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Sánchez-Marqués R, Bocanegra C, Salvador F, Nindia A, Pintar Z, Martínez-Campreciós J, Aixut S, Mossalilo P, Sulleiro E, Espiau M, Mas-Coma S, Bargues MD, Molina I. Prevalence and morbidity of urogenital schistosomiasis among pre-school age children in Cubal, Angola. PLoS Negl Trop Dis 2023; 17:e0011751. [PMID: 37939154 PMCID: PMC10659159 DOI: 10.1371/journal.pntd.0011751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/20/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Schistosomiasis is one of the most important neglected tropical diseases, with a great impact on public health and more than 200,000 deaths annually. Schistosoma haematobium causes urinary tract (UT) morbidity. Since schistosomiasis morbidity control programs focus on children older than 5 years, pre-school age children (PSAC) morbidity is not well known. METHODS We conducted a cross-sectional study in Cubal (Angola) among 245 PSAC with the objective of evaluating the prevalence of S. haematobium infection, the intensity of infection, and associated morbidity. For this purpose, urine filtration test followed by microscopic visualization and ultrasound examinations were performed. RESULTS The estimated overall prevalence of urogenital schistosomiasis was 30.2% (CI 95%; 24.5-35.9), with 20.3% (CI 95%; 15.3-25.3) of the samples analysed showing a high intensity of infection. A total of 54.5% (CI 95%; 47.6-61.8) of infected children presented UT lesions, showing a significant association between schistosomiasis infection and UT morbidity (p-value < 0.001). Bladder wall thickening was the most common lesion, being present in 100% of abnormal ultrasounds. We found that anaemia and severe malnutrition were not significantly associated with the development of UT lesions. CONCLUSIONS S. haematobium infection in PSAC causes great UT detectable morbidities. Therefore, there is an evident need of including them in mass drug administration (MDA) campaigns and consequently the development of an adapted praziquantel treatment dosage for children under 2 years of age.
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Affiliation(s)
- Raquel Sánchez-Marqués
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Bocanegra
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Fernando Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | | | | | - Joan Martínez-Campreciós
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Nossa Senhora da Paz, Cubal, Angola
| | - Sandra Aixut
- Department of Infectious Diseases, Vall Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - María Espiau
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Department of Pediatrics, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ma. Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
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Lo NC, Bezerra FSM, Colley DG, Fleming FM, Homeida M, Kabatereine N, Kabole FM, King CH, Mafe MA, Midzi N, Mutapi F, Mwanga JR, Ramzy RMR, Satrija F, Stothard JR, Traoré MS, Webster JP, Utzinger J, Zhou XN, Danso-Appiah A, Eusebi P, Loker ES, Obonyo CO, Quansah R, Liang S, Vaillant M, Murad MH, Hagan P, Garba A. Review of 2022 WHO guidelines on the control and elimination of schistosomiasis. THE LANCET. INFECTIOUS DISEASES 2022; 22:e327-e335. [PMID: 35594896 DOI: 10.1016/s1473-3099(22)00221-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 01/13/2023]
Abstract
Schistosomiasis is a helminthiasis infecting approximately 250 million people worldwide. In 2001, the World Health Assembly (WHA) 54.19 resolution defined a new global strategy for control of schistosomiasis through preventive chemotherapy programmes. This resolution culminated in the 2006 WHO guidelines that recommended empirical treatment by mass drug administration with praziquantel, predominately to school-aged children in endemic settings at regular intervals. Since then, school-based and community-based preventive chemotherapy programmes have been scaled-up, reducing schistosomiasis-associated morbidity. Over the past 15 years, new scientific evidence-combined with a more ambitious goal of eliminating schistosomiasis and an increase in the global donated supply of praziquantel-has highlighted the need to update public health guidance worldwide. In February, 2022, WHO published new guidelines with six recommendations to update the global public health strategy against schistosomiasis, including expansion of preventive chemotherapy eligibility from the predominant group of school-aged children to all age groups (2 years and older), lowering the prevalence threshold for annual preventive chemotherapy, and increasing the frequency of treatment. This Review, written by the 2018-2022 Schistosomiasis Guidelines Development Group and its international partners, presents a summary of the new WHO guideline recommendations for schistosomiasis along with their historical context, supporting evidence, implications for public health implementation, and future research needs.
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Affiliation(s)
- Nathan C Lo
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA.
| | | | - Daniel G Colley
- Department of Microbiology, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | | | - Mamoun Homeida
- Academy of Medical Sciences and Technology, Khartoum, Sudan
| | - Narcis Kabatereine
- Accelerating Resilient, Innovative, and Sustainable Elimination of NTDs, Vector Control Division, Kampala, Uganda
| | | | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Nicholas Midzi
- National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Francisca Mutapi
- Institute of Immunology and Infection Research, Tackling Infections to Benefit Africa Partnership, University of Edinburgh, Edinburgh, UK
| | - Joseph R Mwanga
- Department of Epidemiology, Biostatistics and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Fadjar Satrija
- School of Veterinary Medicine and Biomedicine, IPB University, Bogor, Indonesia
| | - J Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Joanne P Webster
- Department of Pathobiology and Population Science, Royal Veterinary College, University of London, London, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Paolo Eusebi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Eric S Loker
- Department of Biology, University of New Mexico, Albuquerque, NM, USA
| | - Charles O Obonyo
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Song Liang
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Michel Vaillant
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - M Hassan Murad
- Evidence-based Practice Center, Mayo Clinic, Rochester, NY, USA
| | - Paul Hagan
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Amadou Garba
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
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Cavalcanti MG, Engel DC, de Araujo Cunha AF, Peralta JM. Case Report: Diagnosis and Assessment of Cure Approaches for Acute Schistosomiasis in Pre-School Children. Front Immunol 2021; 12:624736. [PMID: 34054799 PMCID: PMC8149760 DOI: 10.3389/fimmu.2021.624736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/27/2021] [Indexed: 02/02/2023] Open
Abstract
Acute schistosomiasis (AS) manifests with a broad spectrum of clinical features in pediatric populations. Diagnosis may be difficult in the absence of detectable numbers of eggs. As a result, new approaches may be required to achieve an accurate diagnosis. Optimal praziquantel (PZQ) treatment regimen for young children is debatable. Also, the post-treatment response is still poorly evaluated due to the lack of reliable markers. A group of 6 children (a toddler and 5 pre-school children) and one pre-adolescent were investigated for AS clinical manifestations and followed-up for two years after treatment. Ova detection was performed by Kato-Katz (KK) and presence of Schistosoma mansoni DNA was assessed by real-time PCR (rt-PCR) in stool samples. IgG and IgE anti-Schistosoma levels and urinary antigen were detected by ELISA and point-of-care circulating cathodic antigen (POC-CCA) testing in serum and urine, respectively. AS clinical symptoms were present in 5/7 (71.4%) of the infected children, and hypereosinophilia was detected in all of them. Ova detection and serology were positive in only 3/7 (44.9%) and 4/7 (57.1%), respectively. However, real-time PCR (rt-PCR) showed the presence of Schistosoma DNA in 6/7 (85.7%) of the cases, and urinary antigen was detected in all infected children. The long-term follow-up after treatment with three doses of PZQ (80mg/kg/dose), showed high cure rates (CR) as demonstrated by the DNA-based assay as well as reduced levels of side effects. CR based on urinary antigen detection ranged from 28.6 to 100%, being the highest CR due to double testing the 2-year post-treatment samples. The results suggest that high dose and repeated treatment with PZQ might be effective for AS in young children. Also, new laboratory markers should be considered to diagnosis and monitor the drug response.
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Affiliation(s)
- Marta G Cavalcanti
- Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Délia Celser Engel
- Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Fernandes de Araujo Cunha
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Mauro Peralta
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Kalinda C, Mindu T, Chimbari MJ. A systematic review and meta-analysis quantifying schistosomiasis infection burden in pre-school aged children (PreSAC) in sub-Saharan Africa for the period 2000-2020. PLoS One 2020; 15:e0244695. [PMID: 33373405 PMCID: PMC7771669 DOI: 10.1371/journal.pone.0244695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/14/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Following the adoption of the World Health Assembly Resolution WHA 65.21 and Neglected Tropical Diseases road map 2021-2030, schistosomiasis control programmes have shifted from morbidity control to disease elimination. However, several gaps continue to be observed in the implementation of control programmes with certain age groups omitted from these campaigns increasing health inequalities and risks of reinfections to previously treated groups. We used the Inverse Variance Heterogeneity (IVhet) model to estimate the prevalence of schistosomiasis infection among preschool-aged children. METHODS We did a systematic review of peer-reviewed literature on schistosomiasis in sub-Saharan Africa for the period January 1, 2000 to November 30, 2020. Quantitative data for cases of schistosomiasis infection were extracted, including country and region where the studies were done, year of publication and specific schistosome species observed. The IVhet model was used to estimate the pooled prevalence estimate (PPE), the heterogeneity and publication bias. RESULTS We screened 2601 articles to obtain 47 eligible studies containing quantitative data on preschool-aged children. Of the selected studies, 44.7% (n = 22) were from East Africa while the least number of studies obtained (2.1%, n = 1) was from Central Africa. 21712 subjects were screened for infection due to Schistosoma spp; 13924 for S. mansoni and 7788 for S. haematobium. The PPE for schistosomiasis among PreSAC was 19% (95% CI: 11-28). Infection due to S. mansoni (IVhet PPE: 22% (95% CI: 9-36) was higher than that due to S. haematobium (15%; 95% CI: 6-25). A Luis Furuya-Kanamori index of 1.83 indicated a lack of publication bias. High level of heterogeneity was observed (I2 > 90%) and this could not be reduced through subgroup analysis. CONCLUSION Schistosomiasis infection among pre-school aged children 6 years old and below is high. This indicates the importance of including this age group in treatment programmes to reduce infection prevalence and long-term morbidities associated with prolonged schistosome infection.
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Affiliation(s)
- Chester Kalinda
- University of Namibia, Katima Mulilo, Namibia
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Tafadzwa Mindu
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Moses John Chimbari
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Osakunor DNM, Mduluza T, Osei-Hyiaman D, Burgess K, Woolhouse MEJ, Mutapi F. Schistosoma haematobium infection is associated with alterations in energy and purine-related metabolism in preschool-aged children. PLoS Negl Trop Dis 2020; 14:e0008866. [PMID: 33315875 PMCID: PMC7735607 DOI: 10.1371/journal.pntd.0008866] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/08/2020] [Indexed: 12/17/2022] Open
Abstract
Helminths are parasitic worms that infect over a billion people worldwide. The pathological consequences from infection are due in part, to parasite-induced changes in host metabolic pathways. Here, we analyse the changes in host metabolic profiles, in response to the first Schistosoma haematobium infection and treatment in Zimbabwean children. A cohort of 83 schistosome-negative children (2-5 years old) as determined by parasitological examination, guardian interviews and examination of medical records, was recruited at baseline. Children were followed up after three months for parasitological diagnosis of their first S. haematobium infection, by detection of parasite eggs excreted in urine. Children positive for infection were treated with the antihelminthic drug praziquantel, and treatment efficacy checked three months after treatment. Blood samples were taken at each time point, and capillary electrophoresis mass spectrometry in conjunction with multivariate analysis were used to compare the change in serum metabolite profiles in schistosome-infected versus uninfected children. Following baseline at the three-month follow up, 11 children had become infected with S. haematobium (incidence = 13.3%). Our results showed that infection with S. haematobium was associated with significant increases (>2-fold) in discriminatory metabolites, linked primarily with energy (G6P, 3-PG, AMP, ADP) and purine (AMP, ADP) metabolism. These observed changes were commensurate with schistosome infection intensity, and levels of the affected metabolites were reduced following treatment, albeit not significantly. This study demonstrates that early infection with S. haematobium is associated with alterations in host energy and purine metabolism. Taken together, these changes are consistent with parasite-related clinical manifestations of malnutrition, poor growth and poor physical and cognitive performance observed in schistosome-infected children.
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Affiliation(s)
- Derick N. M. Osakunor
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
- * E-mail:
| | - Takafira Mduluza
- Biochemistry Department, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe
| | - Douglas Osei-Hyiaman
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States of America
- Metabolomics Research Division, Human Metabolome Technologies Inc., Tsuruoka, Yamagata, Japan
- Department of Systems Neurophysiology, Graduate School of Medical & Dental Science, Tokyo Medical and Dental University, Bunkyo City, Tokyo, Japan
| | - Karl Burgess
- Centre for Synthetic and Systems Biology, University of Edinburgh, CH Waddington Building, King’s Buildings, Edinburgh, United Kingdom
| | - Mark E. J. Woolhouse
- Usher Institute, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
| | - Francisca Mutapi
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, King’s Buildings, Edinburgh, United Kingdom
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Mduluza T, Jones C, Osakunor DNM, Lim R, Kuebel JK, Phiri I, Manangazira P, Tagwireyi P, Mutapi F. Six rounds of annual praziquantel treatment during a national helminth control program significantly reduced schistosome infection and morbidity levels in a cohort of schoolchildren in Zimbabwe. PLoS Negl Trop Dis 2020; 14:e0008388. [PMID: 32569278 PMCID: PMC7332090 DOI: 10.1371/journal.pntd.0008388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 07/02/2020] [Accepted: 05/13/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The World Health Organization recommends that schistosomiasis be treated through Mass Drug Administration (MDA). In line with this recommendation, Zimbabwe commenced a national helminth control program in 2012 targeting schoolchildren throughout the country for 6 years. This study, part of a larger investigation of the impact of helminth treatment on the overall health of the children, determined the effect of annual praziquantel treatment on schistosome infection and morbidity in a cohort of children during Zimbabwe's 6-year national helminth control program. METHODOLOGY/PRINCIPAL FINDINGS A school-based longitudinal study was carried out in 35 sentinel sites across Zimbabwe from September 2012 to November 2017. The sentinel sites were selected following a countrywide survey conducted in 280 primary schools. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni was diagnosed using both the Kato-Katz and formol-ether concentration techniques. S. haematobium morbidity was determined through detection of macro and microhaematuria. A cohort of children aged 6-15 years old was surveyed annually before MDA and 6 weeks post treatment. Maximum treatment coverage reached 90% over the 6 rounds of MDA. At baseline S. haematobium infection prevalence and intensity were 31.7% (95% CI = 31.1-32.2) and 28.75 eggs/10ml urine (SEM = 0.81) respectively, while S. mansoni prevalence and intensity were 4.6% (95% CI = 4.4-4.8) and 0.28 eggs/25mg (SEM = 0.02). Prior to the 6th round of MDA, S. haematobium infection prevalence had reduced to 1.56% (p<0.001) and infection intensity to 0.07 (SEM 0.02). Six weeks later after the 6th MDA, both were 0. Similarly the prevalence of S. haematobium morbidity as indicated by haematuria also fell significantly from 32.3% (95% CI = 29.9-34.6) to 0% (p< 0.0001) prior to the final MDA. For S.mansoni, both prevalence and intensity had decreased to 0 prior to the 6th MDA. After 6 rounds of annual MDA, prevalence and intensity of both schistosome species decreased significantly to 0% (p< 0.0001). CONCLUSION Zimbabwe's helminth control program significantly reduced schistosome infection intensity and prevalence and urogenital schistosomiasis morbidity prevalence in a cohort of school-aged children, moving the schistosome prevalence in the children from moderate to low by WHO classification. These findings will inform the design of the country's next stage interventions for helminth control and eventual elimination.
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Affiliation(s)
- Takafira Mduluza
- Department of Biochemistry, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe.,TIBA Zimbabwe, NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh, Edinburgh, United Kingdom
| | - Caitlin Jones
- Centre for Infection, Immunity & Evolution and Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
| | - Derick N M Osakunor
- Centre for Infection, Immunity & Evolution and Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
| | - Rivka Lim
- Centre for Infection, Immunity & Evolution and Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
| | - Julius K Kuebel
- Centre for Infection, Immunity & Evolution and Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
| | - Isaac Phiri
- Epidemiology & Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Portia Manangazira
- Epidemiology & Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Paradzayi Tagwireyi
- Department of Geography and Environmental Science, Geo-information and Earth Observation Centre, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe
| | - Francisca Mutapi
- Centre for Infection, Immunity & Evolution and Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh, Ashworth Laboratories, King's Buildings, Edinburgh, United Kingdom
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Oyegue-Liabagui SL, Ndjangangoye NK, Kouna LC, Lekolo GM, Mounioko F, Kwedi Nolna S, Lekana-Douki JB. Molecular prevalence of intestinal parasites infections in children with diarrhea in Franceville, Southeast of Gabon. BMC Infect Dis 2020; 20:350. [PMID: 32414337 PMCID: PMC7226932 DOI: 10.1186/s12879-020-05071-x] [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: 12/27/2019] [Accepted: 05/04/2020] [Indexed: 01/30/2023] Open
Abstract
Background Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution of these parasitic infections overlaps in many environmental, socioeconomic and epidemiological settings. Their distribution and prevalence varies from region to region. In the current study, we assess the prevalence of intestinal parasites among pediatric patients with syndromic diarrheal disease living in Franceville, Gabon. Methods A cross-sectional study conducted in the Amissa Bongo Regional Hospital and Chinese-Gabonese Friendship Hospital in Franceville, between November 2016 and August 2017, enrolled a total of 100 diarrheic children between 0 and 180 months of age. Parasite detection in stool samples was performed using molecular diagnostic by PCR. Difference in means were tested by Student’s t test and ANOVA while principal component analysis was used to determine the correlation between parasite distributions and age groups. Results The overall prevalence of intestinal parasite infection was 61% (61/100). Hymenolepis sp and Cryptosporidium hominis/parvum were the most common parasites (31 and 19%, respectively), followed by Encephalitozoon intestinalis (15%), Trichuris trichiura (4%), Dientamoeba fragilis (4%), and Enterocytozoon bieneusi (2%). The polyparasitism rate was 19.7%, with 83.3% double and 16.7% triple infections. Protozoan infections (66.7%) were more prevalent than helminths infections (33.3%). Seasonal association of the circulation of intestinal parasite was statistically significant (p = 0.03). Correlations between different parasites was also observed. Conclusion The prevalence of intestinal parasitic infections is highest in diarrheic pediatric children. The prevalence of parasitic infections indicates that protozoa and helminths are the most common parasites in the Franceville environment. This study reinforces the importance of routine examination of diarrheic stool samples for the diagnostic of intestinal parasites. Further analyses are required to better understand the local epidemiology and risk factors associated with the transmission of intestinal parasites in Franceville, Gabon. Keyswords diarrhea, children, intestinal parasitic infections, molecular diagnostic, Franceville, Gabon.
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Affiliation(s)
- Sandrine Lydie Oyegue-Liabagui
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku, BP 876, Franceville, Gabon. .,Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon.
| | - Nal Kennedy Ndjangangoye
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku, BP 876, Franceville, Gabon.,Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Lady Charlene Kouna
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Gwladys Mirlande Lekolo
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Franck Mounioko
- Laboratoire d'Ecologie Vectoriel, Institut de Recherche en Ecologie Tropicale, BP 13354, Libreville, Gabon
| | - Sylvie Kwedi Nolna
- Capacity for Leadership Excellence And Research (CLEAR, Inc.), Yaoundé, Cameroon
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon.,Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
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Chimponda TN, Mushayi C, Osakunor DNM, Vengesai A, Enwono E, Amanfo S, Murray J, Tshuma C, Mutapi F, Mduluza T. Elevation of C-reactive protein, P-selectin and Resistin as potential inflammatory biomarkers of urogenital Schistosomiasis exposure in preschool children. BMC Infect Dis 2019; 19:1071. [PMID: 31856765 PMCID: PMC6924053 DOI: 10.1186/s12879-019-4690-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/08/2019] [Indexed: 11/13/2022] Open
Abstract
Background Schistosomiasis is known to induce inflammatory immune responses. C-reactive protein (CRP), resistin and P-selectin are serological inflammatory markers that rise during the acute stages of infection. Here, we propose such inflammatory biomarkers have a potential for use in urogenital schistosomiasis diagnostic screening for exposure and infection in preschool-aged children. Methods As part of a larger study on urogenital schistosomiasis, 299 preschool children aged 1–5 years were included in this cross-sectional study. Parasitological diagnosis was conducted using urine filtration for Schistosoma haemtobium infection, and Kato Katz for S. mansoni infection. Serum levels of P-selectin, resistin, CRP, and antibodies against S. haematobium cercarial antigen preparation (CAP) and soluble worm antigen preparation (SWAP) were measured by ELISA. Results Of the 299 participants, 14% were egg positive for S. haematobium. Serology showed 46 and 9% of the participants to have been exposed to S. haematobium cercarial antigens and adult worm antigens, respectively. Levels of P-selectin were significantly higher in participants infected with S. haematobium (egg-positive) than in uninfected participants (p = 0.001). Levels of P-selectin were also higher in those exposed to cercarial antigen than in unexposed participants (p = 0.019). There was a positive correlation between P-selectin and infection intensity (r = 0.172; p = 0.002), as well as with IgM responses to CAP and SWAP (r = 0.183; p = 0.001); (r = 0.333; p < 0.0001) respectively. CRP significantly correlated with IgM responses to CAP (r = 0.133; p = 0.029) while resistin correlated with IgM responses to CAP and SWAP (r = 0.127; p = 0.016); (r = 0.197; p = 0.0004). CRP levels were higher in those exposed to cercarial and adult worm antigens than unexposed participants (p = 0.035); (p = 0.002) respectively, while resistin was higher in participants exposed to cercarial antigen than unexposed participants (p = 0.024). Conclusion In this preschool population, P-selectin is significantly associated with urogenital schistosome infection and intensity; hence a potential biomarker for infection diagnosis and disease monitoring. The inflammatory biomarkers (P-selectin, Resistin and CRP) were significantly higher in participants exposed to cercarial antigens than unexposed individuals indicating an underlying inflammatory environment.
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Affiliation(s)
- Theresa N Chimponda
- University of Zimbabwe, Biochemistry Department, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe.
| | - Caroline Mushayi
- Mashonaland Central Provincial Health Office, Ministry of Health & Child Care, Harare, Zimbabwe
| | - Derick N M Osakunor
- Statistics Department, University of Zimbabwe, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe
| | - Arthur Vengesai
- University of Zimbabwe, Biochemistry Department, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe
| | - Eyoh Enwono
- Statistics Department, University of Zimbabwe, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe
| | - Seth Amanfo
- Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King's Building Charlotte Auerbach Road, Edinburgh, EH9 3FL, UK.,Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Janice Murray
- Statistics Department, University of Zimbabwe, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe.,Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Cremance Tshuma
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa at the University of Edinburgh, Edinburgh, UK
| | - Francisca Mutapi
- Statistics Department, University of Zimbabwe, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe.,Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Takafira Mduluza
- University of Zimbabwe, Biochemistry Department, P. O. Box MP 167, Mt Pleasant, Harare, Zimbabwe.,Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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9
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Kamdem SD, Konhawa F, Kuemkon EM, Meyo Kamguia L, Tchanana GK, Nche F, Oumarou A, Hamza M, Ouratou Y, Tcheutchoua MN, Ghislain Essomba R, Ngogang MP, Kengne M, Netongo PM, Ondigui BE, Okomo Assoumou MC, Brombacher F, Nono JK. Negative Association of Interleukin-33 Plasma Levels and Schistosomiasis Infection in a Site of Polyparasitism in Rural Cameroon. Front Immunol 2019; 10:2827. [PMID: 31849991 PMCID: PMC6901687 DOI: 10.3389/fimmu.2019.02827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022] Open
Abstract
Background: This study aimed to investigate the association of plasma levels of IL-33, a mucosal alarmin known to elicit type-2 immunity, with infection and liver fibrosis profiles of school children from an endemic area for Schistosoma mansoni, malaria and hepatitis (B & C) in rural Cameroon. Methods: A cross-sectional study enrolling schoolchildren from 5 public schools was conducted. Single schistosomiasis, malaria and hepatitis infections or co-infections were assessed by kato katz, microscopy, and rapid diagnostic tests, respectively. Hepatic fibrosis was assessed by ultrasound according to WHO Niamey guidelines and plasma levels of Interleukin 33 were determined by ELISA. All statistics were performed using R studio software. Principal findings: We found a prevalence of 13.5% (37/275), 18.2% (50/275), and 8% (22/275), respectively for schistosomiasis, malaria and hepatitis (B or C) single infections. Only 7.6% (21/275) of co-infections were reported. Although Plasma IL-33 showed a minimal negative risk for schistosomiasis infection (AOR 0.99; 95% CI 0.97–1.01), S. mansoni infected participants had lower levels of plasma IL-33 (p = 0.003) which decreased significantly as eggs burdens increased (p = 0.01) with a negative Pearson coefficient of r = −0.22. Hepatic fibrosis occurred in 47.3% (130/275) of our study population independently from plasma levels of IL-33 (AOR 1.00; 95% CI 0.99–1.01). Conclusion/Significance: Our data failed to show an association between plasma IL-33 levels and liver disease but convincingly report on a negative association between plasma IL-33 levels and schistosomiasis infection and egg burden in school children from a polyparasitic schistosomiasis endemic area.
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Affiliation(s)
- Severin Donald Kamdem
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa
| | - Francis Konhawa
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Erve Martial Kuemkon
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Leonel Meyo Kamguia
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Gladys K Tchanana
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,CIAB EXACT Medical Laboratory, Yaoundé, Cameroon
| | - Frungwa Nche
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Yasmine Ouratou
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - René Ghislain Essomba
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.,National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | | | - Michel Kengne
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | - Palmer Masumbe Netongo
- Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon.,Department of Biochemistry, University of Yaoundé 1, Yaoundé, Cameroon
| | | | | | - Frank Brombacher
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
| | - Justin Komguep Nono
- Division of Immunology, Health Science Faculty, University of Cape Town, Cape Town, South Africa.,Cape Town Component, International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa.,Immunology of Infectious Diseases Unit, South African Medical Research Centre, Cape Town, South Africa.,The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
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10
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Panic G, Barda B, Kovač J, Coulibaly JT, Keiser J. Evaluation of the Clinitek®, a point-of-care urinalysis system for the measurement of clinically significant urinary metabolites and detection of haematuria in Schistosoma haematobium infected children in southern Côte d'Ivoire. Parasit Vectors 2019; 12:298. [PMID: 31196145 PMCID: PMC6567640 DOI: 10.1186/s13071-019-3555-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary schistosomiasis, caused by Schistosoma haematobium, remains a significant public health problem worldwide, despite years of efforts to control it. Haematuria is one of the notable indirect indicators of S. haematobium infection and is commonly assessed along with other routine screens using a urinary dipstick test. A portable "field friendly" electronic analyser would offer an automated and thus more objective read-out compared to visual-read dipstick methods. METHODS Within the framework of a Phase 2 praziquantel dose finding study in preschool- and school-aged children infected with S. haematobium, in southern Côte d'Ivoire, we compared a visual-read of the urine dipstick strips (Multistix PRO, Siemens Healthcare Diagnostics) to an automated reader (CLINITEK Status+ analyser™ Siemens Healthcare Diagnostics). Urine samples were collected from 148 pre-school aged and 152 school-aged children for urinalysis. Values were compared using a linear weighted kappa statistic and Bland-Altman analysis. RESULTS A very good correlation between the two methods for nitrites and haematuria was observed (κ coefficient of 0.88 and 0.82, respectively), while a good correlation was observed for leukocytes (κ coefficient of 0.63) A moderate to fair correlation was calculated (κ coefficient ≤ 0.6) for all other parameters. When the results were stratified according to infection intensity, the agreements were stronger from the high infection intensity sample measurements, for most of the parameters. CONCLUSION Our results demonstrate the device's utility in detecting haematuria and nitrites but underline the need for further development of this tool in order to improve its performance in the field.
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Affiliation(s)
- Gordana Panic
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Present Address: Department of Surgery and Cancer, Division of Systems and Digestive Medicine, Imperial College London, London, UK
| | - Beatrice Barda
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jana Kovač
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jean T. Coulibaly
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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11
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Rosinger AY, Young SL, Collins SM, Haider SR, Mishra P, Nagai HT, Petro M, Downs JA. Schistosomiasis and hydration status: Schistosoma haematobium, but not Schistosoma mansoni increases urine specific gravity among rural Tanzanian women. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:952-959. [PMID: 29664990 DOI: 10.1002/ajpa.23479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Schistosome infections can damage organs important for water homeostasis, especially the kidneys. Urogenital schistosomiasis (caused by Schistosoma haematobium) increases protein and blood in urine and intestinal schistosomiasis (caused by S. mansoni) affects total body water. However, no data exist on how different schistosome species affect urine specific gravity (USG), a hydration biomarker. Therefore, we assessed the relationship between S. haematobium- and S. mansoni-infected and uninfected women and USG in rural Tanzania. MATERIALS AND METHODS Surveys were conducted and stool and urine samples were collected among 211 nonpregnant women aged 18-50. S. haematobium eggs were detected using the urine filtration method. S. mansoni eggs were detected using the Kato Katz method. USG was measured using a refractometer and analyzed as both a continuous and dichotomous variable. Regression (linear/logistic) models were estimated to test the relationship between infection and hydration status. RESULTS The prevalence of S. haematobium was 5.9% and S. mansoni was 5.4% with no coinfections. In regression models, S. haematobium-infected women had significantly higher USG (Beta = 0.007 g mL-1 ; standard error = 0.002; p = 0.001) and odds (Odds ratio: 7.76, 95% CI: 1.21-49.5) of elevated USG (>1.020 g mL-1 ) than uninfected women, whereas S. mansoni-infected women did not. DISCUSSION Schistosoma haematobium, but not S. mansoni, infection is associated with higher USG and risk of inadequate hydration. Future work should determine whether findings are attributable to parasite-induced debris in urine or urinary tract pathologies and signs of renal damage. Human and non-human primate studies using USG in schistosome-endemic areas should account for schistosomiasis.
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Affiliation(s)
- Asher Y Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania 16802.,Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania 16802
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208.,Institute for Policy Research, Northwestern University, Evanston, Illinois 60208
| | - Shalean M Collins
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
| | - Syeda Razia Haider
- Department of Medicine, Weill Cornell Medicine, Center for Global Health, New York, New York 10065
| | - Pallavi Mishra
- Department of Medicine, Weill Cornell Medicine, Center for Global Health, New York, New York 10065
| | - Honest T Nagai
- National Institute for Medical Research, Mwanza Tanzania
| | - Mnyeshi Petro
- National Institute for Medical Research, Mwanza Tanzania
| | - Jennifer A Downs
- Department of Medicine, Weill Cornell Medicine, Center for Global Health, New York, New York 10065
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12
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Osakunor DNM, Mduluza T, Midzi N, Chase-Topping M, Mutsaka-Makuvaza MJ, Chimponda T, Eyoh E, Mduluza T, Pfavayi LT, Wami WM, Amanfo SA, Murray J, Tshuma C, Woolhouse MEJ, Mutapi F. Dynamics of paediatric urogenital schistosome infection, morbidity and treatment: a longitudinal study among preschool children in Zimbabwe. BMJ Glob Health 2018; 3:e000661. [PMID: 29616147 PMCID: PMC5875666 DOI: 10.1136/bmjgh-2017-000661] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 01/14/2023] Open
Abstract
Background Recent research has shown that in schistosome-endemic areas preschool-aged children (PSAC), that is, ≤5 years, are at risk of infection. However, there exists a knowledge gap on the dynamics of infection and morbidity in this age group. In this study, we determined the incidence and dynamics of the first urogenital schistosome infections, morbidity and treatment in PSAC. Methods Children (6 months to 5 years) were recruited and followed up for 12 months. Baseline demographics, anthropometric and parasitology data were collected from 1502 children. Urinary morbidity was assessed by haematuria and growth-related morbidity was assessed using standard WHO anthropometric indices. Children negative for Schistosoma haematobium infection were followed up quarterly to determine infection and morbidity incidence. Results At baseline, the prevalence of S haematobium infection and microhaematuria was 8.5% and 8.6%, respectively. Based on different anthropometric indices, 2.2%-8.2% of children were malnourished, 10.1% underweight and 18.0% stunted. The fraction of morbidity attributable to schistosome infection was 92% for microhaematuria, 38% for stunting and malnutrition at 9%-34%, depending on indices used. S haematobium-positive children were at greater odds of presenting with microhaematuria (adjusted OR (AOR)=25.6; 95% CI 14.5 to 45.1) and stunting (AOR=1.7; 95% CI 1.1 to 2.7). Annual incidence of S haematobium infection and microhaematuria was 17.4% and 20.4%, respectively. Microhaematuria occurred within 3 months of first infection and resolved in a significant number of children, 12 weeks post-praziquantel treatment, from 42.3% to 10.3%; P<0.001. Conclusion We demonstrated for the first time the incidence of schistosome infection in PSAC, along with microhaematuria, which appears within 3 months of first infection and resolves after praziquantel treatment. A proportion of stunting and malnutrition is attributable to S haematobium infection. The study adds scientific evidence to the calls for inclusion of PSAC in schistosome control programmes.
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Affiliation(s)
- Derick Nii Mensah Osakunor
- Centre for Infection, Immunity and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK
| | - Takafira Mduluza
- Department of Biochemistry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.,School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Nicholas Midzi
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Margo Chase-Topping
- Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Masceline Jenipher Mutsaka-Makuvaza
- Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.,National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Theresa Chimponda
- Department of Biochemistry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Enwono Eyoh
- Centre for Infection, Immunity and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK
| | - Tariro Mduluza
- Department of Biochemistry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Lorraine Tsitsi Pfavayi
- Department of Biochemistry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Welcome Mkululi Wami
- Centre for Infection, Immunity and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK
| | - Seth Appiah Amanfo
- Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Janice Murray
- Centre for Infection, Immunity and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK
| | - Clement Tshuma
- Epidemiology and Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Mark Edward John Woolhouse
- Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Edinburgh, UK
| | - Francisca Mutapi
- Centre for Infection, Immunity and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK.,NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Edinburgh, UK
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13
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Abstract
Schistosomiasis affects over 200 million people worldwide, most of whom are children. Research and control strategies directed at preschool-aged children (PSAC), i.e., ≤5 years old, have lagged behind those in older children and adults. With the recent WHO revision of the schistosomiasis treatment guidelines to include PSAC, and the recognition of gaps in our current knowledge on the disease and its treatment in this age group, there is now a concerted effort to address these shortcomings. Global and national schistosome control strategies are yet to include PSAC in treatment schedules. Maximum impact of schistosome treatment programmes will be realised through effective treatment of PSAC. In this review, we (i) discuss the current knowledge on the dynamics and consequences of paediatric schistosomiasis and (ii) identify knowledge and policy gaps relevant to these areas and to the successful control of schistosome infection and disease in this age group. Herein, we highlight risk factors, immune mechanisms, pathology, and optimal timing for screening, diagnosis, and treatment of paediatric schistosomiasis. We also discuss the tools required for treating schistosomiasis in PSAC and strategies for accessing them for treatment.
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Affiliation(s)
- Derick N. M. Osakunor
- Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- * E-mail:
| | - Mark E. J. Woolhouse
- Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Francisca Mutapi
- Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
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14
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Urogenital Schistosomiasis—Evidence-Based Benefits of Treatment Initiated Early During Childhood. CURRENT CLINICAL MICROBIOLOGY REPORTS 2017. [DOI: 10.1007/s40588-017-0077-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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Sierra-Diaz E, Celis-de la Rosa ADJ, Lozano-Kasten F, Bravo-Cuellar A, Garcia-Gutierrez M, Georgina HF. Non-Traditional Risk Factors of Albuminuria in the Pediatric Population: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101231. [PMID: 29035316 PMCID: PMC5664732 DOI: 10.3390/ijerph14101231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 12/27/2022]
Abstract
The presence of albumin in urine has been used for more than four decades as a marker of renal and cardiovascular damage. Most of the information on this marker is related to adults. The prevalence of albuminuria in the pediatric population has been reported as being 2.2–12.8% in some countries. Most research in this field is related to albuminuria and diseases, such as diabetes and hypertension. Using the methodology described by Arksey and O’Malley in 2005, a scoping review was carried out to show that the presence of albumin in urine in the pediatric population might be associated with environmental, demographic, congenital, infectious, and non-infectious factors. The information collected is supported by 74 references present in PubMed. The results reveal the multiple causes associated with albuminuria in the pediatric population. This information can be very useful for clinical practice by adding knowledge about albuminuria behavior in children.
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Affiliation(s)
- Erick Sierra-Diaz
- Public Health Department, University of Guadalajara, Sierra Mojada 950, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico.
| | | | - Felipe Lozano-Kasten
- Environmental Health Department, University of Guadalajara, Sierra Mojada 950, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico.
| | - Alejandro Bravo-Cuellar
- Immunology Department, Western Research Biomedical Center (IMSS), Sierra Mojada 800, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico.
| | - Mariana Garcia-Gutierrez
- Pediatrics Department, Hospital Angeles del Carmen, Health Services, Tarascos 3473 Interior 240A, Fraccionamiento Monraz, Guadalajara, Jalisco 44670, Mexico.
| | - Hernandez-Flores Georgina
- Immunology Department, Western Research Biomedical Center (IMSS), Sierra Mojada 800, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico.
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16
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Rapid Risk Assessment Report for Schistosomiasis Epidemic in Jianli County Caused by the Sunk "Oriental Star" Cruise Ship. Disaster Med Public Health Prep 2017; 12:147-153. [PMID: 28914224 DOI: 10.1017/dmp.2017.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND At 9:28 pm on June 1, 2015, the cruise ship "Oriental Star" sank into Yangtze River in Jianli County, with 422 people killed. When the accident occurred, the Chinese government took immediate action and dispatched more than 9000 rescuers. The risk for outbreak of schistosomiasis was increased because of the shipwreck. Obviously it is critical to carry out risk assessment as soon as possible. METHODS By means of the Delphi method, the situation was analyzed so that the government could fathom the severity of the accident. Then, through matrix and sigma-plotting (3-dimensional graphics) methods, related authorities performed risk assessment after site investigation. RESULTS The latest news reported that more than 9000 people were involved in the rescue. The affected river was analyzed and mapped using SigmaPlot software, according to which the possibility, harmfulness, and controllability of the accident were determined to be medium (6), medium (6), and poor (7), respectively. CONCLUSION The site of the accident where the cruise ship sank and rescue operations were carried out is a schistosomiasis epidemic area with high mortality and morbidity. The chance of an outbreak of the schistosomiasis epidemic in Jianli County is quite high. To protect people in this county from the epidemic, relevant logistic services should be arranged and all remains should be cleared up carefully. (Disaster Med Public Health Preparedness. 2018;12:147-153).
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17
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Mduluza T, Mutapi F. Putting the treatment of paediatric schistosomiasis into context. Infect Dis Poverty 2017; 6:85. [PMID: 28388940 PMCID: PMC5384153 DOI: 10.1186/s40249-017-0300-8] [Citation(s) in RCA: 38] [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: 11/17/2016] [Accepted: 04/04/2017] [Indexed: 12/19/2022] Open
Abstract
Despite increased international efforts to control schistosomiasis using preventive chemotherapy, several challenges still exist in reaching the target populations. Until recently, preschool-aged children had been excluded from the recommended target population for mass drug administration, i.e. primary school children aged 6-15 years. Our studies and those of others provided the evidence base for the need to treat preschool-aged children that led to recommendations by the World Health Organization to include preschool-aged children in treatment programmes in 2010. The major challenge now lies in the unavailability of a child-size formulation of the appropriate anthelmintic drug, praziquantel.The currently available formulation of praziquantel presents several problems. First, it is a large tablet, making it difficult for young children and infants to swallow it and thus requires its breaking/crushing to allow for safe uptake. Second, it is bitter so it is often mixed with a sweetener to make it palatable for young children. Third, the current formulation of 600 mg does not allow for flexible dose adjustments for this age group. Thus, there is a need to formulate a child-appropriate praziquantel tablet.This paper discusses the target product profile for paediatric praziquantel, as well as knowledge gaps pertinent to the successful control of schistosome infection and disease in preschool-aged children.
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Affiliation(s)
- Takafira Mduluza
- Biochemistry Department, University of Zimbabwe, P.O. Box MP167, Mount Pleasant, Harare, Zimbabwe
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Francisca Mutapi
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Charlotte Auerbach Road, Edinburgh, EH9 3FL UK
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Atalabi TE, Adubi TO, Lawal U. Rapid mapping of urinary schistosomiasis: An appraisal of the diagnostic efficacy of some questionnaire-based indices among high school students in Katsina State, northwestern Nigeria. PLoS Negl Trop Dis 2017; 11:e0005518. [PMID: 28369090 PMCID: PMC5391124 DOI: 10.1371/journal.pntd.0005518] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 04/13/2017] [Accepted: 03/21/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa, over 200 million individuals are estimated to be infected with urinary and intestinal schistosomiasis. In a bid to lay a foundation for effective future control programme, this study was carried out with the aim of assessing the diagnostic efficacy of some questionnaire-based rapid assessment indices of urinary schistosomiasis. METHODOLOGY A total number of 1,363 subjects were enrolled for the study. Questionnaires were administered basically in English and Hausa languages by trained personnel. Following informed consent, terminal urine samples were collected between 09:40 AM and 2:00 PM using clean 20 ml capacity universal bottles. 10μl of each urine residue was examined for the eggs of S. haematobium using x10 objective nose of Motic Binocular Light Microscope (China). PRINCIPAL FINDINGS The average age ± Standard Deviation (SD) of school children examined was 15.30 ± 2.30 years and 40.87% were females. The overall prevalence and geometric mean intensity of S. haematobium infection were 26.41% (24.10─28.85) and 6.59 (5.59─7.75) eggs / 10 ml of urine respectively. Interestingly, a questionnaire equivalence of the prevalence obtained in this survey was 26.41% (24.10─28.85) for Rapid Assessment Procedure based on self-reported blood in urine. The results of correlation analyses demonstrated significant associations between the prevalence of S. haematobium infection and contact with potentially infested open water sources (r = 0.741; P = 0.006). By regression model, cases of respondents with self-reported blood in urine are expected to rise to 24.75% if prevalence of the infection shoots up to 26.5%. CONCLUSIONS/SIGNIFICANCE The best RAP performance was obtained with self-reported blood in urine. Based on the overall prevalence value, the study area was at a "moderate-risk" of endemicity for urinary schistosomiasis. Chemotherapeutic intervention with Praziquantel, the rationale behind rapid assessment procedure for schistosomiasis, has been recommended to be carried out once in every 2 years for such communities.
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Affiliation(s)
- Tolulope Ebenezer Atalabi
- Department of Biological Sciences, Faculty of Science, Federal University Dutsinma, Dutsin-Ma, Katsina State, Nigeria
| | - Taiwo Oluwakemi Adubi
- Department of Biological Sciences and Biotechnology, College of Pure and Applied Sciences, Caleb University, Imota, Lagos State, Nigeria
| | - Umar Lawal
- Department of Biological Sciences, Faculty of Science, Federal University Dutsinma, Dutsin-Ma, Katsina State, Nigeria
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Mewabo AP, Moyou RS, Kouemeni LE, Ngogang JY, Kaptue L, Tambo E. Assessing the prevalence of urogenital schistosomaisis and transmission risk factors amongst school-aged children around Mapé dam ecological suburbs in Malantouen district, Cameroon. Infect Dis Poverty 2017; 6:40. [PMID: 28260525 PMCID: PMC5338087 DOI: 10.1186/s40249-017-0257-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 02/10/2017] [Indexed: 12/01/2022] Open
Abstract
Background Urogenital schistosomiasis is a parasitic infection of public health importance that affects over 112 million people worldwide. The study aimed at assessing the urogenital schistosomiasis prevalence and risk factors of transmission around Mape dam suburds in Malantouen district, West, Cameroon. Methods The study was conducted using semi-structured pretested questionnaires to collect socio-demographic and ecological data. Urine samples were also collected and used to confirm the prevalence of schistosomiasis in consented school-aged children in four primary schools between March – July 2014. Snails’ samples around the dam surburbs were also collected for taxonomy characterization and species identification. Data were compiled and quality control assessed and analysed using SPSS version 17 and Epiinfo data 3.1. P < 0.05 was considered statistical significance. Results Questionnaires were administered to 229 pupils, with gender ratio of 1.04 (m/f). The prevalence of schistosomiasis haematobium was 16.6%. Mambonko school site, which is the closest to the dam suburbs, registered the greatest prevalence rate of 40%. The age group beween 10–13 years was the most infected (18.3%) and boys were more infested than girls (21.0% vs. 15.5%). Haematuria, urination pain, school absentiesm and poor performance were the major recorded complications in 39.5 and 26.3% males to female respectively. Infection rate gender disparity documented is still poorly understood and Bulinus truncatus collected from Mambonko suburb as potential snail intermediate host requires further studies. Conclusions Authors advocated that schools and dam suburds sustained and innovative community-based surveillance and response targeted interventions implementation are needed to inform and support decision-making policy, but also in improving effective contextual behavioural communication changes and MDA improved uptake measures on national schistosomiasis control and elimination in Cameroon. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0257-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adeline P Mewabo
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Roger S Moyou
- Institut de Recherches Médicales et d'Etudes des Plantes Médicinale-Centre de Recherches Médicales (IMPM-CRM), Yaoundé, Cameroon
| | - Lysette E Kouemeni
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Jeanne Y Ngogang
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Lazare Kaptue
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Ernest Tambo
- Department Biochemistry, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon. .,Africa Disease Intelligence and Surveillance, Communication and Response (Africa DISCoR) Institute, Yaoundé, Cameroon.
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Barda B, Coulibaly JT, Hatz C, Keiser J. Ultrasonographic evaluation of urinary tract morbidity in school-aged and preschool-aged children infected with Schistosoma haematobium and its evolution after praziquantel treatment: A randomized controlled trial. PLoS Negl Trop Dis 2017; 11:e0005400. [PMID: 28222149 PMCID: PMC5336295 DOI: 10.1371/journal.pntd.0005400] [Citation(s) in RCA: 21] [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: 12/16/2016] [Revised: 03/03/2017] [Accepted: 02/10/2017] [Indexed: 11/18/2022] Open
Abstract
Background Schistosoma haematobium infections are responsible for significant urinary tract (UT) complications. Schistosomiasis control programs aim to reduce morbidity, yet the extent of morbidity in preschool-aged children and the impact of treatment on morbidity reduction are not well studied. Methodology Our study was embedded in a randomized, placebo-controlled, single-blind trial in Côte d’Ivoire, which evaluated the efficacy and safety of three doses (20, 40 and 60 mg/kg) of praziquantel in school-aged (SAC) and preschool-aged (PSAC) children infected with S. haematobium. Enrolled children were invited to participate in an ultrasound examination prior and six months after treatment. At these time points 3 urine samples were collected for parasitological and clinical examinations. Principal findings 162 PSAC and 141 SAC participated in the ultrasound examination at baseline, of which 128 PSAC and 122 SAC were present at follow-up. At baseline 43% (70/162) of PSAC had UT morbidity, mostly at bladder level and 7% had hydronephrosis. 67% (94/141) of SAC revealed mainly moderate UT pathology, 4% presented pseudopolyps on the bladder wall, and 6% had pyelectasis. At follow up, 45% of PSAC and 58% of SAC were S. haematobium positive, mostly harboring light infection intensities (41% and 51%, respectively). Microhematuria was present in 33% of PSAC and 42% of SAC and leukocyturia in 53% and 40% of PSAC and SAC, respectively. 50% (64/128) of PSAC and 58% (71/122) of SAC presented urinary tract morbidity, which was mainly mild. A significant correlation (p<0.05) was observed between praziquantel treatment and reversal of S. haematobium induced morbidity. Progression of UT pathology decreased with increasing praziquantel dosages. A worsening of morbidity was observed among children in the placebo group. Conclusion/Significance Bladder morbidity is widespread among PSAC. Praziquantel treatment is significantly associated with the reversal of S. haematobium induced morbidity, which underscores the importance of preventive chemotherapy programs. These programs should be expanded to PSAC to prevent or decrease the prevalence of morbidity in young children. This trial is registered as an International Standard Randomized Controlled Trial, number ISRCTN15280205. Schistosoma haematobium is a parasite that infects the human genito-urinary tract. People get infected with the parasite through contact with fresh water and children are at major risk. The complications linked to this infection are due to an inflammation caused by accumulation of the eggs in peri-bladder veins. If not treated, infections can last years and different degrees of severity are observed. These range from thickening of the bladder wall and blurriness of the mucosa to more serious lesions such as pseudo polyps and masses in the bladder that can, with time, evolve in cancer of the bladder. We analyzed preschool-aged children (PSAC) and school-aged children (SAC) with ultrasound before and after praziquantel treatment. Children were randomly assigned to different doses of praziquantel (20, 40 or 60 mg/kg) or to placebo at baseline. Six months after treatment all children underwent another ultrasound of the urinary tract. We included 162 PSAC and 141 SAC at baseline, of which 128 PSAC and 122 SAC had a second ultrasound evaluation six months afterwards. In addition, urine was sampled at both time points for presence of blood, proteins and signs of infection (leukocytes and nitrates). Six months post-treatment 45% of PSAC and 58% of SAC were S. haematobium positive. Already at the first screening 43% of PSAC and 67% of SAC had bladder lesions. After treatment 50% of PSAC and 58% of SAC still had pathology linked to the infection. We found a correlation between the treatment dose and healing of bladder lesions. On the other hand, we experienced an aggravation of lesions in the placebo group. Praziquantel is given to SAC as preventive chemotherapy every year at national level, where this parasite is endemic. This program should be expanded and include PSAC as well in order to reduce the consequences of infection.
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Affiliation(s)
- Beatrice Barda
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
| | - Jean T. Coulibaly
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Felix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Christoph Hatz
- University of Basel, CH-4003 Basel, Switzerland
- Medical Department, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, CH-4003 Basel, Switzerland
- * E-mail:
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Abstract
SUMMARYSchistosomiasis, commonly known as bilharzia, is a parasitic disease prevalent in Africa, Asia and South America. The majority of the cases occur in Sub-Saharan Africa where schistosomiasis is a major public health problem impacting on child health and development as well as adult health when infections become chronic. Control of schistosomiasis is by treatment of infected people with the antihelminthic drug praziquantel. Current schistosome control programmes advocated by the World Health Assembly in 2001 are aimed at regular school-based integrated deworming strategies in order to reduce development of severe morbidity, promote school health and to improve cognitive potential of children. Several countries in Africa have now embarked on national scale deworming programmes treating millions of children exposed to schistosomiasis in endemic areas without prior diagnosis of infection through mass drug administration programmes. Implementing such control programmes requires a concerted effort between scientists, policy makers, health practitioners and several other stake holders and of course a receptive community. This paper considers the contributions to global schistosome control efforts made by research conducted in Zimbabwe and the historical context and developments leading to the national schistosomiasis control programme in Zimbabwe giving an example of Getting Research into Policy and Practice.
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Bustinduy AL, Friedman JF, Kjetland EF, Ezeamama AE, Kabatereine NB, Stothard JR, King CH. Expanding Praziquantel (PZQ) Access beyond Mass Drug Administration Programs: Paving a Way Forward for a Pediatric PZQ Formulation for Schistosomiasis. PLoS Negl Trop Dis 2016; 10:e0004946. [PMID: 27658198 PMCID: PMC5033572 DOI: 10.1371/journal.pntd.0004946] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Amaya L. Bustinduy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Jennifer F. Friedman
- Center for International Health Research, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Eyrun Floerecke Kjetland
- Norwegian Centre for Imported and Tropical Diseases, Department of Infectious Diseases Ullevaal, Oslo University Hospital, Oslo, Norway
- Discipline of Public Health Medicine, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Amara E. Ezeamama
- Department of Epidemiology and Biostatistics University of Georgia, Athens, Georgia, United States of America
| | | | - J. Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
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Comparative Assessment of Health Benefits of Praziquantel Treatment of Urogenital Schistosomiasis in Preschool and Primary School-Aged Children. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9162631. [PMID: 27631011 PMCID: PMC5007301 DOI: 10.1155/2016/9162631] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/21/2016] [Accepted: 07/05/2016] [Indexed: 12/15/2022]
Abstract
Schistosomiasis is a major public health problem in Africa. However, it is only recently that its burden has become recognised as a significant component impacting on the health and development of preschool-aged children. A longitudinal study was conducted in Zimbabwean children to determine the effect of single praziquantel treatment on Schistosoma haematobium-related morbidity markers: microhaematuria, proteinuria, and albuminuria. Changes in these indicators were compared in 1-5 years versus 6-10 years age groups to determine if treatment outcomes differed by age. Praziquantel was efficacious at reducing infection 12 weeks after treatment: cure rate = 94.6% (95% CI: 87.9-97.7%). Infection rates remained lower at 12 months after treatment compared to baseline in both age groups. Among treated children, the odds of morbidity at 12 weeks were significantly lower compared to baseline for proteinuria: odds ratio (OR) = 0.54 (95% CI: 0.31-0.95) and albuminuria: OR = 0.05 (95% CI: 0.02-0.14). Microhaematuria significantly reduced 12 months after treatment, and the effect of treatment did not differ by age group: OR = 0.97 (95% CI: 0.50-1.87). In conclusion, praziquantel treatment has health benefits in preschool-aged children exposed to S. haematobium and its efficacy on infection and morbidity is not age-dependent.
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Bocanegra C, Gallego S, Mendioroz J, Moreno M, Sulleiro E, Salvador F, Sikaleta N, Nindia A, Tchipita D, Joromba M, Kavaya S, Sánchez Montalvá A, López T, Molina I. Epidemiology of Schistosomiasis and Usefulness of Indirect Diagnostic Tests in School-Age Children in Cubal, Central Angola. PLoS Negl Trop Dis 2015; 9:e0004055. [PMID: 26474169 PMCID: PMC4608768 DOI: 10.1371/journal.pntd.0004055] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 08/14/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Schistosomiasis remains a public health major problem and little is known in many areas, mainly in Sub-Saharan Africa. OBJECTIVES To assess the burden and risk factors of schistosomiasis and intestinal parasitic helminthes in the children of Cubal, Angola, and to compare different diagnostic approaches for urinary schistosomiasis under field conditions. METHODS A cross-sectional study was conducted. Urine and faeces samples of school children were microscopically studied. A random sample of children was obtained from an alphabetically arranged list of children, taking one of two children. Urine dipstick, colorimetric test and macrohaematuria were considered as indirect diagnostic methods and compared to direct urine examination. Possible risk factors for the infection were sex, age, distance to the river and previous treatment with praziquantel; the assessment was performed using Chi-square test. RESULTS A total of 785 (61.18%) children showed S. haematobium eggs in urine; children living within 500 meters from the river had a higher odds for infection: Odds ratio 1.97 (1.45-2.7 CI 95%); urine dipstick showed sensitivity of 96% and specificity of 61.3%, with a positive predictive value; colorimetric test showed sensitivity of 52.5%, specificity of 74.6% and a positive predictive value of 77%. Proteinuria was present in 653 (51.1%) children, being more frequent in children with S. haematobium in urine (75.2%); 32 of 191 stool samples (16%) showed the presence of other intestinal parasites and 8 (4%) for S. haematobium. CONCLUSIONS Prevalence of urinary schistosomiasis in our study area is much higher than the national average, considering it as a high-risk community. Proximity to a source of water was a risk factor for the infection. Indirect tests, as urine dipstick and colorimetric test, were useful tools for diagnosis, due to ease of use and low cost. Proteinuria was a common finding, probably showing an early structural damage due to schistosomiasis in this group of children.
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Affiliation(s)
- Cristina Bocanegra
- Special Program for Infectious Diseases Drassanes-Vall d’Hebron. PROSICS Barcelona, Spain/Hospital Nossa Senhora da Paz, Cubal, Angola
- * E-mail:
| | | | - Jacobo Mendioroz
- EpidemiologyDepartment. University Hospital Vall d’Hebron, Barcelona, Spain
| | | | - Elena Sulleiro
- Microbiology Department. University Hospital Vall d’Hebron. PROSICS Barcelona, Spain
| | - Fernando Salvador
- Infectious Diseases Department. University Hospital Vall d’Hebron. PROSICS Barcelona, Spain
| | | | | | | | | | | | | | | | - Israel Molina
- Infectious Diseases Department. University Hospital Vall d’Hebron. PROSICS Barcelona, Spain
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Mtethiwa AHN, Nkwengulila G, Bakuza J, Sikawa D, Kazembe A. Extent of morbidity associated with schistosomiasis infection in Malawi: a review paper. Infect Dis Poverty 2015; 4:25. [PMID: 25954507 PMCID: PMC4423108 DOI: 10.1186/s40249-015-0053-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 04/09/2015] [Indexed: 11/03/2022] Open
Abstract
Data on the extent of the burden due to schistosomiasis is sparse in most Sub-Saharan African countries. However, this data is crucial for triggering medical attention. A review of extent of morbidity and determinants associated with schistosomiasis in Malawi was therefore conducted to quantify the infection in order to concretise the need for medical intervention. A systematic and traditional search strategy was used to find literature for the review, whilst exclusion and inclusion criteria were used to identify appropriate articles. Logistic regression curves of epidemiological model Y = (a + bx (c) )/(1 + bx (c) ) and the recommendation that schistosomiasis prevalence can be used to estimate morbidity were employed to quantify morbidity at various infection stages. Morbidity was quantified as a direct proportion of the population and the respective national schistosomiasis prevalence. Findings showed that both S. mansoni and S. haematobium are present in Malawi with the latter highly prevalent (50%). Furthermore, out of the estimated population of 16,829 million, approximately 8.4 million have schistosomiasis, with about 4.4 million of these aged 18 years and below. The most frequent manifestation is Katayama syndrome, while ascites is the lowest, impacting about 3.0 million and 960 individuals, respectively. Localised studies on association of schistosomiasis infection to risk factors such as occupation, age and gender found odds ratio (OR) ranging from 1.29 to 5.37. Morbidity due to schistosomiasis is high in Malawi. It is therefore recommended that a more detailed study on the determinants of high schistosomiasis and re-evaluation of the current control measures be conducted if the current morbidity statistics are to be remarkably reduced.
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Affiliation(s)
- Austin H N Mtethiwa
- Lilongwe University of Agriculture and Natural Resources (LUANAR), Bunda Campus, PO Box 219, Lilongwe, Malawi
| | - Gamba Nkwengulila
- Zoology Department, University of Dar es Salaam, College of Natural and Applied Science, PO Box 35064, Dar es Salaam, Tanzania
| | - Jared Bakuza
- Biological Sciences Unit, Dar es Salaam University College of Education (DUCE), PO Box 2329, Dar es Salaam, Tanzania
| | - Daniel Sikawa
- Lilongwe University of Agriculture and Natural Resources (LUANAR), Bunda Campus, PO Box 219, Lilongwe, Malawi
| | - Abigail Kazembe
- University of Malawi, Kamuzu College of Nursing, Private Bag 1, Lilongwe, Malawi
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