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Odaibo AB, Komolafe AK, Olajumoke TO, Diyan KD, Aluko DA, Alagbe OA, Ajagbe OA, Olarinloye DB. Endemic status of urogenital schistosomiasis and the efficacy of a single-dose praziquantel treatment in unmapped rural farming communities in Oyo East Local Government Area, Oyo State, Nigeria. PLoS Negl Trop Dis 2024; 18:e0012101. [PMID: 38620032 PMCID: PMC11045121 DOI: 10.1371/journal.pntd.0012101] [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: 07/11/2023] [Revised: 04/25/2024] [Accepted: 03/24/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Schistosomiasis is endemic in Nigeria, and the treatment is largely concentrated on children enrolled in schools. Consequently, the coverage of non-enrolled school-aged children is often neglected. Ajagba and Awosan are two communities in Nigeria that have never had any control intervention. Hence, this survey was designed to determine the endemicity of urogenital schistosomiasis and to evaluate the efficacy of a single-dose praziquantel in the communities. METHODS Urine sample (10 mL) of each participant from Ajagba and Awosan communities was filtered through 12μm polycarbonate filter. The filter was placed on a microscope slide, and stained with a drop of 1% Lugol iodine solution. The stained slides were examined under the microscope and the numbers of S. haematobium eggs were counted. Water contact sites were searched for snail hosts and the snails collected were shed for Schistosoma cercariae. Data were analyzed using SPSS version 24.0 and the significance level was set at 95%. RESULTS The overall prevalence of infection in the Ajagba community was 45.6% with a mean intensity of 61.1 ± 144.5 eggs/10 mL of urine, while the prevalence of infection in the Awosan community was 5.7% with a mean intensity of 1.4 ± 6.8 eggs/10 mL of urine. The school-aged children had a prevalence and mean intensity of infection of 73.1% and 111.6 ± 177.9 eggs/10 mL of urine, respectively. Following treatment, women had a higher egg reduction rate than men (p = 0.0283). Bulinus globosus were found in Ajagba but not in Awosan, with 5.7% shedding Schistosoma spp, cercariae. CONCLUSION Urogenital schistosomiasis was hyperendemic in the Ajagba community, and hypoendemic in the Awosan community. The presence of Bulinus globosus supported the transmission of the schistosomiasis in the Ajagba community. Communities where schistosomiasis is still actively transmitted in Nigeria should be identified for effective intervention through the MDA programs.
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Affiliation(s)
- Alexander B. Odaibo
- Parasitology Research Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Adenike K. Komolafe
- Parasitology Research Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Taiwo O. Olajumoke
- Parasitology Research Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Kanyinsola D. Diyan
- Parasitology Research Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - Damilare A. Aluko
- Parasitology Research Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | | | - Oluwafemi A. Ajagbe
- Adeyemi Primary Health Care Center, OyoEast Local Government Health Authority, Oyo, Nigeria
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Lim RM, Arme TM, Pedersen AB, Webster JP, Lamberton PHL. Defining schistosomiasis hotspots based on literature and shareholder interviews. Trends Parasitol 2023; 39:1032-1049. [PMID: 37806786 DOI: 10.1016/j.pt.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023]
Abstract
The World Health Organization (WHO) recently proposed a new operational definition which designates communities with ≥10% prevalence of Schistosoma spp. infection as a persistent hotspot, when, after at least two rounds of high-coverage annual preventive chemotherapy, there is a lack of appropriate reduction. However, inconsistencies and challenges from both biological and operational perspectives remain, making the prescriptive use of this definition difficult. Here, we present a comprehensive analysis of the use of the term 'hotspot' across schistosomiasis research over time, including both literature searches and opinions from a range of stakeholders, to assess the utility and generalisability of the new WHO definition of a persistent hotspot. Importantly, we propose an updated definition based on our analyses.
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Affiliation(s)
- Rivka M Lim
- Institute of Evolution and Ecology, School of Biological Sciences, Ashworth Laboratories, University of Edinburgh, Edinburgh, UK.
| | - Thomas M Arme
- School of Biodiversity, One Health and Veterinary Medicine, Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, UK
| | - Amy B Pedersen
- Institute of Evolution and Ecology, School of Biological Sciences, Ashworth Laboratories, University of Edinburgh, Edinburgh, UK
| | - Joanne P Webster
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hatfield, Herts, UK
| | - Poppy H L Lamberton
- School of Biodiversity, One Health and Veterinary Medicine, Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, UK
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Chanhanga N, Mindu T, Mogaka J, Chimbari M. The Impact of Targeted Treatment and Mass Drug Administration Delivery Strategies on the Prevalence and Intensity of Schistosomiasis in School Aged Children in Africa: A Systematic Review. Infect Drug Resist 2023; 16:2453-2466. [PMID: 37138838 PMCID: PMC10150034 DOI: 10.2147/idr.s395382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/16/2023] [Indexed: 05/05/2023] Open
Abstract
Schistosomiasis is a public health problem in more than 78 countries in the world. The disease is most prevalent among children than adults due to their high exposure to infectious water sources. Various interventions such as mass drug administration (MDA), snail control, safe water provision and health education have been implemented independently or jointly to control, reduce and ultimately eliminate Schistosomiasis. This scoping review focused on studies reporting the impact of different delivery strategies of targeted treatment and MDA on the prevalence and intensity of schistosomiasis infection in school aged children in Africa. The review focused on Schistosoma haematobium and Schistosoma mansoni species. A systematic search for eligible literature from peer-reviewed articles was done from Google Scholar, Medline, PubMed and EBSCO host databases. The search yielded twenty-seven peer-reviewed articles. All articles found reported a decrease in the prevalence of schistosomiasis infection. Five studies (18.5%) reported a prevalence change below 40%, eighteen studies (66.7%) reported a change between 40% and 80%, and four studies (14.8%) reported a change above 80%. The infection intensity post-treatment was varied: twenty-four studies reported a decrease, while two studies reported an increase. The review showed that the impact of targeted treatment on the prevalence and intensity of schistosomiasis depended on the frequency at which it was offered, complementary interventions, and its uptake by the target population. Targeted treatment can significantly control the infection burden, but cannot eliminate the disease. Constant MDA programs coupled with preventative and health promotional programs are required to reach the elimination stage.
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Affiliation(s)
- Nathan Chanhanga
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Tafadzwa Mindu
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
- Correspondence: Tafadzwa Mindu, Email
| | - John Mogaka
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Moses Chimbari
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
- Research and Innovation, Great Zimbabwe University, Masvingo, Zimbabwe
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Al-Murisi WMS, Al-Mekhlafi AM, Mahdy MAK, Al-Haidari SA, Annuzaili DA, Thabit AAQ. Schistosoma mansoni and soil-transmitted helminths among schoolchildren in An-Nadirah District, Ibb Governorate, Yemen after a decade of preventive chemotherapy. PLoS One 2022; 17:e0273503. [PMID: 36006980 PMCID: PMC9409567 DOI: 10.1371/journal.pone.0273503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022] Open
Abstract
The Ministry of Public Health in Yemen continues the implementation of school and community–based preventive chemotherapy with praziquantel and albendazole for the control and elimination of schistosomiasis and soil-transmitted helminths (STH). The latest remapping to update the distribution of schistosomiasis and STH was conducted seven years ago. This study aimed to estimate the prevalence, intensity and associated risk factors of Schistosoma mansoni and STH among schoolchildren in An-Nadirah District, Ibb Governorate, Yemen. A cross-sectional study was carried out among schoolchildren aged 6–15 years in four selected schools. Biological, demographic, socioeconomic and environmental data were collected using a pre-tested questionnaire. S. mansoni and STH eggs were detected and counted by the microscopic examination of Kato-Katz fecal smears. Out of 417 schoolchildren, 17.0% were infected with at least one intestinal helminth. Prevalence of S. mansoni and STH were 6.5% and 9.1%, respectively. The most prevalent parasite among STH was Ascaris lumbricoides (8.4%). Unemployed fathers (Adjusted Odds Ratio (AOR) = 3.2; 95% Confidence interval (CI): 1.23, 8.52; P = 0.018), eating exposed food (AOR: 2.9; 95%CI = 1.24, 6.89; P = 0.014), not washing hands before eating and after defecation (AOR: 4.8; 95%CI = 1.77, 12.81; P = 0.002), and schools located close to water stream (AOR: 22.1; 95%CI = 5.12, 95.46; P <0.001) were independent risk factors of ascariasis. Swimming in ponds/stream (AOR: 3.9; 95%CI = 1.63, 9.55; P = 0.002), and schools close to the stream (AOR: 24.7; 95%CI = 3.05, 200.07; P = 0.003) were independent risk factors of intestinal schistosomiasis. The present study does not indicate a reduction in the prevalence of intestinal schistosomiasis in this rural area since the latest remapping conducted in 2014, although ascariasis was reduced by half. The prevalence of the two parasites was highly focal in areas close to the valley, suggesting a significant role of the stream in sustaining and accelerating the parasitic infection. Children practicing swimming and having poor hygienic practices were at high exposure to S. mansoni and A. lumbricoides, respectively. Water, Sanitation and Hygiene intervention, school–based health education, and snail control, in addition to mass drug administration, will help in the interruption of transmission of schistosomiasis and STH.
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Affiliation(s)
| | | | - Mohammed A. K. Mahdy
- Department of Parasitology, Faculty of Medicine, Sana’a University, Sana’a, Yemen
- Tropical Disease Research Center, Faculty of Medicine, University of Science and Technology, Sana’a, Yemen
- * E-mail:
| | - Sami Ahmed Al-Haidari
- Diseases Control & Surveillance, Ministry of Public Health and Population, Sana’a, Yemen
| | - Dhekra A. Annuzaili
- Primary Health Care Department, Ministry of Public Health and Population, Aden, Yemen
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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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Musuva RM, Odiere MR, Mwinzi PNM, Omondi IO, Rawago FO, Matendechero SH, Kittur N, Campbell CH, Colley DG. Unprotected water sources and low latrine coverage are contributing factors to persistent hotspots for schistosomiasis in western Kenya. PLoS One 2021; 16:e0253115. [PMID: 34534220 PMCID: PMC8448362 DOI: 10.1371/journal.pone.0253115] [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: 08/03/2020] [Accepted: 05/31/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Evidence indicates that whereas repeated rounds of mass drug administration (MDA) programs have reduced schistosomiasis prevalence to appreciable levels in some communities referred to here as responding villages (R). However, prevalence has remained high or less than anticipated in other areas referred to here as persistent hotspot villages (PHS). Using a cross-sectional quantitative approach, this study investigated the factors associated with sustained high Schistosoma mansoni prevalence in some villages despite repeated high annual treatment coverage in western Kenya. METHOD Water contact sites selected based on observation of points where people consistently go to collect water, wash clothes, bathe, swim or play (young children), wash cars and harvest sand were mapped using hand-held smart phones on the Commcare platform. Quantitative cross-sectional surveys on behavioral characteristics were conducted using interviewer-based semi-structured questionnaires administered to assess water usage/contact patterns and open defecation. Questionnaires were administered to 15 households per village, 50 pupils per school and 1 head teacher per school. One stool and urine sample was collected from 50 school children aged 9-12 year old and 50 adults from both responding (R) and persistent hotspot (PHS) villages. Stool was analyzed by the Kato-Katz method for eggs of S. mansoni and soil-transmitted helminths. Urine samples were tested using the point-of-care circulating cathodic antigen (POC-CCA) test for detection of S. mansoni antigen. RESULTS There was higher latrine coverage in R (n = 6) relative to PHS villages (n = 6) with only 33% of schools in the PHS villages meeting the WHO threshold for boy: latrine coverage ratio versus 83.3% in R, while no villages met the girl: latrine ratio requirement. A higher proportion of individuals accessed unprotected water sources for both bathing and drinking (68.5% for children and 89% for adults) in PHS relative to R villages. In addition, frequency of accessing water sources was higher in PHS villages, with swimming being the most frequent activity. As expected based upon selection criteria, both prevalence and intensity of S. mansoni were higher in the PHS relative to R villages (prevalence: 43.7% vs 20.2%; P < 0.001; intensity: 73.8 ± 200.6 vs 22.2 ± 96.0, P < 0.0001), respectively. CONCLUSION Unprotected water sources and low latrine coverage are contributing factors to PHS for schistosomiasis in western Kenya. Efforts to increase provision of potable water and improvement in latrine infrastructure is recommended to augment control efforts in the PHS areas.
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Affiliation(s)
- Rosemary M. Musuva
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
- * E-mail:
| | - Maurice R. Odiere
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Pauline N. M. Mwinzi
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Isaiah O. Omondi
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Fredrick O. Rawago
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
| | - Carl H. Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
| | - Daniel G. Colley
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
- Department of Microbiology, University of Georgia, Athens, Georgia, United States of America
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N'Diaye M, Keita BF, Danfakha F, Keita F, Keita G, Senghor CS, Diop B, Diawara L, Bessin F, Vernet C, Barbier D, Dewavrin P, Klotz F. A 12-year follow-up of intestinal schistosomiasis in pre-school-aged children in Assoni Village, Eastern Senegal. Infect Dis Poverty 2021; 10:89. [PMID: 34176498 PMCID: PMC8237420 DOI: 10.1186/s40249-021-00867-8] [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: 02/24/2021] [Accepted: 05/21/2021] [Indexed: 12/29/2022] Open
Abstract
Background To monitor the prevalence of schistosomiasis in school-aged children (SAC), the National Bilharzia Control Program (PNLB) was set up by the Senegalese authorities; however, geographically isolated Bedik ethnic groups that did not benefit from this program were found to be heavily infected with Schistosoma mansoni. This observation led us to implement a new schistosomiasis control program in 2008 under the aegis of the non-governmental organization “Le Kaïcedrat” and in partnership with the PNLB/WHO to monitor the prevalence of schistosomiasis in this area. In the village of Assoni, where 100% of SAC were infected, analysis of the stools of pre-school-aged children (PSAC) showed that they were massively infected, so we decided to focus our program on them. Methods From 2008 to 2020, we (i) monitored the prevalence of S. mansoni in PSAC in Assoni using double-stool smear preparation, (ii) treated the infected PSAC with a standard dose of praziquantel 40 mg/kg, (iii) ran educational campaigns each year in the village, and (iv) built latrines to improve sanitation and reduce schistosomiasis transmission. Linear regression was used to examine the trend in the annual schistosomiasis prevalence and a two-sided of Chi-squared test was used to compare prevalence between the different age groups of PSAC. Results We observed an extremely high prevalence of schistosomiasis (78%) in PSAC before implementation of the program in 2008. Contamination occurred in very young children, as 64.3% of children under 2 years old were infected. Moreover, prevalence increased with age and reached 96.8% in children 4 to < 6 years old. Our annual interventions in Assoni Village raised awareness among villagers that water bodies were areas of significant infestation, allowed the building of 88 latrines and led to a decrease in prevalence in PSAC as only 11% of these children were infected in 2020. Conclusion Our study allowed Assoni to be the first village in Senegal to treat PSAC since 2014, but only on an individual basis. It also shows that schistosomiasis is difficult to eradicate and that multi-sectorial actions are required to keep its prevalence at a low level. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00867-8.
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Affiliation(s)
- Monique N'Diaye
- Normandy University, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancer Prevention and Treatment), BioTICLA Axis (Biology and Innovative Therapeutics for Ovarian Cancers), Caen, France. .,Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France. .,NGO Le Kaïcedrat, Paris, France.
| | | | | | - Fili Keita
- Health Post, Bandafassi, Kedougou District, Dakar, Senegal
| | - Gérald Keita
- Health Post, Bandafassi, Kedougou District, Dakar, Senegal
| | | | - Bocar Diop
- Programme National de Lutte Contre Les Bilharzioses (PNLB), Ministry of Health, Dakar, Senegal
| | - Lamine Diawara
- Neglected Tropical Diseases, Inter-Country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - François Bessin
- Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France.,NGO Le Kaïcedrat, Paris, France
| | - Charlotte Vernet
- Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France.,NGO Le Kaïcedrat, Paris, France
| | - Dominique Barbier
- Faculty of Pharmaceutical Sciences, Department of Biodiversity Health, Microbiology, Biotechnology, UNICAEN, Caen, France.,NGO Le Kaïcedrat, Paris, France
| | | | - Francis Klotz
- NGO Le Kaïcedrat, Paris, France.,Military Hospital Val-de-Grâce, Paris, France
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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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Woldeyohannes D, Sahiledengle B, Tekalegn Y, Hailemariam Z. Prevalence of Schistosomiasis (S. mansoni and S. haematobium) and its association with gender of school age children in Ethiopia: A systematic review and meta-analysis. Parasite Epidemiol Control 2021; 13:e00210. [PMID: 33842698 PMCID: PMC8020476 DOI: 10.1016/j.parepi.2021.e00210] [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: 01/04/2020] [Revised: 01/12/2021] [Accepted: 03/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Schistosomiasis (S. mansoni and S. haematobium) is an important neglected tropical disease in sub-Saharan Africa including Ethiopia. In Ethiopia, Schistosomiasis has been prioritized as neglected tropical disease and remained among major public health burden on school age children of the country. Few studies conducted on the association between prevalence of Schistosomiasis and gender of school age children have inconclusive finding about the association between these two variables. Therefore, this systematic review and meta-analysis was done to determine the pooled prevalence of Schistosomiasis and its association with gender of school age children in Ethiopia. METHODS In this systematic review and meta-analysis, databases such as: Medline/PubMed, EMBASE, CINAHL, Cochrane Central library, Google Scholar, and HINARI were systematically searched. STATA version 14 was used to estimate pooled prevalence of Schistosomiasis using random effects model with 95% confidence interval. The results were presented by using forest plot and statistical heterogeneity was checked by using the Cochran Q test (chi-squared statistic), I2 test statistic and by visual examination of the forest plot. RESULTS From the total of 427 studies identified for this review, 50 studies were included in the final analysis. The analysis noted that pooled prevalence of Schistosomiasis in Ethiopia was 28.78% (95% CI: 23.81, 33.74). The subgroup analysis indicated that extreme variability was observed in the prevalence of Schistosomiasis across the regions of the country. The highest (39.77%) prevalence of Schistosomiasis was reported from the southern region, whereas the lowest (14.95%) prevalence of Schistosomiasis was reported from Afar region. Male school age children were 58% more likely infected with Schistosomiasis than female school age children in Ethiopia (OR: 1.58, 95% CI: 1.33, 1.83). CONCLUSIONS The Prevalence of Schistosomiasis was higher than the 2018 report of the Ethiopian federal ministry of health. The prevalence of Schistosomiasis was predominant among male gender of the school age children. Therefore, sustainable control of Schistosomiasis requires the approaches that must go beyond current deworming program. Complementary prevention strategies including health education, safe water and adequate sanitary facilities provision should be simultaneously implemented. The underlining causes of variation in risk factors of Schistosomiasis among males and females should be further studied.
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Affiliation(s)
- Demelash Woldeyohannes
- Department of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia
| | - Biniaym Sahiledengle
- Department of Public Health, School of Health Science, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, School of Health Science, Goba Referral Hospital, Madda Walabu University, Bale Goba, Ethiopia
| | - Zeleke Hailemariam
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Ejike CU, Oluwole AS, Omitola OO, Bayegun AA, Shoneye IY, Akeredolu-Ale BI, Idowu OA, Mafiana CF, Ekpo UF. Schisto and Ladders version 2: a health educational board game to support compliance with school-based mass drug administration with praziquantel - a pilot study. Int Health 2021; 13:281-290. [PMID: 32918827 PMCID: PMC8079310 DOI: 10.1093/inthealth/ihaa057] [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: 05/03/2020] [Revised: 06/09/2020] [Accepted: 08/14/2020] [Indexed: 01/03/2023] Open
Abstract
Background We redesigned the Schisto and Ladders health educational board game and evaluated its potential to encourage compliance to school-based mass drug administration with praziquantel. Methods Two hundred and seventy-five children from six schools who rejected praziquantel treatment were divided into intervention and control groups. Before the intervention, preassessment interviews were conducted on their knowledge about praziquantel treatment and schistosomiasis. The Schisto and Ladders version 2 game as an intervention, and the Snakes and Ladders game as a control, were played for 6 mo. Postassessment interviews, including focus group discussions, were conducted. Results At preassessment, 0/98 (0.0%) children in the intervention group had heard of praziquantel compared with 2/177 (1.1%) in the control group. Similarly, 0/98 (0.0%) children in the intervention group did not know that praziquantel does not kill compared with 4/177 (2.3%) in the control group. The postassessment showed that 53/78 (67.9%) in the intervention group were aware of praziquantel compared with 2/177 (1.1%) in the control group (p=0.000). Similarly, 53 (69.7%) in the intervention group knew about the safety of praziquantel compared with 0/177 (0.0%) in the control group (p=0.000). Sixty-four children (65.3%) from the intervention group sought praziquantel treatment after the trial. Conclusions Schisto and Ladders version 2 is a useful sensitisation tool with which to encourage compliance to praziquantel treatment in schools.
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Affiliation(s)
| | - Akinola Stephen Oluwole
- COUNTDOWN implementation research Consortium, Ogun State.,Sightsavers Nigeria Country Office, 1 Golf Course Road, PO Box 503, Kaduna State, Nigeria
| | - Olaitan Olamide Omitola
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | | | | | | | | | - Chiedu Felix Mafiana
- Research Administration and Advancement, National Open University of Nigeria, Abuja, Nigeria
| | - Uwem Friday Ekpo
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
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11
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Anderson LC, Loker ES, Wearing HJ. Modeling schistosomiasis transmission: the importance of snail population structure. Parasit Vectors 2021; 14:94. [PMID: 33536054 PMCID: PMC7860629 DOI: 10.1186/s13071-021-04587-8] [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: 04/14/2020] [Accepted: 01/08/2021] [Indexed: 12/14/2022] Open
Abstract
Background Schistosomiasis is a neglected tropical disease endemic in 54 countries. A major Schistosoma species, Schistosoma mansoni, is sustained via a life cycle that includes both human and snail hosts. Mathematical models of S. mansoni transmission, used to elucidate the complexities of the transmission cycle and estimate the impact of intervention efforts, often focus primarily on the human host. However, S. mansoni incurs physiological costs in snails that vary with the age of the snail when first infected. Snail demography and the age of snail infection could thus affect the force of infection experienced by humans, which is frequently used to predict the impact of various control strategies. Methods To address how these snail host and parasite interactions influence model predictions, we developed deterministic models of schistosomiasis transmission that include varying complexity in the snail population age structure. Specifically, we examined how model outputs, such as schistosome prevalence in human and snail populations, respond to the inclusion of snail age structure. Results Our models suggest that snail population age structure modifies the force of infection experienced by humans and the relationship between snail infection prevalence and corresponding human infection prevalence. There are significant differences in estimated snail infection, cercarial density and mean worm burden between models without snail population dynamics and those with snail populations, and between models with a homogeneous snail population and those with age stratification. The variation between finely age-stratified snail populations and those grouped into only juvenile and adult life stages is, however, minimal. Conclusions These results indicate that including snails and snail age structure in a schistosomiasis transmission model alters the relationship between snail and human infection prevalence. This highlights the importance of accounting for a heterogeneous intermediate host population in models of schistosomiasis transmission where the impact of proposed control measures is being considered.![]()
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Affiliation(s)
- Larissa C Anderson
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Eric S Loker
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Helen J Wearing
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA.,Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, 87131, USA
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12
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Assaré RK, N’Tamon RN, Bellai LG, Koffi JA, Mathieu TBI, Ouattara M, Hürlimann E, Coulibaly JT, Diabaté S, N’Goran EK, Utzinger J. Characteristics of persistent hotspots of Schistosoma mansoni in western Côte d'Ivoire. Parasit Vectors 2020; 13:337. [PMID: 32616074 PMCID: PMC7333430 DOI: 10.1186/s13071-020-04188-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/13/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Preventive chemotherapy with praziquantel is the cornerstone of schistosomiasis control. However, in some social-ecological settings, the prevalence and/or intensity of Schistosoma infection does not lower meaningfully despite multiple rounds of preventive chemotherapy, a phenomenon termed persistent hotspot (PHS). We assessed the characteristics of PHS in a Schistosoma mansoni-endemic area of Côte d'Ivoire. METHODS In October 2016, a cross-sectional survey was conducted in 14 schools in the western part of Côte d'Ivoire, one year after multiple rounds of preventive chemotherapy. In each school, 50 children aged 9-12 years provided two stool samples and one urine sample. Stool samples were subjected to triplicate Kato-Katz thick smears for S. mansoni diagnosis. Urine samples were examined by a filtration method for S. haematobium eggs. PHS was defined as failure to achieve a reduction in the prevalence of S. mansoni infection of at least 35% and/or a reduction of infection intensity of at least 50%. Six schools underwent more detailed investigations, including a questionnaire survey for demographic characteristics and a malacological survey. RESULTS In the six schools subjected to detailed investigations, the overall prevalence of S. mansoni and S. haematobium was 9.5% and 2.6%, respectively. Four schools were classified as PHS. The S. mansoni prevalence in the four PHS was 10.9% compared to 6.6% in the remaining two schools. The S. mansoni infection intensity, expressed as arithmetic mean eggs per gram of stool (EPG) among infected children, was 123.8 EPG in PHS and 18.7 EPG in the other two schools. Children bathing in open freshwater bodies were at higher odds of S. mansoni infection (odds ratio: 4.5, 95% confidence interval: 1.6-12.6). A total of 76 human-water contact sites (53 in PHS and 23 in the other schools) were examined and 688 snails were collected, including potential intermediate host snails of Schistosoma (Biomphalaria pfeifferi, Bulinus forskalii, Bu. globosus and Bu. truncatus). CONCLUSION Children in PHS schools bathed more frequently in open freshwater bodies, and hence, they are more exposed to Schistosoma transmission. Our findings call for an integrated control approach, complementing preventive chemotherapy with other interventions, particularly in PHS settings.
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Affiliation(s)
- Rufin K. Assaré
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire
- Swiss Tropical and Public Health Institute, CH-4002, Basel, Switzerland
- University of Basel, CH-4003, Basel, Switzerland
| | - Roméo N. N’Tamon
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire
| | - Louise G. Bellai
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire
- Swiss Tropical and Public Health Institute, CH-4002, Basel, Switzerland
- University of Basel, CH-4003, Basel, Switzerland
| | - Judicaelle A. Koffi
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire
- Unité de Formation et de Recherche Science de l’Homme et de la Société, Université Félix Houphouët-Boigny, 08 BP 865, Abidjan 08, Côte d’Ivoire
| | - Tra-Bi I. Mathieu
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, CH-4002, Basel, Switzerland
- University of Basel, CH-4003, Basel, Switzerland
| | - Jean T. Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire
- Swiss Tropical and Public Health Institute, CH-4002, Basel, Switzerland
- University of Basel, CH-4003, Basel, Switzerland
| | - Salia Diabaté
- Centre d’Entomologie Médicale et Vétérinaire, 27 BP 529, Abidjan 27, Côte d’Ivoire
| | - Eliézer K. N’Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 582, Abidjan 22, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4002, Basel, Switzerland
- University of Basel, CH-4003, Basel, Switzerland
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13
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Olliaro PL, Coulibaly JT, Garba A, Halleux C, Keiser J, King CH, Mutapi F, N’Goran EK, Raso G, Scherrer AU, Sousa-Figueiredo JC, Stete K, Utzinger J, Vaillant MT. Efficacy and safety of single-dose 40 mg/kg oral praziquantel in the treatment of schistosomiasis in preschool-age versus school-age children: An individual participant data meta-analysis. PLoS Negl Trop Dis 2020; 14:e0008277. [PMID: 32569275 PMCID: PMC7360067 DOI: 10.1371/journal.pntd.0008277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 07/14/2020] [Accepted: 04/08/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Better knowledge of the efficacy and safety of single-dose 40 mg/kg oral praziquantel in preschool-age children is required, should preventive chemotherapy programs for schistosomiasis be expanded to include this age group. METHODOLOGY We analyzed individual participant-level data from 16 studies (13 single-arm or cohort studies and three randomized trials), amounting to 683 preschool-age children (aged <6 years) and 2,010 school-age children (aged 6-14 years). Children had a documented Schistosoma mansoni or S. haematobium infection, were treated with single 40 mg/kg oral praziquantel, and assessed between 21 and 60 days post-treatment. Efficacy was expressed as arithmetic mean and individual egg reduction rate (ERR) and meta-analyzed using general linear models and mixed models. Safety was summarized using reported adverse events (AEs). PRINCIPAL FINDINGS Preschool-age children had significantly lower baseline Schistosoma egg counts and more losses to follow-up compared to school-age children. No difference in efficacy was found between preschool- and school-age children using a general linear model of individual-participant ERR with baseline log-transformed egg count as covariate and study, age, and sex as fixed variables, and a mixed model with a random effect on the study. Safety was reported in only four studies (n = 1,128 individuals); few AEs were reported in preschool-age children 4 and 24 hours post-treatment as well as at follow-up. Three severe but not serious AEs were recorded in school-age children during follow-up. CONCLUSIONS/SIGNIFICANCE There is no indication that single-dose 40 mg/kg oral praziquantel would be less efficacious and less safe in preschool-age children compared to school-age children, with the caveat that only few randomized comparisons exist between the two age groups. Preventive chemotherapy might therefore be extended to preschool-age children, with proper monitoring of its efficacy and safety.
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Affiliation(s)
- Piero L. Olliaro
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Jean T. Coulibaly
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Amadou Garba
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Christine Halleux
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
- Schistosomiasis Consortium for Operational Research and Evaluation, University of Georgia, Athens, Georgia, United States of America
| | - Francisca Mutapi
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), Ashworth Laboratories, University of Edinburgh, Edinburgh, United Kingdom
- Institute of Immunology and Infection Research, Centre for Immunity, Infection and Evolution, School of Biological Sciences, Ashworth Laboratories, University of Edinburgh, Edinburgh, United Kingdom
| | - 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
| | - Giovanna Raso
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Alexandra U. Scherrer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - José Carlos Sousa-Figueiredo
- Department of Life Sciences, Natural History Museum, Wolfson Wellcome Biomedical Laboratories, London, United Kingdom
- Centro de Investigação em Saúde de Angola, Hospital Provincial, Bengo, Angola
| | - Katarina Stete
- Division of Infectious Diseases, Department of Medicine II, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Michel T. Vaillant
- Centre of Competences for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
- * E-mail:
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14
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Amoah AS, Hoekstra PT, Casacuberta-Partal M, Coffeng LE, Corstjens PLAM, Greco B, van Lieshout L, Lim MD, Markwalter CF, Odiere MR, Reinhard-Rupp J, Roestenberg M, Stothard R, Tchuem Tchuenté LA, de Vlas SJ, van Dam GJ. Sensitive diagnostic tools and targeted drug administration strategies are needed to eliminate schistosomiasis. THE LANCET. INFECTIOUS DISEASES 2020; 20:e165-e172. [PMID: 32595046 DOI: 10.1016/s1473-3099(20)30254-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/03/2020] [Accepted: 03/23/2020] [Indexed: 11/29/2022]
Abstract
Although preventive chemotherapy has been instrumental in reducing schistosomiasis incidence worldwide, serious challenges remain. These problems include the omission of certain groups from campaigns of mass drug administration, the existence of persistent disease hotspots, and the risk of recrudescent infections. Central to these challenges is the fact that the diagnostic tools currently used to establish the burden of infection are not sensitive enough, especially in low-endemic settings, which results in underestimation of the true prevalence of active Schistosoma spp infections. This central issue necessitates that the current schistosomiasis control strategies recommended by WHO are re-evaluated and, possibly, adapted. More targeted interventions and novel approaches have been used to estimate the prevalence of schistosomiasis, such as establishing infection burden by use of precision mapping, which provides high resolution spatial information that delineates variations in prevalence within a defined geographical area. Such information is instrumental in guiding targeted intervention campaigns. However, the need for highly accurate diagnostic tools in such strategies is a crucial factor that is often neglected. The availability of highly sensitive diagnostic tests also opens up the possibility of applying strategies of sample pooling to reduce the cost of control programmes. To interrupt the transmission of, and eventually eliminate, schistosomiasis, better local targeting of preventive chemotherapy, in combination with highly sensitive diagnostic tools, is crucial.
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Affiliation(s)
- Abena S Amoah
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands; Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; Malawi Epidemiology and Intervention Research Unit, Chilumba, Malawi
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands.
| | | | - Luc E Coffeng
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Mark D Lim
- Global Health Division, The Bill & Melinda Gates Foundation, Seattle, WA, USA; Global Public Health Programs, American Society for Microbiology, Washington DC, USA
| | - Christine F Markwalter
- Department of Chemistry, Vanderbilt University, Nashville, TN, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Maurice R Odiere
- Neglected Tropical Diseases Unit, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Meta Roestenberg
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands; Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | | | - Louis-Albert Tchuem Tchuenté
- Laboratory of Parasitology and Ecology, University of Yaoundé I, Yaoundé, Cameroon; Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Sake J de Vlas
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
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15
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Kittur N, King CH, Campbell CH, Kinung'hi S, Mwinzi PNM, Karanja DMS, N'Goran EK, Phillips AE, Gazzinelli-Guimaraes PH, Olsen A, Magnussen P, Secor WE, Montgomery SP, Utzinger J, Walker JW, Binder S, Colley DG. Persistent Hotspots in Schistosomiasis Consortium for Operational Research and Evaluation Studies for Gaining and Sustaining Control of Schistosomiasis after Four Years of Mass Drug Administration of Praziquantel. Am J Trop Med Hyg 2020; 101:617-627. [PMID: 31287046 PMCID: PMC6726953 DOI: 10.4269/ajtmh.19-0193] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Control of schistosomiasis presently relies largely on preventive chemotherapy with praziquantel through mass drug administration (MDA) programs. The Schistosomiasis Consortium for Operational Research and Evaluation has concluded five studies in four countries (Côte d’Ivoire, Kenya, Mozambique, and Tanzania) to evaluate alternative approaches to MDA. Studies involved four intervention years, with final evaluation in the fifth year. Mass drug administration given annually or twice over 4 years reduced average prevalence and intensity of schistosome infections, but not all villages that were treated in the same way responded similarly. There are multiple ways by which responsiveness to MDA, or the lack thereof, could be measured. In the analyses presented here, we defined persistent hotspots (PHS) as villages that achieved less than 35% reduction in prevalence and/or less than 50% reduction in infection intensity after 4 years of either school-based or community-wide MDA, either annually or twice in 4 years. By this definition, at least 30% of villages in each of the five studies were PHSs. We found no consistent relationship between PHSs and the type or frequency of intervention, adequacy of reported MDA coverage, and prevalence or intensity of infection at baseline. New research is warranted to identify PHSs after just one or a few rounds of MDA, and new adaptive strategies need to be advanced and validated for turning PHSs into responder villages.
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Affiliation(s)
- Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Safari Kinung'hi
- National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania
| | - Pauline N M Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Diana M S Karanja
- Neglected Tropical Diseases Branch, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Eliezer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Anna E Phillips
- Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, United Kingdom
| | - Pedro H Gazzinelli-Guimaraes
- Department of Infectious Disease Epidemiology, Schistosomiasis Control Initiative, Imperial College London, London, United Kingdom
| | - Annette Olsen
- Section for Parasitology and Aquatic Pathobiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pascal Magnussen
- Centre for Medical Parasitology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - W Evan Secor
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan P Montgomery
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Juerg Utzinger
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Joseph W Walker
- Odum School of Ecology, University of Georgia, Athens, Georgia.,Department of Epidemiology, College of Public Health, University of Georgia, Athens, Georgia
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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16
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Mutombo N, Landouré A, Man WY, Fenwick A, Dembélé R, Sacko M, Keita AD, Traoré MS, Webster JP, McLaws ML. The association between child Schistosoma spp. infections and morbidity in an irrigated rice region in Mali: A localized study. Acta Trop 2019; 199:105115. [PMID: 31356787 PMCID: PMC6995995 DOI: 10.1016/j.actatropica.2019.105115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/29/2019] [Accepted: 07/25/2019] [Indexed: 11/29/2022]
Abstract
Background Schistosomiasis is one of the neglected tropical diseases endemic to Mali. There has been insufficient investigation of the morbidity burden in highly endemic irrigated rice areas with the ongoing mass drug administration with praziquantel. In February 2005, a year after an initial mass drug administration in 2004, we performed the first cross-sectional survey of schistosomiasis in the Kokry-Bozo village in the Office du Niger rice irrigation region. In the fourteen years since this survey, there has been almost no research into schistosomiasis morbidity in Mali due to lack of funding. Therefore, the 2005 survey supplies near-baseline data for any future research into the treatment impacts in the area. Methods One hundred and ninety-four children aged 6–14 years from two schools were assessed for bladder pathology by ultrasound, and for anaemia and micro-haematuria by laboratory tests. Schistosoma eggs were examined microscopically in fresh stool and urine samples. Multivariate logistic regression analysis quantified the association of Schistosoma infections with anaemia, bladder pathology and micro-haematuria. Akaike’s information criterion was used to test the assumption of linear effects of infection intensity classes and used to compare across models. Results The overall prevalence of schistosomiasis in 189 school children was 97%; 17% (33/189) had a single infection (S. mansoni,13%, or S. haematobium, 4%) and 80% (156/189) were co-infected with S. mansoni and S. haematobium. The overall prevalence of S. mansoni with light infection was 27% (53/194), moderate infection was 24% (47/194) and heavy infection was 42% (81/194). Of the 194 of children investigated for S. haematobium 59% (114/194) had light infection and 26% (50/194) had heavy infection. No hookworm eggs were detected. The level of abnormal bladder pathology was 18% (35/189) with the highest found in 10–14 year old children. The prevalence of anaemia was 91% (172/189) and was twice as likely to be associated (OR 2.0, 95% CI 1.1–3.9) with S. mansoni infections than in children without infection. As infection intensity with S. mansoni increased the risk of anaemia (OR 2.0, 95% CI 1.1–3.9) also increased. As infection intensity with S. haematobium increased bladder pathology (OR 2.4, 95%CI 1.3–4.5), haematuria (OR 6.7, 95%CI 3.3–13.6) and micro-haematuria increased (OR 2.4, 95%CI 1.3–4.5). Conclusion Our research contributes an important micro-geographical assessment of the heavy burden of schistosomiasis and associated morbidity in children who live in the rice irrigation regions. Our literature review found that there has been very limited research conducted on the impact of the treatment to control morbidity in the ON. Therefore, there is a need to do a comparable, but more extensive, study to identify any changes in morbidity and to indicate current requirements for the control programme. Our results from 2005 called for routine integration of iron supplementation, food fortification and diet diversification into the deworming program.
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Affiliation(s)
- Ngoy Mutombo
- Epidemiology and Hospital Infection Prevention and Control, School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Australia; Centre for Biomedical Research, Burnet Institute, Australia
| | - Aly Landouré
- Institut National de Recherche en Santé Publique (INRSP), National Schistosomiasis Control Program, Bamako, Mali
| | - Wing Young Man
- Epidemiology and Hospital Infection Prevention and Control, School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Australia
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Robert Dembélé
- Programme National de Lutte Contre la Schistosomiase, Ministère de la Santé, Bamako, Mali
| | - Moussa Sacko
- Institut National de Recherche en Santé Publique (INRSP), National Schistosomiasis Control Program, Bamako, Mali
| | - Adama D Keita
- Service de la Radiologie, Hôpital National du Point G, Bamako, Mali
| | - Mamadou S Traoré
- Institut National de Recherche en Santé Publique (INRSP), National Schistosomiasis Control Program, Bamako, Mali
| | - Joanne P Webster
- Centre for Emerging, Endemic and Exotic Diseases, Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, AL9 7TA, UK
| | - Mary-Louise McLaws
- Epidemiology and Hospital Infection Prevention and Control, School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Australia.
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Differential impact of mass and targeted praziquantel delivery on schistosomiasis control in school-aged children: A systematic review and meta-analysis. PLoS Negl Trop Dis 2019; 13:e0007808. [PMID: 31603895 PMCID: PMC6808504 DOI: 10.1371/journal.pntd.0007808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/23/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023] Open
Abstract
Background Schistosomiasis is a widespread public health concern in the poorest regions of the world. The principal control strategy is regular praziquantel administration to school-aged children in endemic areas. With calls for the elimination of schistosomiasis as a public health problem, expanding praziquantel delivery to all community members has been advocated. This systematic review and meta-analysis compares the impact of community-wide and child-targeted praziquantel distribution on schistosomiasis prevalence and intensity in school-aged children. Methodology/Principal findings We searched MEDLINE, Embase and Web of Science to identify papers that reported schistosome prevalence before and after praziquantel administration, either to children only or to all community members. Extracted data included Schistosoma species, drug administration strategy, number of treatment rounds, follow-up interval and prevalence and intensity before and after treatment. We used inverse variance weighted generalised linear models to examine the impact of mass versus targeted drug administration on prevalence reduction, and weighted boxplots to examine the impact on infection intensity reduction. This study is registered with PROSPERO, number CRD42018095377. In total, 34 articles were eligible for systematic review and 28 for meta-analysis. Schistosoma mansoni was reported in 20 studies; Schistosoma haematobium in 19 studies, and Schistosoma japonicum in two studies. Results of generalised linear models showed no detectable difference between mass and targeted treatment strategies on prevalence reduction in school-aged children for S. mansoni (odds ratio 0.47, 95%CI 0.13–1.68, p = 0.227) and S. haematobium (0.41, 95%CI 0.06–3.03, p = 0.358). Box plots also showed no apparent differences in intensity reduction between the two treatment strategies. Conclusions/Significance The results of this meta-analysis do not support the hypothesis that community-wide treatment is more effective than targeted treatment at reducing schistosomiasis infections in children. This may be due to the relatively small number of included studies, insufficient treatment coverage, persistent infection hotspots and unmeasured confounders. Further field-based studies comparing mass and targeted treatment are required. Schistosomiasis is a neglected tropical disease, caused by parasitic worms, that affects more than 143 million people worldwide. Chronic infections can lead to significant morbidity including kidney damage, anaemia, malnutrition, infertility and growth impairment. School-aged children between six and 15 years are often targeted for regular treatment with praziquantel in large-scale drug delivery programs, because they suffer a disproportionate burden of morbidity. On the other hand, a mass drug delivery strategy that treats all members of the community has been suggested in a move towards elimination of schistosomiasis as a public health problem. In this systematic review, we assess the impact of community-wide versus children-only praziquantel distribution in reducing schistosomiasis infections in school-aged children. We did not detect a difference between mass and targeted treatment strategies, possibly due to factors including insufficient treatment coverage and persistent sources of reinfection. Addressing these factors may assist in optimising control programs.
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Cha S, Elhag MS, Lee YH, Cho DS, Ismail HAHA, Hong ST. Epidemiological findings and policy implications from the nationwide schistosomiasis and intestinal helminthiasis survey in Sudan. Parasit Vectors 2019; 12:429. [PMID: 31488219 PMCID: PMC6728938 DOI: 10.1186/s13071-019-3689-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 08/28/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The World Health Assembly endorsed the WHO Neglected Tropical Disease (NTD) Roadmap in 2013, in which NTDs were suggested as tracers of equity in the assessment of progress towards the Sustainable Development Goals. Nationwide surveys were undertaken in all 18 states of Sudan to identify the geographical distribution and to estimate the prevalence and intensity of schistosomiasis and other intestinal helminthiases from December 2016 to March 2017. METHODS We used two-stage random sampling. Each district was subdivided into one to three different ecological zones (EZs) based on proximity to water bodies. Probability-proportional-to-size sampling was used to select schools from each EZ. We estimated schistosomiasis and intestinal helminthiasis prevalence by the centrifugation method and Kato-Katz smears. Multi-level mixed-effect models were used to investigate the relationship between the prevalence of infections and risk factors, including improved water or latrine status at the household or school level. We estimated the cost-effectiveness of a one-time mass drug administration (MDA) intervention with 75% coverage at the district and EZ levels. RESULTS A total of 105,167 students from 1772 schools were surveyed. The overall egg-positive rates were: Schistosoma haematobium, 5.2%; S. mansoni, 0.06%; and intestinal helminths, 5.47%. Severe endemic areas were concentrated in East and South Darfur States. Children living in a house or attending schools with an improved latrine were less likely to be infected with schistosomiasis than those without a latrine (adjusted odds ratio, aOR: 0.45, 95% confidence interval, CI: 0.41-0.51 and aOR: 0.75, 95% CI: 0.70-0.81 at the household or the school levels, respectively). Open defecation was strongly associated with schistosomiasis (aOR: 1.50, 95% CI: 1.35-1.66). In community-wide mass treatment at the district level with an 8% threshold for schistosomiasis, 2.2 million people would not benefit from MDA interventions with 75% coverage despite high endemicity, whilst 1.7 million people would receive the MDA intervention unnecessarily. EZ-level MDA was estimated to be more cost-effective than district-level administration under all circumstances. CONCLUSIONS Our findings provide updated prevalence figures to guide preventive chemotherapy programmes for schistosomiasis and intestinal helminthiasis in Sudan. Schistosomiasis was found to be common among the inhabitants of fragile and conflict-affected areas. In addition, we found that MDA interventions would be more cost-effective at the sub-district level than at the district level, and there was a strong association between schistosomiasis prevalence and latrine status, at both the household and school levels. This study will help the Sudanese government and its neighbouring countries develop adequate control and elimination strategies.
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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 South Korea
- Korea Association of Health Promotion, Gangseo-gu, Seoul, 07653 South Korea
- Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Mousab Siddig Elhag
- Communicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum, Sudan
| | - Young-Ha Lee
- Department of Infection Biology and Department of Medical Science, Chungnam National University School of Medicine, Daejeon, 35015 South Korea
| | - Dae-Seong Cho
- Korea Association of Health Promotion, Gangseo-gu, Seoul, 07653 South Korea
| | | | - Sung-Tae Hong
- Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, Daehak-ro, Seoul, 03080 South Korea
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19
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Obonyo CO, Muok EMO, Were V. Biannual praziquantel treatment for schistosomiasis. Hippokratia 2019. [DOI: 10.1002/14651858.cd013412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Charles O Obonyo
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
| | - Erick MO Muok
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
| | - Vincent Were
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
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Bah YM, Paye J, Bah MS, Conteh A, Saffa S, Tia A, Sonnie M, Veinoglou A, Hodges MH, Zhang Y. Schistosomiasis in School Age Children in Sierra Leone After 6 Years of Mass Drug Administration With Praziquantel. Front Public Health 2019; 7:1. [PMID: 30809516 PMCID: PMC6379326 DOI: 10.3389/fpubh.2019.00001] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/03/2019] [Indexed: 01/04/2023] Open
Abstract
Historic data and baseline surveys showed schistosomiasis as highly/moderately endemic in 7 of 14 districts in Sierra Leone, justifying annual/biennial mass drug administration (MDA) with praziquantel. MDA commenced in 2009 and reported treatment coverage had been above the World Health Organization recommended 75% of target population. Assessment in 2012 showed significant reduction in infection. In 2016, another national school-based survey was conducted to evaluate the progress. Two schools from each category (high, moderate or low) of endemic communities in each MDA district and five schools in non-MDA districts were selected. Fifty children (25 boys and 25 girls) aged 9-14 years were randomly selected per school. Parasitological examination of 1,980 stool and 1,382 urine samples were conducted. Overall Schistosoma mansoni prevalence in the seven MDA districts decreased to 20.4% (95% CI: 18.7-22.3%) in 2016 from 42.2% (95% CI: 39.8-44.5%) at baseline (p < 0.0001). Mean overall S. mansoni intensity of infection reduced to 52.8 epg (95% CI: 43.2-62.4 epg) in 2016 from 100.5 epg (95% CI: 88.7-112.3 epg) at baseline (p < 0.001). The prevalence of Schistosoma haematobium in the five MDA districts that had baseline prevalence data decreased to 2.2% (95% CI: 1.5-3.1%) in 2016 from 18.3% (95% CI: 16.3-20.5%) at baseline (p < 0.0001). Mean overall intensity of infection increased to 1.12 e/10 ml (95% CI: 0.55-0.1.70 e/10 ml) in 2016 compared to 0.47 e/10 ml (95% CI: 0.16-0.78 e/10 ml) in 2012 (p < 0.05) (no baseline data). No district was highly endemic in 2016 compared to three at baseline and there was no significant difference in prevalence or intensity of infection by sex for both species. This survey illustrated the significant progress made in controlling schistosomiasis in Sierra Leone. The fact that prevalence and intensity of infection showed an increase from the 2010 level suggested a detrimental effect of missing MDA due to the Ebola toward schistosomiasis control. The national program needs to continue the treatment and adopt a comprehensive approach including water, hygiene, and sanitation measures to achieve control and elimination of schistosomiasis.
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Affiliation(s)
- Yakuba M. Bah
- Neglected Tropical Disease Program, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Jusufu Paye
- Helen Keller International, Freetown, Sierra Leone
| | | | - Abdulai Conteh
- Neglected Tropical Disease Program, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Sam Saffa
- Neglected Tropical Disease Program, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Alie Tia
- Neglected Tropical Disease Program, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Amy Veinoglou
- Headquarters, Helen Keller International, New York, NY, United States
| | | | - Yaobi Zhang
- Regional Office for Africa, Helen Keller International, Dakar, Senegal
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Sokolow SH, Wood CL, Jones IJ, Lafferty KD, Kuris AM, Hsieh MH, De Leo GA. To Reduce the Global Burden of Human Schistosomiasis, Use 'Old Fashioned' Snail Control. Trends Parasitol 2018; 34:23-40. [PMID: 29126819 PMCID: PMC5819334 DOI: 10.1016/j.pt.2017.10.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/30/2017] [Accepted: 10/16/2017] [Indexed: 12/27/2022]
Abstract
Control strategies to reduce human schistosomiasis have evolved from 'snail picking' campaigns, a century ago, to modern wide-scale human treatment campaigns, or preventive chemotherapy. Unfortunately, despite the rise in preventive chemotherapy campaigns, just as many people suffer from schistosomiasis today as they did 50 years ago. Snail control can complement preventive chemotherapy by reducing the risk of transmission from snails to humans. Here, we present ideas for modernizing and scaling up snail control, including spatiotemporal targeting, environmental diagnostics, better molluscicides, new technologies (e.g., gene drive), and 'outside the box' strategies such as natural enemies, traps, and repellants. We conclude that, to achieve the World Health Assembly's stated goal to eliminate schistosomiasis, it is time to give snail control another look.
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Affiliation(s)
- Susanne H Sokolow
- Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA; Marine Science Institute, University of California, Santa Barbara, CA 93106, USA.
| | - Chelsea L Wood
- School of Aquatic and Fishery Sciences, University of Washington, Box 355020, Seattle, WA 98195-5020, USA
| | - Isabel J Jones
- Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
| | - Kevin D Lafferty
- U.S. Geological Survey, Western Ecological Research Center, c/o Marine Science Institute, University of California, Santa Barbara, CA 93106, USA
| | - Armand M Kuris
- Marine Science Institute, University of California, Santa Barbara, CA 93106, USA
| | - Michael H Hsieh
- Children's National Health System, Washington DC, 20010, USA; The George Washington University, Washington DC, 20037, USA; Biomedical Research Institute, Rockville, MD 20850, USA
| | - Giulio A De Leo
- Hopkins Marine Station, Stanford University, Pacific Grove, CA 93950, USA
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Ejike CU, Oluwole AS, Mogaji HO, Adeniran AA, Alabi OM, Ekpo UF. Development and testing of Schisto and Ladders™, an innovative health educational game for control of schistosomiasis in schoolchildren. BMC Res Notes 2017; 10:236. [PMID: 28659195 PMCID: PMC5490240 DOI: 10.1186/s13104-017-2545-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 06/17/2017] [Indexed: 11/29/2022] Open
Abstract
Background Schistosomiasis remains a public health problem in many regions of the world, including Nigeria. Current control strategy involves mass drug administration with praziquantel to the endemic population. To complement and sustain on-going preventive chemotherapy, we developed a health educational game named Schisto and Ladders™ and tested its potential for the control of schistosomiasis among schoolchildren living in Imala-Odo, a highly endemic community near Abeokuta, Nigeria. Methods One hundred school children were randomly selected and divided into intervention and control groups through balloting. Their knowledge, attitudes and practices (KAP) concerning schistosomiasis transmission, control and prevention were assessed using structured questionnaires. Schisto and Ladders™ game were given to the intervention group and the popular Snake and Ladders™ game to the control group. Both games were played for 2 months under the supervision of their class teachers. A post-KAP assessment was carried out in both groups, including focus group discussions (FGDs) to investigate knowledge and the impact of the games. Results Knowledge about urinary schistosomiasis and its transmission significantly improved (P = 0.000) in the intervention group (68.0%) compared to the control group (8.0%). FGDs showed that the frequency of visits to dam water also significantly reduced (P = 0.048) in the intervention group (18.0%) compared to the control group (40.0%). There was a significant increase in knowledge regarding risk behaviours, prevention and control of schistosomiasis among the intervention group, but no new knowledge gained in the control group. Conclusions This study demonstrates the potential of the health education game Schisto and Ladders™ for teaching basic health education and promoting behavioural changes among schoolchildren in endemic communities.
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Affiliation(s)
- Cynthia Uchechukwu Ejike
- Spatial Parasitology and Health GIS Group, Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Akinola Stephen Oluwole
- Spatial Parasitology and Health GIS Group, Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Hammed Oladeji Mogaji
- Spatial Parasitology and Health GIS Group, Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Adebiyi Abdulhakeem Adeniran
- Spatial Parasitology and Health GIS Group, Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Oladimeji Michael Alabi
- Spatial Parasitology and Health GIS Group, Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Uwem Friday Ekpo
- Spatial Parasitology and Health GIS Group, Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria.
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23
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Musuva RM, Matey E, Masaku J, Odhiambo G, Mwende F, Thuita I, Kihara J, Njomo D. Lessons from implementing mass drug administration for soil transmitted helminths among pre-school aged children during school based deworming program at the Kenyan coast. BMC Public Health 2017; 17:575. [PMID: 28615011 PMCID: PMC5471907 DOI: 10.1186/s12889-017-4481-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 06/01/2017] [Indexed: 12/14/2022] Open
Abstract
Background The 2012 London declaration which committed to “sustaining, expanding and extending drug access programmes to ensure the necessary supply of drugs and other interventions to help control soil-transmitted helminths (STH) by 2020” has seen many countries in Africa roll out mass drug administration (MDA) especially among school age children. In Kenya, however, during the National school-based deworming exercise, pre-school aged children (PSAC) have to access treatment at primary schools as the pre-school teachers are not trained to carry out deworming. With studies being conducted on the effectiveness of MDAs, the experiences of key education stakeholders which could improve the programme by giving best practices, and challenges experienced have not been documented. Methods This was a cross-sectional qualitative study using Focus group discussions (FGDs) and Key informant interviews (KIIs). It was conducted in 4 sub-counties with high STH prevalence at the Kenyan coast (Matuga, Malindi, Lunga Lunga and Msambweni) to understand best practices for implementing MDA among PSAC.FGDs categorized by gender were conducted among local community members, whereas KIIs involved pre-school teachers, primary school teachers, community health extension workers (CHEWs) and opinion leaders. Participants were purposefully selected with the saturation model determining the number of interviews and focus groups. Voice data collected was transcribed verbatim then coded and analyzed using ATLAS.Ti version 6. Results Majority of the primary school teachers and CHEWs reported that they were satisfied with the method of mobilization used and the training tools. This was however not echoed by the pre-school teachers, parents and chiefs who complained of being left out of the process. Best practices mentioned included timely drug delivery, support from pre-school teachers, and management of side effects. Overcrowding during the drug administration day, complexity of the forms (for instance the ‘S form’) and long distance between schools were mentioned as challenges. Conclusion There is need to utilize better sensitization methods to include the local administration as well as the parents for better uptake of the drugs. Extending deworming training to pre-school teachers will enhance the national deworming programme. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4481-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rosemary M Musuva
- Center for Global Health Research (CGHR), Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya.
| | - Elizabeth Matey
- Center for Microbiology Research, Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
| | - Janet Masaku
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
| | - Gladys Odhiambo
- Center for Global Health Research (CGHR), Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya
| | - Faith Mwende
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
| | - Isaac Thuita
- Ministry of Education, Directorate of Basic Education, Early Childhood Education Section, P. O. Box- 30040-00100, Nairobi, Kenya
| | - Jimmy Kihara
- Ministry of Health, Division of Vector Borne Diseases, P. O. Box-20750-00202, Nairobi, Kenya
| | - Doris Njomo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
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Diakité NR, Winkler MS, Coulibaly JT, Guindo-Coulibaly N, Utzinger J, N'Goran EK. Dynamics of freshwater snails and Schistosoma infection prevalence in schoolchildren during the construction and operation of a multipurpose dam in central Côte d'Ivoire. Infect Dis Poverty 2017; 6:93. [PMID: 28468667 PMCID: PMC5415719 DOI: 10.1186/s40249-017-0305-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 04/17/2017] [Indexed: 12/03/2022] Open
Abstract
Background The construction and operation of small multipurpose dams in Africa have a history of altering the transmission of water-based diseases, including schistosomiasis. The current study was designed to investigate the abundance and dynamics of schistosomiasis intermediate host snails and Schistosoma infections in humans during the construction and the first years of operation of a small multipurpose dam in Côte d’Ivoire. Methods The study was carried out in Raffierkro and four neighbouring villages in central Côte d’Ivoire between 2007 and 2012. Snails were collected by two experienced investigators using scoops and forceps for 15 min at each site. Snails were identified at genera and, whenever possible, species level, and subjected to testing for cercarial shedding. Schoolchildren aged 6–15 years were examined once every year for Schistosoma haematobium and S. mansoni infection, using urine filtration and duplication Kato-Katz thick smears, respectively. Additionally, 551 adults were examined for Schistosoma infection before (June 2007) and 359 individuals 2 years after dam construction (June 2009). Results Overall, 1 700 snails belonging to nine different genera were collected from 19 sampling sites. Bulinus (potential intermediate host snails of S. haematobium) and Pila were the most common genera, whereas Biomphalaria (potential intermediate host snail of S. mansoni), Lymnaea, Physa and Melanoides were found in two villages. During the first-year sampling period, 65 snails were collected, of which 13 (20%) were schistosomiasis intermediate hosts. In subsequent years, out of 1 635 snails collected, 1 079 (66%) were identified as potential intermediate host for schistosomiasis, but none were shedding cercariae. The prevalence of S. mansoni among adults in the study area was low (0.4% in 2007 and 0.3% in 2009), whereas the prevalence of S. haematobium declined from 13.9% to 2.9% in this two-year period. Conclusions The low prevalence of schistosomiasis in humans and the absence of infected intermediate host snails during the construction and early phase of operation of a small multipurpose dam suggest that there was no or only very little local transmission. However, the considerable increase in the number of intermediate host snails and their dispersion in irrigation canals call for rigorous surveillance, so that adequate public health measures can be taken in case of early signs of an outbreak. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0305-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nana R Diakité
- Laboratoire de Zoologie et Biologie Animale, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 522, Abidjan 22, Côte d'Ivoire.
| | - Mirko S Winkler
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Jean T Coulibaly
- Laboratoire de Zoologie et Biologie Animale, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 522, Abidjan 22, Côte d'Ivoire.,Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland.,Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire
| | - Négnorogo Guindo-Coulibaly
- Laboratoire de Zoologie et Biologie Animale, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 522, Abidjan 22, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Eliézer K N'Goran
- Laboratoire de Zoologie et Biologie Animale, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 522, Abidjan 22, Côte d'Ivoire.,Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire
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25
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N'Diaye M, Dioukhane EM, Ndao B, Diedhiou K, Diawara L, Talla I, Vernet C, Bessin F, Barbier D, Dewavrin P, Klotz F, Georges P. Schistosomiasis Sustained Control Program in Ethnic Groups Around Ninefescha (Eastern Senegal). Am J Trop Med Hyg 2016; 95:614-22. [PMID: 27430549 DOI: 10.4269/ajtmh.15-0125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 03/25/2016] [Indexed: 11/07/2022] Open
Abstract
Schistosomiasis is the second most significant parasitic disease in children in several African countries. For this purpose, the "Programme National de Lutte contre les Bilharzioses" (PNLB) was developed in partnership with the World Health Organization (WHO) to control this disease in Senegal. However, geographic isolation of Bedik ethnic groups challenged implementation of the key elements of the schistosomiasis program in eastern Senegal, and therefore, a hospital was established in Ninefescha to improve access to health care as well as laboratory support for this population. The program we have implemented from 2008 in partnership with the PNLB/WHO involved campaigns to 1) evaluate schistosomiasis prevalence in children of 53 villages around Ninefescha hospital, 2) perform a mass drug administration following the protocol established by the PNLB in school-aged children, 3) monitor annual prevalence, 4) implement health education campaigns, and 5) oversee the building of latrines. This campaign led to a drop in schistosomiasis prevalence but highlighted that sustainable schistosomiasis control by praziquantel treatment, awareness of the use of latrines, and inhabitants' voluntary commitment to the program are crucial to improve Schistosoma elimination. Moreover, this study revealed that preschool-aged children, for whom praziquantel was not recommended until 2014 in Senegal, constituted a significant reservoir for the parasite.
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Affiliation(s)
- Monique N'Diaye
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France.
| | | | | | - Kemo Diedhiou
- Programme National de Lutte contre les Bilharzioses/World Health Organization Neglected Tropical Diseases, Dakar, Senegal
| | - Lamine Diawara
- Inter-country Support Team for West Africa, World Health Organization Neglected Tropical Diseases, Ouagadougou, Burkina Faso
| | - Idrissa Talla
- Programme National de Lutte contre les Bilharzioses/World Health Organization Neglected Tropical Diseases, Dakar, Senegal
| | - Charlotte Vernet
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
| | - François Bessin
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
| | - Dominique Barbier
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
| | | | | | - Pierre Georges
- Université de Caen Normandie, UNICAEN, UFR des Sciences Pharmaceutiques, Laboratoire de Parasitologie et Mycologie Médicale, Caen, France
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Assaré RK, Tian-Bi YNT, Yao PK, N’Guessan NA, Ouattara M, Yapi A, Coulibaly JT, Meïté A, Hürlimann E, Knopp S, Utzinger J, N’Goran EK. Sustaining Control of Schistosomiasis Mansoni in Western Côte d'Ivoire: Results from a SCORE Study, One Year after Initial Praziquantel Administration. PLoS Negl Trop Dis 2016; 10:e0004329. [PMID: 26789749 PMCID: PMC4720284 DOI: 10.1371/journal.pntd.0004329] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 12/04/2015] [Indexed: 12/23/2022] Open
Abstract
Background The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) has launched several large-scale trials to determine the best strategies for gaining and sustaining control of schistosomiasis and transitioning toward elimination. In Côte d’Ivoire, a 5-year cluster-randomized trial is being implemented in 75 schools to sustain the control of schistosomiasis mansoni. We report Schistosoma mansoni infection levels in children one year after the initial school-based treatment (SBT) with praziquantel and compare with baseline results to determine the effect of the intervention. Methodology The baseline cross-sectional survey was conducted in late 2011/early 2012 and the first follow-up in May 2013. Three consecutive stool samples were collected from 9- to 12-year-old children in 75 schools at baseline and 50 schools at follow-up. Stool samples were subjected to duplicate Kato-Katz thick smears. Directly observed treatment (DOT) coverage of the SBT was assessed and the prevalence and intensity of S. mansoni infection compared between baseline and follow-up. Principal Findings The S. mansoni prevalence in the 75 schools surveyed at baseline was 22.1% (95% confidence interval (CI): 19.5–24.4%). The DOT coverage was 84.2%. In the 50 schools surveyed at baseline and one year after treatment, the overall prevalence of S. mansoni infection decreased significantly from 19.7% (95% CI: 18.5–20.8%) to 12.8% (95% CI: 11.9–13.8%), while the arithmetic mean S. mansoni eggs per gram of stool (EPG) among infected children slightly increased from 92.2 EPG (95% CI: 79.2–105.3 EPG) to 109.3 EPG (95% CI: 82.7–135.9 EPG). In two of the 50 schools, the prevalence increased significantly, despite a DOT coverage of >75%. Conclusions/Significance One year after the initial SBT, the S. mansoni prevalence had decreased. Despite this positive trend, an increase was observed in some schools. Moreover, the infection intensity among S. mansoni-infected children was slightly higher at the 1-year follow-up compared to the baseline situation. Our results emphasize the heterogeneity of transmission dynamics and provide a benchmark for the future yearly follow-up surveys of this multi-year SCORE intervention study. Schistosomiasis is a parasitic worm disease that is widespread in sub-Saharan Africa. To better understand how to gain and sustain the control of schistosomiasis and how to eliminate this disease in different epidemiologic settings, the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) has launched several multi-year studies that are being implemented in East and West Africa. This article highlights how the Schistosoma mansoni infection levels changed one year after an initial treatment with the anti-worm drug praziquantel given to children aged 5–15 years in western Côte d’Ivoire. Infection and treatment data at school level were available from more than 4,600 children in 50 schools. One year after the treatment that had been received by more than 80% of the children, the overall S. mansoni prevalence decreased from 19.7% to 12.8%, while the intensity of infection among S. mansoni-positive children slightly increased. In several schools, the S. mansoni intensity and, particularly the prevalence, increased unexpectedly. Our findings show that the dynamics of schistosomiasis transmission varies from one village to another. It will be interesting to monitor changes over longer time periods as this SCORE study unfolds.
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Affiliation(s)
- Rufin K. Assaré
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Yves-Nathan T. Tian-Bi
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Patrick K. Yao
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Nicaise A. N’Guessan
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Ahoua Yapi
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Jean T. Coulibaly
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Aboulaye Meïté
- Programme National de Lutte contre la Schistosomiase, les Géohelminthiases et la Filariose Lymphatique, Abidjan, Côte d’Ivoire
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - 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
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Yooseph S, Kirkness EF, Tran TM, Harkins DM, Jones MB, Torralba MG, O'Connell E, Nutman TB, Doumbo S, Doumbo OK, Traore B, Crompton PD, Nelson KE. Stool microbiota composition is associated with the prospective risk of Plasmodium falciparum infection. BMC Genomics 2015; 16:631. [PMID: 26296559 PMCID: PMC4546150 DOI: 10.1186/s12864-015-1819-3] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 08/05/2015] [Indexed: 12/20/2022] Open
Abstract
Background In humans it is unknown if the composition of the gut microbiota alters the risk of Plasmodium falciparum infection or the risk of developing febrile malaria once P. falciparum infection is established. Here we collected stool samples from a cohort composed of 195 Malian children and adults just prior to an intense P. falciparum transmission season. We assayed these samples using massively parallel sequencing of the 16S ribosomal RNA gene to identify the composition of the gut bacterial communities in these individuals. During the ensuing 6-month P. falciparum transmission season we examined the relationship between the stool microbiota composition of individuals in this cohort and their prospective risk of both P. falciparum infection and febrile malaria. Results Consistent with prior studies, stool microbial diversity in the present cohort increased with age, although the overall microbiota profile was distinct from cohorts in other regions of Africa, Asia and North America. Age-adjusted Cox regression analysis revealed a significant association between microbiota composition and the prospective risk of P. falciparum infection; however, no relationship was observed between microbiota composition and the risk of developing febrile malaria once P. falciparum infection was established. Conclusions These findings underscore the diversity of gut microbiota across geographic regions, and suggest that strategic modulation of gut microbiota composition could decrease the risk of P. falciparum infection in malaria-endemic areas, potentially as an adjunct to partially effective malaria vaccines. Electronic supplementary material The online version of this article (doi:10.1186/s12864-015-1819-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shibu Yooseph
- J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA, 92037, USA.
| | - Ewen F Kirkness
- J. Craig Venter Institute, 9704 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Tuan M Tran
- Laboratory of Immunogenetics, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, 20852, USA.
| | - Derek M Harkins
- J. Craig Venter Institute, 9704 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Marcus B Jones
- J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA, 92037, USA.
| | - Manolito G Torralba
- J. Craig Venter Institute, 9704 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Elise O'Connell
- Laboratory of Parasitic Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA. elise.o'
| | - Thomas B Nutman
- Laboratory of Parasitic Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Safiatou Doumbo
- Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique and Technology of Bamako, Bamako, Mali.
| | - Ogobara K Doumbo
- Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique and Technology of Bamako, Bamako, Mali.
| | - Boubacar Traore
- Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique and Technology of Bamako, Bamako, Mali.
| | - Peter D Crompton
- Laboratory of Immunogenetics, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, 20852, USA.
| | - Karen E Nelson
- J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA, 92037, USA.
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Olliaro PL, Vaillant M, Diawara A, Coulibaly JT, Garba A, Keiser J, King CH, Knopp S, Landouré A, N’Goran EK, Raso G, Scherrer AU, Sousa-Figueiredo JC, Stete K, Zhou XN, Utzinger J. Toward Measuring Schistosoma Response to Praziquantel Treatment with Appropriate Descriptors of Egg Excretion. PLoS Negl Trop Dis 2015; 9:e0003821. [PMID: 26086551 PMCID: PMC4473103 DOI: 10.1371/journal.pntd.0003821] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 05/10/2015] [Indexed: 01/05/2023] Open
Abstract
Background The control of schistosomiasis emphasizes preventive chemotherapy with praziquantel, which aims at decreasing infection intensity and thus morbidity in individuals, as well as transmission in communities. Standardizing methods to assess treatment efficacy is important to compare trial outcomes across settings, and to monitor program effectiveness consistently. We compared customary methods and looked at possible complementary approaches in order to derive suggestions for standardizing outcome measures. Methodology/Principal Findings We analyzed data from 24 studies conducted at African, Asian, and Latin American sites, enrolling overall 4,740 individuals infected with Schistosoma mansoni, S. haematobium, or S. japonicum, and treated with praziquantel at doses of 40–80 mg/kg. We found that group-based arithmetic and geometric means can be used interchangeably to express egg reduction rates (ERR) only if treatment efficacy is high (>95%). For lower levels of efficacy, ERR estimates are higher with geometric than arithmetic means. Using the distribution of individual responses in egg excretion, 6.3%, 1.7% and 4.3% of the subjects treated for S. haematobium, S. japonicum and S. mansoni infection, respectively, had no reduction in their egg counts (ERR = 0). The 5th, 10th, and 25th centiles of the subjects treated for S. haematobium had individual ERRs of 0%, 49.3%, and 96.5%; the corresponding values for S. japonicum were 75%, 99%, and 99%; and for S. mansoni 18.2%, 65.3%, and 99.8%. Using a single rather than quadruplicate Kato-Katz thick smear excluded 19% of S. mansoni-infected individuals. Whilst the effect on estimating ERR was negligible by individual studies, ERR estimates by arithmetic means were 8% lower with a single measurement. Conclusions/Significance Arithmetic mean calculations of Schistosoma ERR are more sensitive and therefore more appropriate to monitor drug performance than geometric means. However, neither are satisfactory to identify poor responders. Group-based response estimated by arithmetic mean and the distribution of individual ERRs are correlated, but the latter appears to be more apt to detect the presence and to quantitate the magnitude of suboptimal responses to praziquantel. To identify whether a person is infected with parasitic worms, stool or urine samples are examined for worm eggs. The drug praziquantel is used against the parasitic disease schistosomiasis. However, there is no definitive agreement as to how the efficacy of praziquantel is best expressed. We put together a database from various studies of the efficacy of praziquantel against schistosomiasis. Efficacy was measured using customary methods: cure rate (CR: percentage of people with eggs in their stool/urine before treatment who became egg-negative after treatment); and egg reduction rate (ERR; percentage reduction in the number of eggs in the stool/urine after treatment, where the mean number of eggs from all people treated is calculated using either geometric or arithmetic means). We found that arithmetic and geometric means can be used interchangeably only if treatment efficacy is very high; arithmetic means are more sensitive to capture drops in efficacy expressed by ERR. A valid complement for drug efficacy monitoring is to study the distribution of individual responses in egg excretion that allows identifying in a single measure both those who had an adequate response to treatment and those who respond less well; e.g., the 5% of the patients with the lowest ERRs.
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Affiliation(s)
- Piero L. Olliaro
- UNICEF/UNDP/World Bank/WHO Special Programme on Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
- Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Michel Vaillant
- Centre of Competence for Methodology and Statistics (CCMS), Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Aïssatou Diawara
- Department of Biology, Division of Science and Mathematics, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Jean T. Coulibaly
- 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
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Amadou Garba
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Réseau International Schistosomoses, Environnement, Aménagement et Lutte (RISEAL-Niger), Niamey, Niger
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
- Schistosomiasis Consortium for Operational Research and Evaluation, University of Georgia, Athens, Georgia, United States of America
| | - Stefanie Knopp
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Aly Landouré
- Institut National de Recherche en Santé Publique, Bamako, Mali
| | - 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
| | - Giovanna Raso
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Alexandra U. Scherrer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - José Carlos Sousa-Figueiredo
- Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katarina Stete
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Center for Infectious Diseases and Travel Medicine, Department of Medicine, University Hospital Freiburg, Freiburg im Breisgau, Germany
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People’s Republic of China
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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Geleta S, Alemu A, Getie S, Mekonnen Z, Erko B. Prevalence of urinary schistosomiasis and associated risk factors among Abobo Primary School children in Gambella Regional State, southwestern Ethiopia: a cross sectional study. Parasit Vectors 2015; 8:215. [PMID: 25886292 PMCID: PMC4399218 DOI: 10.1186/s13071-015-0822-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 03/23/2015] [Indexed: 05/28/2023] Open
Abstract
Background In Ethiopia, urinary schistosomiasis caused by Schistosoma haematobium has been known to be endemic in several lowland areas of the country where it causes considerable public health problems, mainly among school-age children. However, information on recent magnitude and risk factors of the disease is lacking, particularly for Gambella area. Therefore, this study aimed to assess the prevalence of urinary schistosomiasis and associated risk factors among Abobo Primary School children in Gambella, southwestern Ethiopia. Methods A cross-sectional study involving 304 school children was conducted in Abobo Primary School, Gambella Regional State, southwestern Ethiopia, from February to June 2014. Ten ml of urine sample was collected from each study participant and processed for microscopic examination by the urine filtration method; egg load for positive individuals was determined per 10 ml of urine. Data on socio-demographic characteristics and risk factors were collected using an interview-based questionnaire. The data were entered into and analyzed with SPSS version 20. Logistic regression and odds ratio were used to measure association and strength between variables, respectively. P-value < 0.05 at 95% CI was considered as statistically significant. Results The prevalence of urinary schistosomiasis was 35.9% (109/ 304) with a mean egg intensity of 8.76 per 10 ml of urine. Being male [AOR (95%CI) = 2.15(1.31, 3.52)], having father as a farmer [AOR (95%CI) = 1.96(1.19, 3.22)] and children living apart from parents [AOR (95% CI): 3.09 (1.14, 8.4)] were significantly associated with urinary schistosomiasis. Conclusion The present study area in Gambella Regional State, southwestern Ethiopia, represents moderate-risk community for urinary schistosomiasis. Sex, father’s occupation and living apart from parents were found to be associated with infection. Treatment of all school-age children and fishermen is required once every 2 years until the prevalence of infection falls below the level of public health importance. It is also recommended to complement praziquantel treatment with supplementary measures such as provision of sanitation facilities and health education.
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Affiliation(s)
- Shashie Geleta
- Gambella Teachers' Education and Health Sciences College, Gambella, Ethiopia.
| | - Agersew Alemu
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia.
| | - Sisay Getie
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia.
| | - Zeleke Mekonnen
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
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Lee YH, Jeong HG, Kong WH, Lee SH, Cho HI, Nam HS, Ismail HAHA, Alla GNA, Oh CH, Hong ST. Reduction of urogenital schistosomiasis with an integrated control project in Sudan. PLoS Negl Trop Dis 2015; 9:e3423. [PMID: 25569278 PMCID: PMC4288734 DOI: 10.1371/journal.pntd.0003423] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 11/18/2014] [Indexed: 11/23/2022] Open
Abstract
Purpose Schistosomiasis remains a major public health concern in Sudan, particularly Schistosoma haematobium infection. This study presents the disease-reduction outcomes of an integrated control program for schistosomiasis in Al Jabalain locality of White Nile State, Sudan from 2009 through 2011. Methods The total population of the project sites was 482,902, and the major target group for intervention among them was 78,615 primary school students. For the cross-sectional study of the prevalence, urine and stool specimens were examined using the urine sedimentation method and the Kato cellophane thick smear method, respectively. To assess the impacts of health education for students and a drinking water supply facility at Al Hidaib village, questionnaire survey was done. Results The overall prevalence for S. haematobium and S. mansoni at baseline was 28.5% and 0.4%, respectively. At follow-up survey after 6–9 months post-treatment, the prevalence of S. haematobium infection was reduced to 13.5% (95% CI = 0.331–0.462). A higher reduction in prevalence was observed among girls, those with moderately infected status (around 20%), and residents in rural areas, than among boys, those with high prevalence (>40%), and residents in urban areas. After health education, increased awareness about schistosomiasis was checked by questionnaire survey. Also, a drinking water facility was constructed at Al Hidaib village, where infection rate was reduced more compared to that in a neighboring village within the same unit. However, we found no significant change in the prevalence of S. mansoni infection between baseline and follow-up survey (95% CI = 0.933–6.891). Conclusions At the end of the project, the prevalence of S. haematobium infection was reduced by more than 50% in comparison with the baseline rate. Approximately 200,000 subjects had received either praziquantel therapy, health education, or supply of clean water. To consolidate the achievements of this project, the integrated intervention should be adapted continuously. Schistosomiasis remains a major public health concern and is one of the major causes of morbidity among school-aged children in Sudan. To control schistosomiasis in White Nile State of Sudan, the Korea International Cooperation Agency (KOICA) implemented an integrated control program including mass chemotherapy with praziquantel and health education to school children and village residents, and construction of a drinking water supply facility at Al Hidaib village from 2009 to 2011. As a result of this project, the overall prevalence of S. haematobium infection was reduced by >50% in comparison with the baseline rates (95% CI = 0.331–0.462). The infection reduction rates were higher among girls, those with moderate infection status (around 20%), and residents of rural areas; than for those of boys, subjects with high infection status (>40%) and residents of urban areas. A supply of clean water at Al Hidaib village contributed significantly to the reduction in the prevalence of urogenital schistosomiasis in comparison to Khour Ajwal village, which is similar natural environment and lifestyle of Al Hidaib village. However, the prevalence of S. mansoni infection did not significantly change. Also, the awareness of knowledge about schistosomiasis and health improvement was apparently improved by the results of questionnaires survey. Through this project, approximately 200,000 individuals benefited from either drug treatment, health education, or a clean water supply. To consolidate the achievements of the project, sustainable integrated control activities should be implemented in the near future.
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Affiliation(s)
- Young-Ha Lee
- Department of Infection Biology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hoo Gn Jeong
- Korea Association of Health Promotion, Seoul, Korea
| | | | | | - Han-Ik Cho
- Korea Association of Health Promotion, Seoul, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | | | - Gibril Nouman Abd Alla
- National Control Program for Schistosomiasis and Soil-Transmitted Helminthes, Federal Ministry of Health, Sudan
| | | | - Sung-Tae Hong
- Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Bardosh K. Global aspirations, local realities: the role of social science research in controlling neglected tropical diseases. Infect Dis Poverty 2014; 3:35. [PMID: 25320672 PMCID: PMC4197218 DOI: 10.1186/2049-9957-3-35] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/16/2014] [Indexed: 11/23/2022] Open
Abstract
Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the “neglected” status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.
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Affiliation(s)
- Kevin Bardosh
- Centre of African Studies, School of Social and Political Science, College of Humanities and Social Science, The University of Edinburgh, 58 George Square, Edinburgh, EH8 9LD UK ; Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB UK
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Prevalence, intensity of infection and risk factors of urinary schistosomiasis in pre-school and school aged children in Guma Local Government Area, Nigeria. ASIAN PAC J TROP MED 2014; 7:34-9. [PMID: 24418080 DOI: 10.1016/s1995-7645(13)60188-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 11/10/2013] [Accepted: 12/15/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the prevalence and intensity of infection and the risk factors associated with urinary schistosomiasis in pre-school and school aged children in Guma Local Government Area of Benue State, Nigeria. METHODS Urine filtration technique using polycarbonate membrane filters was employed to process urine specimens and to determine presence of Schistosoma haematobium eggs in urine. Questionnaires were also administered to children to collect information on socio-demographic data and water-contact activities. RESULTS An overall prevalence of 55.0% (165/300) was recorded out of the 300 urine samples examined. Prevalence of infection varied between 36.0%-64.0% with a significant difference (χ(2)= 11.59, P=0.041) between the different communities visited. Males were more infected (60.6%, 103/170) than females (47.7%, 62/130) with a significant difference (χ(2)= 4.95, P=0.026). The age-related prevalence showed higher prevalence (70.5%, 36/52) in the 11-15 year old children than that in the 1-5 year old ones (44.9%, 53/118). A significant difference was observed in the prevalence between the age groups (χ(2)=10.56, P=0.014). The prevalence of light intensity of infection (1-49 eggs/10 mL of urine) (86.6%) was significantly higher than that of heavy intensity of infection (≥50 eggs/10 mL of urine) (13.3%) in the area (t=16.48, P=0.000). Water contact activities of the children revealed that children that were involved in irrigation and those that went swimming in water bodies were observed to be at higher risk of becoming infected with urinary schistosomiasis in the area with odd ratios (risk factors) of 2.756 (1.334-5.693) and 2.366 (1.131-4.948) respectively at P<0.05 level. CONCLUSIONS The study revealed the hyperendemicity of urinary schistosomiasis in the pre-school and school aged children in Guma Local Government Area. It is therefore recommended that praziquantel should be administered to children in the area and systematic epidemiological studies should be undertaken in the whole Local Government Area and the State at large to discover new foci of infection.
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Doumbo S, Tran TM, Sangala J, Li S, Doumtabe D, Kone Y, Traoré A, Bathily A, Sogoba N, Coulibaly ME, Huang CY, Ongoiba A, Kayentao K, Diallo M, Dramane Z, Nutman TB, Crompton PD, Doumbo O, Traore B. Co-infection of long-term carriers of Plasmodium falciparum with Schistosoma haematobium enhances protection from febrile malaria: a prospective cohort study in Mali. PLoS Negl Trop Dis 2014; 8:e3154. [PMID: 25210876 PMCID: PMC4161351 DOI: 10.1371/journal.pntd.0003154] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 07/31/2014] [Indexed: 01/22/2023] Open
Abstract
Background Malaria and schistosomiasis often overlap in tropical and subtropical countries and impose tremendous disease burdens; however, the extent to which schistosomiasis modifies the risk of febrile malaria remains unclear. Methods We evaluated the effect of baseline S. haematobium mono-infection, baseline P. falciparum mono-infection, and co-infection with both parasites on the risk of febrile malaria in a prospective cohort study of 616 children and adults living in Kalifabougou, Mali. Individuals with S. haematobium were treated with praziquantel within 6 weeks of enrollment. Malaria episodes were detected by weekly physical examination and self-referral for 7 months. The primary outcome was time to first or only malaria episode defined as fever (≥37.5°C) and parasitemia (≥2500 asexual parasites/µl). Secondary definitions of malaria using different parasite densities were also explored. Results After adjusting for age, anemia status, sickle cell trait, distance from home to river, residence within a cluster of high S. haematobium transmission, and housing type, baseline P. falciparum mono-infection (n = 254) and co-infection (n = 39) were significantly associated with protection from febrile malaria by Cox regression (hazard ratios 0.71 and 0.44; P = 0.01 and 0.02; reference group: uninfected at baseline). Baseline S. haematobium mono-infection (n = 23) did not associate with malaria protection in the adjusted analysis, but this may be due to lack of statistical power. Anemia significantly interacted with co-infection (P = 0.009), and the malaria-protective effect of co-infection was strongest in non-anemic individuals. Co-infection was an independent negative predictor of lower parasite density at the first febrile malaria episode. Conclusions Co-infection with S. haematobium and P. falciparum is significantly associated with reduced risk of febrile malaria in long-term asymptomatic carriers of P. falciparum. Future studies are needed to determine whether co-infection induces immunomodulatory mechanisms that protect against febrile malaria or whether genetic, behavioral, or environmental factors not accounted for here explain these findings. The parasitic diseases malaria and schistosomiasis are tremendous public health burdens, each affecting over 200 million people worldwide with substantial geographic overlap in sub-Saharan Africa. Understanding how schistosomiasis influences the human immune response to Plasmodium, the agent of malaria, can be important for developing effective malaria vaccines. Past studies have tried to determine if infection with Schistosoma haematobium, which causes urinary schistosomiasis, affects the number of febrile attacks from malaria caused by Plasmodium falciparum in communities where the diseases overlap, but the findings have been inconsistent. Here, we examined 616 healthy people from a village in Mali for symptomless infections with S. haematobium and treated those with infections. We then followed them over a single malaria-transmission season of 7 months during which we diagnosed and treated all febrile malaria attacks. After the season, we examined archived blood collected at enrollment to look for occult P. falciparum infection. The study revealed that people who were infected with both parasites at the beginning of the season were better protected from the malaria attacks than those who were uninfected or infected with either parasite alone. Further studies are needed to confirm these findings and to determine the biological basis for this phenomenon.
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Affiliation(s)
- Safiatou Doumbo
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
- * E-mail: (SD); (TMT)
| | - Tuan M. Tran
- Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, United States of America
- * E-mail: (SD); (TMT)
| | - Jules Sangala
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Shanping Li
- Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, United States of America
| | - Didier Doumtabe
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Younoussou Kone
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Abdrahamane Traoré
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Aboudramane Bathily
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Nafomon Sogoba
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Michel E. Coulibaly
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Chiung-Yu Huang
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Aissata Ongoiba
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Kassoum Kayentao
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Mouctar Diallo
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Zongo Dramane
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Peter D. Crompton
- Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, United States of America
| | - Ogobara Doumbo
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
| | - Boubacar Traore
- Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technology of Bamako, Bamako, Mali
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McManus DP. Schistosomiasis in 2012: current status and key research priorities required for control leading to elimination. Expert Rev Anti Infect Ther 2014; 10:1233-6. [DOI: 10.1586/eri.12.121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sesay S, Paye J, Bah MS, McCarthy FM, Conteh A, Sonnie M, Hodges MH, Zhang Y. Schistosoma mansoni infection after three years of mass drug administration in Sierra Leone. Parasit Vectors 2014; 7:14. [PMID: 24401567 PMCID: PMC3895768 DOI: 10.1186/1756-3305-7-14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 01/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosoma mansoni was moderately-highly endemic in the northeast of Sierra Leone. The national neglected tropical disease control program started mass drug administration (MDA) with praziquantel (PZQ) in six districts in 2009 targeting primary school children only. The effort was scaled-up to seven districts in 2010 targeting school aged children (SAC) and at-risk adults. A cross-sectional sentinel site survey was conducted in 2012 after three rounds of MDA to evaluate the impact of the national program. METHODS Twenty-six (26) sentinel sites were randomly selected from the baseline mapping survey sites stratified according to the baseline prevalence into high, moderate or low endemic category. Fifty (50) school children (25 males and 25 females) were randomly selected per site. Fresh stool samples were examined in the field using the Kato Katz technique. The results were compared with the baseline data. RESULTS Program coverage of 94.8%, 77.1% and 81.7% was reported in 2009, 2010 and 2011 respectively. Independent monitoring in 2011 showed program coverage of 83.9%, not significantly different from the reported result in the same year. The overall prevalence of S. mansoni was 16.3% (95% CI: 14.4-18.4%) and mean intensity was 18.98 epg (95% CI: 11.46-26.50 epg) in 2012, representing 67.2% and 85.9% reduction from the baseline respectively. The proportion of moderately and heavily infected children was 3.3% and 1.2%, a significant reduction from 18.2% and 8.8% at baseline respectively. CONCLUSIONS Sierra Leone has maintained effective MDA coverage with PZQ since 2009. Three rounds of MDA led to a significant reduction of S. mansoni infection in the country. In line with the significant progress made in controlling schistosomiasis, the national treatment strategy has been reviewed and MDA will be expanded to include school age children in low endemicity districts with the new national objective for the elimination of schistosomiasis. Sierra Leone is well on its way to eliminate schistosomiasis as a public health problem.
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Affiliation(s)
| | | | | | | | | | | | - Mary H Hodges
- Helen Keller International, PO Box 352, Freetown, Sierra Leone.
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Abdulrab A, Salem A, Algobati F, Saleh S, Shibani K, Albuthigi R. Effect of school based treatment on the prevalence of schistosomiasis in endemic area in yemen. IRANIAN JOURNAL OF PARASITOLOGY 2013; 8:219-26. [PMID: 23914234 PMCID: PMC3724146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 02/12/2013] [Indexed: 11/01/2022]
Abstract
BACKGROUND Schistosomiasis and soil transmitted infection is a major health problem of children from rural areas of developing countries including Yemen. In an attempt to reduce this burden, the Ministry of Public Health and Population in Yemen established in 2002 a programme for Schistosomal, soil transmitted infection control that aimed to reduce morbidity and prevalence rates of Schistosomiasis, and Soil transmitted helminthes to less than 5% by 2015. The study was conducted to assess the current prevalence and intensity of schistosomal infection among schoolchildren in rural areas of the Taiz governorate after 6 years of running National Control Programme. METHODS Grade 3 schoolchildren from Shara'b Al-Raona district of Taiz Governorate were examined for infections with Schistosoma mansoni using Modified Kato-Katz method and S. haematobium applying filtration method in 1998/1999, comparing the prevalence and intensity of infection with base line study, which was done 6 years ago. RESULTS The S. mansoni prevalence in the study population was 31%, while the prevalence of S. haematobium was 18.6%. This result considerably is similar to the prevalence of base line study. The intensity of mild, moderate and severe infection for S. mansoni reached to 15.9%, 60.6% & 23.5% respectively. The severity of S. haematobium infection was 68.4%. It was exceptionally found that the prevalence of S. haematobium is increased. CONCLUSION The high prevalence of schistosomiasis and low effectiveness of control programme against schistosomal infection in the study area demands consideration of alternative treatment approaches.
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Affiliation(s)
- A Abdulrab
- Dept. of Internal Medicine, Faculty of Medicine &Health Sciences’ Sana'a University, Republic of Yemen,Corresponding author:
| | - A Salem
- Dept. of Internal Medicine, Faculty of Medicine &Health Sciences’ Sana'a University, Republic of Yemen
| | - F Algobati
- Dept. of Internal Medicine, Faculty of Medicine &Health Sciences’ Sana'a University, Republic of Yemen
| | - S Saleh
- Laboratory of Ministry of Health, Taiz Republic of Yemen
| | - K Shibani
- Laboratory of Ministry of Health, Taiz Republic of Yemen
| | - R Albuthigi
- Microbiology and Parasitology Taiz Laboratory, Republic of Yemen
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Wang X, Gurarie D, Mungai PL, Muchiri EM, Kitron U, King CH. Projecting the long-term impact of school- or community-based mass-treatment interventions for control of Schistosoma infection. PLoS Negl Trop Dis 2012; 6:e1903. [PMID: 23166850 PMCID: PMC3499404 DOI: 10.1371/journal.pntd.0001903] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 10/01/2012] [Indexed: 11/19/2022] Open
Abstract
Background Schistosomiasis remains a significant health burden in many areas of the world. Morbidity control, focused on limiting infection intensity through periodic delivery of anti-schistosomal medicines, is the thrust of current World Health Organization guidelines (2006) for reduction of Schistosoma-related disease. A new appreciation of the lifetime impact of repeated Schistosoma infection has directed attention toward strategies for greater suppression of parasite infection per se, with the goal of transmission interruption. Variations in drug schedules involving increased population coverage and/or treatment frequency are now undergoing field trials. However, their relative effectiveness in long-term infection suppression is presently unknown. Methodology/Principal Findings Our study used available field data to calibrate advanced network models of village-level Schistosoma transmission to project outcomes of six different community- or school age-based programs, as compared to the impact of current 2006 W.H.O. recommended control strategies. We then scored the number of years each of 10 typical villages would remain below 10% infection prevalence (a practicable level associated with minimal prevalence of disease). All strategies that included four annual treatments effectively reduced community prevalence to less than 10%, while programs having yearly gaps (‘holidays’) failed to reach this objective in half of the communities. Effective post-program suppression of infection prevalence persisted in half of the 10 villages for 7–10 years, whereas in five high-risk villages, program effects on prevalence lasted zero to four years only. Conclusions/Significance At typical levels of treatment adherence (60 to 70%), current WHO recommendations will likely not achieve effective suppression of Schistosoma prevalence unless implemented for ≥6 years. Following more aggressive 4 year annual intervention, some communities may be able to continue without further intervention for 8–10 years, while in higher-risk communities, annual treatment may prove necessary until eco-social factors fostering transmission are removed. Effective ongoing surveillance and locally targeted annual intervention must then become their mainstays of control. Debate persists about how best to prevent disease caused by Schistosoma parasites. Current guidelines focus on suppressing morbidity by limiting average intensity of infection during childhood. However, this may not be sufficient to cure infection or prevent reinfection, leaving risk for sub-clinical morbidities such as growth stunting and anemia. More intensive programs involving broader coverage and/or more frequent treatments could potentially cure most infections and even prevent their return. Because such programs' effectiveness is not currently known, we used computer simulation (grounded by past treatment program results) to project short- and long-term impact in communities where Schistosoma are common. We estimated that 4 annual treatments (delivered community-wide or only to school-age children and high-risk adults) could effectively reduce local prevalence below 10%. Programs with gap years were less effective, particularly in high-risk communities. If a program was successful, infection stayed <10% for 7–10 years in low risk communities. However, rapid resurgence (within 1–5 years) was projected for high risk villages. We conclude that, given the networked transmission of Schistosoma, annual treatment programs of sufficient duration can have secondary benefits, i.e., long-term suppression in some areas. However, high risk areas will need continuing surveillance and frequent retreatment to truly minimize their risk for disease.
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Affiliation(s)
- Xiaoxia Wang
- Department of Mathematics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - David Gurarie
- Department of Mathematics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Peter L. Mungai
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Eric M. Muchiri
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya
| | - Uriel Kitron
- Department of Environmental Sciences, Emory University, Atlanta, Georgia, United States of America
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
- Schistosomiasis Consortium for Research and Evaluation, University of Georgia, Athens, Georgia, United States of America
- * E-mail:
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