis control by endemic countries through the ADOPT program - an implementation research program that paves the way for the large-scale delivery of the child-friendly formulation to treat schistosomiasis in preschool-aged children in endemic countries. A key challenge for comprehensive NTD control including schistosomiasis is reaching all at-risk populations, including those hard to reach. Main access barriers include geographic, social and economic conditions. Objective : This scoping literature review aims to document the epidemiology of schistosomiasis in children under 6 years of age living in hard-to-reach areas and populations. Methods : This review will adopt the five-stage scoping review process of identifying the research question, identifying relevant studies, study selection, charting data and collating, summarizing and reporting results. Electronic databases including Medline, Web of Science, Embase (Ovid), LILACS and African Journals OnLine (AJOL) will be searched for relevant articles. Two independent reviewers will screen identified articles using a two-stage approach of reviewing the title/abstract and then the full text of provisionally retained articles. Relevant literatures will be downloaded into EndNote X9 to maintain and manage citation and facilitate the overall review process. A meta-analysis will be conducted if indicated. Relevance : The results will provide insights into the burden of schistosomiasis among marginalized PSAC, aiming to produce evidence on the need for inclusion of this population when designing the expansion of preventive chemotherapy programs.
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Affiliation(s)
- Phyllis Munyiva Isaiah
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland,
| | - Marta Sólveig Palmeirim
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
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Shehab AY, Allam AF, Saad AAEK, Osman MM, Ibrahim HS, Moneer EA, Tolba MM. Proposed morbidity markers among Schistosoma mansoni patients. Trop Parasitol 2023; 13:40-45. [PMID: 37415754 PMCID: PMC10321587 DOI: 10.4103/tp.tp_46_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 07/08/2023] Open
Abstract
Background Fecal calprotectin (FC) and fecal occult blood (FOB) were suggested as potential inflammatory markers for assessing intestinal schistosomiasis morbidity that are conventionally detected through invasive methods. Aim and Objectives The present work aimed to evaluate FC and FOB as morbidity markers of Schistosoma mansoni infection before and after praziquantel treatment. Materials and Methods A total of 205 stool samples (117 schoolchildren and 88 adults) were collected and examined by Kato Katz. A questionnaire enquiring about diarrhea, history of blood in stool, and abdominal pain was designed and applied. Results S. mansoni prevalence rates were 20.5% and 11.36% among children and adults, respectively; the majority of cases had light infection intensity. FC and FOB were studied among 25 cured S. mansoni cases (17 children and 8 adults) pre and one-month post treatment. Before treatment, six and four children of moderate and high S. mansoni infection intensity tested positive for FC and FOB, respectively, all turning negative after treatment. FC showed borderline statistical significance before and after treatment among children. However, all adults tested negative for FC and FOB. Conclusion FC and FOB could be possibly used as morbidity monitoring tools for S. mansoni infection in children with moderate and high infection intensity.
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Affiliation(s)
- Amel Youssef Shehab
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | - Amal Farahat Allam
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | | | - Mervat Mostafa Osman
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | - Heba Said Ibrahim
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | - Esraa Abdelhamid Moneer
- Department of Medical Laboratory, Applied Health Sciences Technology, Pharos University, Alexandria, Egypt
| | - Mona Mohamed Tolba
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
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Prevalence of Schistosoma mansoni infection among fishermen in Busega district, Tanzania. PLoS One 2022; 17:e0276395. [PMID: 36441724 PMCID: PMC9704623 DOI: 10.1371/journal.pone.0276395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Schistosoma (S.) mansoni infection is endemic in all regions around Lake Victoria and affects all age groups to different degrees. In most endemic areas, less attention has been paid to determining the prevalence of infection, sanitation status, and knowledge about intestinal schistosomiasis (KIS) in fishermen. Therefore, the purpose of this study was to establish the prevalence of S. mansoni infection and associated factors among fishermen in the Busega district. MATERIALS AND METHODS A cross-sectional study was conducted among fishermen in July, 2020 in five fishing villages in the Busega district located along Lake Victoria. A total of 352 fishermen were interviewed with regard to their sanitation status and level of KIS. A single stool sample from fishermen was examined for S.mansoni eggs by using the Formalin-Ether Concentration technique. The potential factors associated with S. mansoni infection were explored using multivariable logistic regression. RESULTS The prevalence of S. mansoni infection was high (65.0%) among fishermen and varied with age, whereby fishermen aged ≤36 years had the highest prevalence. Fishermen had a low level of KIS and the majority of them reported practicing open defecation during fishing (81%). These fishermen with a low level of KIS and who reported defecating in open areas during fishing had 2.8 times (95% CI: 1.0-7.2) and 2.1 times (95% CI: 1.1-3.9) higher odds of being infected with S. mansoni than those with a high level of KIS and those who did not report defecating in open areas during fishing, respectively. CONCLUSION S. mansoni infection was high among fishermen in the Busega district. Furthermore, fishermen had a low level of KIS and were reported to have defecated in open areas during fishing. Infection with S. mansoni was associated with age, a low level of KIS and open defecation behaviour during fishing. Therefore, mass drug administration (MDA) with praziquantel, health education, and sanitation behaviour change interventions were needed.
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Kengne Fokam AC, Sumo L, Bagayan M, Nana-Djeunga HC, Kuete T, Nganjou GSO, Tchami Mbagnia MC, Djune-Yemeli L, Wondji CS, Njiokou F. Exposition of Intermediate Hosts of Schistosomes to Niclosamide (Bayluscide WP 70) Revealed Significant Variations in Mortality Rates: Implications for Vector Control. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12873. [PMID: 36232172 PMCID: PMC9566429 DOI: 10.3390/ijerph191912873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Schistosomiasis remains a public health issue in Cameroon. Snail control using Niclosamide can prevent schistosome transmission. It is safe to determine lethal concentrations for the population. This study aimed at assessing the toxicity of Niclosamide on different developmental stages of snail populations; (2) Methods: Snails were collected, identified, and reared in the laboratory. Egg masses and adult snails were exposed to Niclosamide, at increasing concentrations (0.06, 0.125, 0.25, 0.5, 1 mg/L for egg embryos and 0.06, 0.08, 0.1, 0.12, 0.14, 0.16, 0.18, 0.2 mg/L for adults). After 24 h exposure, egg masses and snails were removed from Niclosamide solutions, washed with source water and observed; (3) Results: Snail susceptibility was species and population dependent. For egg embryos, Biomphalaria pfeifferi was the most susceptible (LC50: 0.1; LC95: 6.3 mg/L) and Bulinus truncatus the least susceptible (LC50: 4.035; LC95: 228.118 mg/L). However, for adults, B. truncatus was the most susceptible (mortality rate: 100%). The LC50 and LC95 for Bi. camerunensis eggs were 0.171 mg/L and 1.102 mg/L, respectively, and were higher than those obtained for adults (0.0357 mg/L and 0.9634 mg/L); (4) Conclusion: These findings will guide the design of vector control strategies targeting these snail species in Cameroon.
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Affiliation(s)
- Alvine Christelle Kengne Fokam
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé P.O. Box 812, Cameroon
- Centre for Research in Infectious Diseases (CRID), Yaoundé P.O. Box 13591, Cameroon
| | - Laurentine Sumo
- Department of Biological Sciences, Faculty of Science, University of Bamenda, Bambili P.O. Box 39, Cameroon
| | - Mohamed Bagayan
- Animal Biology and Ecology Laboratory, University of Joseph Ki-Zerbo, Ouagadougou P.O. Box 7021, Burkina Faso
| | | | - Thomas Kuete
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala P.O. Box 24157, Cameroon
| | - Gabriella S. Ondoua Nganjou
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé P.O. Box 812, Cameroon
- Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé P.O. Box 5797, Cameroon
| | - Murielle Carole Tchami Mbagnia
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé P.O. Box 812, Cameroon
- Centre for Research in Infectious Diseases (CRID), Yaoundé P.O. Box 13591, Cameroon
| | - Linda Djune-Yemeli
- Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé P.O. Box 5797, Cameroon
| | - Charles Sinclair Wondji
- Centre for Research in Infectious Diseases (CRID), Yaoundé P.O. Box 13591, Cameroon
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L35QA, UK
| | - Flobert Njiokou
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé 1, Yaoundé P.O. Box 812, Cameroon
- Centre for Research in Infectious Diseases (CRID), Yaoundé P.O. Box 13591, Cameroon
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Gabaake KP, Phaladze NA, Lucero-Prisno Iii DE, Thakadu OT. Assessment of awareness and knowledge of schistosomiasis among school-aged children (6-13 years) in the Okavango Delta, Botswana. Glob Health Res Policy 2022; 7:36. [PMID: 36175987 PMCID: PMC9524007 DOI: 10.1186/s41256-022-00267-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomiasis is a global health problem affecting 250 million people, with 90% in Sub-Saharan Africa. In Botswana, the burden is high in the Okavango delta because of the water channels. WHO recommends integrated measures, including access to clean water, sanitation, health education, and drugs to control and eliminate schistosomiasis. Gauging knowledge and awareness of schistosomiasis for School-Aged Children (SAC) is crucial. Our study aimed at assessing knowledge and awareness of schistosomiasis among SAC in the Okavango Delta. METHODS A cross-sectional survey assessing awareness and knowledge of schistosomiasis in schools was conducted. 480 questionnaires were administered to gather demographic profiles, awareness, and knowledge of risky behaviors. Chi-square and descriptive analysis determined the differences in SAC`s awareness and knowledge levels based on localities, gender, age, and health education. RESULTS The results showed a low awareness level, with only (42%) of respondents having heard about the disease and (52%) knowing its local name. Younger children from Sekondomboro (83%) and Samochima lacked awareness, while children from Mohembo (77%) and those who had health education (70%) demonstrated significant awareness levels (P ≤ 0.001). Seventy-two percent (72%) lacked knowledge of the cause and (95%) did not know the disease life-cycle. Children from Xakao (91%), (85%) Sepopa, and (75%) of younger children did not know haematuria is a symptom of the disease. Older and SAC with health education were more likely to know that swimming is a risk factor (P ≤ 0.001) and (P ≤ 0.05) respectively. CONCLUSIONS Although respondents from four schools demonstrated some level of awareness of the disease, and knowledge of risky behaviors, the study showed a lack of in-depth knowledge on the life-cycle and cause of the diseases. We, therefore, recommend the implementation of an integrated approach to health education and improvement in access to clean water and sanitation in all study areas.
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Affiliation(s)
- Kebabonye P Gabaake
- School of Allied Health Professions, University of Botswana, Gaborone, Botswana.
| | | | - Don Eliseo Lucero-Prisno Iii
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.,Faculty of Management and Development Studies, University of the Philippines Open University, Los Baños, Laguna, Philippines
| | - Olekae T Thakadu
- Okavango Research Institute, University of Botswana, Maun, Botswana
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21
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The role of infections in the causation of cancer in Kenya. Cancer Causes Control 2022; 33:1391-1400. [PMID: 36087193 DOI: 10.1007/s10552-022-01625-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/31/2022] [Indexed: 12/09/2022]
Abstract
Cancer constitutes a major health care burden in the world today with the situation worsening in resource poor settings as seen in most Sub-Saharan African (SSA) countries. Infections constitute by far the most common risk factors for cancer in SSA and being a typical country in this region, Kenya has experienced an upsurge in the incidence of various types of cancers in the last few decades. Although there is limited population-based data in Kenya of infections-associated cancers, this review provides an up-to-date literature-based discussion on infections-associated cancers, their pathogenesis, and preventive approaches in the country. The primary infectious agents identified are largely viral (human immunodeficiency virus, human papillomavirus (HPV), Kaposi's sarcoma-associated herpes virus, Epstein-Barr virus, hepatitis B virus (HBV), hepatitis C virus), and also bacterial: Helicobacter pylori and parasitic: Schistosomiasis haematobium. Cancers associated with infections in Kenya are varied but the predominant ones are Non-Hodgkin lymphoma, Kaposi's sarcoma, Hodgkin lymphoma, Burkitt's lymphoma, cervical, liver, and gastric cancers. The mechanisms of infections-induced carcinogenesis are varied but they mainly seem to stem from disruption of signaling, chronic inflammation, and immunosuppression. Based on our findings, actionable cancer-preventive measures that are economically feasible and aligned with existing infrastructure in Kenya include screening and treatment of infections, implementation of cancer awareness and screening, and vaccination against infections primarily HBV and HPV. The development of vaccines against other infectious agents associated with causation of cancer remains also as an important goal in cancer prevention.
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Samenjo KT, Bengtson M, Onasanya A, Zambrano JCI, Oladunni O, Oladepo O, van Engelen J, Diehl JC. Stakeholders’ Perspectives on the Application of New Diagnostic Devices for Urinary Schistosomiasis in Oyo State, Nigeria: A Q-Methodology Approach. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00780. [PMID: 36041843 PMCID: PMC9426976 DOI: 10.9745/ghsp-d-21-00780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
New diagnostic devices for schistosomiasis should be designed to function best within the local endemic health care context and support stakeholders at various levels of the health care system in performing the tasks to help control and eventually eliminate schistosomiasis. Urinary schistosomiasis is a waterborne parasitic infection caused by Schistosoma haematobium that affects approximately 30 million people annually in Nigeria. Treatment and eradication of this infection require effective diagnostics. However, current diagnostic tests have critical shortcomings and consequently are of limited value to stakeholders throughout the health care system who are involved in targeting the diagnosis and subsequent control of schistosomiasis. New diagnostic devices that fit the local health care infrastructure and support the different stakeholder diagnostic strategies remain a critical need. This study focuses on understanding, by means of Q-methodology, the context of use and application of a new diagnostic device that is needed to effectively diagnose urinary schistosomiasis in Oyo State, Nigeria. Q-methodology is a technique that investigates subjectivity by exploring how stakeholders rank-order opinion statements about a phenomenon. In this study, 40 statements were administered to evaluate stakeholder perspectives on the context of use and application of potential new diagnostic devices and how these perspectives or viewpoints are shared with other stakeholders. Potential new diagnostic devices will need to be deployable to remote or distant communities, be affordable, identify and confirm infection status before treatment in patients whose diagnosis of urinary schistosomiasis is based on self-reporting, and equip health care facilities with diagnostic devices optimized for the local setting while requiring local minimal infrastructural settings. Similarly, the context of use and application of a potential new diagnostic device for urinary schistosomiasis is primarily associated with the tasks stakeholders throughout the health care system perform or procedures employed. These findings will guide the development of new diagnostic devices for schistosomiasis that match the contextual landscape and diagnostic strategies in Oyo.
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Affiliation(s)
- Karlheinz Tondo Samenjo
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands.
| | - Michel Bengtson
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Adeola Onasanya
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Juan Carlo Intriago Zambrano
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, Netherlands
| | - Opeyemi Oladunni
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladimeji Oladepo
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jo van Engelen
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Ebbs ET, Loker ES, Bu L, Locke SA, Tkach VV, Devkota R, Flores VR, Pinto HA, Brant SV. Phylogenomics and Diversification of the Schistosomatidae Based on Targeted Sequence Capture of Ultra-Conserved Elements. Pathogens 2022; 11:769. [PMID: 35890014 PMCID: PMC9321907 DOI: 10.3390/pathogens11070769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023] Open
Abstract
Schistosomatidae Stiles and Hassall 1898 is a medically significant family of digenetic trematodes (Trematoda: Digenea), members of which infect mammals or birds as definitive hosts and aquatic or amphibious gastropods as intermediate hosts. Currently, there are 17 named genera, for many of which evolutionary interrelationships remain unresolved. The lack of a resolved phylogeny has encumbered our understanding of schistosomatid evolution, specifically patterns of host-use and the role of host-switching in diversification. Here, we used targeted sequence capture of ultra-conserved elements (UCEs) from representatives of 13 of the 17 named genera and 11 undescribed lineages that are presumed to represent either novel genera or species to generate a phylogenomic dataset for the estimation of schistosomatid interrelationships. This study represents the largest phylogenetic effort within the Schistosomatidae in both the number of loci and breadth of taxon sampling. We present a near-comprehensive family-level phylogeny providing resolution to several clades of long-standing uncertainty within Schistosomatidae, including resolution for the placement of the North American mammalian schistosomes, implying a second separate capture of mammalian hosts. Additionally, we present evidence for the placement of Macrobilharzia at the base of the Schistosoma + Bivitellobilharzia radiation. Patterns of definitive and intermediate host use and a strong role for intermediate host-switching are discussed relative to schistosomatid diversification.
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Affiliation(s)
- Erika T. Ebbs
- Department of Biology, Purchase College, The State University of New York, Purchase, NY 10577, USA
| | - Eric S. Loker
- Center for Evolutionary and Theoretical Immunology, Department of Biology, Museum of Southwestern Biology Parasite Division, University of New Mexico, Albuquerque, NM 87131, USA; (E.S.L.); (L.B.); (S.V.B.)
| | - Lijing Bu
- Center for Evolutionary and Theoretical Immunology, Department of Biology, Museum of Southwestern Biology Parasite Division, University of New Mexico, Albuquerque, NM 87131, USA; (E.S.L.); (L.B.); (S.V.B.)
| | - Sean A. Locke
- Department of Biology, University of Puerto Rico at Mayagüez, Box 9000, Mayagüez 00681-9000, Puerto Rico;
| | - Vasyl V. Tkach
- Grand Forks Department of Biology, University of North Dakota, Grand Forks, ND 58202, USA;
| | - Ramesh Devkota
- Vance Granville Community College, Henderson, NC 27536, USA;
| | - Veronica R. Flores
- Laboratorio de Parasitología, INIBIOMA (CONICET-Universidad Nacional del Comahue), Quintral 1250, San Carlos de Bariloche 8400, Argentina;
| | - Hudson A. Pinto
- Department of Parasitology, Institute of Biological Science, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil;
| | - Sara V. Brant
- Center for Evolutionary and Theoretical Immunology, Department of Biology, Museum of Southwestern Biology Parasite Division, University of New Mexico, Albuquerque, NM 87131, USA; (E.S.L.); (L.B.); (S.V.B.)
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Rujeni N, Bayingana JB, Nyandwi E, Ntakarutimana A, Kagabo J, Rutayisire R, Shema E, Kanimba P, Mbonigaba JB, Ruberanziza E. Prevalence Mapping of Schistosoma mansoni Among Pre-school Age Children in Rwanda. Front Pediatr 2022; 10:906177. [PMID: 35813371 PMCID: PMC9267951 DOI: 10.3389/fped.2022.906177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Schistosoma mansoni is endemic in Rwanda, and control programs have been implemented with a special focus on school-age children (SAC), ignoring pre-school age children (pre-SAC) for which the actual prevalence of the disease is not well established. This study consisted of a cross-sectional quantitative mapping of the distribution of Schistosoma mansoni and identification of associated risk factors among pre-SAC throughout the country. The study covered all the 17 districts of Rwanda endemic for Schistosoma mansoni, with a total sample of 4,675 children enrolled from 80 purposively selected villages. The parasitological assessment of children's urine and stool samples was conducted using CCA and Kato Katz methods, respectively, for infection detection. A standard questionnaire was used to collect data on the risk factors, and geospatial assessment was performed using tablets and GPS to record geographic coordinates for plotting locations on maps using ArcGIS software. The overall prevalence of S. mansoni infection across the surveyed areas was 24 and 0.8% by CCA and Kato-Katz, respectively. Infection was significantly associated with bathing children in open water bodies. Furthermore, pre-SAC looked after by siblings (sisters) were two times as much likely to be infected compared to those looked after by mothers. Schistosomiasis control interventions are needed for pre-SAC to limit their exposure to open water bodies with expectations of adapted chemotherapy to be availed. Community-based deworming campaigns may be the best way to ensure good treatment coverage of pre-SAC in Rwanda.
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Affiliation(s)
- Nadine Rujeni
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Bosco Bayingana
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Single Project Implementation Unit, University of Rwanda, Kigali, Rwanda
| | - Elias Nyandwi
- Centre for Geographic Information Systems and Remote Sensing, College of Science and Technology, University of Rwanda, Kigali, Rwanda
| | - Amans Ntakarutimana
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Joseph Kagabo
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Reverien Rutayisire
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Eliah Shema
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Philbert Kanimba
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Bosco Mbonigaba
- Neglected Tropical Diseases and Other Parasitic Diseases Unit, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
| | - Eugene Ruberanziza
- Neglected Tropical Diseases and Other Parasitic Diseases Unit, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
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A simple new screening tool for diagnosing imported schistosomiasis. PUBLIC HEALTH IN PRACTICE 2022; 3:100245. [PMID: 36101771 PMCID: PMC9461506 DOI: 10.1016/j.puhip.2022.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/08/2022] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives We sought to test the sensitivity and feasibility of a Schistosoma infection screening process consisting of a scored patient consultation questionnaire and a serological diagnostic test. Study design Prospective cross-sectional study. Methods We collected from Schistosoma-exposed individuals a 14-point check list of clinical and laboratory data related to Schistosoma infection, alongside a serological test to detect Schistosoma spp infection. A check list score was created and compared with the risk of infection and clinical recovery through an agreement analysis. Results Two-hundred and fifty individuals were enrolled, of whom 220 (88%) were male and 30 (12%) female. The median age was 39 (range 18–78). One hundred-fifty (60%, 95% CI 54.9%–65.1%) had a check-list score ≥2. Serology test results were positive for 142 (56.8%, 95% CI 51.6%–62%). Chronic complications compatible with long-term Schistosoma infection were detected in 29 out of these 142 (20.4%, 95% CI 13.8%–27%).,. The median score value was 3, the area under the receiver operating characteristic (ROC) curve against serology results was 0.85 and the estimated intercept check-list questionnaire score value was 1.72 (95%, CI: 1.3–2.2). Participants with a positive serological test had a substantially higher check-list score (Cohen's kappa coefficient: 0.62, 95% CI: 0.54–0.70). Ninety four percent patients empirically treated showed a subsequent improvement in clinical and laboratory parameters. Conclusions A two-component process consisting of a scored patient consultation questionnaire followed by serological assay can be a suitable strategy for screening populations at high risk of schistosomiasis infection.
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Molecular Techniques as Alternatives of Diagnostic Tools in China as Schistosomiasis Moving towards Elimination. Pathogens 2022; 11:pathogens11030287. [PMID: 35335611 PMCID: PMC8951378 DOI: 10.3390/pathogens11030287] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/13/2022] [Accepted: 02/21/2022] [Indexed: 12/15/2022] Open
Abstract
Schistosomiasis japonica caused by the trematode flukes of Schistosoma japonicum was one of the most grievous infectious diseases in China in the mid-20th century, while its elimination has been placed on the agenda of the national strategic plan of healthy China 2030 after 70 years of continuous control campaigns. Diagnostic tools play a pivotal role in warfare against schistosomiasis but must adapt to the endemic status and objectives of activities. With the decrease of prevalence and infection intensity of schistosomiasis in human beings and livestock, optimal methodologies with high sensitivity and absolute specificity are needed for the detection of asymptomatic cases or light infections, as well as disease surveillance to verify elimination. In comparison with the parasitological methods with relatively low sensitivity and serological techniques lacking specificity, which both had been widely used in previous control stages, the molecular detection methods based on the amplification of promising genes of the schistosome genome may pick up the baton to assist the eventual aim of elimination. In this article, we reviewed the developed molecular methods for detecting S. japonicum infection and their application in schistosomiasis japonica diagnosis. Concurrently, we also analyzed the chances and challenges of molecular tools to the field application process in China.
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Jin Y, Cha S, Kim Y, Hamdan HM, Elhag MS, Ismail HAHA, Lee KH, Hong ST. Association Between the Prevalence of Schistosomiasis in Elementary School Students and Their Parental Occupation in Sudan. THE KOREAN JOURNAL OF PARASITOLOGY 2022; 60:51-56. [PMID: 35247955 PMCID: PMC8898649 DOI: 10.3347/kjp.2022.60.1.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
Abstract
Global efforts to identify groups at high risk for schistosomiasis have mainly concentrated on identifying their geographical distribution. Investigations on the socioeconomic characteristics of high-risk groups are relatively scarce. This study aimed to explore the associations between schistosomiasis among students and their parents’ occupations. A nationwide cross-sectional survey was conducted targeting 105,167 students in 1,772 primary schools across Sudan in 2017. From these students, 100,726 urine and 96,634 stool samples were collected to test for Schistosoma haematobium and S. mansoni infection. A multi-level mixed effect analysis was used with age and sex as fixed factors, and school as a random factor. The odd ratios (ORs) of practicing open defecation among farmers’ children were almost 5 times higher than their counterparts whose parents were government officials (OR=4.97, 95% confidence intervals (CIs): 4.57-5.42, P<0.001). The ORs of contacting water bodies for watering livestock among farmers’ children were more than 4 times higher than those of children whose parents were government officials (OR=4.59, 95% CIs: 4.02-5.24, P<0.001). This study shows that schistosomiasis represents a disease of poverty and that farmers’ children constituted a high-risk group.
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Affiliation(s)
- Yan Jin
- Department of Microbiology, Dongguk University College of Medicine, Gyeongju 38066,
Korea
- Corresponding authors (; )
| | - Seungman Cha
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554,
Korea
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London,
UK
- Corresponding authors (; )
| | - Youngjin Kim
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554,
Korea
| | - Hamdan Mustafa Hamdan
- Communnicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum,
Sudan
| | - Mousab Siddig Elhag
- Communnicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum,
Sudan
| | | | - Keon Hoon Lee
- Korea Association of Health Promotion, Seoul 07653,
Korea
| | - Sung-Tae Hong
- Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, Seoul 03080,
Korea
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Vaccines for Human Schistosomiasis: Recent Progress, New Developments and Future Prospects. Int J Mol Sci 2022; 23:ijms23042255. [PMID: 35216369 PMCID: PMC8879820 DOI: 10.3390/ijms23042255] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 12/18/2022] Open
Abstract
Schistosomiasis, caused by human trematode blood flukes (schistosomes), remains one of the most prevalent and serious of the neglected tropical parasitic diseases. Currently, treatment of schistosomiasis relies solely on a single drug, the anthelmintic praziquantel, and with increased usage in mass drug administration control programs for the disease, the specter of drug resistance developing is a constant threat. Vaccination is recognized as one of the most sustainable options for the control of any pathogen, but despite the discovery and reporting of numerous potentially promising schistosome vaccine antigens, to date, no schistosomiasis vaccine for human or animal deployment is available. This is despite the fact that Science ranked such an intervention as one of the top 10 vaccines that need to be urgently developed to improve public health globally. This review summarizes current progress of schistosomiasis vaccines under clinical development and advocates the urgent need for the establishment of a revolutionary and effective anti-schistosome vaccine pipeline utilizing cutting-edge technologies (including developing mRNA vaccines and exploiting CRISPR-based technologies) to provide novel insight into future vaccine discovery, design, manufacture and deployment.
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Fergus CA, Ozunga B, Okumu N, Parker M, Kamurari S, Allen T. Shifting the dynamics: implementation of locally driven, mixed-methods modelling to inform schistosomiasis control and elimination activities. BMJ Glob Health 2022; 7:e007113. [PMID: 35110273 PMCID: PMC8811568 DOI: 10.1136/bmjgh-2021-007113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 01/03/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The integration of more diverse perspectives into the development of evidence for decision-making has been elusive, despite years of rhetoric to the contrary. This has led to cycles of population-based health interventions which have not delivered the promised results. The WHO most recently set a target for schistosomiasis elimination by 2030 and called for cross-cutting approaches to be driven by endemic countries themselves. The extent to which elimination is feasible within the time frame has been a subject of debate. METHODS Systems maps were developed through participatory modelling activities with individuals working on schistosomiasis control and elimination activities from the village through national levels in Uganda. These maps were first synthesised, then used to frame the form and content of subsequent mathematical modelling activities, and finally explicitly informed model parameter specifications for simulations, using the open-source SCHISTOX model, driven by the participants. RESULTS Based on the outputs of the participatory modelling, the simulation activities centred around reductions in water contact. The results of the simulations showed that mass drug administration, at either the current or target levels of coverage, combined with water contact reduction activities, achieved morbidity control in high prevalence Schistosoma mansoni settings, while both morbidity control and elimination were achieved in high prevalence S. haematobium settings within the 10-year time period. CONCLUSION The combination of participatory systems mapping and individual-based modelling was a rich strategy which explicitly integrated the perspectives of national and subnational policymakers and practitioners into the development of evidence. This strategy can serve as a method by which individuals who have not been traditionally included in modelling activities, and do not hold positions or work in traditional centres of power, may be heard and truly integrated into the development of evidence for decision-making in global health.
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Affiliation(s)
- Cristin Alexis Fergus
- Firoz Lalji Institute for Africa, LSE, London, UK
- Department of International Development, LSE, London, UK
| | - Bono Ozunga
- Vector Control Division, Republic of Uganda Ministry of Health, Mayuge, Uganda
| | - Noah Okumu
- Vector Control Division, Republic of Uganda Ministry of Health, Pakwach, Uganda
| | - Melissa Parker
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Tim Allen
- Firoz Lalji Institute for Africa, LSE, London, UK
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Ismail HAHA, Ahmed AEAAERM, Cha S, Jin Y. The Life Histories of Intermediate Hosts and Parasites of Schistosoma haematobium and Schistosoma mansoni in the White Nile River, Sudan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031508. [PMID: 35162527 PMCID: PMC8835159 DOI: 10.3390/ijerph19031508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 02/05/2023]
Abstract
Background: The epidemiology of schistosomiasis transmission varies depending on the circumstances of the surrounding water bodies and human behaviors. We aimed to explore cercarial emergence patterns from snails that are naturally affected by human schistosomiasis and non-human trematodes. In addition, this study aimed to explore how schistosomiasis infection affects snail survival, reproduction, and growth. Methods: We measured the survival rate, fecundity, and size of Biomphalaria pfeifferi snails and the cercarial rhythmicity of S. haematobium and S. mansoni. The number of egg masses, eggs per egg mass, and snail deaths were counted for 7 weeks. The survival rate and cumulative hazard were assessed for infected and non-infected snails. Results: S. haematobium and S. mansoni cercariae peaked at 9:00–11:00 a.m. Infection significantly reduced the survival rate of B. pfeifferi, which was 35% and 51% for infected and non-infected snails, respectively (p = 0.02), at 7 weeks after infection. The hazard ratio of death for infected snails compared to non-infected snails was 1.65 (95% confidence interval: 1.35–1.99; p = 0.01). Conclusions: An understanding of the dynamics of schistosomiasis transmission will be helpful for formulating schistosomiasis control and elimination strategies. Cercarial rhythmicity can be reflected in health education, and the reproduction and survival rate of infected snails can be used as parameters for developing disease modeling.
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Affiliation(s)
| | | | - Seungman Cha
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea;
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Yan Jin
- Department of Microbiology, College of Medicine, Dongguk University, Gyeongju 38066, Korea
- Correspondence: ; Tel.: +82-10-3375-3118
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Kokaliaris C, Garba A, Matuska M, Bronzan RN, Colley DG, Dorkenoo AM, Ekpo UF, Fleming FM, French MD, Kabore A, Mbonigaba JB, Midzi N, Mwinzi PNM, N'Goran EK, Polo MR, Sacko M, Tchuem Tchuenté LA, Tukahebwa EM, Uvon PA, Yang G, Wiesner L, Zhang Y, Utzinger J, Vounatsou P. Effect of preventive chemotherapy with praziquantel on schistosomiasis among school-aged children in sub-Saharan Africa: a spatiotemporal modelling study. THE LANCET INFECTIOUS DISEASES 2022; 22:136-149. [PMID: 34863336 PMCID: PMC8695385 DOI: 10.1016/s1473-3099(21)00090-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/05/2020] [Accepted: 02/10/2021] [Indexed: 11/18/2022]
Abstract
Background Over the past 20 years, schistosomiasis control has been scaled up. Preventive chemotherapy with praziquantel is the main intervention. We aimed to assess the effect of preventive chemotherapy on schistosomiasis prevalence in sub-Saharan Africa, comparing 2000–10 with 2011–14 and 2015–19. Methods In this spatiotemporal modelling study, we analysed survey data from school-aged children (aged 5–14 years) in 44 countries across sub-Saharan Africa. The data were extracted from the Global Neglected Tropical Diseases database and augmented by 2018 and 2019 survey data obtained from disease control programmes. Bayesian geostatistical models were fitted to Schistosoma haematobium and Schistosoma mansoni survey data. The models included data on climatic predictors obtained from satellites and other open-source environmental databases and socioeconomic predictors obtained from various household surveys. Temporal changes in Schistosoma species prevalence were estimated by a categorical variable with values corresponding to the three time periods (2000–10, 2011–14, and 2015–19) during which preventive chemotherapy interventions were scaled up. Findings We identified 781 references with relevant geolocated schistosomiasis survey data for 2000–19. There were 19 166 unique survey locations for S haematobium and 23 861 for S mansoni, of which 77% (14 757 locations for S haematobium and 18 372 locations for S mansoni) corresponded to 2011–19. Schistosomiasis prevalence among school-aged children in sub-Saharan Africa decreased from 23·0% (95% Bayesian credible interval 22·1–24·1) in 2000–10 to 9·6% (9·1–10·2) in 2015–19, an overall reduction of 58·3%. The reduction of S haematobium was 67·9% (64·6–71·1) and that of S mansoni 53·6% (45·2–58·3) when comparing 2000–10 with 2015–19. Interpretation Our model-based estimates suggest that schistosomiasis prevalence in sub-Saharan Africa has decreased considerably, most likely explained by the scale-up of preventive chemotherapy. There is a need to consolidate gains in the control of schistosomiasis by means of preventive chemotherapy, coupled with other interventions to interrupt disease transmission. Funding European Research Council and WHO.
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Affiliation(s)
- Christos Kokaliaris
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Amadou Garba
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Martin Matuska
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | | | - Daniel G Colley
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, and Department of Microbiology, University of Georgia, Athens, GA, USA
| | - Ameyo M Dorkenoo
- Department of Parasitology and Mycology, University of Lomé, Lomé, Togo
| | - Uwem F Ekpo
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | | | | | | | - Jean B Mbonigaba
- Malaria and Other Parasitic Disease Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
| | - Nicholas Midzi
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Pauline N M Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO, Regional Office for Africa, Brazzaville, Congo
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Maria Rebollo Polo
- Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO, Regional Office for Africa, Brazzaville, Congo
| | - Moussa Sacko
- Department of Diagnostic and Biomedical Research, Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Louis-Albert Tchuem Tchuenté
- Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon; Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | | | - Pitchouna A Uvon
- Neglected Tropical Diseases Unit, Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo
| | - Guojing Yang
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Lisa Wiesner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Yaobi Zhang
- Regional Office for Africa, Helen Keller International, Dakar, Senegal
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
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Orish VN, Morhe EKS, Azanu W, Alhassan RK, Gyapong M. The parasitology of female genital schistosomiasis. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2022; 2:100093. [PMID: 35719849 PMCID: PMC9198370 DOI: 10.1016/j.crpvbd.2022.100093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/14/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022]
Abstract
Female genital schistosomiasis (FGS) is the gynaecological presentation of Schistosoma haematobium infection, resulting from egg deposition in the female genital tract. Despite the fact that this condition has been reported in the early days of the discovery of S. haematobium in Egypt, its existence has been grossly neglected, causing many women in schistosomiasis-endemic areas to go through a preventable, debilitating, and stigmatizing presentation of FGS. To prevent this, increasing awareness of FGS is necessary for all, especially healthcare providers, to improve the diagnosis, management, and treatment. As proposed by the FAST package project, several healthcare professionals with different specializations are expected to be involved in the management of FGS. It is therefore important that basic updated knowledge on the parasitology of the disease be acquired by healthcare professionals. This review provides basic information necessary to improve the knowledge of FGS among healthcare professionals in areas endemic to schistosomiasis. Armed with these basic details, healthcare professionals can improve their confidence in the management and treatment of FGS, contributing significantly to the control and prevention of FGS in endemic areas. A review of female genital schistosomiasis. Data on the life-cycle of Schistosoma haematobium, and pathogenesis and clinical features of female genital schistosomiasis. Summary of diagnostic methods and treatment, control and prevention of female genital schistosomiasis. Increasing awareness among healthcare workers is key to the management, control, and prevention of the disease.
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Affiliation(s)
- Verner N. Orish
- Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
- Corresponding author.
| | - Emmanuel Komla Senanu Morhe
- Department of Obstetrics and Gynecology, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Wisdom Azanu
- Department of Obstetrics and Gynecology, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Robert K. Alhassan
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
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Penkunas MJ, Berdou E, Chong SY, Launois P, Rhule ELM, Allotey P. Increasing Knowledge Translation Capacity in Low- and Middle-Income Countries: A Model for Implementation Research Training. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.762966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Most health professionals lack the training and expertise to translate clinical innovations into actionable programs. Even though some public health expert communities understand that even widely proven solutions need to be adapted to the demands and characteristics of diverse health systems and societies to be successful, such knowledge has yet to inform routine public health approaches and practices. Therefore, it should not be a surprise that the “know-do” gap between clinical innovations and their on-the-ground application that implementation research seeks to bridge is pervasive and enduring, particularly in low- and middle-income countries. This article draws on a study of implementation research training courses to highlight the various competencies needed to translate different types of knowledge into action, many of which are not adequately addressed in existing curricula. We utilized a four-phase modified Delphi methodology that included a review of the academic and grey literature, one-on-one interviews with experts, virtual dialogue series with key stakeholders, and peer review of the synthesized results. The resulting areas in need of further development include the ability of learners to work as part of a multidisciplinary team, engage various stakeholders, and communicate research findings to decision-makers. Based on these insights, it is argued that knowledge translation in implementation research is a multi-faceted, multi-level sensemaking and communication activity that takes place throughout the research and research-to policy-processes.
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Fusco D, Rakotozandrindrainy R, Rakotoarivelo RA, Andrianarivelo MR, Rakotozandrindrainy N, Rasamoelina T, Puradiredja DI, Klein P, Stahlberg K, Dechenaud M, Lorenz E, Jaeger A, Kreidenweiss A, Hoekstra PT, Adegnika AA, Sicuri E, Corstjens PLAM, van Dam GJ, May J, Schwarz NG. A cluster randomized controlled trial for assessing POC-CCA test based praziquantel treatment for schistosomiasis control in pregnant women and their young children: study protocol of the freeBILy clinical trial in Madagascar. Trials 2021; 22:822. [PMID: 34801082 PMCID: PMC8605548 DOI: 10.1186/s13063-021-05769-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/27/2021] [Indexed: 01/16/2023] Open
Abstract
Background Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes. freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers) is an international consortium focused on implementing and evaluating new schistosomiasis diagnostic strategies. In Madagascar, the study aims to determine the effectiveness of a test-based schistosomiasis treatment (TBST) strategy for pregnant women and their infants and children up until the age of 2 years. Methods A two-armed, cluster-randomized, controlled phase III trial including 5200 women and their offspring assesses the impact of TBST on child growth and maternal haemoglobin in areas of medium to high endemicity of Schistosoma mansoni. The participants are being tested with the point of care-circulating cathodic antigen (POC-CCA) test, a commercially available urine-based non-invasive rapid diagnostic test for schistosomiasis. In the intervention arm, a POC-CCA-TBST strategy is offered to women during pregnancy and 9 months after delivery, for their infants at 9 months of age. In the control arm, study visit procedures are the same, but without the POC-CCA-TBST procedure. All participants are being offered the POC-CCA-TBST 24 months after delivery. This trial is being integrated into the routine maternal and child primary health care programmes at 40 different PHCC in Madagascar’s highlands. The purpose of the trial is to assess the effectiveness of the POC-CCA-TBST for controlling schistosomiasis in young children and mothers. Discussion This trial assesses a strategy to integrate pregnant women and their children under the age of 2 years into schistosomiasis control programmes using rapid diagnostic tests. It includes local capacity building for clinical trials and large-scale intervention research. Trial registration Pan-African Clinical Trial Register PACTR201905784271304. Retrospectively registered on 15 May 2019
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Affiliation(s)
- Daniela Fusco
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | | | - Rivo Andry Rakotoarivelo
- Department of Infectious Diseases, University of Fianarantsoa Andrainjato, 301, Fianarantsoa, Madagascar
| | - Mala Rakoto Andrianarivelo
- Centre d'Infectiologie Charles Mérieux (CICM), University of Antananarivo, PO Box 4299, 101, Antananarivo, Madagascar
| | - Njary Rakotozandrindrainy
- Department of Microbiology and Parasitology, University of Antananarivo, 101, Antananarivo, Madagascar.,UPFR in Parasitology-Mycology of University Hospital Joseph Ravoahangy Andrianavalona Ampefiloha, 101, Antananarivo, Madagascar
| | - Tahinamandranto Rasamoelina
- Centre d'Infectiologie Charles Mérieux (CICM), University of Antananarivo, PO Box 4299, 101, Antananarivo, Madagascar
| | - Dewi Ismajani Puradiredja
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Philipp Klein
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Karl Stahlberg
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Marie Dechenaud
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Eva Lorenz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany.,Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anna Jaeger
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Akim Ayola Adegnika
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.,Centre de Recherches Médicales de Lambaréné, 242, Lambarene, BP, Gabon
| | - Elisa Sicuri
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Spain C/ Rosselló, 132, 5th 2nd, 08036, Barcelona, Spain
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Jürgen May
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | - Norbert Georg Schwarz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
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Schistosoma mansoni infection risk for school-aged children clusters within households and is modified by distance to freshwater bodies. PLoS One 2021; 16:e0258915. [PMID: 34735487 PMCID: PMC8568121 DOI: 10.1371/journal.pone.0258915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/07/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The interaction of socio-demographic and ecological factors with Schistosoma mansoni (S. mansoni) infection risk by age and the household clustering of infections between individuals are poorly understood. METHODS This study examined 1,832 individuals aged 5-90 years across 916 households in Mayuge District, Uganda. S. mansoni infection status and intensity were measured using Kato-Katz microscopy. Socio-demographic and ecological factors were examined as predictors of infection status and intensity using logistic and negative binomial regression models, respectively, with standard errors clustered by household. A subgroup analysis of children was conducted to examine the correlation of infection status between children and their caretakers. FINDINGS Infection varied within age groups based on the distance to Lake Victoria. Children aged 9-17 years and young adults aged 18-29 years who lived ≤0.50km from Lake Victoria were more likely to be infected compared to individuals of the same age who lived further away from the lake. Infections clustered within households. Children whose caretakers were heavily infected were 2.67 times more likely to be infected. CONCLUSION These findings demonstrate the focality of schistosome transmission and its dependence on socio-demographic, ecological and household factors. Future research should investigate the sampling of households within communities as a means of progressing towards precision mapping of S. mansoni infections.
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Transmission Dynamics of Schistosoma haematobium among School-Aged Children: A Cohort Study on Prevalence, Reinfection and Incidence after Mass Drug Administration in the White Nile State of Sudan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111537. [PMID: 34770050 PMCID: PMC8583024 DOI: 10.3390/ijerph182111537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/11/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022]
Abstract
The reinfection rate of schistosomiasis after mass drug administration (MDA) has not been documented in Sudan. We aimed to explore the transmission dynamics of urogenital schistosomiasis after MDA, targeting school-aged children in the White Nile State of Sudan, assessing the prevalence, reinfection rate, and incidence. A single dose of praziquantel (40 mg/kg) was administered to 1951 students in five primary schools from January to February 2018 immediately after a baseline survey, and follow-up surveys were performed at 2 weeks and 6 months after treatment. We examined Schistosoma haematobium eggs by centrifugation methods. The overall reinfection rate at 6 months after treatment was 9.8% (95% confidence interval: 0.5-17.4%). By school, the reinfection rate was highest in the Al Hidaib school, whose prevalence was highest at baseline. The reinfection rate was significantly higher in high-infection areas than low-infection areas (p = 0.02). Of the prevalence at 6 months in high-infection areas, 41% of cases were due to reinfection. MDA interventions are decided upon and undertaken at the district level. A more targeted treatment strategy should be developed with a particular focus on tracking high-risk groups, even within a school or a community.
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Cha S, Jin Y, Elhag MS, Kim Y, Ismail HAHA. Unequal geographic distribution of water and sanitation at the household and school level in Sudan. PLoS One 2021; 16:e0258418. [PMID: 34653204 PMCID: PMC8519438 DOI: 10.1371/journal.pone.0258418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 09/27/2021] [Indexed: 11/21/2022] Open
Abstract
The Sudanese Government launched the National SDG-6 Plan and commences its implementation to achieve and sustain universal and equitable access to basic WASH services by 2030. It is critical to understand the geographical heterogeneity of Sudan and patterns in the inequality of access to safe drinking water and sanitation. Through such research, the disease control strategy can be optimized, and resource allocation can be prioritized. We explored spatial heterogeneity and inequality in access to improved water and sanitation across Sudan by mapping the coverage at both the state and district levels. We decomposed the inequality across Sudan into within-state, between-state, within-district, and between-state inequalities using the Theil L and Theil T indices. We calculated the Gini coefficient to assess the inequality of access to improved water and sanitation, based on the deviation of the Lorenz curve from the line of perfect equality. The study population was 105,167 students aged 8–13 at 1,776 primary schools across the country. Geographical heterogeneity was prominent in the Central Darfur, South Darfur, East Darfur, Kassala, West Kordofan, and Blue Nile States, all of which showed severe inequality in access to an improved latrine at the household level in terms of the Theil T or Theil L index. The overall inequality in the coverage of improved sanitation went beyond the warning limit of 0.4 for the Gini coefficient. The inequality in terms of the Theil L and Theil T indices, as well as the Gini coefficient, was always higher for improved sanitation than for improved water at the household level. Within-state inequality accounted for 66% or more of national inequalities in the distribution of improved sanitation and drinking water for both the Theil L and Theil T indices. This is the first study to measure geographical heterogeneity and inequalities in improved water and sanitation coverage across Sudan. The study may help to prioritize resource allocation to areas with the greatest water and sanitation needs.
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Affiliation(s)
- Seungman Cha
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang, South Korea
| | - Yan Jin
- Department of Microbiology, Dongguk University College of Medicine, Gyeongju, South Korea
| | - Mousab Siddig Elhag
- Communicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum, Sudan
| | - Youngjin Kim
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang, South Korea
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Novel tools and strategies for breaking schistosomiasis transmission: study protocol for an intervention study. BMC Infect Dis 2021; 21:1024. [PMID: 34592960 PMCID: PMC8482678 DOI: 10.1186/s12879-021-06620-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022] Open
Abstract
Background Global elimination of schistosomiasis as a public health problem is set as target in the new World Health Organization’s Neglected Tropical Diseases Roadmap for 2030. Due to a long history of interventions, the Zanzibar islands of Tanzania have reached this goal since 2017. However, challenges occur on the last mile towards interruption of transmission. Our study will investigate new tools and strategies for breaking schistosomiasis transmission. Methods The study is designed as an intervention study, documented through repeated cross-sectional surveys (2020–2024). The primary endpoint will be the sensitivity of a surveillance-response approach to detect and react to outbreaks of urogenital schistosomiasis over three years of implementation. The surveys and multi-disciplinary interventions will be implemented in 20 communities in the north of Pemba island. In low-prevalence areas, surveillance-response will consist of active, passive and reactive case detection, treatment of positive individuals, and focal snail control. In hotspot areas, mass drug administration, snail control and behaviour change interventions will be implemented. Parasitological cross-sectional surveys in 20 communities and their main primary schools will serve to adapt the intervention approach annually and to monitor the performance of the surveillance-response approach and impact of interventions. Schistosoma haematobium infections will be diagnosed using reagent strips and urine filtration microscopy, and by exploring novel point-of-care diagnostic tests. Discussion Our study will shed light on the field applicability and performance of novel adaptive intervention strategies, and standard and new diagnostic tools for schistosomiasis elimination. The evidence and experiences generated by micro-mapping of S. haematobium infections at community level, micro-targeting of new adaptive intervention approaches, and application of novel diagnostic tools can guide future strategic plans for schistosomiasis elimination in Zanzibar and inform other countries aiming for interruption of transmission. Trial registration ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493
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Profiro de Oliveira JH, Arruda IES, Izak Ribeiro de Araújo J, Chaves LL, de La Rocca Soares MF, Soares-Sobrinho JL. Why do few drug delivery systems to combat neglected tropical diseases reach the market? An analysis from the technology's stages. Expert Opin Ther Pat 2021; 32:89-114. [PMID: 34424127 DOI: 10.1080/13543776.2021.1970746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Many drugs used to combat schistosomiasis, Chagas disease, and leishmaniasis (SCL) have clinical limitations such as: high toxicity to the liver, kidneys and spleen; reproductive, gastrointestinal, and heart disorders; teratogenicity. In this sense, drug delivery systems (DDSs) have been described in the literature as a viable option for overcoming the limitations of these drugs. An analysis of the level of development (TRL) of patents can help in determine the steps that must be taken for promising technologies to reach the market. AREAS COVERED This study aimed to analyze the stage of development of DDSs for the treatment of SCL described in patents. In addition, we try to understand the main reasons why many DDSs do not reach the market. In this study, we examined DDSs for drugs indicated by WHO and treatment of SCL, by performing a search for patents. EXPERT OPINION In this present work we provide arguments that support the hypothesis that there is a lack of integration between academia and industry to finance and continue research, especially the development of clinical studies. We cite the translational research consortia as the potential alternative for developing DDSs to combat NTDs.
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Affiliation(s)
| | | | | | - Luise Lopes Chaves
- Department of Pharmacy, Federal University of Pernambuco, Recife, Recife-Pernambuco
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Wang W, Bergquist R, King CH, Yang K. Elimination of schistosomiasis in China: Current status and future prospects. PLoS Negl Trop Dis 2021; 15:e0009578. [PMID: 34351907 PMCID: PMC8341657 DOI: 10.1371/journal.pntd.0009578] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Elimination of schistosomiasis as a public health problem among all disease-endemic countries in 2030 is an ambitious goal. Recent achievements resulting from mass drug administration (MDA) with praziquantel is promising but may need to be complemented with also other means. Schistosomiasis was highly prevalent in China before the initiation of the national schistosomiasis control program in the mid-1950s, and, at that time, the country bore the world's highest burden of schistosomiasis. The concerted control efforts, upheld without interruption for more than a half century, have resulted in elimination of the disease as a public health problem in China as of 2015. Here, we describe the current status of schistosomiasis in China, analyze the potential challenges affecting schistosomiasis elimination, and propose the future research needs and priorities for the country, aiming to provide more universal insights into the structures needed for a global schistosomiasis elimination encompassing also other endemic regions.
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Affiliation(s)
- Wei Wang
- Key Laboratory of National Health Commission of Parasitic Disease Prevention and Control, Jiangsu Provincial Key Laboratory of Parasites and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, China
| | - Robert Bergquist
- Ingerod, Brastad, Sweden (formerly with the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases), World Health Organization, Geneva, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Kun Yang
- Key Laboratory of National Health Commission of Parasitic Disease Prevention and Control, Jiangsu Provincial Key Laboratory of Parasites and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, China
- Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu Province, China
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Bulinus senegalensis and Bulinus umbilicatus Snail Infestations by the Schistosoma haematobium Group in Niakhar, Senegal. Pathogens 2021; 10:pathogens10070860. [PMID: 34358010 PMCID: PMC8308860 DOI: 10.3390/pathogens10070860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/28/2021] [Accepted: 06/19/2021] [Indexed: 11/21/2022] Open
Abstract
Thorough knowledge of the dynamics of Bulinus spp. infestation could help to control the spread of schistosomiasis. This study describes the spatio-temporal dynamics of B. senegalensis and B. umbilicatus infestation by the Schistosoma haematobium group of blood flukes in Niakhar, Senegal. Molecular identification of the S. haematobium group was performed by real-time PCR, targeting the Dra 1 gene in 810 samples of Bulinus spp. collected during the schistosomiasis transmission season in 2013. In addition to Dra 1 PCR, a rapid diagnostic-PCR was performed on a sub-group of 43 snails to discriminate S. haematobium, S. bovis, and S. mattheei. Out of 810 snails, 236 (29.1%) were positive for Dra 1 based on the PCR, including 96.2% and 3.8% of B. senegalensis and B. umbilicatus, respectively. Among the sub-group, 16 samples were confirmed to be S. haematobium while one was identified as a mixture of S. haematobium and S. bovis. Snails infestations were detected in all villages sampled and infestation rates ranged from 15.38% to 42.11%. The prevalence of infestation was higher in the north (33.47%) compared to the south (25.74%). Snail populations infestations appear early in the rainy season, with a peak in the middle of the season, and then a decline towards the end of the rainy season. Molecular techniques showed, for the first time, the presence of S. bovis in the Bulinus spp. population of Niakhar. The heterogeneity of snail infestations at the village level must be taken into account in mass treatment strategies. Further studies should help to improve the characterizations of the schistosome population.
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Ayabina D, Kura K, Toor J, Graham M, Anderson RM, Hollingsworth TD. Maintaining Low Prevalence of Schistosoma mansoni: Modeling the Effect of Less Frequent Treatment. Clin Infect Dis 2021; 72:S140-S145. [PMID: 33909064 PMCID: PMC8201569 DOI: 10.1093/cid/ciab246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The World Health Organization previously set goals of controlling morbidity due to schistosomiasis by 2020 and attaining elimination as a public health problem (EPHP) by 2025 (now adjusted to 2030 in the new neglected tropical diseases roadmap). As these milestones are reached, it is important that programs reassess their treatment strategies to either maintain these goals or progress from morbidity control to EPHP and ultimately to interruption of transmission. In this study, we consider different mass drug administration (MDA) strategies to maintain the goals. METHODS We used 2 independently developed, individual-based stochastic models of schistosomiasis transmission to assess the optimal treatment strategy of a multiyear program to maintain the morbidity control and the EPHP goals. RESULTS We found that, in moderate-prevalence settings, once the morbidity control and EPHP goals are reached it may be possible to maintain the goals using less frequent MDAs than those that are required to achieve the goals. On the other hand, in some high-transmission settings, if control efforts are reduced after achieving the goals, particularly the morbidity control goal, there is a high chance of recrudescence. CONCLUSIONS To reduce the risk of recrudescence after the goals are achieved, programs have to re-evaluate their strategies and decide to either maintain these goals with reduced efforts where feasible or continue with at least the same efforts required to reach the goals.
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Affiliation(s)
- Diepreye Ayabina
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Klodeta Kura
- London Centre for Neglected Tropical Disease Research, London, United Kingdom.,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London, United Kingdom.,MRC Centre for Global Infectious Disease Analysis, London,United Kingdom
| | - Jaspreet Toor
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom.,MRC Centre for Global Infectious Disease Analysis, London,United Kingdom.,Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom
| | - Matt Graham
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom.,Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, London, United Kingdom.,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London, United Kingdom.,MRC Centre for Global Infectious Disease Analysis, London,United Kingdom.,The DeWorm3 Project, The Natural History Museum of London, London, United Kingdom
| | - T Deirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
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Ebigbo A, Kahn M, Zellmer S, Messmann H. Advanced endoscopic imaging of colonic schistosomiasis. Endoscopy 2021; 53:E251-E252. [PMID: 32968976 DOI: 10.1055/a-1252-2637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Alanna Ebigbo
- Department of Gastroenterology and Infectious Diseases, University Hospital, Augsburg, Germany
| | - Maria Kahn
- Department of Gastroenterology and Infectious Diseases, University Hospital, Augsburg, Germany
| | - Stephan Zellmer
- Department of Gastroenterology and Infectious Diseases, University Hospital, Augsburg, Germany
| | - Helmut Messmann
- Department of Gastroenterology and Infectious Diseases, University Hospital, Augsburg, Germany
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Aula OP, McManus DP, Jones MK, Gordon CA. Schistosomiasis with a Focus on Africa. Trop Med Infect Dis 2021; 6:109. [PMID: 34206495 PMCID: PMC8293433 DOI: 10.3390/tropicalmed6030109] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022] Open
Abstract
Schistosomiasis is a common neglected tropical disease of impoverished people and livestock in many developing countries in tropical Africa, the Middle East, Asia, and Latin America. Substantial progress has been made in controlling schistosomiasis in some African countries, but the disease still prevails in most parts of sub-Saharan Africa with an estimated 800 million people at risk of infection. Current control strategies rely primarily on treatment with praziquantel, as no vaccine is available; however, treatment alone does not prevent reinfection. There has been emphasis on the use of integrated approaches in the control and elimination of the disease in recent years with the development of health infrastructure and health education. However, there is a need to evaluate the present status of African schistosomiasis, primarily caused by Schistosoma mansoni and S. haematobium, and the factors affecting the disease as the basis for developing more effective control and elimination strategies in the future. This review provides an historical perspective of schistosomiasis in Africa and discusses the current status of control efforts in those countries where the disease is endemic.
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Affiliation(s)
- Oyime Poise Aula
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia;
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Donald P. McManus
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia;
| | - Malcolm K. Jones
- School of Veterinary Sciences, University of Queensland, Gatton 4343, Australia;
| | - Catherine A. Gordon
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane 4006, Australia;
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Green AE, Anchang-Kimbi JK, Wepnje GB, Ndassi VD, Kimbi HK. Distribution and factors associated with urogenital schistosomiasis in the Tiko Health District, a semi-urban setting, South West Region, Cameroon. Infect Dis Poverty 2021; 10:49. [PMID: 33845904 PMCID: PMC8042887 DOI: 10.1186/s40249-021-00827-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/16/2021] [Indexed: 12/11/2022] Open
Abstract
Background Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity, and risk factors associated with the occurrence of UGS. Methods In this cross-sectional survey, 12 communities were purposively selected from four health areas (HAs) (Likomba, Holforth, Holforth-Likomba, and Mutengene) in South West Region of Cameroon between June and August 2018. Consenting individuals were enrolled using a convenient sampling technique and administered a semi-structured questionnaire to document information on socio-demographic and water contact behaviour. Urine samples were examined for Schistosomahaematobium infection using test strip, filtration, and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection. Results The overall prevalence of UGS in Likomba, Holforth-Likomba and Holforth was 31.5% [95% confidence interval (CI): 28.3–34.8] with geometric mean (GM) egg count of 28.7 (range: 2–450) eggs per 10 ml of urine. S.haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (P < 0.001) among the affected communities, ranging from 12.0 to 56.9%. Infection status of the community related positively (P < 0.001) with proximity to stream (< 100 m), the degree of contact with water and number of improved water sources. Younger age group (5–14 years) [adjusted odds ratio (aOR): 3.7, 95% CI: 1.1–12.2] and intense water contact (degree II) (aOR: 5.2, 95% CI: 3.4–8.1) were associated with increased risk of infection. Similarly, significantly higher egg load was observed among younger aged groups (P = 0.02) and those who carried out intense water contact activities (P < 0.001). Conclusions Generally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50.0% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00827-2.
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Affiliation(s)
- Adeline Enjema Green
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.
| | - Judith Kuoh Anchang-Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Godlove Bunda Wepnje
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Vicky Daonyle Ndassi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.,Department of Medical Laboratory Sciences, Faculty of Health Sciences, The University of Bamenda, P.O. Box 39, Bambili, Cameroon
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El Saftawy EA. Validity of urine-CCA cassette test and indirect haem-agglutination assay (IHA) in the detection of schistosomiasis- mansoni infection relative to microscopic examination. J Parasit Dis 2021; 45:285-292. [PMID: 33746416 DOI: 10.1007/s12639-020-01303-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
Several immunodiagnostic assays have been commercially presented over the last years as easy diagnostic methods for schistosomiasis using serum or urine samples. The performance of immunochromatographic test (ICT) and indirect hemagglutination assay (IHA) was validated in the identification of active schistosomiasis infection. Detection of circulating cathodic antigen (CCA) of the parasite in urine samples and anti-Schistosoma antibodies in serum using ICT (Urine-CCA Cassette test) and IHA respectively. Proved diagnosis of Schistosoma mansoni infection was defined by the sum of positive results from microscopic examination (Gold standard) and Kato-Katz method. Out of 173 (mean age, 45 ± 10 years; 70 from Giza, 103 from different Egyptian governorates), 9 4 adult patients were infected. Urine-CCA cassette test despite showing high specificity (91.14%) it was of low sensitivity (23.40%). PPVs was 75.86% and NPV was 50.00% and diagnostic accuracy of 54.34%. The IHA showed a sensitivity of 57.45% and specificity of 48.10%. PPVs was 56.84% whereas NPVs was 48.72%. As for diagnostic accuracy, it was 53.18%. Urine-CCA Cassette test had lower sensitivity than expected for detection of circulating antigen and the IHA kit is generally more expensive than microscopic examination and Urine-CCA cassette test with low sensitivity and specificity. On the basis of this diagnostic performance none of the two tested immune-assays can be a sole tool in the principal diagnosis of active schistosomiasis infections.
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Affiliation(s)
- Enas A El Saftawy
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.,Medical Parasitology Department, Faculty of Medicine, Armed Forces College of Medicine, Cairo, Egypt
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Favre TC, Massara CL, Beck LCNH, Cabello RKSA, Pieri OS. Adherence to diagnosis followed by selective treatment of schistosomiasis mansoni and related knowledge among schoolchildren in an endemic area of Minas Gerais, Brazil, prior to and after the implementation of educational actions. Parasite Epidemiol Control 2021; 13:e00208. [PMID: 33732914 PMCID: PMC7941185 DOI: 10.1016/j.parepi.2021.e00208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/21/2020] [Accepted: 02/25/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Brazilian guidelines for schistosomiasis elimination recommend regular search of infection carriers and their timely treatment. This study evaluates the effect of educational actions (EAs) among schoolchildren on adherence to diagnosis and treatment, as well as on knowledge of the disease. Methods In April/2013, a questionnaire was applied to 6th-to-8th-grade pupils of eight public schools to evaluate prior knowledge of disease and self-reported risk behavior. Baseline parasitological survey (PS) was done in May/2013, followed by selective treatment and cure assessment. The schools were then randomly allocated to experimental (EG) and control (CG) groups, with and without EAs, respectively. EAs were conducted for 3 months from August/2013. Questionnaire was reapplied in November/2013, April/2014, October/2014, and October/2015 to evaluate changes in knowledge about the disease and self-reported risk behavior. Two further annual PSs (May/2014 and May/2015), each followed by treatment of positives, allowed to evaluate between-group differences and intra-group changes in adherence to diagnosis and treatment, and to follow-up prevalence and intensity of infection. Results Adherence to diagnosis did not differ significantly between EG (84.1%) and CG (81.1%) at baseline but was significantly higher in EG in subsequent PSs. Overall, adherence to treatment was higher than 90% in all three PSs; cure was 98.4%, egg-reduction was 99.8% and reinfection, 2.8%. Prevalence fell significantly in EC (from 23.5% to 6.8%) and CG (from 21.8% to 2.4%), the same occurring with intensity (from 54.2 to 4.6 epg in EG and from 38.4 to 1.3 epg in CG). Disease knowledge increased significantly in EG and CG; knowledge about disease transmission increased significantly more in the EG. Self-reported risk behavior remained above 67% and did not differ significantly between EG and CG. Conclusion EAs increased adherence of schoolchildren and improved knowledge about the disease, confirming that EAs are an important tool to enhance schoolchildren participation in control campaigns. Educational actions improved adherence to stool testing. Disease knowledge also improved with educational actions. Risk behavior stayed high despite educational actions.
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Affiliation(s)
- Tereza Cristina Favre
- Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Cristiano Lara Massara
- Helmintology and Medical Malacology Research Group, René Rachou Institute, Fiocruz, Minas Gerais, Brazil
| | | | | | - Otavio Sarmento Pieri
- Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
- Corresponding author.
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Wanderley FSO, Montarroyos U, Bonfim C, Cunha-Correia C. Effectiveness of mass treatment of Schistosoma mansoni infection in socially vulnerable areas of a state in northeastern Brazil, 2011-2014. ACTA ACUST UNITED AC 2021; 79:30. [PMID: 33750474 PMCID: PMC7941929 DOI: 10.1186/s13690-021-00549-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/21/2021] [Indexed: 11/21/2022]
Abstract
Background To assess the effectiveness of mass treatment of Schistosoma mansoni infection in socially vulnerable endemic areas in northeastern Brazil. Method An ecological study was conducted, in which 118 localities in 30 municipalities in the state of Pernambuco were screened before 2011 and in 2014 (after mass treatment). Information on the endemic baseline index, mass treatment coverage, socio-environmental conditions and social vulnerability index were used in the multiple correspondence analysis. One hundred fourteen thousand nine hundred eighty-seven people in 118 locations were examined. Results The first two dimensions of the multiple correspondence analysis represented 55.3% of the variability between locations. The human capital component of the social vulnerability index showed an association with the baseline endemicity index. There was a significant reduction in positivity for schistosomes. For two rounds, for every extra 1% of initial endemicity index, the fixed effect of 13.62% increased by 0.0003%, achieving at most 15.94%. Conclusions The mass treatment intervention helped to reduce transmission of schistosomiasis in areas of high endemicity. Thus, it can be recommended that application of mass treatment should be accompanied by other control actions, such as basic sanitation, monitoring of intermediate vectors and case surveillance. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00549-9.
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Affiliation(s)
- Flávia Silvestre Outtes Wanderley
- Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil
| | - Ulisses Montarroyos
- Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil
| | - Cristine Bonfim
- Social Research Department, Joaquim Nabuco Foundation, Recife, PE, Brazil
| | - Carolina Cunha-Correia
- Department of Neurology, Faculdade de Ciências Médicas, Postgraduate Course on Health Sciences, University of Pernambuco, Rua Arnóbio Marques, 310, Santo Amaro, Recife, Pernambuco, CEP 50100-130, Brazil.
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Onasanya A, Bengtson M, Oladepo O, Van Engelen J, Diehl JC. Rethinking the Top-Down Approach to Schistosomiasis Control and Elimination in Sub-Saharan Africa. Front Public Health 2021; 9:622809. [PMID: 33681133 PMCID: PMC7930368 DOI: 10.3389/fpubh.2021.622809] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/25/2021] [Indexed: 01/09/2023] Open
Abstract
The control and elimination of schistosomiasis have over the last two decades involved several strategies, with the current strategy by the World Health Organization (WHO) focusing mainly on treatment with praziquantel during mass drug administration (MDA). However, the disease context is complex with an interplay of social, economic, political, and cultural factors that may affect achieving the goals of the Neglected Tropical Disease (NTD) 2021-2030 Roadmap. There is a need to revisit the current top-down and reactive approach to schistosomiasis control among sub-Saharan African countries and advocate for a dynamic and diversified approach. This paper highlights the challenges of praziquantel-focused policy for schistosomiasis control and new ways to move from schistosomiasis control to elimination in sub-Saharan Africa. We will also discuss an alternative and diversified approach that consists of a Systems Thinking Framework that embraces intersectoral collaboration fully and includes co-creating locally relevant strategies with affected communities. We propose that achieving the goals for control and elimination of schistosomiasis requires a bottom-up and pro-active approach involving multiple stakeholders. Such a pro-active integrated approach will pave the way for achieving the goals of the NTD 2021-2030 roadmap for schistosomiasis, and ultimately improve the wellbeing of those living in endemic areas.
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Affiliation(s)
- Adeola Onasanya
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Michel Bengtson
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Oladimeji Oladepo
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jo Van Engelen
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Jan Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Masong MC, Wepnje GB, Marlene NT, Gamba V, Mengue MT, Kouokam E, Stothard JR, Ekobo ALS. Female Genital Schistosomiasis (FGS) in Cameroon: A formative epidemiological and socioeconomic investigation in eleven rural fishing communities. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000007. [PMID: 36962084 PMCID: PMC10022362 DOI: 10.1371/journal.pgph.0000007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/15/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Female Genital Schistosomiasis (FGS) is most often caused by presence of Schistosoma haematobium eggs lodged in the female reproductive tract which results in chronic fibrosis and scarring. In Cameroon, despite high community prevalences of urine-patent S. haematobium infections, FGS has yet to be studied in depth. To shed light on the clinical prevalence and socioeconomic effects of FGS, we undertook a formative community-based epidemiological and qualitative survey. METHOD A cross sectional multidisciplinary study of 304 girls and women from 11 remote rural fishing communities in Cameroon was undertaken using parasitological sampling, clinical colposcopy, and interviews. The lived experiences of those with FGS were documented using a process of ethnography with participant observation and in-depth interviews. RESULT Amongst 304 women and girls aged >5 years (Median age: 18; Interquartile range: 9.6-28), 198 females were eligible for FGS testing and 58 adult women were examined by clinical colposcopy. Of these, 34 were positive for FGS (proportion: 58.6%; 95% CI: 45.8-70.4), younger girls showing a higher FGS prevalence, and older women not shedding eggs showing a pattern for cervical lesions from earlier infection. In a subset of women with FGS selected purposively (12/58), in-depth interviews with participant observation revealed out-of-pocket expenditures of up to 500USD related health spending for repeated diagnosis and treatment of gynecological illnesses, and 9 hours daily lost reproductive labour. Psychosocial unrest, loss in social capital, and despair were linked with sub-fertility and persistent vaginal itch. CONCLUSION With our first formative evidence on prevalence, socioeconomic effects and experiences of FGS amongst women and girls in Cameroon, we have clarified to a new level of detail the deficit in provision of and access to peripheral health services in remote areas of Cameroon. Using this information, there is now strong evidence for national programs and services on women's health and schistosomiasis to update and revise policies targeted on prevention and management of FGS. We therefore stress the need for regular provision of Praziquantel treatment to adolescent girls and women in S. haematobium endemic areas, alongside better access to tailored diagnostic services that can detect FGS and appropriately triage care at primary health level.
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Affiliation(s)
- Makia Christine Masong
- Department of Social Sciences and Management, Catholic University of Central Africa, Yaoundé, Cameroon
| | | | - Ntsinda Tchoffo Marlene
- Department of Social Sciences and Management, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Victoria Gamba
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - Marie-Therese Mengue
- Department of Social Sciences and Management, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Estelle Kouokam
- Department of Social Sciences and Management, Catholic University of Central Africa, Yaoundé, Cameroon
| | - J Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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