1
|
Vere M, ten Ham-Baloyi W, Melariri PE. Effects of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic review. PLoS One 2024; 19:e0301464. [PMID: 38696510 PMCID: PMC11065241 DOI: 10.1371/journal.pone.0301464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 03/17/2024] [Indexed: 05/04/2024] Open
Abstract
Preventive chemotherapy by mass drug administration is globally recommended as the primary method of reaching the elimination of schistosomiasis, especially in the high risk-paediatric population. This systematic review provides a summary of the effects of paediatric schistosomiasis control programs on eliminating schistosomiasis in sub-Saharan Africa. A systematic search was conducted in PubMed, EBSCOhost, and other databases to obtain studies regarding the effects of paediatric schistosomiasis control programmes in sub-Saharan Africa. 3455 studies were screened for eligibility, included articles reported on both paediatrics control programmes and schistosomiasis, and articles were excluded when they did not report on schistosomiasis control programmes in paediatrics exclusively. 40 selected studies were critically appraised using the JBI critical appraisal tools for relevance and 30 studies were included in the study. An in-depth quantitative descriptive analysis was conducted, and a comprehensive narrative summary explained the results within the scope of the review questions. The results show that despite preventive chemotherapy lowering schistosomiasis prevalence, chances of re-infection are high in endemic areas. Preventive chemotherapy without complementary interventions including safe water provision and proper sanitation, snail control and health education on the aetiology of schistosomiasis, transmission pattern and control practices might not eliminate schistosomiasis.
Collapse
Affiliation(s)
- Maryline Vere
- Faculty of Health Sciences, Department of Environmental Health, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
| | - Wilma ten Ham-Baloyi
- Faculty of Health Sciences, Department of Environmental Health, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
- Faculty of Health Sciences, Department of Nursing Science, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
| | - Paula Ezinne Melariri
- Faculty of Health Sciences, Department of Nursing Science, Nelson Mandela University, University Way, Summerstrand, Gqeberha, South Africa
| |
Collapse
|
2
|
Tadele T, Astatkie A, Abay SM, Tadesse BT, Makonnen E, Aklillu E. Prevalence and Determinants of Schistosoma mansoni Infection among Pre-School Age Children in Southern Ethiopia. Pathogens 2023; 12:858. [PMID: 37513705 PMCID: PMC10385345 DOI: 10.3390/pathogens12070858] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 07/30/2023] Open
Abstract
School-based deworming program is implemented to control and eliminate Schistosoma mansoni infection in many endemic countries, including Ethiopia. However, pre-school-age children (pre-SAC) are not targeted to receive preventive chemotherapy against S. mansoni infection, partly due to a lack of information on the disease burden. We assessed the prevalence and correlates of S. mansoni infection among pre-SAC in Southern Ethiopia. A total of 1683 pre-SAC aged 4 to 7 years were screened for S. mansoni infection. A multilevel binary logistic regression was fitted to detect the significant determinants of S. mansoni infection. Adjusted odds ratios (AORs) with a 95% confidence interval (CI) were used to identify determinants of S. mansoni infection. The overall prevalence of S. mansoni infection was 14.3% (95% CI: 12.6, 16.0%). S. mansoni infection was significantly higher among 6-year-old (AOR = 2.58, 95% CI: 1.55, 4.27) and 7-year-old children (AOR = 4.63, 95% CI: 2.82, 7.62). Accompanying others to water sources sometimes (AOR = 2.60, 95% CI: 1.12, 6.01) and all the time (AOR = 5.91, 95% CI: 2.51, 13.90), and residing in less than one kilometer from the infested water source (AOR = 3.17, 95% CI: 1.47, 6.83) increased the odds of S. mansoni infection. In conclusion, the prevalence of S. mansoni infection among pre-SAC in the study area was moderate. The study highlights the urgent need to include pre-SAC aged 4 to 7 years in annual preventive chemotherapy campaigns to reduce the risk of possible sources of infection and enhance the achievement of the elimination target.
Collapse
Affiliation(s)
- Tafese Tadele
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa P.O. Box 1560, Ethiopia
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa P.O. Box 1560, Ethiopia
| | - Solomon Mequanente Abay
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
| | - Birkneh Tilahun Tadesse
- Department of Pediatrics, College of Medicine and Health Sciences, Hawassa University, Hawassa P.O. Box 1560, Ethiopia
| | - Eyasu Makonnen
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
| | - Eleni Aklillu
- Department of Global Public Health, Karolinska Institutet, Karolinska University Hospital, 171 77 Stockholm, Sweden
| |
Collapse
|
3
|
Chanhanga N, Mindu T, Mogaka J, Chimbari M. The Impact of Targeted Treatment and Mass Drug Administration Delivery Strategies on the Prevalence and Intensity of Schistosomiasis in School Aged Children in Africa: A Systematic Review. Infect Drug Resist 2023; 16:2453-2466. [PMID: 37138838 PMCID: PMC10150034 DOI: 10.2147/idr.s395382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/16/2023] [Indexed: 05/05/2023] Open
Abstract
Schistosomiasis is a public health problem in more than 78 countries in the world. The disease is most prevalent among children than adults due to their high exposure to infectious water sources. Various interventions such as mass drug administration (MDA), snail control, safe water provision and health education have been implemented independently or jointly to control, reduce and ultimately eliminate Schistosomiasis. This scoping review focused on studies reporting the impact of different delivery strategies of targeted treatment and MDA on the prevalence and intensity of schistosomiasis infection in school aged children in Africa. The review focused on Schistosoma haematobium and Schistosoma mansoni species. A systematic search for eligible literature from peer-reviewed articles was done from Google Scholar, Medline, PubMed and EBSCO host databases. The search yielded twenty-seven peer-reviewed articles. All articles found reported a decrease in the prevalence of schistosomiasis infection. Five studies (18.5%) reported a prevalence change below 40%, eighteen studies (66.7%) reported a change between 40% and 80%, and four studies (14.8%) reported a change above 80%. The infection intensity post-treatment was varied: twenty-four studies reported a decrease, while two studies reported an increase. The review showed that the impact of targeted treatment on the prevalence and intensity of schistosomiasis depended on the frequency at which it was offered, complementary interventions, and its uptake by the target population. Targeted treatment can significantly control the infection burden, but cannot eliminate the disease. Constant MDA programs coupled with preventative and health promotional programs are required to reach the elimination stage.
Collapse
Affiliation(s)
- Nathan Chanhanga
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Tafadzwa Mindu
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
- Correspondence: Tafadzwa Mindu, Email
| | - John Mogaka
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Moses Chimbari
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
- Research and Innovation, Great Zimbabwe University, Masvingo, Zimbabwe
| |
Collapse
|
4
|
Badri M, Olfatifar M, Wandra T, Budke CM, Mahmoudi R, Abdoli A, Hajialilo E, Pestehchian N, Ghaffarifar F, Foroutan M, Hashemipour S, Sotoodeh S, Samimi R, Eslahi AV. The prevalence of human trichuriasis in Asia: a systematic review and meta-analysis. Parasitol Res 2022; 121:1-10. [PMID: 34993634 DOI: 10.1007/s00436-021-07365-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Abstract
Trichuriasis is one of the most common soil-transmitted helminth (STH) infections, affecting populations globally. The condition is particularly prevalent in tropical and subtropical areas with low levels of sanitation and poor living conditions. The objective of this systematic review and meta-analysis was to evaluate the prevalence of Trichuris trichiura infection in Asia at the country and region level. Multiple databases/academic search engines (Web of Science, PubMed, ProQuest, Scopus, and Google Scholar) were searched for literature on T. trichiura prevalence in Asia published through January 2021. Pooled prevalence was determined using the meta-package in R (version 3.6.1). Out of 13,836 articles, 226 studies (5,439,500 individuals) from 26 countries met the inclusion criteria. Of the 226 studies, 151 were community-based studies that included individuals across the age spectrum, while 75 studies focused on school children (typically in the 5-16 years age range). The overall T. trichiura pooled prevalence was 15.3% (95% CI: 12.4-19.1%), with a pooled prevalence of 13.3% (95% CI: 10.0-17.1%) for the community studies and 20.9% (95% CI: 14.7-27.9%) for the studies only including school children. For studies including all age groups, individuals in the 1-15 years age group had the highest pooled prevalence at 23.4% (95% CI: 1.7-49.4%). There was a significant difference found in overall pooled prevalence by sex (p < 0.001) and community type (rural versus urban) (p < 0.001). Although prevalence appears to be decreasing, study findings suggest that T. trichiura infection continues to be a public health problem in Asia. Therefore, control programs focused on at-risk individuals in endemic areas are needed.
Collapse
Affiliation(s)
- Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Toni Wandra
- Directorate of Postgraduate, Sari Mutiara Indonesia University, Medan, Indonesia
| | - Christine M Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A & M University, College Station, TX, USA
| | - Razzagh Mahmoudi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Elham Hajialilo
- Department of Parasitology and Mycology, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nader Pestehchian
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Masoud Foroutan
- Research Center for Environmental Contaminants (RCEC), Abadan University of Medical Sciences, Abadan, Iran
| | - Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Simin Sotoodeh
- Clinical Research Development Unit, Kosar Hospital, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Rasoul Samimi
- Children Growth Research Center Research Institute for Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aida Vafae Eslahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| |
Collapse
|
5
|
Kamau E, Yates A, Maisiba R, Singoei V, Opot B, Adeny R, Arima CO, Otieno V, Sumbi CS, Okoth RO, Abdi F, Mwalo M, Ochola J, Otieno J, Ake J, Imbach M, Turley HA, Juma D, Akala HM, Owuoth J, Andagalu B, Crowell TA, Nwoga C, Cowden J, Polyak CS. Epidemiological and clinical implications of asymptomatic malaria and schistosomiasis co-infections in a rural community in western Kenya. BMC Infect Dis 2021; 21:937. [PMID: 34503469 PMCID: PMC8431856 DOI: 10.1186/s12879-021-06626-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria and schistosomiasis present considerable disease burden in tropical and sub-tropical areas and severity is worsened by co-infections in areas where both diseases are endemic. Although pathogenesis of these infections separately is well studied, there is limited information on the pathogenic disease mechanisms and clinical disease outcomes in co-infections. In this study, we investigated the prevalence of malaria and schistosomiasis co-infections, and the hematologic and blood chemistry abnormalities in asymptomatic adults in a rural fishing community in western Kenya. METHODS This sub-study used samples and data collected at enrollment from a prospective observational cohort study (RV393) conducted in Kisumu County, Kenya. The presence of malaria parasites was determined using microscopy and real-time-PCR, and schistosomiasis infection by urine antigen analysis (CCA). Hematological analysis and blood chemistries were performed using standard methods. Statistical analyses were performed to compare demographic and infection data distribution, and hematologic and blood chemistry parameters based on different groups of infection categories. Clinically relevant hematologic conditions were analyzed using general linear and multivariable Poisson regression models. RESULTS From February 2017 to May 2018, we enrolled 671 participants. The prevalence of asymptomatic Plasmodium falciparum was 28.2% (157/556) and schistosomiasis 41.2% (229/562), with 18.0% (100/556) of participants co-infected. When we analyzed hematological parameters using Wilcoxon rank sum test to evaluate median (IQR) distribution based on malarial parasites and/or schistosomiasis infection status, there were significant differences in platelet counts (p = 0.0002), percent neutrophils, monocytes, eosinophils, and basophils (p < 0.0001 each). Amongst clinically relevant hematological abnormalities, eosinophilia was the most prevalent at 20.6% (116/562), whereas thrombocytopenia was the least prevalent at 4.3% (24/562). In univariate model, Chi-Square test performed for independence between participant distribution in different malaria parasitemia/schistosomiasis infection categories within each clinical hematological condition revealed significant differences for thrombocytopenia and eosinophilia (p = 0.006 and p < 0.0001, respectively), which was confirmed in multivariable models. Analysis of the pairwise mean differences of liver enzyme (ALT) and kidney function (Creatinine Clearance) indicated the presence of significant differences in ALT across the infection groups (parasite + /CCA + vs all other groups p < .003), but no differences in mean Creatinine Clearance across the infection groups. CONCLUSIONS Our study demonstrates the high burden of asymptomatic malaria parasitemia and schistosomiasis infection in this rural population in Western Kenya. Asymptomatic infection with malaria or schistosomiasis was associated with laboratory abnormalities including neutropenia, leukopenia and thrombocytopenia. These abnormalities could be erroneously attributed to other diseases processes during evaluation of diseases processes. Therefore, evaluating for co-infections is key when assessing individuals with laboratory abnormalities. Additionally, asymptomatic infection needs to be considered in control and elimination programs given high prevalence documented here.
Collapse
Affiliation(s)
- Edwin Kamau
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Adam Yates
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Risper Maisiba
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Valentine Singoei
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,HJF Medical Research International, Kisumu, Kenya
| | - Benjamin Opot
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Rose Adeny
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Cornel O Arima
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Victor Otieno
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Catherine S Sumbi
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Raphael O Okoth
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Farid Abdi
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Maurine Mwalo
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Jew Ochola
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,HJF Medical Research International, Kisumu, Kenya
| | - June Otieno
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Julie Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Michelle Imbach
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Hannah A Turley
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Dennis Juma
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Hoseah M Akala
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - John Owuoth
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,HJF Medical Research International, Kisumu, Kenya
| | - Ben Andagalu
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Chiaka Nwoga
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Jessica Cowden
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA. .,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA.
| | | |
Collapse
|
6
|
Abudho BO, Guyah B, Ondigo BN, Ndombi EM, Ireri E, Carter JM, Riner DK, Kittur N, Karanja DMS, Colley DG. Evaluation of morbidity in Schistosoma mansoni-positive primary and secondary school children after four years of mass drug administration of praziquantel in western Kenya. Infect Dis Poverty 2020; 9:67. [PMID: 32539826 PMCID: PMC7296924 DOI: 10.1186/s40249-020-00690-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND World Health Organization guidelines recommend preventive chemotherapy with praziquantel to control morbidity due to schistosomiasis. The primary aim of this cross-sectional study was to determine if 4 years of annual mass drug administration (MDA) in primary and secondary schools lowered potential markers of morbidity in infected children 1 year after the final MDA compared to infected children prior to initial MDA intervention. METHODS Between 2012 and 2016 all students in two primary and three secondary schools within three kilometers of Lake Victoria in western Kenya received annual mass praziquantel administration. To evaluate potential changes in morbidity we measured height, weight, mid-upper arm circumference, hemoglobin levels, abdominal ultrasound, and quality of life in children in these schools. This study compared two cross-sectional samples of Schistosoma mansoni egg-positive children: one at baseline and one at year five, 1 year after the fourth annual MDA. Data were analyzed for all ages (6-18 years old) and stratified by primary (6-12 years old) and secondary (12-18 years old) school groups. RESULTS The prevalence of multiple potential morbidity markers did not differ significantly between the egg-positive participants at baseline and those at 5 years by Mann Whitney nonparametric analysis and Fisher's exact test for continuous and categorical data, respectively. There was a small but significantly higher score in school-related quality of life assessment by year five compared to baseline by Mann Whitney analysis (P = 0.048) in 13-18 year olds where malaria-negative. However, anemia was not positively impacted by four annual rounds of MDA, but registered a significant negative outcome. CONCLUSIONS We did not detect differences in morbidity markers measured in a population of those infected or re-infected after multiple MDA. This could have been due to their relative insensitivity or a failure of MDA to prevent morbidity among those who remain infected. High malaria transmission in this area and/or a lack of suitable methods to measure the more subtle functional morbidities caused by schistosomiasis could be a factor. Further research is needed to identify and develop well-defined, easily quantifiable S. mansoni morbidity markers for this age group.
Collapse
Affiliation(s)
- Bernard O Abudho
- Centre for Global Health Research (KEMRI-CGHR), Kenya Medical Research Institute, Kisumu, Kenya.
- Department of Biomedical Sciences and Technology, Maseno University, Maseno, Kenya.
| | - Bernard Guyah
- Department of Biomedical Sciences and Technology, Maseno University, Maseno, Kenya
| | - Bartholomew N Ondigo
- Centre for Global Health Research (KEMRI-CGHR), Kenya Medical Research Institute, Kisumu, Kenya
- Department of Biochemistry and Molecular Biology, Egerton University, Nakuru, Kenya
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Eric M Ndombi
- Centre for Global Health Research (KEMRI-CGHR), Kenya Medical Research Institute, Kisumu, Kenya
- Department of Pathology, Kenyatta University, Nairobi, Kenya
| | - Edmund Ireri
- Centre for Clinical Research-Radiology Unit, Kenya Medical Research Institute, Nairobi, Kenya
| | - Jennifer M Carter
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Diana K Riner
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Nupur Kittur
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Diana M S Karanja
- Centre for Global Health Research (KEMRI-CGHR), Kenya Medical Research Institute, Kisumu, Kenya
| | - Daniel G Colley
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
- Department of Microbiology, University of Georgia, Athens, GA, USA
| |
Collapse
|
7
|
Mollinedo S, Gutierrez P, Azurduy R, Valle F, Salas A, Mollinedo Z, Soto P, Villarroel CF, Ransom J, Lawrence R, Berman J, Soto J. Mass Drug Administration of Triclabendazole for Fasciola Hepatica in Bolivia. Am J Trop Med Hyg 2020; 100:1494-1497. [PMID: 31115295 DOI: 10.4269/ajtmh.19-0060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Human infection with Fasciola hepatica leads to obstruction of the common bile duct by adult worms and disease characterized by biliary colic, epigastric pain, and nausea. Recommended treatment is a single dose of triclabendazole (TCBZ) (10 mg/kg). Because in the 1990s the Bolivian Altiplano bordering Lake Titicaca was thought to have the highest prevalence of human fascioliasis worldwide, the Bolivian Ministry of Health instituted TCBZ mass drug administration (MDA). From 2008 to 2016 (excepting 2015), one dose of 250 mg was administered, usually in September/October, to each resident of highly endemic regions willing to participate. This is apparently the first reported use of MDA for Fasciola. The proportion of persons in key regions receiving TCBZ MDA was 87% in 2016. In 2017, we resurveyed key regions, and found that the MDA program had been dramatically successful. Whereas Fasciola prevalence was reported as 26.9% in Huacullani/Tiahuanaco and 12.6% in Batallas in 1999, there was 0.7% prevalence in Huacullani/Tiahuanaco and 1% in Batallas in 2017. However, lessons from schistosomiasis control efforts suggest that for sustained control of Fasciola infection, Fasciola MDA needs to be maintained and coupled with measures to control infection in the intermediary snail and in the animal hosts of F. hepatica.
Collapse
Affiliation(s)
| | | | - Rosa Azurduy
- Servicio Departamental de Salud (SEDES), La Paz, Bolivia
| | - Freddy Valle
- Servicio Departamental de Salud (SEDES), La Paz, Bolivia
| | | | | | - Paula Soto
- FUNDERMA (Fundación Nacional de Dermatología), Santa Cruz, Bolivia
| | | | - Janet Ransom
- Fast-Track Drugs and Biologics, North Potomac, Maryland
| | | | | | - Jaime Soto
- FUNDERMA (Fundación Nacional de Dermatología), Santa Cruz, Bolivia
| |
Collapse
|
8
|
Differential impact of mass and targeted praziquantel delivery on schistosomiasis control in school-aged children: A systematic review and meta-analysis. PLoS Negl Trop Dis 2019; 13:e0007808. [PMID: 31603895 PMCID: PMC6808504 DOI: 10.1371/journal.pntd.0007808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/23/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023] Open
Abstract
Background Schistosomiasis is a widespread public health concern in the poorest regions of the world. The principal control strategy is regular praziquantel administration to school-aged children in endemic areas. With calls for the elimination of schistosomiasis as a public health problem, expanding praziquantel delivery to all community members has been advocated. This systematic review and meta-analysis compares the impact of community-wide and child-targeted praziquantel distribution on schistosomiasis prevalence and intensity in school-aged children. Methodology/Principal findings We searched MEDLINE, Embase and Web of Science to identify papers that reported schistosome prevalence before and after praziquantel administration, either to children only or to all community members. Extracted data included Schistosoma species, drug administration strategy, number of treatment rounds, follow-up interval and prevalence and intensity before and after treatment. We used inverse variance weighted generalised linear models to examine the impact of mass versus targeted drug administration on prevalence reduction, and weighted boxplots to examine the impact on infection intensity reduction. This study is registered with PROSPERO, number CRD42018095377. In total, 34 articles were eligible for systematic review and 28 for meta-analysis. Schistosoma mansoni was reported in 20 studies; Schistosoma haematobium in 19 studies, and Schistosoma japonicum in two studies. Results of generalised linear models showed no detectable difference between mass and targeted treatment strategies on prevalence reduction in school-aged children for S. mansoni (odds ratio 0.47, 95%CI 0.13–1.68, p = 0.227) and S. haematobium (0.41, 95%CI 0.06–3.03, p = 0.358). Box plots also showed no apparent differences in intensity reduction between the two treatment strategies. Conclusions/Significance The results of this meta-analysis do not support the hypothesis that community-wide treatment is more effective than targeted treatment at reducing schistosomiasis infections in children. This may be due to the relatively small number of included studies, insufficient treatment coverage, persistent infection hotspots and unmeasured confounders. Further field-based studies comparing mass and targeted treatment are required. Schistosomiasis is a neglected tropical disease, caused by parasitic worms, that affects more than 143 million people worldwide. Chronic infections can lead to significant morbidity including kidney damage, anaemia, malnutrition, infertility and growth impairment. School-aged children between six and 15 years are often targeted for regular treatment with praziquantel in large-scale drug delivery programs, because they suffer a disproportionate burden of morbidity. On the other hand, a mass drug delivery strategy that treats all members of the community has been suggested in a move towards elimination of schistosomiasis as a public health problem. In this systematic review, we assess the impact of community-wide versus children-only praziquantel distribution in reducing schistosomiasis infections in school-aged children. We did not detect a difference between mass and targeted treatment strategies, possibly due to factors including insufficient treatment coverage and persistent sources of reinfection. Addressing these factors may assist in optimising control programs.
Collapse
|
9
|
Sacolo-Gwebu H, Chimbari M, Kalinda C. Prevalence and risk factors of schistosomiasis and soil-transmitted helminthiases among preschool aged children (1-5 years) in rural KwaZulu-Natal, South Africa: a cross-sectional study. Infect Dis Poverty 2019; 8:47. [PMID: 31202273 PMCID: PMC6571117 DOI: 10.1186/s40249-019-0561-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/28/2019] [Indexed: 02/17/2023] Open
Abstract
Background Despite efforts to control neglected tropical diseases (NTDs), schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa. Recent data suggest that these infections are prevalent among preschool aged children (PSAC) in poor communities. Evidence of schistosomiasis and soil-transmitted helminths (STH) infection patterns and prevalence among PSAC is essential for effective treatment and control programmes. The aim of the study was to determine the prevalence, intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District, South Africa. Methods A cross-sectional study was conducted among 1143 PSAC aged 1–5 years in 34 preschools and early childhood development (ECD) centres. Data on risk factors was collected using a semi-structured questionnaire. A Kruskal–Wallis test was used to compare the differences in infection intensity with age. Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status, sociodemographic, household, water and sanitation variables and hygiene practices of PSAC and their caregivers. Results We observed a low prevalence of Schistosoma haematobium (1.0%) and S. mansoni (0.9%). The prevalence of Ascaris lumbricoides (18.3%) was high compared to Trichuris trichiura (1.2%), hookworms (1.6%) and Taenia (6.4%). The odds of schistosome infection were lowest among PSAC under younger (15–24 years) caregivers (0.1, 95% CI: 0.02–0.54) and those who used tap water (0.3, 95% CI: 0.09–0.78) for domestic purposes. Schistosome infection was however higher among PSAC who bathed in river water (17.4, 95% CI: 5.96–51.04). STH infection on the other hand was lowest among PSAC who did not play in soil (0.1, 95% CI: 0.51–0.28), were from households that used tap water for domestic purposes (0.5, 95% CI: 0.27–0.80) and PSAC under the care of younger (25–35 years) caregivers (0.3, 95% CI: 0.10–0.75). The risk of STH infection was highest among PSAC who did not wash their hands with soap (3.5, 95% CI: 1.04–11.67) and PSAC whose nails were not trimmed (3.6, 95% CI: 1.75–7.26). Conclusions The findings show low prevalence and infection intensity of schistosomiasis and STH infection except A. lumbricoides among PSAC. Factors predicting schistosomiasis and STH infection among PSAC were related to caregivers’ age, educational status, water and hygiene practices. STH infection was exclusively associated with PSAC playing and handwashing habits. These findings highlight the need to include PSAC caregivers in schistosomiasis and STH prevention and control programmes. Electronic supplementary material The online version of this article (10.1186/s40249-019-0561-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hlengiwe Sacolo-Gwebu
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.
| | - Moses Chimbari
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa
| | - Chester Kalinda
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.,University of Namibia, Katima Mulilo Campus, Winela Road, Box 1096, Katima Mulilo, Namibia
| |
Collapse
|
10
|
Weber CJ, Hargan-Calvopiña J, Graef KM, Manner CK, Dent J. WIPO Re:Search-A Platform for Product-Centered Cross-Sector Partnerships for the Elimination of Schistosomiasis. Trop Med Infect Dis 2019; 4:E11. [PMID: 30634429 PMCID: PMC6473617 DOI: 10.3390/tropicalmed4010011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/26/2018] [Accepted: 01/02/2019] [Indexed: 02/06/2023] Open
Abstract
Schistosomiasis is an acute and chronic disease that affects over 200 million people worldwide, and with over 700 million people estimated to be at risk of contracting this disease, it is a pressing issue in global health. However, research and development (R&D) to develop new approaches to preventing, diagnosing, and treating schistosomiasis has been relatively limited. Praziquantel, a drug developed in the 1970s, is the only agent used in schistosomiasis mass drug administration (MDA) campaigns, indicating a critical need for a diversified therapeutic pipeline. Further, gaps in the vaccine and diagnostic pipelines demonstrate a need for early-stage innovation in all areas of schistosomiasis product R&D. As a platform for public-private partnerships (PPPs), the WIPO Re:Search consortium engages the private sector in early-stage R&D for neglected diseases by forging mutually beneficial collaborations and facilitating the sharing of intellectual property (IP) assets between the for-profit and academic/non-profit sectors. The Consortium connects people, resources, and ideas to fill gaps in neglected disease product development pipelines by leveraging the strengths of these two sectors. Using WIPO Re:Search as an example, this article highlights the opportunities for the PPP model to play a key role in the elimination of schistosomiasis.
Collapse
Affiliation(s)
- Callie J Weber
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
| | | | - Katy M Graef
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
| | - Cathyryne K Manner
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
| | - Jennifer Dent
- BIO Ventures for Global Health, 2101 Fourth Avenue, Suite 1950, Seattle, WA 98121, USA.
| |
Collapse
|
11
|
Young Adults in Endemic Areas: An Untreated Group in Need of School-Based Preventive Chemotherapy for Schistosomiasis Control and Elimination. Trop Med Infect Dis 2018; 3:tropicalmed3030100. [PMID: 30274496 PMCID: PMC6160920 DOI: 10.3390/tropicalmed3030100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/16/2018] [Accepted: 08/31/2018] [Indexed: 11/30/2022] Open
Abstract
Parasitologic surveys of young adults in college and university settings are not commonly done, even in areas known to be endemic for schistosomiasis and soil-transmitted helminths. We have done a survey of 291 students and staff at the Kisumu National Polytechnic in Kisumu, Kenya, using the stool microscopy Kato-Katz (KK) method and the urine point-of-care circulating cathodic antigen (POC-CCA) test. Based on three stools/two KK slides each, in the 208 participants for whom three consecutive stools were obtained, Schistosoma mansoni prevalence was 17.8%. When all 291 individuals were analyzed based on the first stool, as done by the national neglected tropical disease (NTD) program, and one urine POC-CCA assay (n = 276), the prevalence was 13.7% by KK and 23.2% by POC-CCA. Based on three stools, 2.5% of 208 participants had heavy S. mansoni infections (≥400 eggs/gram feces), with heavy S. mansoni infections making up 13.5% of the S. mansoni cases. The prevalence of the soil-transmitted helminths (STH: Ascaris lumbricoides, Trichuris trichiura and hookworm) by three stools was 1.4%, 3.1%, and 4.1%, respectively, and by the first stool was 1.4%, 2.4% and 1.4%, respectively. This prevalence and intensity of infection with S. mansoni in a college setting warrants mass drug administration with praziquantel. This population of young adults is ‘in school’ and is both approachable and worthy of inclusion in national schistosomiasis control and elimination programs.
Collapse
|
12
|
Ondigo BN, Muok EMO, Oguso JK, Njenga SM, Kanyi HM, Ndombi EM, Priest JW, Kittur N, Secor WE, Karanja DMS, Colley DG. Impact of Mothers' Schistosomiasis Status During Gestation on Children's IgG Antibody Responses to Routine Vaccines 2 Years Later and Anti-Schistosome and Anti-Malarial Responses by Neonates in Western Kenya. Front Immunol 2018; 9:1402. [PMID: 29967622 PMCID: PMC6015899 DOI: 10.3389/fimmu.2018.01402] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/06/2018] [Indexed: 02/04/2023] Open
Abstract
The potential consequences of parasitic infections on a person’s immune responsiveness to unrelated antigens are often conjectured upon in relationship to allergic responses and autoimmune diseases. These considerations sometimes extend to whether parasitic infection of pregnant women can influence the outcomes of responses by their offspring to the immunizations administered during national Expanded Programs of Immunization. To provide additional data to these discussions, we have enrolled 99 close-to-term pregnant women in western Kenya and determined their Schistosoma mansoni and Plasmodium falciparum infection status. At 2 years of age, when the initial immunization schedule was complete, we determined their children’s IgG antibody levels to tetanus toxoid, diphtheria toxoid, and measles nucleoprotein (N-protein) antigens using a multiplex assay. We also monitored antibody responses during the children’s first 2 years of life to P. falciparum MSP119 (PfMSP119), S. mansoni Soluble Egg Antigen (SEA), Ascaris suum hemoglobin (AsHb), and Strongyloides stercoralis (SsNIE). Mothers’ infections with either P. falciparum or S. mansoni had no impact on the level of antibody responses of their offspring or the proportion of offspring that developed protective levels of antibodies to either tetanus or diphtheria antigens at 2 years of age. However, children born of S. mansoni-positive mothers and immunized for measles at 9 months of age had significantly lower levels of anti-measles N-protein antibodies when they were 2 years old (p = 0.007) and a lower proportion of these children (62.5 vs. 90.2%, OR = 0.18, 95% CI = 0.04–0.68, p = 0.011) were considered positive for measles N-protein antibodies. Decreased levels of measles antibodies may render these children more susceptible to measles infection than children whose mothers did not have schistosomiasis. None of the children demonstrated responses to AsHb or SsNIE during the study period. Anti-SEA and anti-PfMSP119 responses suggested that 6 and 70% of the children acquired schistosomes and falciparum malaria, respectively, during the first 2 years of life.
Collapse
Affiliation(s)
- Bartholomew N Ondigo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.,Department of Biochemistry and Molecular Biology, Egerton University, Nakuru, Kenya
| | - Erick M O Muok
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - John K Oguso
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Henry M Kanyi
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Eric M Ndombi
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.,Department of Pathology, Kenyatta University, Nairobi, Kenya
| | - Jeffrey W Priest
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nupur Kittur
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, United States
| | - William Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Diana M S Karanja
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Daniel G Colley
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, United States.,Department of Microbiology, University of Georgia, Athens, GA, United States
| |
Collapse
|
13
|
Ndombi EM, Abudho B, Kittur N, Carter JM, Korir H, Riner DK, Ochanda H, Lee YM, Secor WE, Karanja DM, Colley DG. Effect of four rounds of annual school-wide mass praziquantel treatment for schistosoma mansoni control on schistosome-specific immune responses. Parasite Immunol 2018; 40:e12530. [PMID: 29604074 PMCID: PMC6001474 DOI: 10.1111/pim.12530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/22/2018] [Indexed: 11/27/2022]
Abstract
This study evaluated potential changes in antischistosome immune responses in children from schools that received 4 rounds of annual mass drug administration (MDA) of praziquantel (PZQ). In a repeated cross‐sectional study design, 210 schistosome egg‐positive children were recruited at baseline from schools in western Kenya (baseline group). Another 251 children of the same age range were recruited from the same schools and diagnosed with schistosome infection by microscopy (post‐MDA group). In‐vitro schistosome‐specific cytokines and plasma antibody levels were measured by ELISA and compared between the 2 groups of children. Schistosome soluble egg antigen (SEA) and soluble worm antigen preparation (SWAP) stimulated higher IL‐5 production by egg‐negative children in the post‐MDA group compared to the baseline group. Similarly, anti‐SEA IgE levels were higher in egg‐negative children in the post‐MDA group compared to the baseline group. Anti‐SEA and anti‐SWAP IgG4 levels were lower in egg‐negative children in the post‐MDA group compared to baseline. This resulted in higher anti‐SEA IgE/IgG4 ratios for children in the post‐MDA group compared to baseline. These post‐MDA immunological changes are compatible with the current paradigm that treatment shifts immune responses to higher antischistosome IgE:IgG4 ratios in parallel with a potential increase in resistance to reinfection.
Collapse
Affiliation(s)
- E M Ndombi
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.,School of Biological Sciences, University of Nairobi, Nairobi, Kenya.,Department of Pathology, Kenyatta University, Nairobi, Kenya
| | - B Abudho
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.,Department of Biomedical Sciences, Maseno University, Maseno, Kenya
| | - N Kittur
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - J M Carter
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - H Korir
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - D K Riner
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - H Ochanda
- School of Biological Sciences, University of Nairobi, Nairobi, Kenya
| | - Y-M Lee
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - W E Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D M Karanja
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - D G Colley
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA.,Department of Microbiology, University of Georgia, Athens, GA, USA
| |
Collapse
|