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Ndum NC, Trippler L, Mohammed UA, Ali AS, Hattendorf J, Utzinger J, Ali SM, Knopp S. Capacities and needs of health care facilities for schistosomiasis diagnosis and management in elimination settings. Parasit Vectors 2024; 17:263. [PMID: 38886811 PMCID: PMC11184784 DOI: 10.1186/s13071-024-06311-8] [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: 01/17/2024] [Accepted: 04/29/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Schistosomiasis is a debilitating neglected tropical disease endemic in sub-Saharan Africa. The role of health facilities in the prevention, diagnosis, control, and elimination of schistosomiasis is poorly documented. In a setting targeted for schistosomiasis elimination in Zanzibar, we assessed the prevalence of Schistosoma haematobium among patients seeking care in a health facility and investigated schistosomiasis-related knowledge of staff, and health facilities' capacities and needs for schistosomiasis diagnosis and management. METHODS We conducted a health facility-based mixed-method study on Pemba Island from June to August 2023. Patients aged ≥ 4 years seeking care in four health facilities were screened for S. haematobium infection using urine filtration and reagent strips. Those patients aged ≥ 10 years were additionally interviewed about signs and symptoms. Staff from 23 health facilities responded to a questionnaire assessing knowledge and practices. Ten staff participated in a focus group discussion (FGD) about capacities and needs for schistosomiasis diagnosis and management. RESULTS The prevalence of S. haematobium infection in patients attending the health facilities, as determined by the presence of eggs in urine, was 1.1% (8/712). Microhaematuria was detected in 13.3% (95/712) of the patients using reagent strips. Among patients responding to the questionnaire, pelvic pain, pain during sex, and painful urination were reported by 38.0% (237/623), 6.3% (39/623), and 3.2% (20/623), respectively. Among the health facility staff, 90.0% (44/49) and 87.8% (43/49) identified blood in urine and pelvic pain, respectively, as symptoms of urogenital schistosomiasis, 81.6% (40/49) and 93.9% (46/49) reported collecting a urine sample and pursuing a reagent strip test, respectively, for diagnosis, and 87.8% (43/49) administered praziquantel for treatment. The most reoccurring themes in the FGD were the need for more staff training about schistosomiasis, requests for diagnostic equipment, and the need to improve community response to schistosomiasis services in health facilities. CONCLUSIONS The prevalence of S. haematobium infection in patients seeking care in health facilities in Pemba is very low and similar to what has been reported from recent community-based cross-sectional surveys. The health facility staff had good schistosomiasis-related knowledge and practices. However, to integrate schistosomiasis patient management more durably into routine health facility activities, scalable screening pathways need to be identified and capacities need to be improved by regular staff training, and an unbroken supply of accurate point-of-care diagnostics and praziquantel for the treatment of cases.
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Affiliation(s)
- Naomi C Ndum
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Lydia Trippler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ulfat A Mohammed
- Public Health Laboratory-Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Anisa S Ali
- Public Health Laboratory-Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Said M Ali
- Public Health Laboratory-Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
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Kihumuro RB, Kintu TM, Atimango L, Kanyike AM, Bazira J. Assessing the knowledge, training and capacity of health workers in the diagnosis and management of soil-transmitted helminths and schistosomiasis in eastern Uganda. Trans R Soc Trop Med Hyg 2024:trae029. [PMID: 38768308 DOI: 10.1093/trstmh/trae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/20/2024] [Accepted: 04/18/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) affect millions of people in Africa, with Uganda bearing a significant burden. The World Health Organization (WHO) set a goal to reduce NTDs and improve access to diagnosis and management by 2030. However, NTDs have not been well integrated into primary healthcare in many countries, including Uganda, due to limited knowledge and resources among health workers. The study aimed to assess the readiness and capacity of primary healthcare centres to diagnose and manage soil-transmitted helminths (STHs) and schistosomiasis. METHODS A cross-sectional quantitative study was conducted among 204 health workers in 20 health facilities in four districts bordering Lake Kyoga. In this study we evaluated health workers' knowledge of symptoms, diagnosis and management of STHs and schistosomiasis as well as the availability of resources and training. RESULTS Our findings indicate that health workers have strong knowledge about STHs (86.76%), with lower knowledge levels regarding Schistosoma haematobium (59.72%) and Schistosoma mansoni (71.43%). Regarding resources and training, 95% of health facilities had laboratory services, but the majority lacked diagnostic equipment. Furthermore, only 17% of health workers reported prior training on schistosomiasis and related topics and only 25% had training on surveillance and reporting. CONCLUSIONS While health workers in eastern Uganda demonstrated a good knowledge base for some NTDs, there were knowledge gaps and challenges in training on surveillance and reporting mechanisms. Continuously building the capacity of health workers along with investing in diagnostic infrastructure is essential for improved NTD control and ultimately reducing associated morbidity and mortality in the region.
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Affiliation(s)
- Raymond Bernard Kihumuro
- Faculty of Medicine, Mbarara University of Science and Technology
- Department of Internal Medicine, Mulago National Referral Hospital
- Way Forward Youth Africa
| | - Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology
- Department of Internal Medicine, Mulago National Referral Hospital
- Way Forward Youth Africa
| | - Lorna Atimango
- Faculty of Medicine, Mbarara University of Science and Technology
- Way Forward Youth Africa
| | - Andrew Marvin Kanyike
- Faculty of Medicine, Mbarara University of Science and Technology
- Way Forward Youth Africa
- Department of Internal Medicine, Mengo Hospital
| | - Joel Bazira
- Faculty of Medicine, Mbarara University of Science and Technology
- Department of Internal Medicine, Mulago National Referral Hospital
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Ecological niche modeling based on ensemble algorithms to predicting current and future potential distribution of African swine fever virus in China. Sci Rep 2022; 12:15614. [PMID: 36114368 PMCID: PMC9481527 DOI: 10.1038/s41598-022-20008-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/07/2022] [Indexed: 11/08/2022] Open
Abstract
African swine fever (ASF) is a tick-borne infectious disease initially described in Shenyang province China in 2018 but is now currently present nationwide. ASF has high infectivity and mortality rates, which often results in transportation and trade bans, and high expenses to prevent and control the, hence causing huge economic losses and a huge negative impact on the Chinese pig farming industry. Ecological niche modeling has long been adopted in the epidemiology of infectious diseases, in particular vector-borne diseases. This study aimed to establish an ecological niche model combined with data from ASF incidence rates in China from August 2018 to December 2021 in order to predict areas for African swine fever virus (ASFV) distribution in China. The model was developed in R software using the biomod2 package and ensemble modeling techniques. Environmental and topographic variables included were mean diurnal range (°C), isothermality, mean temperature of wettest quarter (°C), precipitation seasonality (cv), mean precipitation of warmest quarter(mm), mean precipitation of coldest quarter (mm), normalized difference vegetation index, wind speed (m/s), solar radiation (kJ /day), and elevation/altitude (m). Contribution rates of the variables normalized difference vegetation index, mean temperature of wettest quarter, mean precipitation of coldest quarter, and mean precipitation of warmest quarter were, respectively, 47.61%, 28.85%, 10.85%, and 7.27% (according to CA), which accounted for over 80% of contribution rates related to variables. According to model prediction, most of areas revealed as suitable for ASF distribution are located in the southeast coast or central region of China, wherein environmental conditions are suitable for soft ticks’ survival. In contrast, areas unsuitable for ASFV distribution in China are associated with arid climate and poor vegetation, which are less conducive to soft ticks’ survival, hence to ASFV transmission. In addition, prediction spatial suitability for future ASFV distribution suggests narrower areas for ASFV spread. Thus, the ensemble model designed herein could be used to conceive more efficient prevention and control measure against ASF according to different geographical locations in China.
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Mazigo HD, Samson A, Lambert VJ, Kosia AL, Ngoma DD, Murphy R, Kabole FM, Matungwa DJ. Healthcare Workers’ Low Knowledge of Female Genital Schistosomiasis and Proposed Interventions to Prevent, Control, and Manage the Disease in Zanzibar. Int J Public Health 2022; 67:1604767. [PMID: 36188750 PMCID: PMC9520356 DOI: 10.3389/ijph.2022.1604767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study was conducted to explore healthcare workers’ knowledge of female genital schistosomiasis (FGS) and describe proposed interventions to raise awareness about FGS and strengthen healthcare facilities’ capacity to manage FGS cases.Methods: We conducted four cross-sectional focus group discussions and 16 key informant interviews with purposively selected healthcare workers in Zanzibar. Discussions and interviews were digitally recorded, transcribed, and analyzed using NVivo software.Results: Most participants had limited or no knowledge of FGS and lacked skills for managing it. They confused FGS with urogenital schistosomiasis and thought it was sexually transmitted. A few participants knew about FGS and associated it with Human Immunodeficiency Virus (HIV), ectopic pregnancy, cervical cancer, and infertility. To prevent and control FGS, participants proposed interventions targeting communities (including community-based health education) and the healthcare system (including training healthcare workers on FGS).Conclusion: Healthcare workers lacked knowledge of and skills for managing FGS. Besides, healthcare facilities had no diagnostic capacity to manage FGS. Along with on-going interventions to break S. haematobium transmission and eventually eliminate urogenital schistosomiasis in Zanzibar, we recommend training healthcare workers on FGS and equip healthcare facilities with medical equipment and supplies for managing FGS.
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Affiliation(s)
- Humphrey D. Mazigo
- Department of Parasitology and Entomology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Anna Samson
- Department of Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Valencia J. Lambert
- Center for Global Health, Weill Cornell Medicine, New York, NY, United States
| | - Agnes L. Kosia
- School of Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Deogratias D. Ngoma
- Accelerating the Sustainable Control and Elimination of Neglected Tropical Diseases, Crown Agents, London, United Kingdom
| | | | | | - Dunstan J. Matungwa
- Department of Sexual and Reproductive Health, National Institute for Medical Research, Mwanza, Tanzania
- Department of Anthropology, School of Arts and Sciences, Rutgers University, New Brunswick, NJ, United States
- *Correspondence: Dunstan J. Matungwa,
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Oliveira ACD, Lima SVMA, Lopes-Sousa ÁF, Farias Neto JPD, Araújo KCGMD. Construction and validation of an instrument for assessing the functionality of individuals with schistosomiasis. Rev Bras Enferm 2021; 75:e20210306. [PMID: 34787239 DOI: 10.1590/0034-7167-2021-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/17/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to construct and validate an instrument for assessing the functionality of individuals with schistosomiasis. METHODS methodological study, developed in three stages: 1) construction of the instrument and its association with categories of the International Classification of Functionality, which the study used to elaborate the questions; 2) validation of content, performed by judges experts in the subject; 3) application of the instrument by the test-retest technique in the population with schistosomiasis in 14 days. The study used the correlation coefficient kappa to calculate the degree of agreement between the judges kappa. RESULTS in its final version, the instrument consists of 27 items, 9 of which are from the Body functions component, 6 from Body structures, 4 from Activity and participation, and 8 from Environmental factors. CONCLUSIONS the constructed instrument has a biopsychosocial approach, considering four components of the ICF, besides presenting good validity and interobserver reliability.
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Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study. BMC Public Health 2021; 21:1064. [PMID: 34088297 PMCID: PMC8178865 DOI: 10.1186/s12889-021-11106-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Understanding the health behavior of the target population is crucial for sustainable schistosomiasis control. The aim of this study was to assess schistosomiasis related levels of knowledge, attitude, and practices of communities in lowland areas of western Ethiopia, where schistosomiasis is endemic. Methods A community-based multilevel triangulation mixed-methods design was conducted in three schistosomiasis endemic villages in the Abbey and Didessa valleys of the Benishangul Gumuz Region of Western Ethiopia, where mass drug administration (MDA) was done 30 years back and again the last 5 years. A structured survey questionnaire, in-depth interviews, focused group discussions, and observation was conducted to assess levels of knowledge, attitude, and practices related to schistosomiasis in the communities. Results Among the survey participants, 13% reported having heard of schistosomiasis, locally called Pecka (meaning worm). The majority of this 13% believe that schistosomiasis is caused by the biting of the worm Pecka, while others say drinking dirty water is the cause of infection, or they didn’t know what the cause is. A majority of respondents answered “I don’t know” to most of the questions about established knowledge of schistosomiasis. Male participants and students were more aware of schistosomiasis than their counterparts, and awareness increased with the educational level. Only one participant perceived that schistosomiasis was a serious disease. There were negative attitudes and misconceptions about the drug used in the mass treatment and many complaints were raised related to the size of the tablet and its side effects. There was no local budget and specific plan to prevent and control the disease. Local health personnel had insufficient knowledge about schistosomiasis, and the diagnosis and treatment capacities of local health institutions were poor. Conclusion In the current research area, schistosomiasis prevention and control recommendations should be redesigned to change the knowledge, attitudes, and practices of the community and local health workers. It is also necessary to have the local budget and trained manpower in order to diagnose and treat schistosomiasis locally. There is a great need to have a safer Praziquantel pediatric formulation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11106-y.
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Mazigo HD, Uisso C, Kazyoba P, Mwingira UJ. Primary health care facilities capacity gaps regarding diagnosis, treatment and knowledge of schistosomiasis among healthcare workers in North-western Tanzania: a call to strengthen the horizontal system. BMC Health Serv Res 2021; 21:529. [PMID: 34053433 PMCID: PMC8165992 DOI: 10.1186/s12913-021-06531-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background The World Health Organization (WHO) calls for schistosomiasis endemic countries to integrate schistosomiasis control measures into the primary health care (PHC) services; however, in Tanzania, little is known about the capacity of the primary health care system to assume this role. The objective of this study was to assess the capacity of the primary health care system to diagnose and treat schistosomiasis in endemic regions of north-western Tanzania. Methods A total of 80 randomly-selected primary health care facilities located in the Uyui, Geita and Ukerewe districts of North-western Tanzania participated in the study. At each facility, the in-charge clinician, or any other healthcare worker appointed by the in-charge clinician, participated in the questionnaire survey. A quantitative questionnaire installed in a Data Tool Kit software was used to collect data. Healthcare workers working at various stations (laboratory, pharmacy, data clerks, outpatient section) were interviewed. The questionnaire collected information related to healthcare workers’ knowledge about urogenital and intestinal schistosomiasis symptoms, human and material resources, laboratory services, data capture, and anti-schistosomiasis treatment availability. Results A total of 80 healthcare workers were interviewed. Bloody stool (78.3 %) and haematuria (98.7 %) were the most common symptoms of intestinal and urogenital schistosomiasis mentioned by healthcare workers. Knowledge on the chronic symptoms such as hepatosplenomegaly and hematemesis for intestinal schistosomiasis, and oliguria and dysuria for urogenital schistosomiasis, were inadequate. Laboratory services were only available in 33.8 % (27/80) of the health facilities and direct wet preparation was the most common diagnostic technique used for both urine and stool samples. All healthcare workers knew that praziquantel was the drug of choice for the treatment of schistosomiasis and the drug was available in 91.3 % (73/80) of the health facilities. Conclusions The capacity of the primary health care facilities included in the current study is inadequate in terms of diagnosis, treatment, reporting and healthcare workers’ knowledge of schistosomiasis. Thus, the integration of schistosomiasis control activities into the primary healthcare system requires these gaps to be addressed. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06531-z.
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Affiliation(s)
- Humphrey Deogratias Mazigo
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
| | - Cecilia Uisso
- National Neglected Tropical Diseases Control Programme, National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, 11101, Dar-Es-Salaam, Tanzania
| | - Paul Kazyoba
- National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, 11101, Dar-Es-Salaam, Tanzania
| | - Upendo J Mwingira
- National Neglected Tropical Diseases Control Programme, National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, 11101, Dar-Es-Salaam, Tanzania.,National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, 11101, Dar-Es-Salaam, Tanzania.,RTI International, 701 13th Street NW, 20005, Washington, DC, USA
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Quality and composition of Albendazole, Mebendazole and Praziquantel available in Burkina Faso, Côte d'Ivoire, Ghana and Tanzania. PLoS Negl Trop Dis 2021; 15:e0009038. [PMID: 33493211 PMCID: PMC7861518 DOI: 10.1371/journal.pntd.0009038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/04/2021] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
Background Even though the international combat against Neglected Tropical Diseases such as schistosomiasis or soil-transmitted helminthiases depends on reliable therapeutics, anthelminthic pharmacovigilance has been neglected on many national African drug markets. Therefore, quality and composition of Albendazole, Mebendazole and Praziquantel locally collected in Burkina Faso, Côte d’Ivoire, Ghana and Tanzania were analysed. Methods Samples of 88 different batches were obtained from randomly selected facilities. Sampling took place in Northwest Tanzania, Western Burkina Faso, Southeast Côte d’Ivoire and Southwest Ghana. Visual examination of both packaging and samples was performed according to the WHO ‘Be Aware’ tool. Products were then screened with the GPHF Minilab, consisting of tests of mass uniformity, disintegration times and thin-layer chromatography (TLC). Confirmatory tests were performed according to international pharmacopoeiae, applying assays for dissolution profiles and high-performance liquid chromatography (HPLC). Findings Despite minor irregularities, appearance of the products did not hint at falsified medicines. However, 19.6% of the brands collected in Ghana and Tanzania were not officially licensed for sale. Mass uniformity was confirmed in 53 out of 58 brands of tablets. 41 out of 56 products passed disintegration times; 10 out of the 15 failing products did not disintegrate at all. Evaluating TLC results, only 4 out of 83 batches narrowly missed specification limits, 18 batches slightly exceeded them. Not more than 46.3% (31 / 67) of the tablets assayed passed the respective pharmaceutical criteria for dissolution. HPLC findings confirmed TLC results despite shifted specification limits: 10 out of 83 tested batches contained less than 90%, none exceeded 110%. Conclusion In the four study countries, no falsified anthelminthic medicine was encountered. The active pharmaceutical ingredient was not found to either exceed or fall below specification limits. Galenic characteristics however, especially dissolution profiles, revealed great deficits. Among Neglected Tropical Diseases, schistosomiasis and soil-transmitted helminthiases are still highly prevalent and affect more than 1.5 billion people on our planet. Key players in the combat against these entities are the anthelminthic medicines Albendazole, Mebendazole and Praziquantel, which are applied in therapy and preventive chemotherapy likewise. Despite widely available in tropical regions and, particularly for both benzimidazoles, relatively cheap, their quality has been poorly monitored. By this study, we illuminated products from East (Tanzania) and West Africa (Burkina Faso, Côte d’Ivoire and Ghana) and thus extended the African map of reproducibly assessed deworming drugs. Although containing sufficient active pharmaceutical ingredient, a failure of more than 50% in galenic features significantly mars a thorough elimination of parasites from patients. Our findings emphasize the need for quality-assured products. Regular local screening, efficient and expressive confirmation of irregularities and a swift appropriate reaction by governmental authorities contribute to a successful fight against these infectious diseases. Otherwise, their sequelae pose a tremendous burden to the development and prosperity of afflicted regions–not only in heavily affected Africa but around the globe.
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Bizimana P, Polman K, Ortu G, Krit M, Nsabiyumva F, Nkeshimana A, Bijabuka U, Nibakire M, Van Geertruyden JP. Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment. Parasit Vectors 2020; 13:206. [PMID: 32317007 PMCID: PMC7175485 DOI: 10.1186/s13071-020-04076-4] [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: 12/24/2019] [Accepted: 04/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel has been rolled out in 11 endemic districts. The national programme relies on school-based surveys with kato-katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used. Methods From the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts during 2011–2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n = 11) were compared with those without (n = 34). In addition, prevalence data on intestinal schistosomiasis based on kato-katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts. Results In the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (β2014 = − 0.826, P = 0.010) and 2015 (β2015 = − 1.294, P < 0.001) and for the five-year period (β = − 0.286, P < 0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (β = − 0.087, P = 0.219). In most of the 45 sanitary districts, the low prevalence based on kato-katz in school children was confirmed by low incidence rates based on direct smears in the health centres. Conclusions National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the point-of-care circulating cathodic antigen assay are desirable.![]()
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Affiliation(s)
- Paul Bizimana
- Global Health Institute, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. .,Département des Sciences de la Santé Publique, Direction de la Formation, Institut National de Santé Publique, Bujumbura, Burundi. .,Département de Médecine Communautaire, Faculté de Médecine de Bujumbura, Université du Burundi, Bujumbura, Burundi. .,Département des Sciences de la Santé Publique, Institut Universitaire des Sciences de la Santé et de Développement Communautaire, Bujumbura, Burundi. .,Faculté de Médecine, Université de Ngozi, Ngozi, Burundi.
| | - Katja Polman
- Medical Helminthology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Section of Infectious Diseases, Department of Health Sciences, VU Amsterdam, Amsterdam, The Netherlands
| | | | - Meryam Krit
- Biostatistics and Epidemiology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Frédéric Nsabiyumva
- Département de Médecine Interne, Faculté de Médecine de Bujumbura, Université du Burundi, Bujumbura, Burundi
| | - Audace Nkeshimana
- Département des Sciences de la Santé Publique, Direction de la Formation, Institut National de Santé Publique, Bujumbura, Burundi.,Département des Sciences de la Santé Publique, Institut Universitaire des Sciences de la Santé et de Développement Communautaire, Bujumbura, Burundi
| | - Urlich Bijabuka
- Département des Sciences de la Santé Publique, Institut Universitaire des Sciences de la Santé et de Développement Communautaire, Bujumbura, Burundi
| | - Marcelline Nibakire
- Bureau de la Municipalité Sanitaire de Bujumbura, Ministère de la Santé Publique et de la Lutte contre le Sida, Bujumbura, Burundi
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Zhou XN, Leonardo L, Utzinger J, Lv S, Xu J, Willingham AL, Lu Y, McManus D, Li SZ, Venturina M, Olveda R, Bergquist R. Needs and coordination mechanism for capacity building by the RNAS .. ADVANCES IN PARASITOLOGY 2019; 105:53-68. [PMID: 31530395 DOI: 10.1016/bs.apar.2019.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
For the Regional Network on Asian Schistosomiasis and Other Helminth Zoonosis (RNAS+), capacity building with emphasis on modern technology with correspondence to traditional techniques was found to be a priority. This article summarized the actual needs of capacity building among RNAS+ member countries and the working mechanism of capacity building during the last 20 years. The needs with respect to the RNAS+ target diseases are highly correlated with the research priorities, since most problems with regard to the performance of the national disease control programme in the member countries are connected with inadequate capacity in relation to implementation of innovative research, epidemiological investigations, laboratory performance; and sociological investigations. The capacity building arranged through RNAS+ platform includes short training courses, individual training in member institutions, e.g., supervision of Ph.D./Masters students; postdoctoral training; and internship training in institutions of southeast Asia as well as in famous institutions of Europe and the United States. In the future, capacity building will focus on platform design and technical standardization aiming at fostering research capacity in the future. Moreover, new training projects, such as massive online courses (MOOC) will be explored under RNAS+ platform.
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Affiliation(s)
- Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai, China; WHO Collaborating Centre for Tropical Diseases, Shanghai, China; National Center for International Research on Tropical Diseases, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.
| | - Lydia Leonardo
- Institute of Biology, College of Science, University of the Philippines Diliman and University of the East Ramon Magsaysay Graduate School, Quezon City, Philippines
| | - Juerg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai, China; WHO Collaborating Centre for Tropical Diseases, Shanghai, China; National Center for International Research on Tropical Diseases, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai, China; WHO Collaborating Centre for Tropical Diseases, Shanghai, China; National Center for International Research on Tropical Diseases, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Yan Lu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai, China; WHO Collaborating Centre for Tropical Diseases, Shanghai, China; National Center for International Research on Tropical Diseases, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Don McManus
- QIMR Berghofer Medical Research Institute, Molecular Parasitology Laboratory, Brisbane, QLD, Australia
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Chinese Center for Tropical Diseases Research, Shanghai, China; WHO Collaborating Centre for Tropical Diseases, Shanghai, China; National Center for International Research on Tropical Diseases, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Marilu Venturina
- Asian Tropical Foundation, Filinvest Corporate City, Research Institute for Tropical Medicine Compound, Muntinlupa, Philippines
| | - Remigio Olveda
- Asian Tropical Foundation, Filinvest Corporate City, Research Institute for Tropical Medicine Compound, Muntinlupa, Philippines
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11
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Bizimana P, Ortu G, Van Geertruyden JP, Nsabiyumva F, Nkeshimana A, Muhimpundu E, Polman K. Integration of schistosomiasis control activities within the primary health care system: a critical review. Parasit Vectors 2019; 12:393. [PMID: 31391100 PMCID: PMC6686413 DOI: 10.1186/s13071-019-3652-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/01/2019] [Indexed: 01/11/2023] Open
Abstract
Background Schistosomiasis is a chronic disease linked to poverty and is widely endemic, particularly in sub-Saharan Africa. For decades, the World Health Organization has called for a larger role of the primary health care system in schistosomiasis control, and its integration within the routine activities of primary health care facilities. Here, we reviewed existing studies on the integration of schistosomiasis control measures within the primary health care system, more precisely at the health centre, and we analysed their outcomes. Methods An online search of studies published via PubMed and Embase databases was carried out until December 2017. Keywords were used to identify articles related to the integration of schistosomiasis control within the primary health care system, especially at the health centre level. Studies on integration of the following control measures were included: diagnosis and treatment, supplemented or not with (i) health education; (ii) snail control; and (iii) clean water supply and sanitation. A qualitative review was undertaken. To conclude on the effectiveness of an intervention, intermediate outcomes (knowledge, attitude and practice, coverage, access to health care) and distal outcomes (prevalence, incidence, mortality) were considered, and pre/post-intervention results were compared. Results Of 569 records found, 11 met the inclusion criteria. Studies were classified in three groups, according to the control measures they included. Integration of diagnosis and treatment, and health education in the first group resulted in an improvement of knowledge level of care providers, access to health care and health care seeking behaviour of the community. However, no positive effect was observed on the knowledge level of symptoms and modes of transmission at the community level. Most studies in the second group (with snail control as additional measure) and the third group (with clean water supply and sanitation as additional measure) showed a positive effect on schistosomiasis prevalence and incidence post-intervention, independent of the additional control measures implemented. Conclusions The results of this review suggest a positive impact of integration of schistosomiasis control within the primary health care system. However, more robust studies are needed, especially in resource-limited regions, for conclusive evidence on the effectiveness and the sustainability of this strategy.
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Affiliation(s)
- Paul Bizimana
- Global Health Institute, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. .,Département des Sciences de la Santé Publique, Direction de la Formation, Institut National de Santé Publique, Bujumbura, Burundi. .,Département de Médecine Communautaire, Faculté de Médecine de Bujumbura, Université du Burundi, Bujumbura, Burundi. .,Département des Sciences de la Santé Publique, Institut Universitaire des Sciences de la Santé et de Développement Communautaire, Bujumbura, Burundi.
| | - Giuseppina Ortu
- Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Frédéric Nsabiyumva
- Département de Médecine Interne, Faculté de Médecine de Bujumbura, Université du Burundi, Bujumbura, Burundi
| | - Audace Nkeshimana
- Département des Sciences de la Santé Publique, Direction de la Formation, Institut National de Santé Publique, Bujumbura, Burundi.,Département des Sciences de la Santé Publique, Institut Universitaire des Sciences de la Santé et de Développement Communautaire, Bujumbura, Burundi
| | - Elvis Muhimpundu
- Programme National Intégré de Lutte contre les Maladies Tropicales Négligées et la Cécité, Département des programmes de santé, Ministère de la Santé Publique et de la Lutte contre le Sida, Bujumbura, Burundi
| | - Katja Polman
- Medical Helminthology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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12
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Sacolo-Gwebu H, Chimbari M, Kalinda C. Prevalence and risk factors of schistosomiasis and soil-transmitted helminthiases among preschool aged children (1-5 years) in rural KwaZulu-Natal, South Africa: a cross-sectional study. Infect Dis Poverty 2019; 8:47. [PMID: 31202273 PMCID: PMC6571117 DOI: 10.1186/s40249-019-0561-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/28/2019] [Indexed: 02/17/2023] Open
Abstract
Background Despite efforts to control neglected tropical diseases (NTDs), schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa. Recent data suggest that these infections are prevalent among preschool aged children (PSAC) in poor communities. Evidence of schistosomiasis and soil-transmitted helminths (STH) infection patterns and prevalence among PSAC is essential for effective treatment and control programmes. The aim of the study was to determine the prevalence, intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District, South Africa. Methods A cross-sectional study was conducted among 1143 PSAC aged 1–5 years in 34 preschools and early childhood development (ECD) centres. Data on risk factors was collected using a semi-structured questionnaire. A Kruskal–Wallis test was used to compare the differences in infection intensity with age. Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status, sociodemographic, household, water and sanitation variables and hygiene practices of PSAC and their caregivers. Results We observed a low prevalence of Schistosoma haematobium (1.0%) and S. mansoni (0.9%). The prevalence of Ascaris lumbricoides (18.3%) was high compared to Trichuris trichiura (1.2%), hookworms (1.6%) and Taenia (6.4%). The odds of schistosome infection were lowest among PSAC under younger (15–24 years) caregivers (0.1, 95% CI: 0.02–0.54) and those who used tap water (0.3, 95% CI: 0.09–0.78) for domestic purposes. Schistosome infection was however higher among PSAC who bathed in river water (17.4, 95% CI: 5.96–51.04). STH infection on the other hand was lowest among PSAC who did not play in soil (0.1, 95% CI: 0.51–0.28), were from households that used tap water for domestic purposes (0.5, 95% CI: 0.27–0.80) and PSAC under the care of younger (25–35 years) caregivers (0.3, 95% CI: 0.10–0.75). The risk of STH infection was highest among PSAC who did not wash their hands with soap (3.5, 95% CI: 1.04–11.67) and PSAC whose nails were not trimmed (3.6, 95% CI: 1.75–7.26). Conclusions The findings show low prevalence and infection intensity of schistosomiasis and STH infection except A. lumbricoides among PSAC. Factors predicting schistosomiasis and STH infection among PSAC were related to caregivers’ age, educational status, water and hygiene practices. STH infection was exclusively associated with PSAC playing and handwashing habits. These findings highlight the need to include PSAC caregivers in schistosomiasis and STH prevention and control programmes. Electronic supplementary material The online version of this article (10.1186/s40249-019-0561-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hlengiwe Sacolo-Gwebu
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.
| | - Moses Chimbari
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa
| | - Chester Kalinda
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.,University of Namibia, Katima Mulilo Campus, Winela Road, Box 1096, Katima Mulilo, Namibia
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