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Masaku J, Mutuku F, Kihara JH, Mwandawiro C, Okoyo C, Kanyi H, Kamau J, Kaduka L, Ng’ang’a Z, Jeza VT. Helminthiasis and malaria co-infection among women of reproductive age in a rural setting of Kilifi County, coastal Kenya: A mixed method study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003310. [PMID: 38829897 PMCID: PMC11146690 DOI: 10.1371/journal.pgph.0003310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/13/2024] [Indexed: 06/05/2024]
Abstract
Soil transmitted helminthiasis (STH), Schistosoma haematobium and malaria co-infection lead to increased susceptibility to other infections and poor pregnancy outcomes among women of reproductive age (WRA). This study sought to establish risk factors, burden of co-infection with STH, S. haematobium and Plasmodium sp. among WRA in Kilifi County, Kenya.A mixed method cross-sectional study was conducted on 474 WRA in 2021. Simple random sampling was used to select WRA from four villages in two purposively sampled sub-counties. Study participants were interviewed, and stool samples collected and analysed using Kato-Katz technique for STH. Urine samples were collected for examination of S. haematobium while malaria microscopic test was done using finger prick blood samples. Further, 15 focus group discussions (FGDs) were conducted with purposively selected WRA and qualitative data analyzed thematically using Nvivo software. Quantitative and qualitative methods were triangulated to comprehensively strengthen the study findings. Prevalence of S. haematobium was 22.3% (95%CI: 13.5-36.9), any STH 5.2% (95%CI: 1.9-14.3) and malaria 8.3% (95%: 3.8-18.2). Co-infections between any STH and S. haematobium was 0.8% (95%CI: 0.2-3.2) and between S. haematobium and malaria 0.8% (95%CI: 0.2-3.1). Multivariable analysis showed increased odds of any STH infections among participants in Rabai Sub-County, (aOR = 9.74; p = 0.026), businesswomen (aOR = 5.25; p<0.001), housewives (aOR = 2.78; p = 0.003), and casual laborers (aOR = 27.03; p<0.001). Qualitative analysis showed that the three parasitic diseases were common and responsible for possible causes of low birth weight, susceptibility to other infections and complications such as infertility and cancer later in life.The study demonstrated that STH, S. haematobium and malaria are still a public health problem to WRA. Some of the associated risks of infection were geographical location, socio-economic and WASH factors. Hence the need to implement integrated control efforts of the three parasitic infection.
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Affiliation(s)
- Janet Masaku
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Francis Mutuku
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Jimmy H. Kihara
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Collins Okoyo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Henry Kanyi
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Joyce Kamau
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Lydia Kaduka
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Zipporah Ng’ang’a
- Department of Medical Laboratory Sciences, South Eastern Kenya University, Kitui, Kenya
| | - Victor T. Jeza
- Department of Medical Sciences, Technical University of Mombasa, Mombasa, Kenya
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Masaku J, Gachohi JM, Sinkeet A, Maghanga M, Wakesho F, Omondi W, Monnier N, Steinmann P, Reigl LS, Lange IL, Winkler AS, Njenga SM, Amuyunzu-Nyamongo M. Community preferred drug delivery approaches for pilot roll-out of a potential novel paediatric schistosomiasis treatment option in two endemic counties of Kenya: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003221. [PMID: 38820456 PMCID: PMC11142487 DOI: 10.1371/journal.pgph.0003221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/22/2024] [Indexed: 06/02/2024]
Abstract
Treating preschool age children (PSAC) for schistosomiasis has remained a challenge due to lack of a pediatric formulation. In response to this unmet need, the Paediatric Praziquantel Consortium has developed a potential novel paediatric treatment option. In advance to its roll-out to follow regulatory response, we conducted a social science study to gather information on preferred drug delivery approaches to inform implementation. A cross-sectional study was conducted in eight villages in two purposively selected Kenyan counties. A questionnaire was administered on 690 parents/guardians of PSAC at household level. Preferred drug delivery approaches were analyzed using frequencies and proportions. We conducted key informant interviews with 17 opinion leaders and 28 healthcare workers, and 12 focus group discussions with parents/guardians of PSAC and 7 with community health volunteers (CHVs). Thematic analysis was performed on the qualitative data. Majority of the 690 respondents were women 594 (86.1%) with a mean age of 34.1 (SD = 11.3, min-max = 18-86). Community-based mass drug administration (cMDA) was the most preferred drug delivery method by 598 participants (86.7%), followed by health facility/fixed points by 398 participants (57.7%). Similarly, in the qualitative data participants indicated they prefer cMDA since the CHVs who would distribute the medication are familiar with households with PSAC and are trusted to explain the drug effects. Health facilities/fixed points were the second most preferred drug delivery approach, but some health workers we interviewed expressed concern about potential understaffing and overcrowding of facilities. Appropriate timing of the drug distribution, not to interfere with farming activities, was considered critical, irrespective of the approach used. All profiles of study participants preferred cMDA over the other delivery approaches due to the convenience of receiving drugs at home and providing explanations about the new drug. For positive outcomes, adequate planning, proper timings and community involvement are highly recommended.
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Affiliation(s)
- Janet Masaku
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya
| | - John M. Gachohi
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya
| | - Alice Sinkeet
- African Institute for Health and Development (AIHD), Nairobi, Kenya
| | - Mary Maghanga
- African Institute for Health and Development (AIHD), Nairobi, Kenya
| | - Florence Wakesho
- Division of Vector Borne and Neglected Tropical Diseases (DVB/NTDs), Ministry of Health (MoH), Nairobi, Kenya
| | - Wyckliff Omondi
- Division of Vector Borne and Neglected Tropical Diseases (DVB/NTDs), Ministry of Health (MoH), Nairobi, Kenya
| | - Nora Monnier
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Peter Steinmann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Lisa Sophie Reigl
- Department of Neurology, Center for Global Health, Technical University of Munich (TUM), Munich, Germany
| | - Isabelle L. Lange
- Department of Neurology, Center for Global Health, Technical University of Munich (TUM), Munich, Germany
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Technical University of Munich (TUM), Munich, Germany
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Mary Amuyunzu-Nyamongo
- Division of Vector Borne and Neglected Tropical Diseases (DVB/NTDs), Ministry of Health (MoH), Nairobi, Kenya
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Cheruiyot NB, Nagi S, Chadeka AE, Takeuchi R, Sassa M, Felix B, Kobayashi N, Moriyasu T, Masaku J, Okomo G, Ouma C, Njomo D, Njenga SM, Hamano S. Barriers and misconceptions hindering reduction of intestinal schistosomiasis in Mbita Sub-County, Western Kenya. Trop Med Health 2024; 52:38. [PMID: 38745247 PMCID: PMC11092127 DOI: 10.1186/s41182-024-00602-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Community and individual participation are crucial for the success of schistosomiasis control. The World Health Organization (WHO) has highlighted the importance of enhanced sanitation, health education, and Mass Drug Administration (MDA) in the fight against schistosomiasis. These approaches rely on the knowledge and practices of the community to be successful; however, where the community knowledge is low and inappropriate, it hinders intervention efforts. Hence, it is essential to identify barriers and misconceptions related to awareness of schistosomiasis, sources of infection, mode of transmission, symptoms, and control measures. METHODS This was a mixed-method cross-sectional study involving 1200 pre-school children randomly selected and examined for Schistosoma mansoni infection using the Kato-Katz technique. All parents/guardians of selected children were enrolled for a pre-tested questionnaire survey, while 42 were engaged in focus group discussions (FGDs). The level of knowledge and awareness among parents/guardians about schistosomiasis was evaluated in relation to the infection status of their pre-school children. RESULTS Among pre-school children, the prevalence of intestinal schistosomiasis was 45.1% (95% CI 41.7-48.5). A majority of parents/guardians (85.5%) had heard about schistosomiasis, and this awareness was associated with the participant's level of education (OR = 0.16, 95% CI 0.08, 0.34). In addition, a positive association was observed between higher educational attainment and knowledge of the causative agent (OR = 0.69, 95% CI 0.49, 0.96). Low education level was significantly associated with limited knowledge of transmission through lake water contact (OR = 0.71, 95% CI 0.52, 0.97) and infection from the lake (OR = 0.33, 95% CI 0.19, 0.57). Notably, parents/guardians who have heard of schistosomiasis could not recognize symptoms of S. mansoni infection, such as abdominal pain (91.8%, 815/888) and blood in the stool (85.1%, 756/888). Surprisingly, 49.8% (442/888) incorrectly identified hematuria (blood in urine), a key sign of S. haematobium, but not S. mansoni, in an endemic area for S. mansoni infection. The majority (82.6%, 734/888) of parents/guardians were unaware that dams are potential infection sites, despite 53.9% (479/888) of their pre-school-aged children testing positive for schistosome infection. CONCLUSIONS Despite the high level of awareness of intestinal schistosomiasis in the study area, we identified a low level of knowledge regarding its causes, modes of transmission, signs and symptoms and potential sites of transmission within the community. This study emphasizes the need for targeted educational interventions to address the misconceptions and knowledge gaps surrounding intestinal schistosomiasis through tailored community-based programs.
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Affiliation(s)
- Ngetich B Cheruiyot
- Nagasaki University, Institute of Tropical Medicine (NUITM): Kenya Medical Research Institute (KEMRI) Project, P O Box 19993-00202, Nairobi, Kenya
| | - Sachiyo Nagi
- Department of Hygiene and Public Health, Tokyo Women's Medical University, 8-1 Kawada-Machi, Shinjuku-ku, Tokyo, 162-0054, Japan.
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | - Asena E Chadeka
- Nagasaki University, Institute of Tropical Medicine (NUITM): Kenya Medical Research Institute (KEMRI) Project, P O Box 19993-00202, Nairobi, Kenya
| | - Rie Takeuchi
- Nagasaki University, Institute of Tropical Medicine (NUITM): Kenya Medical Research Institute (KEMRI) Project, P O Box 19993-00202, Nairobi, Kenya
- Graduate School of Public Health, International University of Health and Welfare, 4-3, Kodunomori, Narita, Chiba, 286-8686, Japan
| | - Miho Sassa
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Bahati Felix
- Nagasaki University, Institute of Tropical Medicine (NUITM): Kenya Medical Research Institute (KEMRI) Project, P O Box 19993-00202, Nairobi, Kenya
| | - Noriko Kobayashi
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Taeko Moriyasu
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Janet Masaku
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Gordon Okomo
- Department of Health Services, County Government of Homa Bay, Homa Bay, Kenya
| | - Collins Ouma
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Kisumu, Kenya
| | - Doris Njomo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Shinjiro Hamano
- Nagasaki University, Institute of Tropical Medicine (NUITM): Kenya Medical Research Institute (KEMRI) Project, P O Box 19993-00202, Nairobi, Kenya.
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
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Mazigo HD, Ambrose EE, Mwingira UJ. Where will pediatric praziquantel be needed in Tanzania? Geographical variation in prevalence, and risk factors of Schistosoma mansoni in pre-school aged children in southern and north-western Tanzania. Parasite Epidemiol Control 2024; 24:e00337. [PMID: 38323193 PMCID: PMC10844104 DOI: 10.1016/j.parepi.2024.e00337] [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: 08/16/2023] [Revised: 12/12/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Background Pediatric schistosomiasis has been recognized as a public health concern in schistosomiasis endemic areas of sub-Saharan Africa, including Tanzania. However, there is limited epidemiological information relating to pediatric schistosomiasis in Tanzania. Therefore, this current focused on assessing the geographical prevalence of S. mansoni infection and its associated risk factors in pre-school children (PreSAC) in southern and north-western Tanzania. Methods A total of 1585 PreSAC aged 1-6 years were enrolled in a cross-sectional study. A single urine and stool sample were obtained from each child and processed using point-of-care circulating cathodic (POC-CCA) antigen and Kato Katz (K-K) technique. The overall prevalence of S. mansoni infection based on K-K technique and POC-CCA test were 18.6% (95%CI:16.7-20.6) and 28.3% (95%CI:26.1-30.6), respectively. The overall geometrical mean eggs per gram of faeces was 110.38epg (95% CI:97.3-125.3). The age group 4-6 years had the highest prevalence (P < 0.01) of S. mansoni in both diagnostic tests and infection intensity (t = -2.8398, P < 0.005) using K-K technique. On multivariable analysis, only Ukerewe district was associated with S. mansoni infection based on K-K technique (aOR = 2.8 (95%CI:2.1-3.9), P < 0.001). Based on POC-CCA test, age group (4-6 years), aOR = 1.7, 95%CI:1.3-2.2, P < 0.001), Nyasa (aOR = 6.2, 95%CI:3.0-12.5, P < 0.001), Geita (aOR = 4.2, 95%CI:2.1-8.2, P < 0.001) and Ukerewe (aOR = 28.9, 95%CI:15.0-55.8, P < 0.001) districts remained independently associated with S. mansoni infection. Conclusion Schistosoma mansoni is a public health concern among PreSAC in the study districts and its prevalence varies from one geographical setting to another. These findings strongly support the need to include pre-school aged in preventive chemotherapy.
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Affiliation(s)
- Humphrey D. Mazigo
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Emmanuela E. Ambrose
- Department of Paediatrics and Child Health, Bugando Medical Centre, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Upendo J. Mwingira
- National Neglected Tropical Diseases Control Programme, National Institute for Medical Research, P.O. Box 9653, 3 Barack Obama Drive, 11101 Dar-Es-Salaam, Tanzania
- RTI International, 701 13 Street NW, Washington, DC 20005, USA
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Kishino M, Hida A, Chadeka EA, Inoue M, Osada-Oka M, Matsumoto S, Njenga SM, Hamano S, Nagi S. Association between diet quality and risk of stunting among school-aged children in Schistosoma mansoni endemic area of western Kenya: a cross-sectional study. Trop Med Health 2024; 52:12. [PMID: 38233936 DOI: 10.1186/s41182-023-00566-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/16/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya. METHODS This cross-sectional study included 260 school-aged children (age 9-17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children's age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status. RESULTS Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016). CONCLUSIONS A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet-malnutrition relationship in areas endemic for S. mansoni infection.
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Affiliation(s)
- Madoka Kishino
- Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Azumi Hida
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan.
| | - Evans A Chadeka
- Nagasaki University Institute of Tropical Medicine (NUITM) - Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Manabu Inoue
- Kyokuto Pharmaceutical Industrial Co., Ltd, Tokyo, Japan
| | - Mayuko Osada-Oka
- Food Hygiene and Environmental Health Division of Applied Life Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Sohkichi Matsumoto
- Department of Bacteriology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Laboratory of Tuberculosis, Institute of Tropical Disease, Universitas Airlangga, Surabaya, East Java, Indonesia
- Hokkaido University Institute for Vaccine Research and Development, Kita 20, Nishi 10, Kita-ku, Sapporo, Japan
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Sachiyo Nagi
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
- Department of Hygiene and Public Health, Tokyo Women's Medical University, Tokyo, Japan.
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Abie A, Hailu T, Alemu G, Nibret E, Amor A, Munshea A. Prevalence of Soil-Transmitted Helminths and Schistosoma mansoni among Schoolchildren across Altitudinal Gradients in Amhara National Regional State, Ethiopia. Am J Trop Med Hyg 2023; 109:667-675. [PMID: 37580029 PMCID: PMC10484247 DOI: 10.4269/ajtmh.23-0124] [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: 02/24/2023] [Accepted: 04/28/2023] [Indexed: 08/16/2023] Open
Abstract
Soil-transmitted helminths (STHs) and Schistosoma mansoni infections are common parasitic infections in sub-Saharan Africa. Their distributions vary across altitudes in Ethiopia. Hence, ongoing updates of infection risk factors and prevalence data are necessary for successful intervention. A school-based, cross-sectional study was conducted from October to December 2019 involving 530 schoolchildren who were recruited by systematic random sampling from Amhara Regional State. A structured questionnaire was used to collect data on sociodemographic, geographical and environmental factors. Stool samples were collected and processed by Ritchie's and Kato Katz techniques. Data were entered into EpiData and analyzed using SPSS. Descriptive statistics were used to compute prevalence, and logistic regression was used to assess factors associated with STHs and S. mansoni infections. Variables with P < 0.05 were considered statistically significant. Among 530 schoolchildren, 169 (31.9%) and 78 (14.7%) were infected with STHs and S. mansoni, respectively. The prevalence of STHs (40.2%) in the semi-highlands and S. mansoni (30.4%) in the lowlands was high. Infrequent shoes wearing, exposure to soil, not washing vegetables before eating, and living outside in lowland areas were significantly associated with STHs infections (P < 0.05). Schoolchildren who fetched water to irrigate fields, swam in rivers, and lived in lowland areas were significantly associated with S. mansoni infection (P < 0.05). In conclusion, prevalence rates of STHs and S. mansoni infections differed across altitudes in Amhara Regional State. Therefore, current control strategies including deworming and provision of clean water and education on sanitation and hygiene should be intensified and adapted to the local context.
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Affiliation(s)
- Alehegn Abie
- Department of Medical Laboratory Sciences, Bahir Dar Health Science College, Bahir Dar, Ethiopia
| | - Tadesse Hailu
- Department of Medical Laboratory Science, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getaneh Alemu
- Department of Medical Laboratory Science, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Arancha Amor
- Mundo Sano Foundations, Institute of Health Carlos III, Madrid, Spain
| | - Abaineh Munshea
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
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Liyih M, Damtie D, Tegen D. Prevalence and Associated Risk Factors of Human Intestinal Helminths Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis. ScientificWorldJournal 2022; 2022:3905963. [PMID: 36093316 PMCID: PMC9451958 DOI: 10.1155/2022/3905963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce the pooled prevalence and associated risk factors of human intestinal helminth parasitic infections (HIHPIs) in Ethiopia. Methods Articles written in English were searched from online databases. Sixty-seven studies were included. Meta-analysis was computed using STATA version 14. Result The pooled prevalence of HIHPIs was (33.35%, 95% CI: 28.85%, 37.86%). Ascaris lumbricoides (10.84%, 95% CI: 9.34, 12.34), hookworm spp. (8.89%, 95% CI: 7.75, 10.04), Schistosoma mansoni (4.22%, 95% CI: 3.64, 4.81), Trichuris trichiura (2.51%, 95% CI: 2.17, 2.86), Hymenolepis nana (2.29%, 95% CI: 1.96, 2.63), Taenia species (1.01%, 95% CI: 0.80, 1.22), Strongyloides stercoralis (1.17%, 95% CI: 0.92, 1.41), and Enterobius vermicularis(0.71%, 95% CI: 0.52, 0.90) were recorded. Handwashing before food (OR: 5.22,95% CI: 3.49, 6.94), handwashing after toilet (OR: 3.03, 95%; CI: 1.01, 5.05), age (OR: 1.66, 95% CL. 1.09, 2.23), open defecation (OR: 2.42, 95% CI: 1.60, 3.24), eating raw and unwashed vegetables/fruits (OR: 1.98, 95%; CI: 1.30, 2.66), maternal education (OR: 1.81, 95% CI: 0.91, 2.72), family income (OR: 2.00, 95% CI: 0.87, 3.31), source of drinking water (OR: 3.12, 95% CI: 1.96, 4.27), swimming/contact with river water (OR: 1.90, 95% CI: 1.11, 2.69), barefoot (OR: 3.28, 95% CI: 1.67, 4.88), playing with soil (OR: 2.64, 95% CI: 1.40, 3.88), and family size (OR: 3.75, 95% CI: 2.03, 5.46) were factors associated with HIHPIs in Ethiopia. High heterogeneity of the prevalence of HIHPIs was observed among the studies within and among regions (I2 > 99.6% and P ≤ 0.001). Conclusion HIHPIs in Ethiopia were significantly high. Therefore, special attention should be given by all stakeholders to minimize HIHPIs in Ethiopia.
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Affiliation(s)
- Minichil Liyih
- Abune Gorgorios Schools, Bahir Dar Branch, Bahir Dar, Ethiopia
| | - Destaw Damtie
- Bahir Dar University, College of Sciences, Department of Biology, Bahir Dar, Ethiopia
| | - Dires Tegen
- Dera Woreda Education Office, South Gondar Zone, Gondar, Ethiopia
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Takeuchi R, Njomo DW, Njenga SM, Tomokawa S, Mutua A, Kazama H, Walema B, Akiyama T, Asakura T, Kamiya Y, Kobayashi J. Has the double burden of malnutrition reached pupils in rural western Kenya? Pediatr Int 2022; 64:e14729. [PMID: 33829604 PMCID: PMC9298995 DOI: 10.1111/ped.14729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/25/2021] [Accepted: 03/30/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Undernutrition and overnutrition have been considered separate challenges caused by the distinct factors in distinct settings. The double burden of malnutrition is defined as the coexistence of both undernutrition and overnutrition, which has now spread globally, especially in low- and middle-income countries. In Kenya, the double burden of malnutrition is present in the capital city but the situation in rural areas currently remains unknown. The aim of this study was therefore to analyze nutritional status in rural Kenya. METHODS Data from height and weight measurements conducted by teachers in the third term of school year 2013 were collected from primary schools. Teachers were trained by experts before starting the measurements. The Z-scores of height-for-age, weight-for-age, and body mass index-for-age were calculated using AnthroPlus, and nutritional status was defined according to the World Health Organization guidelines. RESULTS Data analyzed from 7,447 pupils (3,763 boys and 3,684 girls) showed that 12.4% were stunted and 7.8% were underweight among those ≤120 months old, and 11.7% were thin among those >120 months old. Boys were more likely to be stunted than girls. Boys were more likely to be underweight and girls were more likely to be overweight in the older age group. CONCLUSION The double burden of malnutrition was not found, and undernutrition was still common among schoolchildren in the study area. However, it is important to monitor nutritional status due to adverse effects of rapid urbanization. Height and weight measurements in schools may be useful for monitoring the nutritional status of schoolchildren.
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Affiliation(s)
- Rie Takeuchi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan.,Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nagasaki City, Nagasaki, Japan.,Japanese Consortium for Global school Health and Research, Okinawa, Japan
| | - Doris W Njomo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Sachi Tomokawa
- Japanese Consortium for Global school Health and Research, Okinawa, Japan.,Department of Sports and Health Sciences, Faculty of Education, Shinshu University, Nagano City, Nagano, Japan
| | | | - Haruki Kazama
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nagasaki City, Nagasaki, Japan
| | | | - Takeshi Akiyama
- Japanese Consortium for Global school Health and Research, Okinawa, Japan.,Department of Health Science, Nagano College of Nursing, Nagano City, Nagano, Japan
| | - Takashi Asakura
- Department of Education, Tokyo Gakugei University, Koganei City, Tokyo, Japan
| | - Yasuhiko Kamiya
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki City, Nagasaki, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan.,Japanese Consortium for Global school Health and Research, Okinawa, Japan
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9
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Bisetegn H, Eshetu T, Erkihun Y. Prevalence of Schistosoma mansoni infection among children in Ethiopia: a systematic review and meta-analysis. Trop Dis Travel Med Vaccines 2021; 7:30. [PMID: 34847958 PMCID: PMC8638414 DOI: 10.1186/s40794-021-00156-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia. Schistosoma mansoni is a major public health problem in Ethiopia especially among children. This review is aimed to indicate the prevalence of Schistosoma mansoni among children at the national and regional levels. METHODS AND MATERIAL The PRISMA guidelines were followed. An electronic search of PubMed, Google Scholar, Web of Science, Scopus, MEDLINE, and Google search were carried out using key terms. Articles published from the proceeding of professional associations such as the Ethiopian medical laboratory association, the Ethiopian public health association, and annual national research conferences were also searched to find additional eligible studies. Data were extracted independently by two investigators, and cross-checked by a third reviewer. The quality of included studies was assessed using JBI quality assessment criteria. Data were extracted using Microsoft excel and finally analyzed using STATA version 12. The pooled prevalence was done using a random-effects model. RESULT Overall 49 studies involving 20,493 children (10,572 male and 9, 921 females) were included in this meta-analysis. The pooled prevalence of Schistosoma mansoni infection was 37.13% (95%CI:30.02-44.24). High heterogeneity was observed with I2 of 99.4%, P < 0.000. According to subgroup analysis, the pooled prevalence was high in the SNNPR (41.49%: 95%CI: 19.52-63.46) followed by the Amhara region (41.11%: 95%CI: 30.41-51.8), the Tigray region (31.40%: 95%CI:11.72-51.09), and the Oromia region (28.98%: 95%CI: 18.85-39.1). Year from 2011 to 2015 contributed to the highest prevalence of Schistosoma mansoni infection among children (46.31%: 95%:34.21-59.05). CONCLUSION This study revealed a 37.13% prevalence of Schistosoma mansoni infection among children. This is an alert to improve and implement appropriate control strategies such as mass drug administration in Ethiopia.
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Affiliation(s)
- Habtye Bisetegn
- College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Wollo University, Dessie, Ethiopia
| | - Tegegne Eshetu
- College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Department of Medical Parasitology, University of Gondar, Gondar, Ethiopia
| | - Yonas Erkihun
- College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Wollo University, Dessie, Ethiopia
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10
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Hailegebriel T, Nibret E, Munshea A, Ameha Z. Prevalence, intensity and associated risk factors of Schistosoma mansoni infections among schoolchildren around Lake Tana, northwestern Ethiopia. PLoS Negl Trop Dis 2021; 15:e0009861. [PMID: 34705817 PMCID: PMC8550401 DOI: 10.1371/journal.pntd.0009861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schistosomiasis is one of the widely distributed neglected tropical diseases. It is a serious public health problem in sub-Saharan Africa. The disease is highly prevalent and widely distributed in Ethiopia due to suitable environmental factors and human activities. The prevalence and infection intensity varied from locality to locality in the country. This study aimed to assess the prevalence and intensity of S. mansoni infection and associated risk factors among schoolchildren around Lake Tana. METHODS A school-based cross-sectional study was conducted among 710 schoolchildren from February to April 2021 in eight selected primary schools around Lake Tana. A questionnaire was used to collect data on socio-demographic information and potential risk factors of S. mansoni infection. After collecting socio-demographic information, students were requested to bring about 2grams of stool specimens for parasitological examination. The collected stool samples were processed using a single Kato-Katz and Ritchie's concentration techniques. The data were analyzed using SPSS software version 23 and factors with a p-value < 0.05 were considered as statistically significant. RESULTS The overall prevalence of S. mansoni was 34.9% (95% CI: 31.4-38.7) among schoolchildren in the study area. The eggs per gram (EPG) of stool ranged from 24 to 1659 with arithmetic and geometric mean values of 138.1 EPG and 85.1 EPG, respectively. The majority of S. mansoni infections (61.4%) were classified as low infection intensity. Among the different determinant factors being male (AOR = 1.74; 95%CI = 1.233-2.457; P-value = 0.002), bathing habits (AOR = 1.494; 95%CI = 1.013-2.199; P-value = 0.043) and students attending at Qunzela primary school (AOR = 10.545; 95%CI = 3.264-34.067; P-value = 0.001), Alabo primary school (AOR = 3.386; 95%CI = 1.084-10.572; P-value = 0.036) were significantly associated with S. mansoni infection. CONCLUSION This study revealed that more than one-third of schoolchildren were infected by S. mansoni in the study area. The majority of the infections were classified as low infection intensity. Being male, bathing habits and schools in which students attended were independent explanatory factors for S. mansoni infection. Therefore, integrated control strategies are needed to improve the health conditions of schoolchildren in the study area.
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Affiliation(s)
- Tamirat Hailegebriel
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Biotechnology Research Institute (BRI), Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Biotechnology Research Institute (BRI), Bahir Dar University, Bahir Dar, Ethiopia
| | - Abaineh Munshea
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Biotechnology Research Institute (BRI), Bahir Dar University, Bahir Dar, Ethiopia
| | - Zena Ameha
- Amhara Public Health Institute (APHI), Bahir Dar, Ethiopia
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11
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Mewamba EM, Tiofack AAZ, Kamdem CN, Ngassam RIK, Mbagnia MCT, Nyangiri O, Noyes H, Womeni HM, Njiokou F, Simo G. Field assessment in Cameroon of a reader of POC-CCA lateral flow strips for the quantification of Schistosoma mansoni circulating cathodic antigen in urine. PLoS Negl Trop Dis 2021; 15:e0009569. [PMID: 34260610 PMCID: PMC8312929 DOI: 10.1371/journal.pntd.0009569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/26/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Determining Schistosoma mansoni infection rate and intensity is challenging due to the low sensitivity of the Kato-Katz (KK) test that underestimates the true disease prevalence. Circulating cathodic antigen (CCA) excreted in urine is constantly produced by adult worms and has been used as the basis of a simple, non-invasive point of care test (POC-CCA) for Schistosoma mansoni infections. Although the abundance of CCA in urine is proportional to worm burden, the POC-CCA test is marketed as a qualitative test, making it difficult to investigate the wide range of infection intensities. This study was designed to compare the prevalence and intensity of S. mansoni by KK and POC-CCA and quantify, on fresh and frozen (<-20°C) urine samples, CCA using the visual scores and the ESEquant LR3 reader. Methodology Stool and urine samples were collected from 759 school-aged children. The prevalence and intensity of S. mansoni were determined using KK and POC-CCA. The degree of the positivity of POC-CCA was estimated by quantifying CCA on fresh and frozen urine samples using visual scores and strip reader. The prevalence, the infection intensity as well the relative amounts of CCA were compared. Results The S. mansoni infection rates inferred from POC-CCA and KK were 40.7% and 9.4% respectively. Good correlations were observed between infection intensities recorded by; i) the reader and visual scoring system on fresh (Rho = 0.89) and frozen samples (Rho = 0.97), ii) the reader on fresh urine samples and KK (epg) (Rho = 0.44). Nevertheless, 238 POC-CCA positive children were negative for KK, and sixteen of them had high levels of CCA. The correlation between results from the reader on fresh and frozen samples was good (Rho = 0.85). On frozen samples, CCA was not detected in 55 samples that were positive in fresh urine samples. Conclusion This study confirmed the low sensitivity of KK and the high capacity of POC-CCA to provide reliable data on the prevalence and intensity of S. mansoni infections. The lateral flow reader enabled accurate quantification of CCA under field conditions on fresh and frozen urine samples with less time and effort than KK. Diagnosis of schistosomiasis has relied on the Kato-Katz technique which remains challenging due to its low sensitivity. To overcome this limitation, the Point-of-care-Circulating Cathodic Antigen (POC-CCA) test has been developed to detect CCA produced by adult living worm. However, this test is sold for qualitative use only because it is difficult to estimate the intensity of the positive band by eye. This study was designed with the aim of comparing the prevalence and intensity of S. mansoni infections by KK and POC-CCA and quantifying under field conditions on fresh and frozen (<-20°C) urine samples, CCA using the visual scores and the ESEquant LR3 reader. We conducted the KK and POC-CCA tests on stool and urine samples collected from SAC (5 to 4 years) in Makenene, Cameroon. Our results showed discrepancies between results from KK and POC-CCA test. The numerical values generated by the reader made it possible to avoid subjective visual interpretation of POC-CCA results. This study also identified children with high levels of CCA in their urine but without schistosome eggs in their stools. The good correlation observed between results obtained on fresh and frozen urine samples confirmed that POC-CCA test can be used on samples stored for one year at -20° C.
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Affiliation(s)
- Estelle Mezajou Mewamba
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Arnol Auvaker Zebaze Tiofack
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Cyrille Nguemnang Kamdem
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | | | - Mureille Carole Tchami Mbagnia
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Oscar Nyangiri
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
| | - Hilaire Marcaire Womeni
- Unité de Recherche de Biochimie, des plantes Médicinales, des Sciences alimentaires et Nutrition, University of Dschang, Dschang, Cameroon
| | - Flobert Njiokou
- Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon
| | - Gustave Simo
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
- * E-mail: ,
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12
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Omondi I, Odiere MR, Rawago F, Mwinzi PN, Campbell C, Musuva R. Socioeconomic determinants of Schistosoma mansoni infection using multiple correspondence analysis among rural western Kenyan communities: Evidence from a household-based study. PLoS One 2021; 16:e0253041. [PMID: 34161354 PMCID: PMC8221481 DOI: 10.1371/journal.pone.0253041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Socioeconomic inequality including wealth distribution is a barrier to implementation of health policies. Wealth distribution can be measured effectively using household data on durable assets. Compared to other methods of analysing Socio-economic Status (SES) using durable assets, Multiple Correspondence Analysis (MCA) can create more reliable wealth quintiles. We therefore evaluated socioeconomic determinants of Schistosoma mansoni using MCA on household data among adult population in western Kenya. The hypothesis of this study was that MCA would be a useful predictor of S. mansoni prevalence and/or intensity. METHODOLOGY Twelve villages, 6 villages that had showed the greatest decrease in S. mansoni prevalence (Responder villages) and 6 villages that showed relatively lower decrease (Hotspot villages) between the year 2011 and 2015 were randomly selected for this study. This was according to a previous Schistosomiasis Consortium for Operational Research and Elimination (SCORE) report from western Kenya. From each village, convenience sampling was used to identify 50 adults from 50 households for inclusion in this study. An interview with a questionnaire based upon MCA indicators was conducted. One stool sample from each of the 600 adults was examined based on four slides for S. mansoni eggs using Kato Katz technique. Mean Eggs per gram(EPG) was calculated by taking the average of the readings from the four slides. A log binomial regression model was used to identify the influence of the various age-groups(<30 years, 30-60 years and >60 years), household size, wealth class, occupation, education status, main water supply, sex and sub-county of residence on S. mansoni infection. EPG was then compared across variables that were significant based on multivariate log binomial model analysis using a mixed model. PRINCIPAL FINDINGS Overall prevalence of S. mansoni was 41.3%. Significantly higher prevalence of S. mansoni were associated with males, those aged below 30 years, those who use unsafe water sources (unprotected wells, lakes and rivers), residents of Rachuonyo North, Hotspot villages and those earning livelihood from fishing. Only sex and household size were significant predictors in the multivariate model. Males were associated with significantly higher prevalence compared to the females (aPR = 1.37; 95% CI = 1.14-1.66). In addition, households with at least four persons had higher prevalence compared to those with less than four (aPR = 1.29; 95% CI = 1.03-1.61). However, there was no difference in prevalence between the wealth classes(broadly divided into poor and less poor categories). Intensity of infection (Mean EPG)was also significantly higher among males, younger age group, Rachuonyo North residents and Hotspot Villages. CONCLUSION Socioeconomic status based on an MCA model was not a contributing factor to S. mansoni prevalence and/or intensity possibly because the study populations were not sufficiently dissimilar. The use of convenience sampling to identify participants could also have contributed to the lack of significant findings.
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Affiliation(s)
- Isaiah Omondi
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Maurice R. Odiere
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Fredrick Rawago
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Pauline N. Mwinzi
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Carl Campbell
- Center for Tropical and Emerging Global Diseases and Department of Microbiology, University of Georgia, Athens, Georgia, United States of America
| | - Rosemary Musuva
- Neglected Tropical Diseases Branch, Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
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Minakawa N, Kongere JO, Sonye GO, Lutiali PA, Awuor B, Kawada H, Isozumi R, Futami K. Long-Lasting Insecticidal Nets Incorporating Piperonyl Butoxide Reduce the Risk of Malaria in Children in Western Kenya: A Cluster Randomized Controlled Trial. Am J Trop Med Hyg 2021; 105:461-471. [PMID: 34125699 PMCID: PMC8437186 DOI: 10.4269/ajtmh.20-1069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
Malaria vectors have acquired an enzyme that metabolizes pyrethroids. To tackle this problem, we evaluated long-lasting insecticidal nets incorporating piperonyl butoxide (PBO-LLINs) with a community-based cluster randomized control trial in western Kenya. The primary endpoints were anopheline density and Plasmodium falciparum polymerase chain reaction (PCR)-positive prevalence (PCRpfPR) of children aged 7 months to 10 years. Four clusters were randomly selected for each of the treatment and control arms (eight clusters in total) from 12 clusters, and PBO-LLINs and standard LLINs were distributed in February 2011 to 982 and 1,028 houses for treatment and control arms, respectively. Entomological surveys targeted 20 houses in each cluster, and epidemiological surveys targeted 150 children. Cluster-level permutation tests evaluated the effectiveness using the fitted values from individual level regression models adjusted for baseline. Bootstrapping estimated 95% confidence intervals (CIs). The medians of anophelines per house were 1.4 (interquartile range [IQR]: 2.3) and 3.4 (IQR: 3.7) in the intervention and control arms after 3 months, and 0.4 (IQR: 0.2) and 1.6 (IQR: 0.5) after 10 months, respectively. The differences were -2.5 (95% CI: -6.4 to -0.6) and -1.3 (95% CI: -2.0 to -0.7), respectively. The datasets of 861 and 775 children were analyzed in two epidemiological surveys. The median PCRpfPRs were 25% (IQR: 11%) in the intervention arm and 52% (IQR: 11%) in the control arm after 5 months and 33% (IQR: 11%) and 45% (IQR: 5%) after 12 months. The PCRpfPR ratios were 0.67 (95% CI: 0.38, 0.91) and 0.74 (95% CI: 0.53, 0.90), respectively. We confirmed the superiority of PBO-LLINs.
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Affiliation(s)
- Noboru Minakawa
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - James O. Kongere
- Kenya Medical Research Institute, Nairobi, Kenya
- Center for Research in Tropical Medicine and Community Development (CRTMCD), Nairobi, Kenya
| | | | - Peter A. Lutiali
- Kenya Medical Research Institute, Nairobi, Kenya
- Center for Research in Tropical Medicine and Community Development (CRTMCD), Nairobi, Kenya
| | | | - Hitoshi Kawada
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Rie Isozumi
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Kyoko Futami
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
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14
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Bekana T, Berhe N, Eguale T, Aemero M, Medhin G, Tulu B, G/Hiwot Y, Liang S, Hu W, Erko B. Prevalence and factors associated with intestinal schistosomiasis and human fascioliasis among school children in Amhara Regional State, Ethiopia. Trop Med Health 2021; 49:35. [PMID: 33971981 PMCID: PMC8111779 DOI: 10.1186/s41182-021-00326-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background Schistosomiasis and fascioliasis are digenean parasitic infections and are among the neglected tropical diseases that have both medical and veterinary importance. They are found mainly in areas having limited access to safe water supply and improved sanitation. Methods A cross-sectional study was conducted to determine the prevalence of Schistosoma mansoni and Fasciola species infections and to identify associated risk factors among school children in Amhara Regional State, Ethiopia. Stool specimens were collected from 798 children (419 males, 379 females) and processed using Kato-Katz and formol-ether concentration techniques. A semi-structured questionnaire was used to collect socio-demographic and other exposure information to explore potential risk factors for the infections. Results The overall prevalence of S. mansoni and Fasciola species infections was 25.6% (95% confidence interval (CI): 22.5-28.6) and 5.5% (95% CI: 3.9-7.1), respectively. S. mansoni was present in all surveyed schools with the prevalence ranging from 12.8% (16/125; 95% CI = 5.6-20.0) to 39.7% (64/161; 95% CI = 32.2-47.2) while Fasciola species was identified in five schools with the prevalence ranging from 2.5% (4/160; 95% CI = 0.001–4.9) to 9.8% (13/133; 95% CI = 4.7–14.8). The prevalence of S. mansoni infection was significantly associated with swimming in rivers (Adjusted odds ratio (AOR): 1.79, 95% CI, 1.22–2.62; P=0.003), bathing in open freshwater bodies (AOR, 2.02; 95% CI, 1.39–2.94; P<0.001) and engaging in irrigation activities (AOR, 1.69; 95% CI, 1.19-2.39; P=0.004), and was higher in children attending Addis Mender (AOR, 2.56; 95% CI, 1.20–5.46; P=0.015 ) and Harbu schools (AOR, 3.53; 95% CI, 1.64–7.59; P=0.001). Fasciola species infection was significantly associated with consumption of raw vegetables (AOR, 2.47; 95% CI, 1.23-4.97; P=0.011) and drinking water from unimproved sources (AOR, 2.28; 95% CI, 1.11–4.70; P=0.026). Conclusion Both intestinal schistosomiasis and human fascioliasis are prevalent in the study area, affecting school children. Behaviors and access to unimproved water and sanitation are among significant risk factors. The findings are instrumental for targeted interventions.
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Affiliation(s)
- Teshome Bekana
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. .,Department of Biomedical Sciences, Faculty of Public Health and Medical Science, Mettu University, Mettu, Ethiopia.
| | - Nega Berhe
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mulugeta Aemero
- Department of Medical Parasitology, College of Medicine & Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Begna Tulu
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yirgalem G/Hiwot
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32610, USA
| | - Wei Hu
- Department of Microbiology and Microbial Engineering, School of Life Science, Fudan University, Shanghai, China
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Tanaka M, Kildemoes AO, Chadeka EA, Cheruiyot BN, Sassa M, Moriyasu T, Nakamura R, Kikuchi M, Fujii Y, de Dood CJ, Corstjens PLAM, Kaneko S, Maruyama H, Njenga SM, de Vrueh R, Hokke CH, Hamano S. Potential of antibody test using Schistosoma mansoni recombinant serpin and RP26 to detect light-intensity infections in endemic areas. Parasitol Int 2021; 83:102346. [PMID: 33857597 DOI: 10.1016/j.parint.2021.102346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/31/2021] [Accepted: 04/08/2021] [Indexed: 11/24/2022]
Abstract
Schistosomiasis remains a worldwide public health problem, especially in sub-Saharan Africa. The World Health Organization targets the goal for its elimination as a public health problem in the 2030 Neglected Tropical Diseases (NTDs) Roadmap. Concerted action and agile responses to challenges will be necessary to achieve the targets. Better diagnostic tests can accelerate progress towards the elimination by monitoring disease trends and evaluating the effectiveness of interventions; however, current examinations such as Kato-Katz technique are of limited power to detect light-intensity infections. The point-of-care circulating cathodic antigen (POC-CCA) test shows a higher sensitivity compared to the reference standard, Kato-Katz technique, but it still lacks sufficient sensitivity with low infection intensity. In this study, we examined antibody reactions against recombinant protein antigens; Schistosoma mansoni serine protease-inhibitor (SmSerpin) and RP26, by enzyme-linked immunosorbent assay (ELISA) in plasma samples with light-intensity infection. The sensitivity using the cocktail antigen of recombinant SmSerpin and RP26 showed 83.7%. The sensitivity using S. mansoni soluble egg antigen (SmSEA) was 90.8%, but it showed poor specificity (29.7%), while the cocktail antigen presented improved specificity (61.4%). We conclude that antibody detection to the SmSerpin and RP26 protein antigens is effective to detect S. mansoni light-intensity infections. Our study indicates the potential of detecting antibody against recombinant protein antigens to monitor the transmission of schistosomiasis in low endemicity contexts.
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Affiliation(s)
- Mio Tanaka
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Anna O Kildemoes
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Evans Asena Chadeka
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Benard Ngetich Cheruiyot
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Miho Sassa
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Taeko Moriyasu
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya; Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Risa Nakamura
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Mihoko Kikuchi
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Yoshito Fujii
- Department of Medical Technology, Sanyo Women's College, Hatsukaichi, Japan
| | - Claudia J de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Satoshi Kaneko
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya; Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Haruhiko Maruyama
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | | | - Cornelis H Hokke
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya.
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Okoyo C, Campbell SJ, Owaga C, Owuor N, Medley G, Mwandawiro C. Statistical Regression Model of Water, Sanitation, and Hygiene; Treatment Coverage; and Environmental Influences on School-Level Soil-Transmitted Helminths and Schistosome Prevalence in Kenya: Secondary Analysis of the National Deworming Program Data. Am J Trop Med Hyg 2021; 104:2251-2263. [PMID: 33844645 PMCID: PMC8176504 DOI: 10.4269/ajtmh.20-1189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 02/01/2021] [Indexed: 11/07/2022] Open
Abstract
According to the Kenya National School-Based Deworming program launched in 2012 and implemented for the first 5 years (2012-2017), the prevalence of soil-transmitted helminths (STH) and schistosomiasis substantially reduced over the mentioned period among the surveyed schools. However, this reduction is heterogeneous. In this study, we aimed to determine the factors associated with the 5-year school-level infection prevalence and relative reduction (RR) in prevalence in Kenya following the implementation of the program. Multiple variables related to treatment, water, sanitation, and hygiene (WASH) and environmental factors were assembled and included in mixed-effects linear regression models to identify key determinants of the school location STH and schistosomiasis prevalence and RR. Reduced prevalence of Ascaris lumbricoides was associated with low (< 1%) baseline prevalence, seven rounds of treatment, high (50-75%) self-reported coverage of household handwashing facility equipped with water and soap, high (20-25°C) land surface temperature, and community population density of 5-10 people per 100 m2. Reduced hookworm prevalence was associated with low (< 1%) baseline prevalence and the presence of a school feeding program. Reduced Trichuris trichiura prevalence was associated with low (< 1%) baseline prevalence. Reduced Schistosoma mansoni prevalence was associated with low (< 1%) baseline prevalence, three treatment rounds, and high (> 75%) reported coverage of a household improved water source. Reduced Schistosoma haematobium was associated with high aridity index. Analysis indicated that a combination of factors, including the number of treatment rounds, multiple related program interventions, community- and school-level WASH, and several environmental factors had a major influence on the school-level infection transmission and reduction.
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Affiliation(s)
- Collins Okoyo
- 1Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.,2School of Mathematics, College of Biological and Physical Sciences, University of Nairobi, Nairobi, Kenya
| | - Suzy J Campbell
- 3Deworm the World, Evidence Action, Washington, District of Columbia
| | | | - Nelson Owuor
- 2School of Mathematics, College of Biological and Physical Sciences, University of Nairobi, Nairobi, Kenya
| | - Graham Medley
- 5Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Charles Mwandawiro
- 1Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
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Impact of seven years of mass drug administration and recrudescence of Schistosoma haematobium infections after one year of treatment gap in Zanzibar: Repeated cross-sectional studies. PLoS Negl Trop Dis 2021; 15:e0009127. [PMID: 33577601 PMCID: PMC7880478 DOI: 10.1371/journal.pntd.0009127] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background Considerable progress towards the elimination of urogenital schistosomiasis was made by the Zanzibar Elimination of Schistosomiasis Transmission project from 2012 till 2016, when biannual praziquantel mass drug administration (MDA) alone or with additional snail control or behaviour change interventions were implemented. Annual MDA was continued in 2017 and 2018, but not in 2019, imposing a 16-month treatment gap. We monitored the Schistosoma haematobium prevalence from 2012 till 2020 and assessed recrudescence patterns with focus on 2020. Methodology Repeated cross-sectional surveys were conducted from 2011/12 till 2020 in 90 communities and 90 schools in Zanzibar. Annually, around 4,500 adults and up to 20,000 schoolchildren were surveyed. The S. haematobium prevalence was detected by urine filtration and reagent strips. In 2020, risk factors for infection were investigated using generalized estimated equation models. Principal findings In adults, the apparent S. haematobium prevalence was 3.9% in 2011 and 0.4% in 2020. In schoolchildren, the prevalence decreased from 6.6% in 2012 to 1.2% in 2019 with vicissitudes over the years. Prominent recrudescence of infection from 2.8% in 2019 to 9.1% (+225%) in 2020 was observed in 29 schools with historically moderate prevalences (≥10%). Compared with 2019, reinfection in 2020 was particularly striking in boys aged 9–16 years. Being male was a risk factor for infection in 2020 (adults: odds ratio (OR): 6.24, 95% confidence interval (95% CI): 1.96–19.60; schoolchildren: OR: 2.06, 95% CI: 1.52–2.78). Living near to a natural freshwater body significantly increased the odds of infection in adults (OR: 2.90, CI: 1.12–7.54). Conclusions/Significance After 11 rounds of MDA over 7 years and a 16-month treatment gap, the urogenital schistosomiasis prevalence considerably rebounded in hotspot areas. Future elimination efforts in Zanzibar should focus on re-intensifying MDA plus additional interventions in hotspot areas. In low-prevalence areas, the strategy might be adapted from MDA to targeted surveillance-response. Schistosomiasis is a neglected tropical disease caused by parasitic blood flukes of the genus Schistosoma. On the Zanzibar islands, United Republic of Tanzania, interventions to eliminate urogenital schistosomiasis commenced in 2012. From 2012 to 2016, the population was treated biannually with praziquantel and, additionally, some areas received mollusciciding against the intermediate host snail, or educational measures for behavior change. Mass drug administration (MDA) with praziquantel was continued annually in 2017 and 2018, but not in 2019. As a result of the interventions, the overall S. haematobium prevalence was reduced to 0.4% in adults and 3.4% in schoolchildren in 2020. However, in some areas, the MDA gap in 2019 resulted in a considerable rebound of infections. The recrudescence in 2020 was particularly striking for boys aged 9–16 years. In general, in 2020, male participants had higher odds of infection than females. Adults living near to a natural freshwater body also showed an increased risk of S. haematobium infection. Future elimination efforts in Zanzibar should focus on re-intensifying elimination interventions, including MDA, snail control and behavior change in hotspot areas. In low-prevalence areas, the strategy might be adapted from MDA to targeted interventions, such as surveillance-response.
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Prevalence, Intensity, and Associated Factors of Schistosoma mansoni among School Children in Northwest Ethiopia. J Parasitol Res 2020; 2020:8820222. [PMID: 33274074 PMCID: PMC7676956 DOI: 10.1155/2020/8820222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 11/18/2022] Open
Abstract
Background Schistosomiasis is one of the Neglected Tropical Diseases in Ethiopia, and its burden may show variations from time to time across different regions. Thus, this study was aimed at determining the prevalence, intensity, and associated risk factors of Schistosoma mansoni (S. mansoni) among schoolchildren in Northwest Ethiopia. Methods A school-based cross-sectional study was conducted. A multistage sampling technique was used to select the study participants. Stool specimens were collected and examined using two-slide Kato-Katz method. Data were analyzed using SPSS version 20 software. Multivariate logistic regression analysis was used to identify risk factors. p values less than 0.05 were taken as statistically significant. Result A total of 786 schoolchildren were participated in this study. The prevalence of S. mansoni was 33.5%. The mean egg count of the parasite among the infected study participants was 523.665 eggs per gram (epg) of stool. Thirty-seven, 42, and 21 percent of the study participant's infection were due to light, moderate, and heavy infection intensities, respectively. Age of 8-11 years old (AOR = 1,687, 95%CI = 1.163, 2.892), 5th-8th grade level (AOR = 2.280, 95%CI = 1.348, 3.856), residing in Chuahit District (AOR = 95.559, 95%CI = 12.945, 705.419), and using untreated water for domestic supply (AOR = 1.724, 95%CI = 1.457, 2.148) were found to be risk factors for S. mansoni infection. Conclusion High prevalence of S. mansoni and relatively higher proportion of moderate intensity of infection in this study imply that schistosomiasis is still one of the major public health problems in Northwest Ethiopia. It is also highlighted that study sites, provision of water supply, age, and grade level of the schoolchildren were identified as a risk factors for the disease.
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Akiyama T, Njenga SM, Njomo DW, Takeuchi R, Kazama H, Mutua A, Walema B, Tomokawa S, Estrada CA, Henzan H, Asakura T, Shimada M, Ichinose Y, Kamiya Y, Kaneko S, Kobayashi J. Implementation of Kenyan comprehensive school health program: improvement and association with students' academic attainment. Health Promot Int 2020; 35:1441-1461. [PMID: 32125374 DOI: 10.1093/heapro/daaa005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There is growing evidence supporting the effectiveness of a comprehensive school health program. However, implementation in developing countries is a challenge. Furthermore, the available information on the association between a comprehensive school health program and students' academic attainment is limited. In Kenya, a project to verify the effects of a comprehensive school health program was carried out in Mbita sub-county, Homa Bay County from September 2012 to August 2017. This study aimed to clarify the improvement of school health during the project years and the association between school health and students' academic attainment. Primary schools in Mbita sub-county were selected as study sites. We assessed 44 schools' scores on a school health checklist developed from the Kenyan Comprehensive School Health Program, the students' mean score on the Kenya Certificate of Primary Education (KCPE), and absenteeism during the project years (2013-16). The mean school health checklist score (n = 44 schools) was 135.6 in 2013, 169.9 in 2014, 158.2 in 2015 and 181.3 in 2016. The difference of the mean score between 2013 and 2016 was significant. In addition, correlation analysis showed a significant association between mean KCPE score in the project years and school health checklist score (Pearson's coefficient was 0.43, p = 0.004). The results of this study suggest improvements of school health by the implementation of the Kenyan Comprehensive School Health Program and students' academic attainment.
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Affiliation(s)
- Takeshi Akiyama
- Department of Health Science, Nagano College of Nursing, 694 Akaho, Komagane, Nagano 399-4117, Japan.,Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Sammy M Njenga
- Kenya Medical Research Institute, PO Box 54840 00200, Off Mbagathi Road, Nairobi, Kenya
| | - Doris Wairimu Njomo
- Kenya Medical Research Institute, PO Box 54840 00200, Off Mbagathi Road, Nairobi, Kenya
| | - Rie Takeuchi
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Haruki Kazama
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Alex Mutua
- Ministry of Health, Afya House, Cathedral Road, PO Box 30016-00100, Nairobi, Kenya
| | - Barnett Walema
- State Department of Early Learning and Basic Education, Ministry of Education, PO Box 30040-00100, Nairobi, Kenya
| | - Sachi Tomokawa
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Sports and Health Sciences, Faculty of Education, Shinshu University, 6-Ro Nishi Nagano, Nagano City, Nagano 380-8544, Japan
| | - Crystal Amiel Estrada
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Hanae Henzan
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Takashi Asakura
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Education, Tokyo Gakugei University, 4-1-1 Nukuikita-machi, Koganei-shi, Tokyo 184-8501, Japan
| | - Masaaki Shimada
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Yoshio Ichinose
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Yasuhiko Kamiya
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Satoshi Kaneko
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Jun Kobayashi
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
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20
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Okoyo C, Campbell SJ, Williams K, Simiyu E, Owaga C, Mwandawiro C. Prevalence, intensity and associated risk factors of soil-transmitted helminth and schistosome infections in Kenya: Impact assessment after five rounds of mass drug administration in Kenya. PLoS Negl Trop Dis 2020; 14:e0008604. [PMID: 33027264 PMCID: PMC7540847 DOI: 10.1371/journal.pntd.0008604] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/15/2020] [Indexed: 12/23/2022] Open
Abstract
Background In Kenya, over five million school age children (SAC) are estimated to be at risk of parasitic worms causing soil-transmitted helminthiasis (STH) and schistosomiasis. As such, the Government of Kenya launched a National School Based Deworming (NSBD) program in 2012 targeting the at-risk SAC living in endemic regions, with the aim of reducing infections prevalence to a level where they no longer constitute a public health problem. The impact of the program has been consistently monitored from 2012 to 2017 through a robust and extensive monitoring and evaluation (M&E) program. The aim of the current study was to evaluate the parasitological outcomes and additionally investigate water, sanitation and hygiene (WASH) related factors associated with infection prevalence after five rounds of mass drug administration (MDA), to inform the program’s next steps. Materials and methods We utilized a cross-sectional design in a representative, stratified, two-stage sample of school children across six regions in Kenya. A sample size of 100 schools with approximately 108 children per school was purposively selected based on the Year 5 STH infection endemicity prior to the survey. Stool samples were examined for the presence of STH and Schistosoma mansoni eggs using double-slide Kato-Katz technique, urine samples were processed using urine filtration technique for the presence of S. haematobium eggs. Survey questionnaires were administered to all the participating children to collect information on their demographic and individual, household and school level WASH characteristics. Principal findings Overall, STH prevalence was 12.9% (95%CI: 10.4–16.1) with species prevalence of 9.7% (95%CI: 7.5–12.6) for Ascaris lumbricoides, 3.6% (95%CI: 2.2–5.8) for Trichuris trichiura and 1.0% (95%CI: 0.6–1.5) for hookworm. S. mansoni prevalence was 2.2% (95%CI: 1.2–4.3) and S. haematobium prevalence was 0.3% (95%CI: 0.1–1.0). All the infections showed significant prevalence reductions when compared with the baseline prevalence, except S. mansoni. From multivariable analysis, increased odds of any STH infections were associated with not wearing shoes, adjusted odds ratio (aOR) = 1.36 (95%CI: 1.09–1.69); p = 0.007; high number of household members, aOR = 1.21 (95%CI: 1.04–1.41); p = 0.015; and school absenteeism of more than two days, aOR = 1.33 (95%CI: 1.01–1.80); p = 0.045. Further, children below five years had up to four times higher odds of getting STH infections, aOR = 4.68 (95%CI: 1.49–14.73); p = 0.008. However, no significant factors were identified for schistosomiasis, probably due to low prevalence levels affecting performance of statistical analysis. Conclusions After five rounds of MDA, the program shows low prevalence of STH and schistosomiasis, however, not to a level where the infections are not a public health problem. With considerable inter-county infection prevalence heterogeneity, the program should adopt future MDA frequencies based on the county’s infection prevalence status. Further, the program should encourage interventions aimed at improving coverage among preschool age children and improving WASH practices as long-term infection control strategies. This paper presents the findings of an evaluation survey conducted in Year 6 of the Kenya National School-Based Deworming (NSBD) Program, following five years (2012–2017) of prior baseline and subsequent impact monitoring. The survey was conducted in 20 counties, covering six regions in Kenya. The survey showed continued and considerable reductions in prevalence over time, with most marked decline for hookworm, followed by Ascaris lumbricoides. Overall, the mass drug administration (MDA) program has driven both STH and schistosomiasis prevalence to relatively low levels, however not to a point where they no longer constitute a public health problem in Kenya. For these neglected tropical diseases (NTDs), and STH in particular, there are relatively few published examples of programmatic impact assessments enabling refined decisions regarding helminth control strategies. Kenya’s experiences in implementing, monitoring, and evaluating a high-coverage NSBD program are a continuing and increasingly important success story for the country, which provides learnings of importance for the international community.
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Affiliation(s)
- Collins Okoyo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- School of Mathematics, College of Biological and Physical Sciences, University of Nairobi, Nairobi, Kenya
- * E-mail: ,
| | - Suzy J. Campbell
- Deworm the World, Evidence Action, Washington DC, United States of America
| | | | - Elses Simiyu
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | | | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
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Mohammed ES, Nakamura R, Kalenda YDJ, Deloer S, Moriyasu T, Tanaka M, Fujii Y, Kaneko S, Hirayama K, Ibrahim AI, El-Seify MA, Metwally AM, Hamano S. Dynamics of serological responses to defined recombinant proteins during Schistosoma mansoni infection in mice before and after the treatment with praziquantel. PLoS Negl Trop Dis 2020; 14:e0008518. [PMID: 32915790 PMCID: PMC7485895 DOI: 10.1371/journal.pntd.0008518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022] Open
Abstract
To eliminate schistosomiasis, appropriate diagnostic tests are required to monitor its prevalence and transmission, especially in the settings with low endemicity resulting from the consecutive mass drug administration. Antibodies that react with either crude soluble schistosome egg antigens or soluble worm antigen preparations have been used to monitor infection in low-prevalence regions. However, these detection methods cannot discriminate current and past infections and are cross-reactive with other parasites because both antigens contain numerous proteins and glycans from schistosomes, and standard preparations need maintenance of the life cycle of the schistosome. To evaluate the potential utility of nine recombinant Schistosoma mansoni proteins as single defined antigens for serological diagnosis, we monitored the kinetics of antibodies to each antigen during S. mansoni infection in mice before and after the treatment with praziquantel. C57BL/6 mice were infected with 50 cercariae. The levels of immunoglobulin G (IgG) raised against five recombinant antigens (RP26, sm31, sm32, GST, and LAP1) significantly increased as early as 2-4 weeks after infection and rapidly declined by 2 weeks after the treatment, whereas those raised against crude S. mansoni egg antigens or other antigens remained elevated long after the treatment. The IgG1 raised against RP26, sm31, and serpin decreased after the treatment with praziquantel, whereas the IgE raised against serpin declined strikingly after the treatment. This study clarifies the dynamics of the serological responses to recombinant S. mansoni proteins during infection and after the treatment with praziquantel and identifies several candidate antigens with potential utility in the monitoring and surveillance of schistosomiasis toward the elimination of schistosomiasis.
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Affiliation(s)
- Eman Sayed Mohammed
- Department of Parasitology, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Risa Nakamura
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yombo DJ Kalenda
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Eco-epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sharmina Deloer
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Taeko Moriyasu
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Mio Tanaka
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshito Fujii
- Department of Eco-epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Satoshi Kaneko
- Department of Eco-epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University Nairobi Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Ahmed I. Ibrahim
- Department of Poultry Disease, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
| | - Mahmoud A. El-Seify
- Department of Parasitology, Faculty of Veterinary Medicine, Kafrelsheikh University, Egypt
| | - Asmaa M. Metwally
- Department of Parasitology, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Nagasaki University Nairobi Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- * E-mail:
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22
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Sassa M, Chadeka EA, Cheruiyot NB, Tanaka M, Moriyasu T, Kaneko S, Njenga SM, Cox SE, Hamano S. Prevalence and risk factors of Schistosoma mansoni infection among children under two years of age in Mbita, Western Kenya. PLoS Negl Trop Dis 2020; 14:e0008473. [PMID: 32841228 PMCID: PMC7447014 DOI: 10.1371/journal.pntd.0008473] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/10/2020] [Indexed: 02/07/2023] Open
Abstract
Despite growing evidence that infants and very young children can be infected with schistosomes, the epidemiological features and risk factors are not well described in this age group. We aimed to assess the prevalence of S. mansoni infection in children under two years of age from a population with a known high burden of infection in school-aged children and adults and thus inform the need for interventions in this potentially vulnerable age group. In a cross-sectional study in Mbita Sub-county, along the east coast of Lake Victoria, Western Kenya, we enrolled 361 children aged 6-23 months. The prevalence of S. mansoni infection was detected using the Kato-Katz stool examination and a point-of-care test for urinary circulating cathodic antigen (POC-CCA) (Rapid Medical Diagnostics, Pretoria, South Africa). Three-hundred and five (305) children had complete data of whom 276 (90.5%, 95%CI: 86.6-93.5) children were positive for S. mansoni by the POC-CCA test, while 11 (3.6%, 95%CI: 1.8-6.4) were positive by the Kato-Katz method. All Kato-Katz positive cases were also positive by the POC-CCA test. In multivariable analysis, only geographical area, Rusinga West (AOR = 7.1, 95%CI: 1.4-35.2, P = 0.02), was associated with S. mansoni infection using Kato-Katz test. Independent associations for POC-CCA positivity included age, (12-17 months vs 6-11 months; AOR = 7.8, 95%CI: 1.8-32.6, P = 0.002) and breastfeeding in the previous 24 hours (AOR = 3.4, 95%CI: 1.3-9.0, P = 0.009). We found a potentially very high prevalence of S. mansoni infection among children under two years of age based on POC-CCA test results in Mbita Sub-county, Kenya, which if confirmed strongly supports the need to include infants in public health strategies providing universal prophylactic treatment in high burden settings. Further research is required to determine the accuracy of diagnostic tools to detect light infection among very young children and possible long-term health impacts.
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Affiliation(s)
- Miho Sassa
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- The Joint Usage/ Research Centre on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Evans A. Chadeka
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/ Research Centre on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Ngetich B. Cheruiyot
- The Joint Usage/ Research Centre on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Mio Tanaka
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/ Research Centre on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Leading program, Program for Nuring Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Taeko Moriyasu
- The Joint Usage/ Research Centre on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Satoshi Kaneko
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- The Joint Usage/ Research Centre on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Sharon E. Cox
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Global Health Development Policy Science, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail: (SEC); (SH)
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- The Joint Usage/ Research Centre on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- Leading program, Program for Nuring Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- * E-mail: (SEC); (SH)
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Schistosoma haematobium infection and environmental factors in Southwestern Tanzania: A cross-sectional, population-based study. PLoS Negl Trop Dis 2020; 14:e0008508. [PMID: 32833959 PMCID: PMC7446842 DOI: 10.1371/journal.pntd.0008508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 06/22/2020] [Indexed: 12/30/2022] Open
Abstract
Schistosomiasis is a leading cause of morbidity in Africa. Understanding the disease ecology and environmental factors that influence its distribution is important to guide control efforts. Geographic information systems have increasingly been used in the field of schistosomiasis environmental epidemiology. This study reports prevalences of Schistosoma haematobium infection and uses remotely sensed and questionnaire data from over 17000 participants to identify environmental and socio-demographic factors that are associated with this parasitic infection. Data regarding socio-demographic status and S. haematobium infection were obtained between May 2006 and May 2007 from 17280 participants (53% females, median age = 17 years) in the Mbeya Region, Tanzania. Combined with remotely sensed environmental data (vegetation cover, altitude, rainfall etc.) this data was analyzed to identify environmental and socio-demographic factors associated with S. haematobium infection, using mixed effects logistic regression and geostatistical modelling. The overall prevalence of S. haematobium infection was 5.3% (95% confidence interval (CI): 5.0-5.6%). Multivariable analysis revealed increased odds of infection for school-aged children (5-15 years, odds ratio (OR) = 7.8, CI: 5.9-10.4) and the age groups 15-25 and 25-35 years (15-25 years: OR = 5.8, CI: 4.3-8.0, 25-35 years: OR = 1.6, CI: 1.1-2.4) compared to persons above 35 years of age, for increasing distance to water courses (OR = 1.4, CI: 1.2-1.6 per km) and for proximity to Lake Nyasa (<1 km, OR = 4.5, CI: 1.8-11.4; 1-2 km, OR = 3.5, CI: 1.7-7.5; 2-4 km; OR = 3.3, CI: 1.7-6.6), when compared to distances >4 km. Odds of infection decreased with higher altitude (OR = 0.7, CI: 0.6-0.8 per 100 m increase) and with increasing enhanced vegetation index EVI (OR = 0.2, CI: 0.1-0.4 per 0.1 units). When additionally adjusting for spatial correlation population density became a significant predictor of schistosomiasis infection (OR = 1.3, CI: 1.1-1.5 per 1000 persons/km2) and altitude turned non-significant. We found highly focal geographical patterns of S. haematobium infection in Mbeya Region in Southwestern Tanzania. Despite low overall prevalence our spatially heterogeneous results show that some of the study sites suffer from a considerable burden of S. haematobium infection, which is related to various socio-demographic and environmental factors. Our results could help to design more effective control strategies in the future, especially targeting school-aged children living in low altitude sites and/or crowded areas as the persons at highest need for preventive chemotherapy.
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Mnkugwe RH, Minzi OS, Kinung'hi SM, Kamuhabwa AA, Aklillu E. Prevalence and correlates of intestinal schistosomiasis infection among school-aged children in North-Western Tanzania. PLoS One 2020; 15:e0228770. [PMID: 32023307 PMCID: PMC7001966 DOI: 10.1371/journal.pone.0228770] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 01/23/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schistosomiasis is a neglected tropical disease that continues to cause morbidity and mortality in Sub Saharan Africa. Due to its endemicity, co-infection with malaria is common. The diseases cause anaemia and impaired nutritional status among children. We investigated the prevalence of intestinal schistosomiasis and its association with malaria, anaemia and nutritional status among school children. METHODS This was a cross sectional survey among 830 children in Nyamikoma village along Lake Victoria in Tanzania. A pre-tested questionnaire was used to collect socio-demographic data, history of drug use, and clinical data. Two faecal samples were collected on two consecutive days and analyzed using thick smears Kato Katz method. Diagnosis of malaria was done by malaria rapid diagnostic test, and haemoglobin concentration was determined using HemoCue. Nutritional status was assessed by anthropometric measurements. RESULTS The overall prevalence of intestinal schistosomiasis was 90.6% (95% CI = 88.6% - 92.6%). Intensity of infection was light 24.1% (200/830), moderate 38.4% (319/830) and heavy 28.1% (233/830). Pre-adolescents (≤12 years) were more infected with intestinal schistosomiasis (93.2%) than adolescents (>12 years) (84.7%) (p < 0.001). Prevalence of malaria was 1.7% (14/824), and that of intestinal schistosomiasis-malaria co-infection was 1.6% (13/824). The overall prevalence of anaemia was 24.6% (95%CI = 18.7% - 30.5%). Severe anaemia was found in 2.3% (19/824) of study participants. The prevalence of stunting and wasting were 29.0% and 11.3%, respectively. On both univariate and multivariate regression analysis, only lower age was significantly associated intestinal schistosomiasis infection, but not anemia, malaria, stunting or wasting. However among those infected, a negative binomial regression analysis indicated independent significant association of male sex, loose stool consistency, and stunting with high eggs count/gram of stool. CONCLUSIONS Despite several rounds of annual mass praziquantel administration, intestinal schistosomiasis is highly prevalent among school children particularly in younger children living in the study area. Biannual targeted mass praziquantel treatments or alternative regimens may be considered in future in the study area to redress the situation.
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Affiliation(s)
- Rajabu Hussein Mnkugwe
- Department of Clinical Pharmacology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska University Hospital-Huddinge, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Omary S. Minzi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Safari M. Kinung'hi
- National Institute for Medical Research (NIMR), Mwanza Research Centre, Mwanza, Tanzania
| | - Appolinary A. Kamuhabwa
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska University Hospital-Huddinge, Karolinska Institutet, Stockholm, Sweden
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Laidemitt MR, Anderson LC, Wearing HJ, Mutuku MW, Mkoji GM, Loker ES. Antagonism between parasites within snail hosts impacts the transmission of human schistosomiasis. eLife 2019; 8:e50095. [PMID: 31845890 PMCID: PMC6917487 DOI: 10.7554/elife.50095] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 11/16/2019] [Indexed: 01/16/2023] Open
Abstract
Human disease agents exist within complex environments that have underappreciated effects on transmission, especially for parasites with multi-host life cycles. We examined the impact of multiple host and parasite species on transmission of the human parasite Schistosoma mansoni in Kenya. We show S. mansoni is impacted by cattle and wild vertebrates because of their role in supporting trematode parasites, the larvae of which have antagonistic interactions with S. mansoni in their shared Biomphalaria vector snails. We discovered the abundant cattle trematode, Calicophoron sukari, fails to develop in Biomphalaria pfeifferi unless S. mansoni larvae are present in the same snail. Further development of S. mansoni is subsequently prevented by C. sukari's presence. Modeling indicated that removal of C. sukari would increase S. mansoni-infected snails by two-fold. Predictable exploitation of aquatic habitats by humans and their cattle enable C. sukari to exploit S. mansoni, thereby limiting transmission of this human pathogen.
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Affiliation(s)
- Martina R Laidemitt
- Department of BiologyUniversity of New MexicoAlbuquerqueUnited States
- Center for Evolutionary and Theoretical Immunology (CETI)University of New MexicoAlbuquerqueUnited States
| | - Larissa C Anderson
- Department of BiologyUniversity of New MexicoAlbuquerqueUnited States
- Center for Evolutionary and Theoretical Immunology (CETI)University of New MexicoAlbuquerqueUnited States
| | - Helen J Wearing
- Department of BiologyUniversity of New MexicoAlbuquerqueUnited States
- Center for Evolutionary and Theoretical Immunology (CETI)University of New MexicoAlbuquerqueUnited States
- Department of Mathematics and StatisticsUniversity of New MexicoAlbuquerqueUnited States
| | - Martin W Mutuku
- Centre for Biotechnology Research and DevelopmentKenya Medical Research InstituteNairobiKenya
| | - Gerald M Mkoji
- Centre for Biotechnology Research and DevelopmentKenya Medical Research InstituteNairobiKenya
| | - Eric S Loker
- Department of BiologyUniversity of New MexicoAlbuquerqueUnited States
- Center for Evolutionary and Theoretical Immunology (CETI)University of New MexicoAlbuquerqueUnited States
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Takeuchi R, Njenga SM, Ichinose Y, Kaneko S, Estrada CA, Kobayashi J. Is there a gap between health education content and practice toward schistosomiasis prevention among schoolchildren along the shores of Lake Victoria in Kenya? PLoS Negl Trop Dis 2019; 13:e0007572. [PMID: 31425499 PMCID: PMC6715249 DOI: 10.1371/journal.pntd.0007572] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 08/29/2019] [Accepted: 06/22/2019] [Indexed: 01/07/2023] Open
Abstract
Despite provision of preventive measures against schistosomiasis such as mass drug administration (MDA), the prevalence of Schistosoma mansoni remains high in communities living near Lake Victoria. This study aimed to analyse the status of schistosomiasis, including its prevalence, health education, knowledge, attitudes, and practices (KAP) among pupils, and water use in schools in Mbita situated along the shores of Lake Victoria. Four primary schools were selected as target schools and pupils in classes six and seven were recruited as study participants. The prevalence of S. mansoni was examined by Kato-Katz method. Simultaneously, a KAP survey toward schistosomiasis was conducted among the pupils. Health education contents were extracted from textbooks. All primary schools in the study site were surveyed regarding how each secured water used for daily school life. The prevalence of S. mansoni was 56% and 36% in 2015 and 2016, respectively. 60–70% of pupils chose a correct answer for the mode of transmission. More than 70% of pupils answered that bathing in Lake Victoria causes Schistosoma infection; however, more than 70% of pupils bathed in Lake Victoria sometimes or every day. According to the science textbook, “avoiding contact with contaminated water” is the way to prevent schistosomiasis; however, 66% of schools asked pupils to bring water from Lake Victoria. The prevalence of S. mansoni among pupils remains high. Schoolchildren are taught to avoid contact with contaminated water but are often asked to fetch water from the lake. From the school health viewpoint, health education that reflects the social and cultural context of the community in the contents and teaching methods are needed. In addition to this, provision of sanitation infrastructure is needed. A comprehensive and innovative approach which harmonises central and local governments and other stakeholders, as well as community is important to prevent schistosomiasis. According to WHO, it is estimated that at least 206 million people required preventive treatment for schistosomiasis in 2016 and of those at least 90% live in Africa. Moreover, school-age children are most affected by this worm. In Kenya, despite preventive measures against schistosomiasis such as mass drug administration (MDA) in primary schools, it remains a major public health problem, especially along the shores of Lake Victoria. Our study revealed that the prevalence of Schistosoma mansoni was high among pupils despite their knowledge about schistosomiasis transmission. This can be attributed to lack of safe water supply and latrines. A comprehensive approach which harmonises central and local governments and other stakeholders, as well as community is needed to prevent schistosomiasis. For example, the combination of health education (in which schools play as focal point) with provision of water infrastructure, encouragement to use and construct toilets in both schools and community/households, snail control, and MDA with monitoring can be employed to control and prevent schistosomiasis. From the school health viewpoint, it is necessary to develop health education contents and teaching methods that reflect the social and cultural context of the community in order to improve their behaviour and change the social norm.
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Affiliation(s)
- Rie Takeuchi
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nairobi, Kenya
- * E-mail:
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Yoshio Ichinose
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nairobi, Kenya
| | - Satoshi Kaneko
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nairobi, Kenya
- Department of Eco-epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Crystal A. Estrada
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan
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Workineh L, Yimer M, Gelaye W, Muleta D. The magnitude of Schistosoma mansoni and its associated risk factors among Sebatamit primary school children, rural Bahir Dar, Northwest Ethiopia: a cross-sectional study. BMC Res Notes 2019; 12:447. [PMID: 31331397 PMCID: PMC6647128 DOI: 10.1186/s13104-019-4498-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 07/17/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the magnitude of Schistosoma mansoni and its associated risk factors in the study area. RESULTS Of 422 school children, 223 (52.8%) and 199 (47.2%) were males and females, respectively. The Overall prevalence of Schistosoma mansoni infection was 24.9% (105/422). Seventy-five out of 422 (71.4%) of the infected individuals showed light infections. The overall mean intensity of Schistosoma mansoni in the study was 106.16 eggs per gram of stool. Age (p = 0.013), swimming habit (p = 0.001), participating in irrigational activities (p = 0.03) and washing clothes in the river (p = 0.039) were factors associated with Schistosoma mansoni infection.
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Affiliation(s)
- Lemma Workineh
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Mulat Yimer
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Woyneshet Gelaye
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desalegn Muleta
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, MizanTepi University, Mizan Teferi, Ethiopia
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Gichuki PM, Kepha S, Mulewa D, Masaku J, Kwoba C, Mbugua G, Mazigo HD, Mwandawiro C. Association between Schistosoma mansoni infection and access to improved water and sanitation facilities in Mwea, Kirinyaga County, Kenya. BMC Infect Dis 2019; 19:503. [PMID: 31174478 PMCID: PMC6556037 DOI: 10.1186/s12879-019-4105-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 05/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background Schistosomiasis remains a public health problem in Central Kenya despite concerted control efforts. Access to improved water and sanitation has been emphasized as important control measures. Few studies have assessed the association between access to improved water sources and sanitation facilities with Schistosoma mansoni infection in different environmental settings. This study assessed the association between S. mansoni infection and household access to improved water sources and sanitation facilities in Mwea, Kirinyaga County, Kenya. Methods A cross sectional study was conducted between the months of August and October 2017. A total of 905 household heads from seven villages were interviewed and their stool samples screened for S. mansoni using the Kato Katz technique. Comparisons of demographic factors by S. mansoni infection were tested for significance using the chi-square test (χ2) or the Fisher exact test for categorical variables. Variables associated with S. mansoni infection were analyzed using univariable analysis and the strength of the association measured as odds ratio (OR) using mixed effects logistic regression at 95% CI, with values considered significant at p < 0.05. Results The overall prevalence of S. mansoni was, 23.1% (95% CI: 20.5–26.0%), with majority of the infections being of light intensity. Rurumi village had the highest prevalence at 33.3%, with Kirogo village having the least prevalence at 7.0%. Majority (84.1%) of the households lacked access to improved water sources but had access to improved sanitation facilities (75%). Households with access to piped water had the lowest S. mansoni infections. However, there was no significant association between S. mansoni infections with either the main source of water in the household (Odds Ratio (OR) =0.782 (95% CI: 0.497–1.229) p = 0.285 or sanitation facilities (OR = 1.018 (95% CI: 0.705–1.469) p = 0.926. Conclusion Our study suggests that S. mansoni is still a public health problem among all age groups in Mwea irrigation scheme, Kirinyaga County, Central Kenya. Majority of the households lacks access to improved water sources but have access to improved sanitation facilities. This study recommends initiatives to ensure adequate provision of improved water sources, and the inclusion of the adult community in preventive chemotherapy programs. Electronic supplementary material The online version of this article (10.1186/s12879-019-4105-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul M Gichuki
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya. .,School of Health Sciences, Meru University of Science and Technology, P.O BOX 972-60200, Meru, Kenya.
| | - Stella Kepha
- London School of Tropical Medicine and Hygiene, Keppel St, Bloomsbury, London, WCIE 7HT, UK.,School of Public Health, Pwani University, P.O BOX 195-80108, Mombasa, Kenya
| | - Damaris Mulewa
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya
| | - Janet Masaku
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya
| | - Celestine Kwoba
- Vectorborne diseases Control Unit, Ministry of Health, P.o box 86-10303, Wanguru, Kenya
| | - Gabriel Mbugua
- School of Health Sciences, Meru University of Science and Technology, P.O BOX 972-60200, Meru, Kenya
| | - Humphrey D Mazigo
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Charles Mwandawiro
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya
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Chadeka EA, Nagi S, Cheruiyot NB, Bahati F, Sunahara T, Njenga SM, Hamano S. A high-intensity cluster of Schistosoma mansoni infection around Mbita causeway, western Kenya: a confirmatory cross-sectional survey. Trop Med Health 2019; 47:26. [PMID: 31015786 PMCID: PMC6463626 DOI: 10.1186/s41182-019-0152-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/21/2019] [Indexed: 06/24/2024] Open
Abstract
In Kenya, communities residing along the shores and islands of Lake Victoria bear a substantial burden of schistosomiasis. Although there is a school-based deworming program in place, the transmission of Schistosoma mansoni varies even at a fine scale. Given the focal nature of schistosomes’ transmission, we aim to identify areas with high intensity of S. mansoni infection in Mbita, Homabay County, western Kenya, for prioritized integrated control measures. Our findings confirm a high intensity of S. mansoni infection cluster around Mbita causeway. While the current efforts to curtail morbidity due to schistosomiasis through preventive chemotherapy in schools are crucial, fine-scale mapping of risk areas is necessary for specific integrated control measures.
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Affiliation(s)
- Evans Asena Chadeka
- 1Leading program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sachiyo Nagi
- 2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Ngetich B Cheruiyot
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Felix Bahati
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Toshihiko Sunahara
- 3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,5Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sammy M Njenga
- 6Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Shinjiro Hamano
- 1Leading program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
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Gitaka J, Mwaura P, Oware K, Kongere J, Wasonga J, Matendechero S. Evaluating community’s knowledge on integrated malaria, schistosomiasis and soil transmitted helminth (STH) infections in a Lake Victoria island, Kenya: A mixed method approach. AAS Open Res 2019. [DOI: 10.12688/aasopenres.12897.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The burden of malaria, schistosomiasis and soil transmitted helminthes (STH) in the islands of Lake Victoria, Kenya, poses a considerable public health challenge. Although many studies have been conducted on the co-infection arising from these parasites, few have evaluated communities’ knowledge of the same. Increasing the level of knowledge about a disease or preventive chemotherapy is important, but efforts need to be focused on community perception and understanding of the problem so as to encourage engagement with the proposed control measures. This study aimed at understanding a community’s knowledge of malaria, schistosomiasis and STH in Lake Victoria island where an integrated preventive chemotherapy intervention was implemented. Methods: This study was conducted in Ngodhe Island in Lake Victoria in Homa Bay County, western Kenya region between April and May 2016. The study adopted a mixed method approach where both qualitative and quantitative data collection was performed concurrently. Results: A total of 239 people participated in this study. All the respondents reported that they had heard about malaria, 89.1% had heard about schistosomiasis while 87.4% had heard about STH. The majority of the respondents (93.3%) drew their drinking water directly from the lake and 80.3% reported bathing in the lake. Out of all the respondents, 96.2% knew about the ongoing preventive chemotherapy. Most respondents (94.1%) said they would participate in a preventive chemotherapy again, while 0.4% was not sure. The majority of the respondents (86.6%) reported that integrated strategy is the most effective approach to control the three infections in the Island. Conclusion: The findings show a very high knowledge about these diseases. Although this study found majority of the respondents are aware of the co-infection of malaria, schistosomiasis and STH, their behaviors such as bathing in the lake exacerbates the problem.
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Odero SO, Ogonda L, Sang D, Munde EO, Shiluli C, Chweya P. Distribution of Biomphalaria Snails in Associated Vegetations and Schistosome Infection Prevalence Along the Shores of Lake Victoria in Mbita, Kenya: A Cross-Sectional Study. East Afr Health Res J 2019; 3:172-177. [PMID: 34308211 PMCID: PMC8279174 DOI: 10.24248/eahrj-d-19-00013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 09/11/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Schistosomiasis due to Schistosoma mansoni remains a major public health problem and cause of morbidity and mortality in sub-Saharan Africa despite the implementation of control programmes. More than 6 million Kenyans are at risk of infection. Regarding control measures, Biomphalaria snail species, which are the obligatory intermediate hosts for transmission of S. mansoni, have been neglected. Mbita subcounty in Homa Bay County, western Kenya, along Lake Victoria basin, has a high prevalence of S. mansoni infection despite mass drug administration. This study aimed to determine the abundance of Biomphalaria, with their associated vegetation and schistosome infection rates, along Mbita shoreline. Methods: Sixteen purposively selected sites along the Mbita shoreline were sampled for Biomphalaria snails using a 30-minute scooping technique. Global positioning system technology was used to map selected sites. The associated vegetation at sampling sites were collected and identified. Schistosome infection status among the snails was determined via the detection of cercaria shedding. Results: A total of 3,135 Biomphalaria sudanica snails were collected. The number of snails collected differed significantly between the 16 sites (F=11.735; degrees of freedom [df]=15.836; P<.001). Significant mean differences (MD) were also observed in terms of the number of snails collected per vegetation type (F=7.899; df=5.846; P<.001). The mean number of snails collected from Cyprus gracilis was significantly higher than that from Enydra fluactuants (MD= 2.03; P<.001), Eichhornia crassipes (MD=4.15; P<.010), and E. fluactuants mixed with E. crassipes (MD=2.516; P<.010). A total of 21 (0.67%) snails shed human cercariae, while 27 (0.86%) snails shed nonhuman cercariae, despite 14 sites having human faeces contamination. Conclusion: Although the schistosome infection prevalence among the snails was low, these sites may still be important exposure sites. C. gracilis is the main vegetation type associated with a high abundance of Biomphalaria snails. Molecular techniques are necessary for verification of schistosome positivity among the snails.
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Affiliation(s)
- Sabiano O Odero
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Lilian Ogonda
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - David Sang
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Elly O Munde
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya.,School of Health Sciences, Kirinyaga University, Kerugoya, Kenya
| | - Clement Shiluli
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Patrick Chweya
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
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Nono JK, Kamdem SD, Netongo PM, Dabee S, Schomaker M, Oumarou A, Brombacher F, Moyou-Somo R. Schistosomiasis Burden and Its Association With Lower Measles Vaccine Responses in School Children From Rural Cameroon. Front Immunol 2018; 9:2295. [PMID: 30356757 PMCID: PMC6189399 DOI: 10.3389/fimmu.2018.02295] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/17/2018] [Indexed: 12/19/2022] Open
Abstract
Background and Methods: Schistosomiasis is debilitating and reported to impair immune responsiveness of infected hosts. In Cameroon, mass drug administration (MDA) is used in schoolchildren to reduce transmission of S. haematobium and S. mansoni. The effects of MDA and the impact of schistosomiasis on the titers of antibodies in vaccinated children have been poorly studied. We therefore assessed the prevalence of schistosomiasis in schoolchildren, eight months after MDA, in two locations: Barombi Koto (BK), endemic for S. haematobium (N = 169) and Yoro (Y), endemic for S. mansoni (N = 356). Age, gender, residence time and frequency of contact with river water were assessed as risk factors for infection and morbidity in both localities. In 70 schoolchildren from BK and 83 from Y, ultrasound was used to assess morbidity according to the WHO guidelines. Evaluation of measles antibodies was performed in previously vaccinated schoolchildren (14 with S. haematobium and 12 egg-negative controls from BK and 47 with S. mansoni and12 egg-negative controls from Y). Principal Findings and conclusions: The prevalence of S. haematobium was 25. 4% in BK (43/169) and 34.8% for S. mansoni in Y (124/356), indicating the persistent transmission of schistosomiasis despite MDA. Older age (AOR 1.31; 95%CI 1.12–1.54) and higher frequencies of exposure to river water (AOR 1.99; 95%CI 1.03–3.86) were identified as risks for infection in BK whereas only older age (OR 1.15; 95%CI 1.04–1.27) was a risk for infection in Y. Bladder pathology (score 2 to 5) was observed in 29.2% (7/24) of egg-positive children in BK and liver pathology (pattern C) in 31.1% (19/61) of egg-positive children in Y. There was a positive correlation between S. haematobium egg burden and bladder pathology (AOR 1.01; 95% CI 0.99–1.02) and positive correlation between S. mansoni-driven liver pathology and female gender (AOR 3.01; 95% CI 0.88–10.26). Anti-measles antibodies in vaccinated children were significantly lower in S. mansoni-infected when compared to egg-negative controls (p = 0.001), which was not observed in the S. haematobium-infected group from BK. Our results demonstrate a questionable efficacy of MDA alone in halting schistosomiasis transmission and confirm a possible immunomodulatory effect of S. mansoni on response to vaccines.
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Affiliation(s)
- Justin Komguep Nono
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon.,Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | - Smritee Dabee
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Michael Schomaker
- Centre for Infectious Disease Epidemiology & Research, University of Cape Town, Cape Town, South Africa
| | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cytokines and Diseases Group, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Roger Moyou-Somo
- The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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Mohammed J, Weldegebreal F, Teklemariam Z, Mitiku H. Clinico-epidemiology, malacology and community awareness of Schistosoma mansoni in Haradenaba and Dertoramis kebeles in Bedeno district, eastern Ethiopia. SAGE Open Med 2018; 6:2050312118786748. [PMID: 30034806 PMCID: PMC6048690 DOI: 10.1177/2050312118786748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Schistosoma mansoni is a major public health problem.
Different studies reported unidentified sites in Ethiopia with variable
prevalence and intensity, but there is no report from this study area. Objective: To assess the clinico-epidemiology, malacology, risk factors, and community
awareness of S. mansoni in Haradenaba and Dertoramis
kebeles in the Bedeno district, eastern Ethiopia. Methods: A cross-sectional study was conducted among 1011 study participants in 413
systematically selected households from Haradenaba and Dertoramis kebeles
from 30 June 2016 to 30 July 2017. Data were collected by using pretested,
structured questionnaires, clinical examinations, and stool examinations.
Stool samples were processed by the Kato-Katz method and examined
microscopically. Snails were collected by scooping from water contact
points. Data were analyzed using SPSS, version 16 statistical software. Result: The overall prevalence of S. mansoni was 35.7%.
Heavy-intensity infection was detected in 8.9% of the study participants.
Results included: participants who were unaware about the possible source of
infection (adjusted odds ratio: 2.95; 95% confidence interval: 1.25, 7.95),
modes of transmission (adjusted odds ratio: 5.51; 95% confidence interval:
3.52, 12.51), prevention (adjusted odds ratio: 4.01; 95% confidence
interval: 2.00, 8.75) about schistosomiasis/bilharziasis were more likely
infected with S. mansoni than those who were aware.
Participants who swim or bathe in the river were more likely infected with
S. mansoni than those who do not (adjusted odds ratio:
6.41; 95% confidence interval: 3.15, 11.25). Biomphalaria
pfeifferi snails were collected from all water bodies in
Haradenaba and Dertoramis, but they did not shed schistosome cercaria in the
laboratory. Conclusion: S. mansoni infection is found in high magnitude in these
study areas, despite not being previously reported. A majority of the study
participants had low awareness about the source of infection, mode of
transmission, and prevention methods of schistosomiasis. Efforts should be
made to improve community awareness about transmission and prevention of
schistosomiasis.
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Affiliation(s)
- Jemal Mohammed
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fitsum Weldegebreal
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Zelalem Teklemariam
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Mitiku
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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High-density lipoprotein suppresses tumor necrosis factor alpha production by mycobacteria-infected human macrophages. Sci Rep 2018; 8:6736. [PMID: 29712918 PMCID: PMC5928146 DOI: 10.1038/s41598-018-24233-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 03/23/2018] [Indexed: 12/23/2022] Open
Abstract
Immune responses to parasitic pathogens are affected by the host physiological condition. High-density lipoprotein (HDL) and low-density lipoprotein (LDL) are transporters of lipids between the liver and peripheral tissues, and modulate pro-inflammatory immune responses. Pathogenic mycobacteria are parasitic intracellular bacteria that can survive within macrophages for a long period. Macrophage function is thus key for host defense against mycobacteria. These basic facts suggest possible effects of HDL and LDL on mycobacterial diseases, which have not been elucidated so far. In this study, we found that HDL and not LDL enhanced mycobacterial infections in human macrophages. Nevertheless, we observed that HDL remarkably suppressed production of tumor necrosis factor alpha (TNF-α) upon mycobacterial infections. TNF-α is a critical host-protective cytokine against mycobacterial diseases. We proved that toll-like receptor (TLR)-2 is responsible for TNF-α production by human macrophages infected with mycobacteria. Subsequent analysis showed that HDL downregulates TLR2 expression and suppresses its intracellular signaling pathways. This report demonstrates for the first time the substantial action of HDL in mycobacterial infections to human macrophages.
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Wiegand RE, Mwinzi PNM, Montgomery SP, Chan YL, Andiego K, Omedo M, Muchiri G, Ogutu MO, Rawago F, Odiere MR, Karanja DMS, Secor WE. A Persistent Hotspot of Schistosoma mansoni Infection in a Five-Year Randomized Trial of Praziquantel Preventative Chemotherapy Strategies. J Infect Dis 2017; 216:1425-1433. [PMID: 28968877 PMCID: PMC5913648 DOI: 10.1093/infdis/jix496] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 09/13/2017] [Indexed: 12/28/2022] Open
Abstract
Background Persistent hotspots have been described after mass drug administration (MDA) for the control of schistosomiasis, but they have not been studied during the course of a multiyear MDA program. Methods In data from a 5-year study of school-based and village-wide preventive chemotherapy strategies for Schistosoma mansoni, spatial scan statistics were used to find infection hotspots in 3 populations: 5- to 8-year-olds, 9- to 12-year-olds, and adults. Negative binomial regression was used to analyze changes from baseline, and receiver operating characteristic analyses were used to predict which villages would reach prevalence and intensity endpoints. Results We identified a persistent hotspot, not associated with study arm, where S. mansoni infection prevalence and intensity did not decrease as much as in villages outside the hotspot. Significant differences from baseline were realized after 1 year of MDA: we did not identify factors that moderated this relationship. Villages meeting specified endpoints at year 5 were predicted from prior year data with moderately high sensitivity and specificity. Conclusions The MDA strategies were less effective at reducing prevalence and intensity in the hotspot compared with other villages. Villages that reached year 5 endpoints could be detected earlier, which may provide the opportunity to amend intervention strategies.
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Affiliation(s)
- Ryan E Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pauline N M Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Susan P Montgomery
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Kennedy Andiego
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Martin Omedo
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Geoffrey Muchiri
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Michael O Ogutu
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Fredrick Rawago
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Maurice R Odiere
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Diana M S Karanja
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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Nyati-Jokomo Z, Chimbari MJ. Risk factors for schistosomiasis transmission among school children in Gwanda district, Zimbabwe. Acta Trop 2017; 175:84-90. [PMID: 28377221 DOI: 10.1016/j.actatropica.2017.03.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION A nationwide cross sectional schistosomiasis survey conducted in 2011 in 280 primary schools found a prevalence rate of 22.7%. This warranted an intervention with Mass Drug Administration at all schools in line with WHO guidelines. This study aimed to identify risk factors for schistosomiasis transmission among Grade 3 children at two primary schools in Gwanda district. METHODS A descriptive cross sectional survey which was part of a larger study on Malaria and Bilharzia in Southern Africa (MABISA) was conducted. Grade 3 children (n=120) attending two purposively selected rural primary schools in Dombo and Ntalale in Gwanda were respondents. Data on socio-demographic characteristics and risk factors which included knowledge and practices were collected using a pretested interviewer administered questionnaire. RESULTS Of the 120 children, 98 (81.7%) of the children indicated that they did not consistently use the toilet. The other risk factors for schistosomiasis were bathing and swimming in rivers and dams 80 (66.7%), watering the vegetable gardens using unprotected water sources 77 (64.7%) and crossing rivers on their way to school barefooted 31.7%. History of schistosomiasis cases based on self-reporting indicated that of the 9 children 7 were girls. There was poor knowledge of schistosomiasis among the children with 54% of the children indicating that they had never heard about the disease. Misconceptions on the causes of schistosomiasis which included drinking dirty water, mosquitoes and flies as the causes of schistosomiasis were reported by the children. Parents were cited as the least disseminators of information on schistosomiasis with only 4 out of the 120 children having received information from their parents. CONCLUSION Frequent contact with unprotected water sources, non-use of the toilet, and lack of information on schistosomiasis could predispose the children to infection. There is need to raise awareness about schistosomiasis in schools and the community to reduce the risk of contracting schistosomiasis due to risky behaviour.
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Affiliation(s)
- Zibusiso Nyati-Jokomo
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Zimbabwe.
| | - Moses J Chimbari
- University of KwaZulu-Natal, College of Health Sciences, School of Nursing and Public Health, Howard Campus, Durban, South Africa
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Chadeka EA, Nagi S, Sunahara T, Cheruiyot NB, Bahati F, Ozeki Y, Inoue M, Osada-Oka M, Okabe M, Hirayama Y, Changoma M, Adachi K, Mwende F, Kikuchi M, Nakamura R, Kalenda YDJ, Kaneko S, Hirayama K, Shimada M, Ichinose Y, Njenga SM, Matsumoto S, Hamano S. Spatial distribution and risk factors of Schistosoma haematobium and hookworm infections among schoolchildren in Kwale, Kenya. PLoS Negl Trop Dis 2017; 11:e0005872. [PMID: 28863133 PMCID: PMC5599053 DOI: 10.1371/journal.pntd.0005872] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 09/14/2017] [Accepted: 08/14/2017] [Indexed: 11/19/2022] Open
Abstract
Background Large-scale schistosomiasis control programs are implemented in regions with diverse social and economic environments. A key epidemiological feature of schistosomiasis is its small-scale heterogeneity. Locally profiling disease dynamics including risk factors associated with its transmission is essential for designing appropriate control programs. To determine spatial distribution of schistosomiasis and its drivers, we examined schoolchildren in Kwale, Kenya. Methodology/Principal findings We conducted a cross-sectional study of 368 schoolchildren from six primary schools. Soil-transmitted helminths and Schistosoma mansoni eggs in stool were evaluated by the Kato-Katz method. We measured the intensity of Schistosoma haematobium infection by urine filtration. The geometrical mean intensity of S. haematobium was 3.1 eggs/10 ml urine (school range, 1.4–9.2). The hookworm geometric mean intensity was 3.2 eggs/g feces (school range, 0–17.4). Heterogeneity in the intensity of S. haematobium and hookworm infections was evident in the study area. To identify factors associated with the intensity of helminth infections, we utilized negative binomial generalized linear mixed models. The intensity of S. haematobium infection was associated with religion and socioeconomic status (SES), while that of hookworm infection was related to SES, sex, distance to river and history of anthelmintic treatment. Conclusions/Significance Both S. haematobium and hookworm infections showed micro-geographical heterogeneities in this Kwale community. To confirm and explain our observation of high S. haematobium risk among Muslims, further extensive investigations are necessary. The observed small scale clustering of the S. haematobium and hookworm infections might imply less uniform strategies even at finer scale for efficient utilization of limited resources. The World Health Organization is spearheading the war on neglected tropical diseases, including helminth infections, by encouraging its member states to intensify control efforts. This call has recently been answered in most endemic regions of helminthiasis and governments are scaling up chemotherapy-based control programs in collaboration with private and public partners. However, it is necessary to clearly understand factors driving local transmission dynamics of helminth infections to design effective control programs. Here, we conducted a cross-sectional survey of 368 primary schoolchildren in Kwale, Kenya, and identified factors associated with the intensity of Schistosoma haematobium and hookworm infections. The negative binomial generalized linear mixed model showed the intensity of S. haematobium infection was much higher among Muslims and schoolchildren from low socioeconomic status households. High intensity of hookworm infection was associated with sex, SES, distance to river and history of anthelmintic treatment. Our findings demonstrate considering social and cultural drivers of NTDs could be beneficial in designing of efficient control programs and expediting NTDs control.
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Affiliation(s)
- Evans Asena Chadeka
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sachiyo Nagi
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Toshihiko Sunahara
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | | | - Felix Bahati
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Yuriko Ozeki
- Department of Bacteriology, Niigata University School of Medicine, Niigata, Japan
| | - Manabu Inoue
- Department of Bacteriology and Virology, Osaka-City University Graduate School of Medicine, Osaka, Japan
| | - Mayuko Osada-Oka
- Food Hygiene and Environmental Health Division of Applied Life Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Mayuko Okabe
- Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukio Hirayama
- Department of Bacteriology, Niigata University School of Medicine, Niigata, Japan
| | - Mwatasa Changoma
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Keishi Adachi
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Immunology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Faith Mwende
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Mihoko Kikuchi
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Risa Nakamura
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Yombo Dan Justin Kalenda
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Satoshi Kaneko
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Kenji Hirayama
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Masaaki Shimada
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- Department of Eco-Epidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Yoshio Ichinose
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Sohkichi Matsumoto
- Department of Bacteriology, Niigata University School of Medicine, Niigata, Japan
| | - Shinjiro Hamano
- Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
- * E-mail:
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Gazzinelli A, Oliveira-Prado R, Matoso LF, Veloso BM, Andrade G, Kloos H, Bethony JM, Assunção RM, Correa-Oliveira R. Schistosoma mansoni reinfection: Analysis of risk factors by classification and regression tree (CART) modeling. PLoS One 2017; 12:e0182197. [PMID: 28813451 PMCID: PMC5558968 DOI: 10.1371/journal.pone.0182197] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/13/2017] [Indexed: 01/28/2023] Open
Abstract
Praziquantel (PZQ) is an effective chemotherapy for schistosomiasis mansoni and a mainstay for its control and potential elimination. However, it does not prevent against reinfection, which can occur rapidly in areas with active transmission. A guide to ranking the risk factors for Schistosoma mansoni reinfection would greatly contribute to prioritizing resources and focusing prevention and control measures to prevent rapid reinfection. The objective of the current study was to explore the relationship among the socioeconomic, demographic, and epidemiological factors that can influence reinfection by S. mansoni one year after successful treatment with PZQ in school-aged children in Northeastern Minas Gerais state Brazil. Parasitological, socioeconomic, demographic, and water contact information were surveyed in 506 S. mansoni-infected individuals, aged 6 to 15 years, resident in these endemic areas. Eligible individuals were treated with PZQ until they were determined to be negative by the absence of S. mansoni eggs in the feces on two consecutive days of Kato-Katz fecal thick smear. These individuals were surveyed again 12 months from the date of successful treatment with PZQ. A classification and regression tree modeling (CART) was then used to explore the relationship between socioeconomic, demographic, and epidemiological variables and their reinfection status. The most important risk factor identified for S. mansoni reinfection was their “heavy” infection at baseline. Additional analyses, excluding heavy infection status, showed that lower socioeconomic status and a lower level of education of the household head were also most important risk factors for S. mansoni reinfection. Our results provide an important contribution toward the control and possible elimination of schistosomiasis by identifying three major risk factors that can be used for targeted treatment and monitoring of reinfection. We suggest that control measures that target heavily infected children in the most economically disadvantaged households would be most beneficial to maintain the success of mass chemotherapy campaigns.
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Affiliation(s)
- Andréa Gazzinelli
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
- * E-mail:
| | - Roberta Oliveira-Prado
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo Ferreira Matoso
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
| | - Bráulio M. Veloso
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gisele Andrade
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California Medical Center, San Francisco, California, United States of America
| | - Jeffrey M. Bethony
- Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Science, George Washington University, Washington DC, United States of America
| | - Renato M. Assunção
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Correa-Oliveira
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
- Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
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Non-malaria fevers in a high malaria endemic area of Ghana. BMC Infect Dis 2016; 16:327. [PMID: 27400781 PMCID: PMC4940727 DOI: 10.1186/s12879-016-1654-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 06/07/2016] [Indexed: 12/04/2022] Open
Abstract
Background The importance of fevers not due to malaria [non–malaria fevers, NMFs] in children in sub-Saharan Africa is increasingly being recognised. We have investigated the influence of exposure-related factors and placental malaria on the risk of non-malaria fevers among children in Kintampo, an area of Ghana with high malaria transmission. Methods Between 2008 and 2011, a cohort of 1855 newborns was enrolled and followed for at least 12 months. Episodes of illness were detected by passive case detection. The primary analysis covered the period from birth up to 12 months of age, with an exploratory analysis of a sub-group of children followed for up to 24 months. Results The incidence of all episodes of NMF in the first year of life (first and subsequent) was 1.60 per child-year (95 % CI 1.54, 1.66). The incidence of NMF was higher among infants with low birth weight [adjusted hazard ratio (aHR) 1.22 (95 % CI 1.04–1.42) p = 0.012], infants from households of poor socio-economic status [aHR 1.22 (95 % CI 1.02–1.46) p = 0.027] and infants living furthest from a health facility [aHR 1.20 (95 % CI 1.01–1.43) p = 0.037]. The incidence of all episodes of NMF was similar among infants born to mothers with or without placental malaria [aHR 0.97 (0.87, 1.08; p = 0.584)]. Conclusion The incidence of NMF in infancy is high in the study area. The incidence of NMF is associated with low birth weight and poor socioeconomic status but not with placental malaria. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1654-4) contains supplementary material, which is available to authorized users.
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Manyangadze T, Chimbari MJ, Gebreslasie M, Mukaratirwa S. Risk factors and micro-geographical heterogeneity of Schistosoma haematobium in Ndumo area, uMkhanyakude district, KwaZulu-Natal, South Africa. Acta Trop 2016; 159:176-84. [PMID: 27012720 DOI: 10.1016/j.actatropica.2016.03.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/18/2016] [Accepted: 03/20/2016] [Indexed: 01/07/2023]
Abstract
Schistosomiasis is a snail-transmitted parasitic disease endemic in most rural areas of sub-Saharan Africa. However, the currently used prediction models fail to capture the focal nature of its transmission due to the macro-geographical levels considered and paucity of data at local levels. This study determined the spatial distribution of Schistosoma haematobium and related risk factors in Ndumo area, uMkhanyakude District, KwaZulu-Natal province in South Africa. A sample of 435 schoolchildren between 10 to 15 years old from 10 primary schools was screened for S. haematobium using the filtration method. Getis-Ord Gi* and Bernoulli model were used to determine the hotspots of S. haematobium infection intensity based on their spatial distribution. Semiparametric-Geographically Weighted Regression (s-GWR) model was used to predict and analyse the spatial distribution of S. haematobium in relation to environmental and socio-economic factors. We confirmed that schistosomiasis transmission is focal in nature as indicated by significant S. haematobium cases and infection intensity clusters (p<0.05) in the study area. The s-GWR model performance was low (R(2)=0.45) and its residuals did not show autocorrelation (Moran's I=-0.001; z-score=0.003 and p-value=0.997) indicating that the model was correctly spelled. The s-GWR model also indicated that the coefficients for some of the socio-economic variables such as distances of households from operational piped water collection points, distance from open water sources, religion, toilet use, household head and places of bath and laundry significantly (t-values+/-1.96) varied across the landscape thereby determining the variation of S. haematobium infection intensity. This evidence may be used for control and management of the disease at micro scale. However, there is need for further research into more factors that may improve the performance of the s-GWR models in determining the local variation of S. haematobium infection intensity.
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Houmsou RS, Panda SM, Elkanah SO, Garba LC, Wama BE, Amuta EU, Kela SL. Cross-sectional study and spatial distribution of schistosomiasis among children in Northeastern Nigeria. Asian Pac J Trop Biomed 2016. [DOI: 10.1016/j.apjtb.2016.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Njaanake KH, Vennervald BJ, Simonsen PE, Madsen H, Mukoko DA, Kimani G, Jaoko WG, Estambale BB. Schistosoma haematobium and soil-transmitted Helminths in Tana Delta District of Kenya: infection and morbidity patterns in primary schoolchildren from two isolated villages. BMC Infect Dis 2016; 16:57. [PMID: 26842961 PMCID: PMC4739089 DOI: 10.1186/s12879-016-1387-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomes and soil-transmitted helminths (STH) (hookworm, Trichuris trichiura and Ascaris lumbricoides) are widely distributed in developing countries where they infect over 230 million and 1.5 billion people, respectively. The parasites are frequently co-endemic and many individuals are co-infected with two or more of the species, but information on how the parasites interact in co-infected individuals is scarce. The present study assessed Schistosoma haematobium and STH infection and morbidity patterns among school children in a hyper-endemic focus in the Tana River delta of coastal Kenya. METHODS Two hundred and sixty-two children aged 5-12 years from two primary schools were enrolled in the study. For each child, urine was examined for S. haematobium eggs and haematuria, stool was examined for STH eggs, peripheral blood was examined for eosinophilia and haemoglobin level, the urinary tract was ultrasound-examined for S. haematobium-related pathology, and the height and weight was measured and used to calculate the body mass index (BMI). RESULTS Prevalences of S. haematobium, hookworm, T. trichiura and A. lumbricoides infection were 94, 81, 88 and 46 %, respectively. There was no significant association between S. haematobium and STH infection but intensity of hookworm infection significantly increased with that of T. trichiura. Lower BMI scores were associated with high intensity of S. haematobium (difference =-0.48, p > 0.05) and A. lumbricoides (difference =-0.67, p < 0.05). Haematuria (both macro and micro) was common and associated with S. haematobium infection, while anaemia was associated with high intensity of S. haematobium (OR = 2.08, p < 0.05) and high hookworm infections OR = 4.75; p < 0.001). The majority of children had eosinophilia, which was significantly associated with high intensity of hookworm infection (OR = 5.34, p < 0.05). Overall 38 % of the children had ultrasound-detectable urinary tract morbidity, which was associated with high intensity of S. haematobium infection (OR = 3.13, p < 0.05). CONCLUSION Prevalences of S. haematobium and STH infections among the primary school children were high and the parasites were responsible for significant morbidity. A clear synergistic interaction was observed between hookworm and T. trichiura infections. Increased coverage in administration of praziquantel and albendazole in the area is recommended to control morbidity due to these infections.
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Affiliation(s)
- Kariuki H Njaanake
- Department of Medical Microbiology, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.
| | - Birgitte J Vennervald
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870, Frederiksberg C, Denmark.
| | - Paul E Simonsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870, Frederiksberg C, Denmark.
| | - Henry Madsen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 100, 1870, Frederiksberg C, Denmark.
| | - Dunstan A Mukoko
- Division of Vector Borne & Neglected Tropical Diseases, Ministry of Public Health & Sanitation, P.O. Box 54840-00202, Nairobi, Kenya.
| | - Gachuhi Kimani
- Centre for Biotechnology Research & Development, Kenya Medical Research Institute, P. O. Box 54840-00200, Nairobi, Kenya.
| | - Walter G Jaoko
- Department of Medical Microbiology, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.
| | - Benson B Estambale
- Jaramogi Oginga Odinga University of Science and Technology, P. O. Box 210-40601, Bondo, Kenya.
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Prevalence of Schistosoma mansoni Infection in Four Health Areas of Kisantu Health Zone, Democratic Republic of the Congo. Adv Med 2016; 2016:6596095. [PMID: 27579346 PMCID: PMC4992513 DOI: 10.1155/2016/6596095] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 11/25/2022] Open
Abstract
Background. Schistosomiasis is a public health problem in Democratic Republic of the Congo but estimates of its prevalence vary widely. The aim of this study was to determine prevalence of Schistosoma mansoni infection and associated risk factors among children in 4 health areas of Kisantu health zone. Methods. A cross-sectional study was carried out in 4 health areas of Kisantu health zone. 388 children randomly selected were screened for S. mansoni using Kato Katz technique and the sociodemographic data was collected. Data were entered and encoded using software EpiData version 3.1. Analysis was performed using SPSS version 21 software. Results. The prevalence of S. mansoni was 26.5% (103); almost two-thirds (63) (61.2%) had light infection intensity. A significant association was found between S. mansoni infection and age (p = 0.005), educational level (p = 0.001), and practices of swimming/bathing (p < 0.001) and using water from river/lake/stream for domestic use (p < 0.001). Kipasa health area had high prevalence of schistosomiasis (64.6%) (64/99; 95% CI 54.4-74.0) compared to other health areas. Conclusion. Schistosoma mansoni infection still remains a public health problem in these areas. There is a need to promote health education and promote behavioral changes in children towards schistosomiasis.
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Tanigawa C, Fujii Y, Miura M, Nzou SM, Mwangi AW, Nagi S, Hamano S, Njenga SM, Mbanefo EC, Hirayama K, Mwau M, Kaneko S. Species-Specific Serological Detection for Schistosomiasis by Serine Protease Inhibitor (SERPIN) in Multiplex Assay. PLoS Negl Trop Dis 2015; 9:e0004021. [PMID: 26291988 PMCID: PMC4546333 DOI: 10.1371/journal.pntd.0004021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/30/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Both Schistosoma mansoni and Schistosoma haematobium cause schistosomiasis in sub-Saharan Africa. We assessed the diagnostic value of selected Schistosoma antigens for the development of a multiplex serological immunoassay for sero-epidemiological surveillance. METHODOLOGY/PRINCIPAL FINDINGS Diagnostic ability of recombinant antigens from S. mansoni and S. haematobium was assessed by Luminex multiplex immunoassay using plasma from school children in two areas of Kenya, endemic for different species of schistosomiasis. S. mansoni serine protease inhibitor (SERPIN) and Sm-RP26 showed significantly higher reactivity to patient plasma as compared to the control group. Sm-Filamin, Sm-GAPDH, Sm-GST, Sm-LAP1, Sm-LAP2, Sm-Sm31, Sm-Sm32 and Sm-Tropomyosin did not show difference in reactivity between S. mansoni infected and uninfected pupils. Sm-RP26 was cross-reactive to plasma from S. haematobium patients, whereas Sm-SERPIN was species-specific. Sh-SEPRIN was partially cross-reactive to S. mansoni infected patients. ROC analysis for Sm-RP26, Sm-SERPIN and Sh-SERPIN showed AUC values of 0.833, 0.888 and 0.947, respectively. Using Spearman's rank correlation coefficient analysis, we also found significant positive correlation between the number of excreted eggs and median fluorescence intensity (MFI) from the multiplex immunoassays for Sm-SERPIN (ρ = 0.430, p-value = 0.003) and Sh-SERPIN (ρ = 0.433, p-value = 0.006). CONCLUSIONS/SIGNIFICANCE Sm-SERPIN is a promising species-specific diagnostic antigen. Sh-SEPRIN was partially cross-reactive to S. mansoni infected patients. SERPINs showed correlation with the number of excreted eggs. These indicate prospects for inclusion of SERPINs in the multiplex serological immunoassay system.
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Affiliation(s)
- Chihiro Tanigawa
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yoshito Fujii
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- * E-mail:
| | - Masashi Miura
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Samson Muuo Nzou
- Nagasaki University Institute of Tropical Medicine—Kenya Medical Research Institute Project, Nairobi, Kenya
- Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya
| | | | - Sachiyo Nagi
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Shinjiro Hamano
- Nagasaki University Institute of Tropical Medicine—Kenya Medical Research Institute Project, Nairobi, Kenya
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Sammy M. Njenga
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Matilu Mwau
- Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya
- Consortium for National Health Research (CNHR), Nairobi, Kenya
| | - Satoshi Kaneko
- Department of Eco-Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Nagasaki University Institute of Tropical Medicine—Kenya Medical Research Institute Project, Nairobi, Kenya
- Graduate School of International Health Development, Nagasaki University, Nagasaki, Japan
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Masaku J, Madigu N, Okoyo C, Njenga SM. Current status of Schistosoma mansoni and the factors associated with infection two years following mass drug administration programme among primary school children in Mwea irrigation scheme: A cross-sectional study. BMC Public Health 2015; 15:739. [PMID: 26231050 PMCID: PMC4522152 DOI: 10.1186/s12889-015-1991-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 06/29/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Schistosomiasis is a major public health problem in Kenya as well as in many other tropical countries and is considered one of the most prevalent diseases in the rural population. Between 2004 and 2009, primary school children in Mwea irrigation scheme were treated for Schistosoma mansoni. In the four year control programme, there was occurrence of light re-infection with S. mansoni. Therefore, the aim of this study was to assess the current prevalence of S. mansoni, infection two years after the withdrawal of mass drug administration (MDA) programme. METHODS We carried out a cross-sectional study on a population of 387 children attending 3 primary schools located in Mwea irrigation scheme. Children, aged 8-16 years were interviewed and screened for S. mansoni using duplicate Kato-Katz thick smears. Comparisons of prevalence by age group and gender were tested for significance on the basis of the Wald test. Best prediction factors for infection with S. mansoni were selected using forward - stepwise variable selection method. RESULTS The overall prevalence of S. mansoni was 53.7 %, (95%CI: 49.0-59.0, p-value = 0.000). Male children had higher prevalence of infection, 66.1 % (95%CI: 59.8-73.2, p-value = 0.000) compared to females. The gender (sex) of a child was the only factor reported to be significantly associated with S. mansoni infection, (OR = 1.9, p-value = 0.015, 95%CI: 1.13-3.21). CONCLUSIONS There was high prevalence of S. mansoni infections in the study area, two years after the withdrawal of MDA programme. We suggest that treatment should be continued in the school children at regular intervals, monitoring and surveillance intensified to ensure interruption of transmission areas.
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Affiliation(s)
- Janet Masaku
- Esatern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O Box 54840 - 00200, Nairobi, Kenya. .,Great Lakes University of Kisumu (GLUK), P.O. Box 60827, 00200, Nairobi, Kenya.
| | - Nancy Madigu
- Great Lakes University of Kisumu (GLUK), P.O. Box 60827, 00200, Nairobi, Kenya.
| | - Collins Okoyo
- Esatern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O Box 54840 - 00200, Nairobi, Kenya.
| | - Sammy M Njenga
- Esatern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O Box 54840 - 00200, Nairobi, Kenya.
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Mugono M, Konje E, Kuhn S, Mpogoro FJ, Morona D, Mazigo HD. Intestinal schistosomiasis and geohelminths of Ukara Island, North-Western Tanzania: prevalence, intensity of infection and associated risk factors among school children. Parasit Vectors 2014; 7:612. [PMID: 25533267 PMCID: PMC4297386 DOI: 10.1186/s13071-014-0612-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 12/18/2014] [Indexed: 12/02/2022] Open
Abstract
Background Schistosoma mansoni and soil-transmitted helminths (STH) are among the most prevalent and highly neglected tropical diseases in Tanzania. However, little is known on the distribution of these infections in rural settings, especially in the island areas on Lake Victoria. Identifying the local risk factors of S. mansoni and soil-transmitted helminths is one step towards understanding their transmission patterns and will facilitate the design of cost-effective intervention measures. The present study was therefore conducted to determine the prevalence, intensity of infection and risk factors associated with S. mansoni and soil-transmitted helminth infections among school children in Ukara Island. Methods This was a cross sectional study which enrolled 774 school children aged 4-15 years in 5 primary schools in Ukara Island, North-Western Tanzania. Single stool samples were collected, processed using the Kato Katz technique and examined for eggs of S. mansoni and geohelminths under a light microscope. A pre-tested questionnaire was used to collect socio-demographic information. Results Overall, 494/773 (63.91%, 95% CI; 45.19-90.36) of the study participants were infected with S. mansoni and the overall geometrical mean eggs per gram (GM-epg) of feaces were 323.41epg (95% CI: 281.09 – 372.11). The overall prevalence of soil-transmitted helminth (STH) was 6.73% (n = 52/773, 95% CI = 4.39 – 10.32) with the most prevalent species being hookworms, 5.69% (n = 44/773, 95% CI; 3.68 – 8.79). Location of school in the study villages (P < 0.0001), parent occupation, fishing (P < 0.03) and reported involvement in fishing activities (P < 0.048) remained significantly associated with the prevalence and intensity of S.mansoni infection. Conclusion Schistosoma mansoni infection is highly prevalent in the islands whereas the prevalence of soil-transmitted helminths is low. The risk of infection with S. mansoni and the intensity of infection increased along the shorelines of Lake Victoria. These findings call for the need to urgently implement integrated control interventions, starting with targeted mass drug administration. Electronic supplementary material The online version of this article (doi:10.1186/s13071-014-0612-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Moshi Mugono
- School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
| | - Evelyne Konje
- School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
| | - Susan Kuhn
- Department of Paediatrics, Section of Infectious Diseases, University of Calgary, Calgary, Canada.
| | - Filbert J Mpogoro
- School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
| | - Domenica Morona
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
| | - Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
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Dida GO, Gelder FB, Anyona DN, Matano AS, Abuom PO, Adoka SO, Ouma C, Kanangire CK, Owuor PO, Ofulla AVO. Distribution and abundance of schistosomiasis and fascioliasis host snails along the Mara River in Kenya and Tanzania. Infect Ecol Epidemiol 2014; 4:24281. [PMID: 25405008 PMCID: PMC4216393 DOI: 10.3402/iee.v4.24281] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 09/23/2014] [Accepted: 10/02/2014] [Indexed: 11/14/2022] Open
Abstract
We purposively selected 39 sampling sites along the Mara River and its two perennial tributaries of Amala and Nyangores and sampled snails. In addition, water physicochemical parameters (temperature, turbidity, dissolved oxygen, conductivity, alkalinity, salinity and pH) were taken to establish their influence on the snail abundance and habitat preference. Out of the 39 sites sampled, 10 (25.6%) had snails. The snail species encountered included Biomphalaria pfeifferi Krauss – the intermediate host of Schistosoma mansoni Sambon, Bulinus africanus – the intermediate host of Schistosoma haematobium, and Lymnaea natalensis Krauss – the intermediate host of both Fasciola gigantica and F. hepatica Cobbold. Ceratophallus spp., a non-vector snail was also encountered. Most (61.0%) of the snails were encountered in streamside pools. Schistosomiasis-transmitting host snails, B. pfeifferi and B. africanus, were fewer than fascioliasis-transmitting Lymnaea species. All the four different snail species were found to be attached to different aquatic weeds, with B. pfeifferi accounting for over half (61.1%) of the snails attached to the sedge, followed by B. africanus and Lymnaea spp., accounting for 22.2 and 16.7%, respectively. Ceratophallus spp. were non-existent in sedge. The results from this preliminary study show that snails intermediate hosts of schistosomiasis and fascioliasis exists in different habitats, in few areas along the Mara River, though their densities are still low to have any noticeable impacts on disease transmission in case they are infected. The mere presence of the vector snails in these focal regions calls for their immediate control and institution of proper regulations, management, and education among the locals that can help curtail the spread of the snails and also schistosomiasis and fascioliasis within the Mara River basin.
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Affiliation(s)
- Gabriel O Dida
- School of Public Health and Community Development, Maseno University, Maseno, Kenya ; Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Frank B Gelder
- Probe International, Inc., Copley, OH, USA ; Probe International, Inc., Auckland, New Zealand
| | - Douglas N Anyona
- School of Environment and Earth Science, Maseno University, Maseno, Kenya
| | - Ally-Said Matano
- School of Environment and Earth Science, Maseno University, Maseno, Kenya ; EAC-Lake Victoria Basin Commission Secretariat, Kisumu, Kenya
| | - Paul O Abuom
- School of Environment and Earth Science, Maseno University, Maseno, Kenya
| | - Samson O Adoka
- School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Collins Ouma
- School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | | | | | - Ayub V O Ofulla
- School of Public Health and Community Development, Maseno University, Maseno, Kenya
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