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Kalinna BH, Ross AG, Walduck AK. Schistosome Transgenesis: The Long Road to Success. BIOLOGY 2024; 13:48. [PMID: 38248478 PMCID: PMC10813141 DOI: 10.3390/biology13010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
As research on parasitic helminths has entered the post-genomic era, research efforts have turned to deciphering the function of genes in the public databases of genome sequences. It is hoped that, by understanding the role of parasite genes in maintaining their parasitic lifestyle, critical insights can be gained to develop new intervention and control strategies. Methods to manipulate and transform parasitic worms are now developed to a point where it has become possible to gain a comprehensive understanding of the molecular mechanisms underlying host-parasite interplay, and here, we summarise and discuss the advances that have been made in schistosome transgenesis over the past 25 years. The ability to genetically manipulate schistosomes holds promise in finding new ways to control schistosomiasis, which ultimately may lead to the eradication of this debilitating disease.
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Affiliation(s)
- Bernd H. Kalinna
- Rural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia; (A.G.R.); (A.K.W.)
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Mu Y, Rivera J, McManus DP, Weerakoon KG, Ross AG, Olveda RM, Gordon CA, You H, Jones MK, Cai P. Comparative assessment of the SjSAP4-incorporated gold immunochromatographic assay for the diagnosis of human schistosomiasis japonica. Front Public Health 2023; 11:1249637. [PMID: 37736084 PMCID: PMC10509475 DOI: 10.3389/fpubh.2023.1249637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/17/2023] [Indexed: 09/23/2023] Open
Abstract
Background Schistosomiasis, a disease caused by parasites of the genus Schistosoma, remains a global public health threat. This study aimed to validate the diagnostic performance of a recently developed gold immunochromatographic assay (GICA) for the detection of S. japonicum infection in a rural endemic area of the Philippines. Methods Human clinical samples were collected from 412 subjects living in Laoang and Palapag municipalities, Northern Samar, the Philippines. The presence of Schistosoma-specific antibodies in serum samples was tested with the SjSAP4-incorporated GICA strips and the results were converted to fully quantitative data by introducing an R value. The performance of the established GICA was further compared with other diagnostic tools, including the Kato-Katz (KK) technique, point-of-care circulating cathodic antigen (POC-CCA), droplet digital (dd) PCR, and enzyme-linked immunosorbent assays (ELISAs). Results The developed GICA strip was able to detect KK positive individuals with a sensitivity of 83.3% and absolute specificity. When calibrated with the highly sensitive faecal ddPCR assay, the immunochromatographic assay displayed an accuracy of 60.7%. Globally, the GICA assay showed a high concordance with the SjSAP4-ELISA assay. The schistosomiasis positivity rate determined by the GICA test was similar to those obtained with the SjSAP4-ELISA assay and the ddPCR assay performed on serum samples (SR_ddPCR), and was 2.3 times higher than obtained with the KK method. Conclusion The study further confirms that the developed GICA is a valuable diagnostic tool for detecting light S. japonicum infections and implies that this point-of-care assay is a viable solution for surveying endemic areas of low-intensity schistosomiasis and identifying high-priority endemic areas for targeted interventions.
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Affiliation(s)
- Yi Mu
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jonas Rivera
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Donald P. McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Kosala G. Weerakoon
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Allen G. Ross
- Rural Health and Medical Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Remigio M. Olveda
- Department of Immunology, Research Institute for Tropical Medicine, Manila, Philippines
| | - Catherine A. Gordon
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Hong You
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Veterinary Science, The University of Queensland, Brisbane, QLD, Australia
| | - Malcolm K. Jones
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Veterinary Science, The University of Queensland, Brisbane, QLD, Australia
| | - Pengfei Cai
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
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Trippler L, Knopp S, Welsche S, Webster BL, Stothard JR, Blair L, Allan F, Ame SM, Juma S, Kabole F, Ali SM, Rollinson D, Pennance T. The long road to schistosomiasis elimination in Zanzibar: A systematic review covering 100 years of research, interventions and control milestones. ADVANCES IN PARASITOLOGY 2023; 122:71-191. [PMID: 37657854 DOI: 10.1016/bs.apar.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
Zanzibar is among the few places in sub-Saharan Africa where interruption of Schistosoma transmission seems an achievable goal. Our systematic review identifies and discusses milestones in schistosomiasis research, control and elimination efforts in Zanzibar over the past 100 years. The search in online databases, libraries, and the World Health Organization Archives revealed 153 records published between May 1928 and August 2022. The content of records was summarised to highlight the pivotal work leading towards urogenital schistosomiasis elimination and remaining research gaps. The greatest achievement following 100 years of schistosomiasis interventions and research is undoubtedly the improved health of Zanzibaris, exemplified by the reduction in Schistosoma haematobium prevalence from>50% historically down to<5% in 2020, and the absence of severe morbidities. Experiences from Zanzibar have contributed to global schistosomiasis guidelines, whilst also revealing challenges that impede progression towards elimination. Challenges include: transmission heterogeneity requiring micro-targeting of interventions, post-treatment recrudescence of infections in transmission hotspots, biological complexity of intermediate host snails, emergence of livestock Schistosoma species complicating surveillance whilst creating the risk for interspecies hybridisation, insufficient diagnostics performance for light intensity infections and female genital schistosomiasis, and a lack of acceptable sanitary alternatives to freshwater bodies. Our analysis of the past revealed that much can be achieved in the future with practical implementation of integrated interventions, alongside operational research. With continuing national and international commitments, interruption of S. haematobium transmission across both islands is within reach by 2030, signposting the future demise of urogenital schistosomiasis across other parts of sub-Saharan Africa.
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Affiliation(s)
- Lydia Trippler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | | | - Bonnie L Webster
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | | | - Fiona Allan
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom; University of St Andrews, St Andrews, United Kingdom
| | - Shaali Makame Ame
- Neglected Diseases Programme, Zanzibar Ministry of Health, Lumumba, Unguja, United Republic of Tanzania
| | - Saleh Juma
- Neglected Diseases Programme, Zanzibar Ministry of Health, Mkoroshoni, Pemba, United Republic of Tanzania
| | - Fatma Kabole
- Neglected Diseases Programme, Zanzibar Ministry of Health, Lumumba, Unguja, United Republic of Tanzania
| | - Said Mohammed Ali
- Public Health Laboratory - Ivo de Carneri, Wawi, Chake Chake, Pemba, United Republic of Tanzania
| | - David Rollinson
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom; Global Schistosomiasis Alliance, London, United Kingdom
| | - Tom Pennance
- Natural History Museum, London, United Kingdom; London Centre for Neglected Tropical Disease Research, London, United Kingdom; Western University of Health Sciences, Lebanon, OR, United States.
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Mu Y, McManus DP, Gordon CA, You H, Ross AG, Olveda RM, Cai P. Development and assessment of a novel gold immunochromatographic assay for the diagnosis of schistosomiasis japonica. Front Immunol 2023; 14:1165480. [PMID: 37077910 PMCID: PMC10106775 DOI: 10.3389/fimmu.2023.1165480] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/07/2023] [Indexed: 04/05/2023] Open
Abstract
BackgroundThe neglected zoonosis, schistosomiasis japonica, remains a major public health problem in the Philippines. The current study aims to develop a novel gold immunochromatographic assay (GICA) and evaluate its performance in the detection of Schistosoma japonicum infection.MethodsA GICA strip incorporating a S. japonicum saposin protein, SjSAP4 was developed. For each GICA strip test, diluted serum sample (50 µl) was loaded and strips were scanned after 10 min to convert the results into images. ImageJ was used to calculate an R value, which was defined as the signal intensity of the test line divided by the signal intensity of the control line within the cassette. After determination of optimal serum dilution and diluent, the GICA assay was evaluated with sera collected from non-endemic controls (n = 20) and individuals living in schistosomiasis-endemic areas of the Philippines (n = 60), including 40 Kato Katz (KK)-positive participants and 20 subjects confirmed as KK-negative and faecal droplet digital PCR assay (F_ddPCR)-negative at a dilution of 1:20. An ELISA assay evaluating IgG levels against SjSAP4 was also performed on the same panel of sera.ResultsPhosphate-buffered saline (PBS) and 0.9% NaCl were determined as optimal dilution buffer for the GICA assay. The strips tested with serial dilutions of a pooled serum sample from KK-positive individuals (n = 3) suggested that a relatively wide range of dilutions (from 1:10 to 1:320) can be applied for the test. Using the non-endemic donors as controls, the GICA strip showed a sensitivity of 95.0% and absolute specificity; while using the KK-negative and F_ddPCR-negative subjects as controls, the immunochromatographic assay had a sensitivity of 85.0% and a specificity of 80.0%. The SjSAP4-incorperated GICA displayed a high concordance with the SjSAP4-ELISA assay.ConclusionsThe developed GICA assay exhibited a similar diagnostic performance with that of the SjSAP4-ELISA assay, yet the former can be performed by local personnel with minimal training with no requirement for specialised equipment. The GICA assay established here represents a rapid, easy-to-use, accurate and field-friendly diagnostic tool for the on-site surveillance/screening of S. japonicum infection.
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Affiliation(s)
- Yi Mu
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Donald P. McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Catherine A. Gordon
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Hong You
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Allen G. Ross
- Rural Health and Medical Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Remigio M. Olveda
- Department of Immunology, Research Institute for Tropical Medicine, Manila, Philippines
| | - Pengfei Cai
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- *Correspondence: Pengfei Cai,
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Ross AG, Harn DA, Chy D, Inobaya M, Guevarra JR, Shollenberger L, Li Y, McManus DP, Gray DJ, Williams GM. First bovine vaccine to prevent human schistosomiasis - a cluster randomised Phase 3 clinical trial. Int J Infect Dis 2023; 129:110-117. [PMID: 36736992 DOI: 10.1016/j.ijid.2023.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Schistosomiasis is a neglected tropical parasitic disease caused by blood flukes of the genus Schistosoma. Schistosoma japonicum is zoonotic in China, the Philippines, and Indonesia, with bovines acting as major reservoirs of human infection. The primary objective of the trial was to examine the impact of a combination of human mass chemotherapy, snail control through mollusciciding, and SjCTPI bovine vaccination on the rate of human infection. METHODS A 5-year phase IIIa cluster randomized control trial was conducted among 18 schistosomiasis-endemic villages comprising 18,221 residents in Northern Samar, The Philippines. RESULTS Overall, bovine vaccination resulted in a statistically significant decrease in human infection (relative risk [RR] = 0.75; 95% confidence interval [CI] = 0.69 to 0.82) across all trial follow-ups. The best outcome of the trial was when bovine vaccination was combined with snail mollusciciding. This combination resulted in a 31% reduction (RR = 0.69; 95% CI = 0.61 to 0.78) in human infection. CONCLUSION This is the first trial to demonstrate the effectiveness of a bovine vaccine for schistosomiasis in reducing human schistosome infection. The trial is registered with Australian New Zealand Clinical Trials Registry (ACTRN12619001048178).
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Affiliation(s)
- Allen G Ross
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia.
| | - Donald A Harn
- Department of Infectious Diseases, College of Veterinary Medicine and Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, USA
| | - Delia Chy
- Municipal Officer of Health, Palapag, Northern Samar, The Philippines
| | | | | | - Lisa Shollenberger
- Department of Biological Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Yuesheng Li
- Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Donald P McManus
- Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Darren J Gray
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Gail M Williams
- School of Public Health, University of Queensland, Brisbane, Australia
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Mu Y, Weerakoon KG, Olveda RM, Ross AG, McManus DP, Cai P. Diagnostic performance of a urine-based ELISA assay for the screening of human schistosomiasis japonica: A comparative study. Front Microbiol 2022; 13:1051575. [PMID: 36452928 PMCID: PMC9703063 DOI: 10.3389/fmicb.2022.1051575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/24/2022] [Indexed: 09/23/2023] Open
Abstract
The current study developed and evaluated the performance of a urine-based enzyme-linked immunosorbent assay (ELISA) for the screening of Schistosoma japonicum infection in a human cohort (n = 412) recruited from endemic areas, Northern Samar, the Philippines. The diagnostic performance of the urine ELISA assay was further compared with the Kato-Katz (KK) technique, serum-based ELISA assays, point-of-care circulating cathodic antigen (POC-CCA) urine cassette test, and droplet digital (dd)PCR assays performed on feces, serum, urine, and saliva samples, which were designated as F_ddPCR, SR_ddPCR, U_ddPCR, and SL_ddPCR, respectively. When urine samples concentrated 16× were assessed, the SjSAP4 + Sj23-LHD-ELISA (U) showed sensitivity/specificity values of 47.2/93.8% for the detection of S. japonicum infection in KK-positive individuals (n = 108). The prevalence of S. japonicum infection in the total cohort determined by the urine ELISA assay was 48.8%, which was lower than that obtained with the F_ddPCR (74.5%, p < 0.001), SR_ddPCR (67.2%, p < 0.001), and SjSAP4 + Sj23-LHD-ELISA (S) (66.0%, p < 0.001), but higher than that determined by the Sj23-LHD-ELISA (S) (24.5%, p < 0.001), POC-CCA assay (12.4%, p < 0.001), and SL_ddPCR (25.5%, p < 0.001). Using the other diagnostic tests as a reference, the urine ELISA assay showed a sensitivity between 47.2 and 56.9%, a specificity between 50.7 and 55.2%, and an accuracy between 49.3 and 53.4%. The concentrated urine SjSAP4 + Sj23-LHD-ELISA developed in the current study was more sensitive than both the KK test and POC-CCA assay, and showed a comparable level of diagnostic accuracy to that of the U_ddPCR. However, its diagnostic performance was less robust than that of the F_ddPCR, SR_ddPCR, and SjSAP4 + Sj23-LHD-ELISA (S) assays. Although they are convenient and involve a highly acceptable non-invasive procedure for clinical sample collection, the insufficient sensitivity of the three urine-based assays (the urine ELISA assay, the U_ddPCR test, and the POC-CCA assay) will limit their value for the routine screening of schistosomiasis japonica in the post mass drug administration (MDA) era, where low-intensity infections are predominant in many endemic areas.
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Affiliation(s)
- Yi Mu
- Molecular Parasitology Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Kosala G. Weerakoon
- Molecular Parasitology Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Remigio M. Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, Philippines
| | - Allen G. Ross
- Research Institute for Rural Health, Charles Sturt University, Orange, NSW, Australia
| | - Donald P. McManus
- Molecular Parasitology Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Pengfei Cai
- Molecular Parasitology Laboratory, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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Ncube MV, Kabuyaya M, Chimbari MJ. Patient journey and resources mapping to implement a praziquantel mass drug administration program for children aged 5 years and below in resource-limited settings. Syst Rev 2022; 11:227. [PMID: 36271455 PMCID: PMC9585827 DOI: 10.1186/s13643-022-02087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/28/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The early childhood development of millions of children in some low- and medium-income countries may be compromised by schistosomiasis infections contracted at the age of 5 years and below. Currently, there are no standard guidelines for treating schistosomiasis in children that are 5 years and younger using praziquantel (PZQ), the only drug that the World Health Organization (WHO) recommends for treating schistosomiasis. The review is on processes and resources involved in the treatment of schistosomiasis in children aged 5 years and below. METHODS An electronic search for peer-reviewed articles published in the period from January 2011 to August 2021 was done in the Academic Search Complete, CINAHL with Full Text, Health Source: Nursing/Academic Edition, and MEDLINE databases via EBSCOHost and Google Scholar databases. The search targeted journals that described the treatment of schistosomiasis in children 5 years and below using praziquantel. RESULTS Thirteen studies met the inclusion criteria. The patient journey for treating schistosomiasis in children aged 5 years old and below using PZQ included the following activities: enrolment of the children into the treatment program; clinical examination; diagnosis; taking anthropometric measurements; feeding the children, making the PZQ palatable to the children; administration of PZQ; and monitoring of side effects. There was also a variation in the resources used to treat children aged 5 and below for schistosomiasis. CONCLUSIONS A PZQ mass drug administration program for children aged 5 years old and below in endemic areas should exclude the diagnosis of schistosomiasis before treatment. The resources required in the treatment process should be affordable, and should not require skills and maintenance resources that are beyond those that are available at the primary healthcare level.
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Affiliation(s)
- Mhlengi Vella Ncube
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. .,Medical Affairs Institute, Johannesburg, South Africa.
| | - Muhubiri Kabuyaya
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Moses John Chimbari
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Ghazy RM, Ellakany WI, Badr MM, Taktak NEM, Elhadad H, Abdo SM, Hagag A, Hussein AR, Tahoun MM. Determinants of Schistosoma mansoni transmission in hotspots at the late stage of elimination in Egypt. Infect Dis Poverty 2022; 11:102. [PMID: 36138424 PMCID: PMC9503191 DOI: 10.1186/s40249-022-01026-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/25/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND In certain settings, the prevalence and severity of schistosoma infection do not lessen despite repeated rounds of preventative chemotherapy; these areas are known as hotspots. This study aimed to investigate the role of human practices, besides environmental and malacological factors, in the maintenance of the Schistosoma mansoni infection transmission chain in hotspot areas in Egypt. METHODS This cross-sectional study was conducted between July and November 2019 in Kafr El-Sheikh Governorate, Egypt. A pre-designed structured interviewing questionnaire was used to collect humanitarian data. Stool samples were collected from children aged 6-15 years on three successive days and examined using the Kato-Katz technique. Simultaneously, water and snail samples were taken from watercourses surrounding houses. Snails were identified based on their shell morphology and structure and tested for cercaria shedding. Water samples were analyzed for their physicochemical and biological characteristics. RESULTS A total of 2259 fecal samples (1113 in summer and 1146 in fall) were collected from 861 children. About 46.9% of the participants were males, and 31.8% were aged 6-10 years. The prevalence of S. mansoni infection was higher during the summer than during the fall (19.1% vs 7.2%, respectively, P < 0.01). The intensity of infection (light, moderate, and heavy) during summer versus fall was (93.55 vs 89.38%, 6.45 vs 8.85%, and 0.00% vs 1.77%), respectively (P < 0.05). A higher prevalence of human infection was observed among males than females [OR = 1.63, 95% confidence interval (CI):1.10-2.40, P = 0.015], children aged 11-15 years than among their counterparts aged 6-10 years (OR = 2.96, 95% CI: 1.72-5.06, P < 0.001), and mothers with a low level of education (OR = 3.33, 95% CI: 1.70-6.52, P < 0.001). The main identified risk factors were contacting the main body of water-canal for washing clothes (OR = 1.81, 95% CI: 1.12-2.49, P = 0.015), land irrigation (OR = 2.56, 95% CI: 1.32-4.96, P = 0.004), water collection (OR = 2.94, 95% CI: 1.82-4.73, P < 0.001), bathing (OR = 2.34, 95% CI: 1.21-4.31, P = 0.009), and garbage disposal (OR = 2.38, 95% CI:1.38-4.12, P < 0.001). The count of Biomphalaria alexandrina was distinct between seasons (P < 0.01) in consistent with statistically significant differences in water temperature, salinity, turbidity, the total concentration of coliforms, depth, velocity, and water level (P < 0.01). The presence of grasses and duckweeds was significantly associated with snail infection (P = 0.00 l). Significant effects of water depth, pH, temperature, and total dissolved solids on snail count were also observed (P < 0.05). CONCLUSIONS The persistence of the infection is due to adoption of risky behaviors and environmental factors that enhance snail survival and infection. Schistosomiasis elimination in hotspots requires an integrated control approach that combines preventive chemotherapy with other complementary measures.
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Affiliation(s)
- Ramy Mohamed Ghazy
- grid.7155.60000 0001 2260 6941Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Walid Ismail Ellakany
- grid.7155.60000 0001 2260 6941Department of Tropical Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mai M. Badr
- grid.7155.60000 0001 2260 6941Department of Environmental Health, High Institute of Public Health Alexandria University, Alexandria, Egypt
| | - Nehad E. M. Taktak
- grid.7155.60000 0001 2260 6941Department of Environmental Health, High Institute of Public Health Alexandria University, Alexandria, Egypt
| | - Heba Elhadad
- grid.7155.60000 0001 2260 6941Parasitology Department, Medical Research Institute, Alexandria university, Alexandria, Egypt
| | - Sarah M. Abdo
- grid.411978.20000 0004 0578 3577Department of Medical Parasitology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, 35516 Egypt
| | - Ayat Hagag
- grid.411978.20000 0004 0578 3577Department of Medical Parasitology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, 35516 Egypt
| | | | - Mohamed Mostafa Tahoun
- grid.7155.60000 0001 2260 6941Department of Epidemiology, High Institute of Public Health Alexandria University, Alexandria, Egypt
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Gal LB, Bruck M, Tal R, Baum S, Ali JM, Weldegabriel LL, Sabar G, Golan R, Bentwich Z. Sustainable Elimination of Schistosomiasis in Ethiopia-A Five-Year Follow-Up Study. Trop Med Infect Dis 2022; 7:tropicalmed7090218. [PMID: 36136629 PMCID: PMC9501490 DOI: 10.3390/tropicalmed7090218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/21/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
In 2009, Mekele, the capital of the Tigray Region in Ethiopia, presented a mean prevalence of 44.7% of schistosomiasis (S. mansoni) in school children. Termed a public health problem, NALA, an international public health non-governmental organization, and their partners implemented a novel model of intervention, which aimed to compliment mass drug administration (MDA) campaigns with behavioral change (BC) and improved sanitation to achieve sustained elimination of schistosomiasis. The four-year intervention (2009−2012) covered 38 primary schools. The objective of this study was to examine factors associated with control or resurgence of the disease, and the association between the behavioral change program and disease prevalence, ten years after initiation. Eleven primary schools were selected for this follow-up study. All students provided a stool sample and filled in a knowledge, attitude and practice (KAP) questionnaire. In seven out of eleven schools (63.6%) the prevalence of schistosomiasis was maintained below 2% ten years after the initiation of the intervention. In four schools, prevalence returned to pre-intervention levels, defining them as persistent hot spots (PHS). Students from PHS schools scored lower on KAP questionnaires compared to students from responder schools; 3.9 ± 0.9 vs. 4.2 ± 0.9 (p-value < 0.001) for practice questions and 4.4 ± 1.4 vs. 4.6 ± 1.5 (p-value = 0.03) for attitude questions. The prevalence of schistosomiasis correlated positively with age, (p-value = 0.049), sex (relative risk = 1.7, p-value < 0.001), and location. Semi-urban locations (n = 382) had higher disease prevalence than urban locations (n = 242), (22.7% vs. 5.5%, p-value < 0.001). Students residing in semi-urban areas and close to a river (<500 m) were at higher risk of contracting schistosomiasis than those living in urban areas far from the river (RR = 5.95, p-value < 0.001). Finally, a correlation between prevalence and proximity of schools to rivers was found (semi-urban areas; RR = −0.91, p-value = 0.001 vs. urban areas; RR = −0.51, p-value = 0.001). Soil-transmitted-helminths prevalence in 2009 was 8.1% and declined during the intervention years to 0.5%. Prevalence in 2018 was found to be stable at 0.8%. These results demonstrate the long-term success of NALAs’ comprehensive model of intervention for elimination of schistosomiasis in school children, combining behavioral change and improved sanitation with MDA.
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Affiliation(s)
| | - Michal Bruck
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Robyn Tal
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Sarit Baum
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Jemal Mahdi Ali
- Department of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | | | - Galia Sabar
- The Department of Middle Eastern and African History, Tel Aviv University, Tel Aviv-Yafo P.O. Box 39040, Israel
| | - Rachel Golan
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer Sheva P.O. Box 653, Israel
| | - Zvi Bentwich
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
- Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev, Beer Sheva P.O. Box 653, Israel
- Correspondence: ; Tel.: +972-522440060
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Samenjo KT, Bengtson M, Onasanya A, Zambrano JCI, Oladunni O, Oladepo O, van Engelen J, Diehl JC. Stakeholders’ Perspectives on the Application of New Diagnostic Devices for Urinary Schistosomiasis in Oyo State, Nigeria: A Q-Methodology Approach. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00780. [PMID: 36041843 PMCID: PMC9426976 DOI: 10.9745/ghsp-d-21-00780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
New diagnostic devices for schistosomiasis should be designed to function best within the local endemic health care context and support stakeholders at various levels of the health care system in performing the tasks to help control and eventually eliminate schistosomiasis. Urinary schistosomiasis is a waterborne parasitic infection caused by Schistosoma haematobium that affects approximately 30 million people annually in Nigeria. Treatment and eradication of this infection require effective diagnostics. However, current diagnostic tests have critical shortcomings and consequently are of limited value to stakeholders throughout the health care system who are involved in targeting the diagnosis and subsequent control of schistosomiasis. New diagnostic devices that fit the local health care infrastructure and support the different stakeholder diagnostic strategies remain a critical need. This study focuses on understanding, by means of Q-methodology, the context of use and application of a new diagnostic device that is needed to effectively diagnose urinary schistosomiasis in Oyo State, Nigeria. Q-methodology is a technique that investigates subjectivity by exploring how stakeholders rank-order opinion statements about a phenomenon. In this study, 40 statements were administered to evaluate stakeholder perspectives on the context of use and application of potential new diagnostic devices and how these perspectives or viewpoints are shared with other stakeholders. Potential new diagnostic devices will need to be deployable to remote or distant communities, be affordable, identify and confirm infection status before treatment in patients whose diagnosis of urinary schistosomiasis is based on self-reporting, and equip health care facilities with diagnostic devices optimized for the local setting while requiring local minimal infrastructural settings. Similarly, the context of use and application of a potential new diagnostic device for urinary schistosomiasis is primarily associated with the tasks stakeholders throughout the health care system perform or procedures employed. These findings will guide the development of new diagnostic devices for schistosomiasis that match the contextual landscape and diagnostic strategies in Oyo.
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Affiliation(s)
- Karlheinz Tondo Samenjo
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands.
| | - Michel Bengtson
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Adeola Onasanya
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Juan Carlo Intriago Zambrano
- Department of Water Management, Faculty of Civil Engineering and Geosciences, Delft University of Technology, Delft, Netherlands
| | - Opeyemi Oladunni
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladimeji Oladepo
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jo van Engelen
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Jan-Carel Diehl
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Circulating microRNAs as Biomarkers of Hepatic Fibrosis in Schistosomiasis Japonica Patients in the Philippines. Diagnostics (Basel) 2022; 12:diagnostics12081902. [PMID: 36010252 PMCID: PMC9406767 DOI: 10.3390/diagnostics12081902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022] Open
Abstract
Host-derived microRNAs (miRNAs) play important regulatory roles in schistosomiasis-induced hepatic fibrosis. This study analyzed selected serum miRNAs among Filipino schistosomiasis japonica patients with ultrasound (US)-detectable hepatic fibrosis. A prospective cohort study design with convenience sampling was employed from 2017 to 2019. The study sites were eight endemic barangays in Leyte, Philippines. Eligible chronic schistosomiasis patients with varying severities of hepatic fibrosis were enrolled in the cohort and serially examined at 6, 12, and 24 months from baseline. Baseline serum miR-146a-5p, let-7a-5p, miR-150-5p, miR-122-5p, miR-93-5p, and miR200b-3p were measured using RT-qPCR. A total of 136 chronic schistosomiasis patients were included in this prospective cohort study. Approximately, 42.6% had no fibrosis, 22.8% had mild fibrosis, and 34.6% had severe fibrosis at baseline The serum levels of the antifibrotic miR-146a (p < 0.0001), miR-150 (p = 0.0058), and let-7a (p < 0.0001) were significantly lower in patients with hepatic fibrosis while the profibrotic miR-93 (p = 0.0024) was elevated. miR-146a-5p (AUC = 0.90, 95% CI [0.84, 0.96], p < 0.0001) has the most promising potential to differentiate patients with (n = 78) versus without (n = 58) hepatic fibrosis. The baseline level of serum miR-146-5p was significantly different in patients with progressive fibrosis (n = 17) compared to those who never developed fibrosis (n = 30, p < 0.01) or those who had fibrosis reversal (n = 20, p < 0.01) after 24 months. These findings demonstrate the potential utility of serum miRNAs, particularly of miR-146a, as a supplementary tool for assessing hepatic fibrosis in chronic schistosomiasis japonica patients.
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Identification of a linear B-cell epitope on the Schistosoma japonicum saposin protein, SjSAP4: Potential as a component of a multi-epitope diagnostic assay. PLoS Negl Trop Dis 2022; 16:e0010619. [PMID: 35816547 PMCID: PMC9302751 DOI: 10.1371/journal.pntd.0010619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/21/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background Schistosoma japonicum is one of three major species of blood flukes causing schistosomiasis, a disease, which continues to be a major public health issue in the Philippines. SjSAP4, a member of a multigene family of saposin-like proteins, is a recognized immunodiagnostic biomarker for schistosomiasis japonica. This study aimed to identify linear B-cell epitopes on SjSAP4 and to validate their potential as components of a multi-epitope assay for the serological diagnosis of schistosomiasis japonica. Methodology SjSAP4-derived peptides were expressed as GST-peptide-fused proteins and these were Western blot probed with human serum samples from S. japonicum Kato-Katz (KK)-positive individuals and uninfected controls. A core epitope was further identified by Western blotting through probing a series of truncated peptides with the schistosomiasis patient sera. The diagnostic performance of the core epitope-containing peptides and the full-length SjSAP4 was evaluated by enzyme-linked immunosorbent assay (ELISA) using a panel of sera collected from subjects resident in a schistosomiasis-endemic area of the Philippines. Main findings As a result of the peptide mapping, one peptide (P15) was found to be highly immunogenic in the KK-positive individuals. We subsequently showed that -S163QCSLVGDIFVDKYLD178- is a core B-cell epitope of P15. Subsequent ELISAs incorporating SjSAP4, SjSAP4-Peptide and SjSP-13V2-Peptide showed a sensitivity of 94.0%, 46.0% and 74.0%, respectively, and a specificity of 97.1%, 100% and 100%, respectively. Notably, complementary recognition of the B-cell epitopes (SjSAP4-Peptide and SjSP-13V2-Peptide) was observed in a subset of the KK-positive individuals. A dual epitope-ELISA (SjSAP4-Peptide + SjSP-13V2-Peptide-ELISA) showed a diagnostic sensitivity of 84.0% and a specificity of 100%. Conclusions/Significance In this study, -S163QCSLVGDIFVDKYLD178- was identified as a dominant linear B-cell epitope on SjSAP4. This peptide and the complementary recognition of other B-cell epitopes using sera from different KK-positive individuals can provide the basis of developing a multi-epitope assay for the serological diagnosis of schistosomiasis. The recent road map (2021–2030) released by WHO for controlling or eliminating neglected tropical diseases (NTDs) highlights diagnostics as a major focus. Development and deployment of accurate, affordable and field-friendly diagnostics/surveillance tools will be crucial for the control and elimination of schistosomiasis. Multi-epitope chimeric antigens, constructed based on linear B-cell epitopes identified from highly antigenic antigens, may achieve not only an equivalent or superior diagnostic performance compared to the parent immunogens but also exhibit more optimal physicochemical properties. However, to date, only a limited number of linear B-cell epitopes have been identified for the serological diagnosis of schistosomiasis. In this study, we identified a linear B-cell epitope (-S163QCSLVGDIFVDKYLD178-) on SjSAP4, a recognized immunodiagnostic biomarker for schistosomiasis japonica, and validated its potential as a component of a multi-epitope assay for the serological diagnosis of schistosomiasis japonica. Notably, differential recognition of B-cell epitopes (SjSAP4-Peptide and SjSP-13V2-Peptide) was observed in a subset of subjects positive by the Kato-Katz technique for the disease. A dual epitope-ELISA (SjSAP4-Peptide + SjSP-13V2-Peptide-ELISA) showed a superior diagnostic performance (84.0% sensitivity and 100% specificity) than individual-epitope ELISAs. The findings in this study provide support for the development of multi-epitope antigen-based diagnostics for schistosomiasis.
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Makaula P, Kayuni SA, Mamba KC, Bongololo G, Funsanani M, Musaya J, Juziwelo LT, Furu P. An assessment of implementation and effectiveness of mass drug administration for prevention and control of schistosomiasis and soil-transmitted helminths in selected southern Malawi districts. BMC Health Serv Res 2022; 22:517. [PMID: 35439991 PMCID: PMC9016207 DOI: 10.1186/s12913-022-07925-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/08/2022] [Indexed: 11/15/2022] Open
Abstract
Background Mass drug administration (MDA) is one of the key interventions recommended by WHO for prevention and control of neglected tropical diseases (NTD). In Malawi, MDA is widely carried out annually since 2009 for prevention and control of schistosomiasis and soil-transmitted helminths (STH). No study has been carried out to assess effectiveness of the MDA approach and to document perceptions of health providers and beneficiaries regarding use of MDA. This study was done to understand how well MDA is being implemented and to identify opportunities for improvement in MDA delivery in Malawi. Methods Designed as a cross-sectional and multi-methods research, the study was carried out in three southern Malawi districts of Chiradzulu, Mangochi and Zomba. In each district, four health centres and 16 villages were randomly selected to participate. A mixed-methods approach to data collection focusing on quantitative data for coverage and knowledge, attitudes and practices assessments; and qualitative data for assessing perceptions of health providers and beneficiaries regarding MDA was used. Quantitative data were processed and analyzed using IBM SPSS software version 26 while qualitative data were analysed using NVivo 12 for Windows. Results Knowledge levels about schistosomiasis and STH in the districts varied according to disease aspects asked about. Majority are more knowledgeable about what schistosomiasis is (78%) and whether STH are treatable with drugs (97%); with least knowledgeable about the organism that transmits schistosomiasis (18%), types of schistosomiasis (11%) and what causes STH (20%). In 2018 and 2019 the districts registered high coverage rates for praziquantel and albendazole using community-based MDA (73–100%) and using school-based MDA (75–91%). Both the health authorities and community members perceived the MDA approach as good because it brings treatment closer to people. Conclusion With the high MDA coverage obtained in communities and schools, the effectiveness of MDA in the target districts is satisfactory. There are, however, several challenges including disproportionate knowledge levels, which are hampering progress towards attainment of the 2030 global NTD goals. There is a need for promotion of community participation and partnerships as well as implementation of other recommended interventions for sustainable prevention and control of schistosomiasis and STH. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07925-3.
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Automated diagnosis of schistosomiasis by using faster R-CNN for egg detection in microscopy images prepared by the Kato–Katz technique. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-06924-z] [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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Tantengco OAG, Rojo RD. Bibliometric analysis of schistosomiasis research in Southeast Asia (1908-2020). Acta Trop 2022; 228:106322. [PMID: 35065014 DOI: 10.1016/j.actatropica.2022.106322] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES This study determined the characteristics and trends of published articles regarding schistosomiasis in Southeast Asian countries through a bibliometric analysis. METHODS Using the Scopus database, we identified all original research articles on schistosomiasis from 1908 to 2020 from SEA countries: Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam. Bibliographic and citation information was obtained, and visualization of collaboration networks of countries and keywords related to schistosomiasis was conducted using VOSviewer software. RESULTS We obtained 528 schistosomiasis articles published between 1908 and 2020 from SEA countries. The number of publications continued to increase and peaked from 2000 until 2020. The Philippines had the highest number of publications (n = 231), followed by Thailand (n = 153), and Malaysia (n = 64). The leading journals with the highest number of publications in this field include the Southeast Asian Journal of Tropical Medicine and Public Health (n = 96), Acta Tropica (n = 27), and Plos Neglected Tropical Diseases (n = 24). The most common keywords related to schistosomiasis research in SEA were "schistosomiasis", "Schistosoma japonicum", "Schistosoma mekongi", "Schistosoma mansoni", and "praziquantel". International collaboration was significantly correlated with scientific productivity for schistosomiasis research. CONCLUSION Our study showed the research landscape, trends and development, and collaboration among researchers in schistosomiasis in SEA. Our results also revealed the limited schistosomiasis research in several SEA countries. There is a need for more research to improve our understanding of the epidemiology of schistosomiasis in SEA, which can help in improving the control and prevention of this disease.
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Lund AJ, Sokolow SH, Jones IJ, Wood CL, Ali S, Chamberlin A, Sy AB, Sam MM, Jouanard N, Schacht AM, Senghor S, Fall A, Ndione R, Riveau G, De Leo GA, López-Carr D. Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. PLoS Negl Trop Dis 2021; 15:e0009806. [PMID: 34610025 PMCID: PMC8525765 DOI: 10.1371/journal.pntd.0009806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 10/19/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
Background Infectious disease risk is driven by three interrelated components: exposure, hazard, and vulnerability. For schistosomiasis, exposure occurs through contact with water, which is often tied to daily activities. Water contact, however, does not imply risk unless the environmental hazard of snails and parasites is also present in the water. By increasing reliance on hazardous activities and environments, socio-economic vulnerability can hinder reductions in exposure to a hazard. We aimed to quantify the contributions of exposure, hazard, and vulnerability to the presence and intensity of Schistosoma haematobium re-infection. Methodology/Principal findings In 13 villages along the Senegal River, we collected parasitological data from 821 school-aged children, survey data from 411 households where those children resided, and ecological data from all 24 village water access sites. We fit mixed-effects logistic and negative binomial regressions with indices of exposure, hazard, and vulnerability as explanatory variables of Schistosoma haematobium presence and intensity, respectively, controlling for demographic variables. Using multi-model inference to calculate the relative importance of each component of risk, we found that hazard (Ʃwi = 0.95) was the most important component of S. haematobium presence, followed by vulnerability (Ʃwi = 0.91). Exposure (Ʃwi = 1.00) was the most important component of S. haematobium intensity, followed by hazard (Ʃwi = 0.77). Model averaging quantified associations between each infection outcome and indices of exposure, hazard, and vulnerability, revealing a positive association between hazard and infection presence (OR = 1.49, 95% CI 1.12, 1.97), and a positive association between exposure and infection intensity (RR 2.59–3.86, depending on the category; all 95% CIs above 1) Conclusions/Significance Our findings underscore the linkages between social (exposure and vulnerability) and environmental (hazard) processes in the acquisition and accumulation of S. haematobium infection. This approach highlights the importance of implementing both social and environmental interventions to complement mass drug administration. While the impacts of natural hazards tend to be described in terms of social determinants such as exposure and vulnerability, the risk for infectious disease is often expressed in terms of environmental determinants without fully considering the socio-ecological processes that put people in contact with infective agents of disease. In the case of schistosomiasis, risk is determined by human interactions with freshwater environments where schistosome parasites circulate between people and aquatic snails. In this study, we quantified the relative contributions of exposure, hazard, and vulnerability to schistosome re-infection among schoolchildren in an endemic region of northern Senegal. We find that hazard and vulnerability influence whether a child becomes infected, while exposure and hazard influence the burden of worms once infection is acquired. Increasing numbers of worms is known to be positively associated with increasing severity of disease. Our findings underscore the importance of evaluating social and environmental determinants of disease simultaneously; omitting measures of exposure, hazard or vulnerability may limit our understanding of risk.
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Affiliation(s)
- Andrea J. Lund
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California, United States of America
- * E-mail:
| | - Susanne H. Sokolow
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
- Woods Institute for the Environment, Stanford University, Stanford, California, United States of America
| | - Isabel J. Jones
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
| | - Chelsea L. Wood
- School of Aquatic and Fishery Sciences, University of Washington, Seattle, Washington, United States of America
| | - Sofia Ali
- Stanford University, Stanford, California, United States of America
| | - Andrew Chamberlin
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
| | - Alioune Badara Sy
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - M. Moustapha Sam
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Nicolas Jouanard
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
- Station d’Innovation Aquacole, Saint Louis, Sénégal
| | - Anne-Marie Schacht
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
- University of Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Simon Senghor
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Assane Fall
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Raphael Ndione
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
| | - Gilles Riveau
- Centre de Recherche Biomédicale–Espoir Pour La Sante, Saint Louis, Sénégal
- University of Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Giulio A. De Leo
- Hopkins Marine Station, Stanford University, Pacific Grove, California, United States of America
- Woods Institute for the Environment, Stanford University, Stanford, California, United States of America
| | - David López-Carr
- Department of Geography, University of California, Santa Barbara, CA, United States of America
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Cai P, Mu Y, Weerakoon KG, Olveda RM, Ross AG, McManus DP. Performance of the point-of-care circulating cathodic antigen test in the diagnosis of schistosomiasis japonica in a human cohort from Northern Samar, the Philippines. Infect Dis Poverty 2021; 10:121. [PMID: 34556183 PMCID: PMC8460201 DOI: 10.1186/s40249-021-00905-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/09/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Zoonotic schistosomiasis, caused by Schistosoma japonicum, remains a major public health problem in the Philippines. This study aimed to evaluate the commercially available rapid diagnostic point-of-care circulating cathodic antigen (POC-CCA) test in detecting individuals infected with S. japonicum in a human cohort from an endemic area for schistosomiasis japonica in the Philippines. METHODS Clinical samples were collectedin 18 barangays endemic for S. japonicum infection in Laoang and Palapag municipalities, Northern Samar, the Philippines, in 2015. The presence of CCA in filter-concentrated urine samples (n = 412) was evaluated using the commercial kits and the results were converted to images, which were further analyzed by ImageJ software to calculate R values. The diagnostic performance of the immunochromatographic POC-CCA test was compared using the Kato-Katz (KK) procedure, in-house enzyme-linked immunosorbent assays (ELISAs) and droplet digital (dd) PCR assays as reference. RESULTS The POC-CCA test was able to detect S. japonicum-infected individuals in the cohort with an eggs per gram of faeces (EPG) more than or equal to 10 with sensitivity/specificity values of 63.3%/93.3%. However, the assay showed an inability to diagnose schistosomiasis japonica infections in all cohort KK-positive individuals, of which the majority had an extremely low egg burden (EPG: 1-9). The prevalence of S. japonicum infection in the total cohort determined by the POC-CCA test was 12.4%, only half of that determined by the KK method (26.2%). When compared with the ELISAs and ddPCR assays as a reference, the POC-CCA assay was further shown to be a test with low sensitivity. Nevertheless, the assay exhibited significant positive correlations with egg burden determined by the KK technique and the target gene copy number index values determined by the ddPCR assays within the entire cohort. CONCLUSIONS By using in silico image analysis, the POC-CCA cassette test could be converted to a quantitative assay to avoid reader-variability. Because of its low sensitivity, the commercially available POC-CCA assay had limited potential for determining the status of a S. japonicum infection in the target cohort. The assay should be applied with caution in populations where schistosome parasites (especially S. japonicum) are present at low infection intensity.
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Affiliation(s)
- Pengfei Cai
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Yi Mu
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kosala G Weerakoon
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, Philippines
| | | | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Musuva RM, Odiere MR, Mwinzi PNM, Omondi IO, Rawago FO, Matendechero SH, Kittur N, Campbell CH, Colley DG. Unprotected water sources and low latrine coverage are contributing factors to persistent hotspots for schistosomiasis in western Kenya. PLoS One 2021; 16:e0253115. [PMID: 34534220 PMCID: PMC8448362 DOI: 10.1371/journal.pone.0253115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/31/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Evidence indicates that whereas repeated rounds of mass drug administration (MDA) programs have reduced schistosomiasis prevalence to appreciable levels in some communities referred to here as responding villages (R). However, prevalence has remained high or less than anticipated in other areas referred to here as persistent hotspot villages (PHS). Using a cross-sectional quantitative approach, this study investigated the factors associated with sustained high Schistosoma mansoni prevalence in some villages despite repeated high annual treatment coverage in western Kenya. METHOD Water contact sites selected based on observation of points where people consistently go to collect water, wash clothes, bathe, swim or play (young children), wash cars and harvest sand were mapped using hand-held smart phones on the Commcare platform. Quantitative cross-sectional surveys on behavioral characteristics were conducted using interviewer-based semi-structured questionnaires administered to assess water usage/contact patterns and open defecation. Questionnaires were administered to 15 households per village, 50 pupils per school and 1 head teacher per school. One stool and urine sample was collected from 50 school children aged 9-12 year old and 50 adults from both responding (R) and persistent hotspot (PHS) villages. Stool was analyzed by the Kato-Katz method for eggs of S. mansoni and soil-transmitted helminths. Urine samples were tested using the point-of-care circulating cathodic antigen (POC-CCA) test for detection of S. mansoni antigen. RESULTS There was higher latrine coverage in R (n = 6) relative to PHS villages (n = 6) with only 33% of schools in the PHS villages meeting the WHO threshold for boy: latrine coverage ratio versus 83.3% in R, while no villages met the girl: latrine ratio requirement. A higher proportion of individuals accessed unprotected water sources for both bathing and drinking (68.5% for children and 89% for adults) in PHS relative to R villages. In addition, frequency of accessing water sources was higher in PHS villages, with swimming being the most frequent activity. As expected based upon selection criteria, both prevalence and intensity of S. mansoni were higher in the PHS relative to R villages (prevalence: 43.7% vs 20.2%; P < 0.001; intensity: 73.8 ± 200.6 vs 22.2 ± 96.0, P < 0.0001), respectively. CONCLUSION Unprotected water sources and low latrine coverage are contributing factors to PHS for schistosomiasis in western Kenya. Efforts to increase provision of potable water and improvement in latrine infrastructure is recommended to augment control efforts in the PHS areas.
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Affiliation(s)
- Rosemary M. Musuva
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
- * E-mail:
| | - Maurice R. Odiere
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Pauline N. M. Mwinzi
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Isaiah O. Omondi
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | - Fredrick O. Rawago
- Neglected Tropical Diseases Unit, Centre for Global Health, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
| | - Carl H. Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
| | - Daniel G. Colley
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, United States of America
- Department of Microbiology, University of Georgia, Athens, Georgia, United States of America
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19
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Aruleba RT, Tincho MB, Pretorius A, Kappo AP. In silico prediction of new antimicrobial peptides and proteins as druggable targets towards alternative anti-schistosomal therapy. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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20
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Al-Naseri A, Al-Absi S, El Ridi R, Mahana N. A comprehensive and critical overview of schistosomiasis vaccine candidates. J Parasit Dis 2021; 45:557-580. [PMID: 33935395 PMCID: PMC8068781 DOI: 10.1007/s12639-021-01387-w] [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: 01/16/2021] [Accepted: 03/31/2021] [Indexed: 12/11/2022] Open
Abstract
A digenetic platyhelminth Schistosoma is the causative agent of schistosomiasis, one of the neglected tropical diseases that affect humans and animals in numerous countries in the Middle East, sub-Saharan Africa, South America and China. Several control methods were used for prevention of infection or treatment of acute and chronic disease. Mass drug administration led to reduction in heavy-intensity infections and morbidity, but failed to decrease schistosomiasis prevalence and eliminate transmission, indicating the need to develop anti-schistosome vaccine to prevent infection and parasite transmission. This review summarizes the efficacy and protective capacity of available schistosomiasis vaccine candidates with some insights and future prospects.
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Affiliation(s)
- Aya Al-Naseri
- Zoology Department, Faculty of Science, Cairo Univesity, Giza, 12613 Egypt
| | - Samar Al-Absi
- Zoology Department, Faculty of Science, Cairo Univesity, Giza, 12613 Egypt
| | - Rashika El Ridi
- Zoology Department, Faculty of Science, Cairo Univesity, Giza, 12613 Egypt
| | - Noha Mahana
- Zoology Department, Faculty of Science, Cairo Univesity, Giza, 12613 Egypt
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21
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Abstract
Dams enable the production of food and renewable energy, making them a crucial tool for both economic development and climate change adaptation in low- and middle-income countries. However, dams may also disrupt traditional livelihood systems and increase the transmission of vector- and water-borne pathogens. These livelihood and health impacts diminish the benefits of dams to rural populations dependent on rivers, as hydrological and ecological alterations change flood regimes, reduce nutrient transport and lead to the loss of biodiversity. We propose four agricultural innovations for promoting equity, health, sustainable development, and climate resilience in dammed watersheds: (1) restoring migratory aquatic species, (2) removing submerged vegetation and transforming it into an agricultural resource, (3) restoring environmental flows and (4) integrating agriculture and aquaculture. As investment in dams accelerates in low- and middle-income countries, appropriately addressing their livelihood and health impacts can improve the sustainability of modern agriculture and economic development in a changing climate.
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Loffredo-Verde E, Bhattacharjee S, Malo A, Festag J, Kosinska AD, Ringelhan M, Rim Sarkar S, Steiger K, Heikenwaelder M, Protzer U, Prazeres da Costa CU. Dynamic, Helminth-Induced Immune Modulation Influences the Outcome of Acute and Chronic Hepatitis B Virus Infection. J Infect Dis 2021; 221:1448-1461. [PMID: 31875228 DOI: 10.1093/infdis/jiz594] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/23/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chronic hepatitis B develops more frequently in countries with high prevalence of helminth infections. The crosstalk between these 2 major liver-residing pathogens, Schistosoma mansoni and hepatitis B virus (HBV), is barely understood. METHODS We used state-of-the-art models for both acute and chronic HBV infection to study the pathogen-crosstalk during the different immune phases of schistosome infection. RESULTS Although liver pathology caused by schistosome infection was not affected by either acute or chronic HBV infection, S mansoni infection influenced HBV infection outcomes in a phase-dependent manner. Interferon (IFN)-γ secreting, HBV- and schistosome-specific CD8 T cells acted in synergy to reduce HBV-induced pathology during the TH1 phase and chronic phase of schistosomiasis. Consequently, HBV was completely rescued in IFN-γ-deficient or in TH2 phase coinfected mice demonstrating the key role of this cytokine. It is interesting to note that secondary helminth infection on the basis of persistent (chronic) HBV infection increased HBV-specific T-cell frequency and resulted in suppression of virus replication but failed to fully restore T-cell function and eliminate HBV. CONCLUSIONS Thus, schistosome-induced IFN-γ had a prominent antiviral effect that outcompeted immunosuppressive effects of TH2 cytokines, whereas HBV coinfection did not alter schistosome pathogenicity.
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Affiliation(s)
- Eva Loffredo-Verde
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University Munich, Munich, Germany.,Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
| | - Sonakshi Bhattacharjee
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University Munich, Munich, Germany
| | - Antje Malo
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
| | - Julia Festag
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany
| | - Anna D Kosinska
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany.,German Center for Infection Research, Munich partner site, Munich, Germany
| | - Marc Ringelhan
- 2nd Medical Department, University Hospital rechts der Isar, Technical University Munich, Munich, Germany.,German Center for Infection Research, Munich partner site, Munich, Germany
| | - Sabrina Rim Sarkar
- Comparative Experimental Pathology, Institute of Pathology, School of Medicine, Technical University Munich, Munich, Germany
| | - Katja Steiger
- Comparative Experimental Pathology, Institute of Pathology, School of Medicine, Technical University Munich, Munich, Germany
| | - Mathias Heikenwaelder
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany.,Institute of Molecular Immunology, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| | - Ulrike Protzer
- Institute of Virology, Technical University of Munich/Helmholtz Zentrum München, Munich, Germany.,German Center for Infection Research, Munich partner site, Munich, Germany
| | - Clarissa U Prazeres da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University Munich, Munich, Germany.,German Center for Infection Research, Munich partner site, Munich, Germany
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Abstract
Hookworms are some of the most widespread of the soil-transmitted helminths (STH) with an estimated 438.9 million people infected. Until relatively recently Ancylostoma ceylanicum was regarded as a rare cause of hookworm infection in humans, with little public health relevance. However, recent advances in molecular diagnostics have revealed a much higher prevalence of this zoonotic hookworm than previously thought, particularly in Asia. This study examined the prevalence of STH and A. ceylanicum in the municipalities of Palapag and Laoang in the Philippines utilizing real-time polymerase chain reaction (PCR) on stool samples previously collected as part of a cross-sectional survey of schistosomiasis japonica. Prevalence of hookworm in humans was high with 52.8% (n = 228/432) individuals positive for any hookworm, 34.5% (n = 149/432) infected with Necator americanus, and 29.6% (n = 128/432) with Ancylostoma spp; of these, 34 were PCR-positive for A. ceylanicum. Considering dogs, 12 (n = 33) were PCR-positive for A. ceylanicum. This is the first study to utilize molecular diagnostics to identify A. ceylanicum in the Philippines with both humans and dogs infected. Control and elimination of this zoonotic hookworm will require a multifaceted approach including chemotherapy of humans, identification of animal reservoirs, improvements in health infrastructure, and health education to help prevent infection.
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Cai P, Mu Y, Olveda RM, Ross AG, Olveda DU, McManus DP. Serum Exosomal miRNAs for Grading Hepatic Fibrosis Due to Schistosomiasis. Int J Mol Sci 2020; 21:ijms21103560. [PMID: 32443549 PMCID: PMC7278994 DOI: 10.3390/ijms21103560] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 02/07/2023] Open
Abstract
Chronic infection with Schistosoma japonicum or Schistosoma mansoni results in hepatic fibrosis of the human host. The staging of fibrosis is crucial for prognosis and to determine the need for treatment of patients with schistosomiasis. This study aimed to determine whether there is a correlation between the levels of serum exosomal micro-ribonucleic acids (miRNAs) (exomiRs) and fibrosis progression in schistosomiasis. Reference gene (RG) validation was initially carried out for the analysis of serum exomiRs expression in staging liver fibrosis caused by schistosome infection. The expression levels of liver fibrosis-associated exomiRs in serum were determined in a murine schistosomiasis model and in a cohort of Filipino schistosomiasis japonica patients (n = 104) with different liver fibrosis grades. Of twelve RG candidates validated, miR-103a-3p and miR-425-5p were determined to be the most stable genes in the murine schistosomiasis model and subjects from the schistosomiasis-endemic area, respectively. The temporal expression profiles of nine fibrosis-associated serum exomiRs, as well as their correlations with the liver pathologies, were determined in C57BL/6 mice during S. japonicum infection. The serum levels of three exomiRs (miR-92a-3p, miR-146a-5p and miR-532-5p) were able to distinguish subjects with fibrosis grades I-III from those with no fibrosis, but only the serum level of exosomal miR-146a-5p showed potential for distinguishing patients with mild (grades 0–I) versus severe fibrosis (grades II–III). The current data imply that serum exomiRs can be a supplementary tool for grading liver fibrosis in hepatosplenic schistosomiasis with moderate accuracy.
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Affiliation(s)
- Pengfei Cai
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia;
- Correspondence: (P.C.); (D.P.M.); Tel.: +61-7-3362-0406 (P.C.); +61-7-3362-0401 (D.P.M.)
| | - Yi Mu
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia;
| | - Remigio M. Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila 1781, Philippines;
| | - Allen G. Ross
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (A.G.R.); (D.U.O.)
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka 1212, Bangladesh
| | - David U. Olveda
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia; (A.G.R.); (D.U.O.)
| | - Donald P. McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia;
- Correspondence: (P.C.); (D.P.M.); Tel.: +61-7-3362-0406 (P.C.); +61-7-3362-0401 (D.P.M.)
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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.
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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
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26
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Parasite-derived circulating microRNAs as biomarkers for the detection of human Schistosoma japonicum infection. Parasitology 2019; 147:889-896. [PMID: 31840631 PMCID: PMC7391863 DOI: 10.1017/s0031182019001690] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Novel tools for early diagnosis and monitoring of schistosomiasis are urgently needed. This study aimed to validate parasite-derived miRNAs as potential novel biomarkers for the detection of human Schistosoma japonicum infection. A total of 21 miRNAs were initially validated by real-time-polymerase chain reaction (RT-PCR) using serum samples of S. japonicum-infected BALB/c mice. Of these, 6 miRNAs were further validated with a human cohort of individuals from a schistosomiasis-endemic area of the Philippines. RT-PCR analysis showed that two parasite-derived miRNAs (sja-miR-2b-5p and sja-miR-2c-5p) could detect infected individuals with low infection intensity with moderate sensitivity/specificity values of 66%/68% and 55%/80%, respectively. Analysis of the combined data for the two parasite miRNAs revealed a specificity of 77.4% and a sensitivity of 60.0% with an area under the curve (AUC) value of 0.6906 (P = 0.0069); however, a duplex RT-PCR targeting both sja-miR-2b-5p and sja-miR-2c-5p did not result in an increased diagnostic performance compared with the singleplex assays. Furthermore, the serum level of sja-miR-2c-5p correlated significantly with faecal egg counts, whereas the other five miRNAs did not. Targeting S. japonicum-derived miRNAs in serum resulted in a moderate diagnostic performance when applied to a low schistosome infection intensity setting.
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27
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Gao J, Yang N, Lewis FA, Yau P, Collins JJ, Sweedler JV, Newmark PA. A rotifer-derived paralytic compound prevents transmission of schistosomiasis to a mammalian host. PLoS Biol 2019; 17:e3000485. [PMID: 31622335 PMCID: PMC6797223 DOI: 10.1371/journal.pbio.3000485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/13/2019] [Indexed: 12/31/2022] Open
Abstract
Schistosomes are parasitic flatworms that infect over 200 million people, causing the neglected tropical disease, schistosomiasis. A single drug, praziquantel, is used to treat schistosome infection. Limitations in mass drug administration programs and the emergence of schistosomiasis in nontropical areas indicate the need for new strategies to prevent infection. It has been known for several decades that rotifers colonizing the schistosome's snail intermediate host produce a water-soluble factor that paralyzes cercariae, the life cycle stage infecting humans. In spite of its potential for preventing infection, the nature of this factor has remained obscure. Here, we report the purification and chemical characterization of Schistosome Paralysis Factor (SPF), a novel tetracyclic alkaloid produced by the rotifer Rotaria rotatoria. We show that this compound paralyzes schistosome cercariae and prevents infection and does so more effectively than analogous compounds. This molecule provides new directions for understanding cercariae motility and new strategies for preventing schistosome infection.
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Affiliation(s)
- Jiarong Gao
- Cellular and Molecular Biology Program, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Cell and Developmental Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Ning Yang
- Department of Chemistry and the Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Fred A. Lewis
- Biomedical Research Institute, Rockville, Maryland, United States of America
| | - Peter Yau
- Roy J. Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - James J. Collins
- Department of Cell and Developmental Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Jonathan V. Sweedler
- Department of Chemistry and the Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Phillip A. Newmark
- Department of Cell and Developmental Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Howard Hughes Medical Institute, Chevy Chase, Maryland, United States of America
- Morgridge Institute for Research, Madison, Wisconsin, United States of America
- Department of Integrative Biology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
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28
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Abstract
Over the past 20 years, RNAS+ has been generating research results from highly collaborative projects meant to promote and advance understanding in various aspects of schistosomiasis. Epidemiological studies in endemic countries like the Philippines, the People's Republic of China (PR China), the Lao People's Democratic Republic (Lao PDR) and Cambodia clarified the role of reservoir hosts in transmission and the use of spatio-temporal methods such as remote sensing and geographical information systems (GIS) in surveillance of schistosomiasis. Morbidity studies proposed factors that might influence development of fibrosis, anaemia and malnutrition in schistosomiasis. Immune responses in schistosomiasis continue to be an interesting focus in research to explain possible development of resistance with age. Results of evaluation of candidate vaccine molecules are also presented. New diagnostics are continually being developed in response to the call for more sensitive and field applicable techniques that will be used for surveillance in areas nearing elimination of the disease. Several studies presented here show the insufficiency of mass drug administration (MDA) with praziquantel in eliminating the disease. Emphasis is given to an integrated control approach that can be accomplished through intensive and extensive intersectoral collaboration.
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Leonardo L, Bergquist R, Olveda R, Satrija F, Sripa B, Sayasone S, Khieu V, Willingham AL, Utzinger J, Zhou XN. From country control programmes to translational research. ADVANCES IN PARASITOLOGY 2019; 105:69-93. [PMID: 31530396 DOI: 10.1016/bs.apar.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
From the time it was conceptualized in 1998 to the present, RNAS+ has largely concentrated on research that will generate results to facilitate control, prevention and elimination of its target diseases. Diagnostics has remained an active field of research in order to develop tools that are appropriate for each stage from the first efforts until attempts to block transmission. For example, with regard to schistosomiasis, chemotherapy has excellent impact on morbidity, while better diagnostics and vaccine research have been promoted to complement the other components of the control programme. The need for surveillance in areas where the prevalence has been brought down to very low levels necessitated development of spatio-temporal tools and ecological models based on geographical information systems (GIS) to produce risk and distribution maps for monitoring and evaluation of programme success. New knowledge and experiences in management of the diseases contribute to the formulation of new schemes in management and treatment. Ways of drawing attention to the disease, such as determining disability weights for use in computation of burden of disease, updating epidemiological profile and unravelling new aspects of the disease provide bases for modifying the operation of control programmes as we move forward. Programme evaluation based on reports of actual implementation of activities brought to the fore problems related to the distribution of chemotherapy as well as social, cultural and behavioural aspects of endemic communities. Importantly, this highlighted the necessity of adapting control activities to specific situations of the endemic areas. New models evolving from reviews of this kind and success stories, such us the elimination of lymphatic filariasis (LF) in PR China and Cambodia are presented.
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Affiliation(s)
- Lydia Leonardo
- Institute of Biology, College of Science, University of the Philippines Diliman and University of the East Ramon Magsaysay Graduate School, Quezon City, Philippines
| | | | - Remigio Olveda
- Asian Tropical Foundation, Filinvest Corporate City, Research Institute for Tropical Medicine Compound, Muntinlupa, Philippines
| | - Fadjar Satrija
- Bogor Agricultural University (IPB), JL. Agatis, Kampus IPB, Bogor, Indonesia
| | - Banchob Sripa
- Department of Pathology, Khon Kaen University, Khon Kaen, Thailand
| | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Vientianne, Lao People's Democratic Republic
| | - Virak Khieu
- National Helminth Control Program, National Center for Parasitology, Entomology and Malaria Control Ministry of Health, Phnom Penh, Cambodia
| | - Arve Lee Willingham
- One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, West Indies
| | - Juerg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases, China; National Center for International Research on Tropical Diseases, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, China, Shanghai, China.
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30
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Obonyo CO, Muok EMO, Were V. Biannual praziquantel treatment for schistosomiasis. Hippokratia 2019. [DOI: 10.1002/14651858.cd013412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Charles O Obonyo
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
| | - Erick MO Muok
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
| | - Vincent Were
- Kenya Medical Research Institute; Centre for Global Health Research; P.O. Box 1578 Kisumu Kenya 40100
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Zhang LJ, Dai SM, Xue JB, Li YL, Lv S, Xu J, Li SZ, Guo JG, Zhou XN. The epidemiological status of schistosomiasis in P. R. China after the World Bank Loan Project, 2002-2017. Acta Trop 2019; 195:135-141. [PMID: 31047863 DOI: 10.1016/j.actatropica.2019.04.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 12/22/2022]
Abstract
World Bank Loan Project (WBLP) for schistosomiasis control conducted from 1992 to 2001, resulted in significant reduction of schistosomiasis morbidity and mortality in People's Republic of China (P.R. China), with implementation of morbidity control. Thereafter, an integrated control strategy, which targeted blocking disease transmission from reservoir hosts to the environment, was initiated in order to conquer schistosomiasis rebound after WBLP completion. Data obtained from the national schistosomiasis control reporting systems was collected and analyzed. The number of confirmed cases and infected cattle decreased significantly from 2002 to 2017, while no infected snails were found by dissection for four consecutive years. However, lake and marshland regions and some parts areas of Yunnan Province require attention for rigorous schistosomiasis control efforts. There is need to strengthen precise interventions and sensitive surveillance to achieve schistosomiasis elimination in P.R. China.
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Martel RA, Osei BG, Kulinkina AV, Naumova EN, Abdulai AA, Tybor D, Kosinski KC. Assessment of urogenital schistosomiasis knowledge among primary and junior high school students in the Eastern Region of Ghana: A cross-sectional study. PLoS One 2019; 14:e0218080. [PMID: 31194804 PMCID: PMC6563970 DOI: 10.1371/journal.pone.0218080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 05/24/2019] [Indexed: 11/29/2022] Open
Abstract
Background Knowledge of urogenital schistosomiasis can empower individuals to limit surface water contact and participate in mass drug administration campaigns, but nothing is currently known about the schistosomiasis knowledge that schoolchildren have in Ghana. We developed and implemented a survey tool aiming to assess the knowledge of urogenital schistosomiasis (treatment, transmission, prevention, symptoms) among science teaches and primary and junior high school students in the Eastern Region of Ghana. Methods We developed a 22-question knowledge survey tool and administered it to 875 primary and 938 junior high school students from 74 schools in 37 communities in the Eastern Region of Ghana. Teachers (n = 57) answered 20 questions matched to student questions. We compared knowledge scores (as percent of correct answers) across topics, gender, and class year and assessed associations with teacher’s knowledge scores using t-tests, chi-squared tests, univariate, and multivariate linear regression, respectively. Results Students performed best when asked about symptoms (mean±SD: 76±21% correct) and prevention (mean±SD: 69±25% correct) compared with transmission (mean±SD: 50±15% correct) and treatment (mean±SD: 44±23% correct) (p<0.0005). Teachers performed best on prevention (mean±SD: 93±12% correct, p<0.0005) and poorest on treatment (mean±SD: 69±16% correct, p<0.001). When listing five facts about urogenital schistosomiasis, teachers averaged 2.9±1.2 correct. Multiple regression models suggest that gender, class year, teacher score, and town of residency explain ~27% of variability in student scores. On average, junior high school students outperformed primary school students by 10.2 percentage points (CI95%: 8.6–11.8); boys outperformed girls by 3.5 percentage points (CI95%: 2.3–4.7). Conclusions Our survey parsed four components of student and teacher knowledge. We found strong knowledge in several realms, as well as knowledge gaps, especially on transmission and treatment. Addressing relevant gaps among students and science teachers in UGS-endemic areas may help high-risk groups recognize risky water contact activities, improve participation in mass drug administration, and spark interest in science by making it practical.
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Affiliation(s)
- Rachel A. Martel
- Department of Community Health, Tufts University School of Arts and Sciences, Medford, Massachusetts, United States of America
| | - Bernard Gyamfi Osei
- University College of Agriculture and Environmental Studies, Bunso, Eastern Region, Ghana
| | - Alexandra V. Kulinkina
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts, United States of America
| | - Elena N. Naumova
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts, United States of America
- Division of Nutrition Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
| | | | - David Tybor
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | - Karen Claire Kosinski
- Department of Community Health, Tufts University School of Arts and Sciences, Medford, Massachusetts, United States of America
- * E-mail:
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Francisco I, Jiz M, Rosenbaum M, Baltazar P, Steele JA. Knowledge, attitudes and practices related to schistosomiasis transmission and control in Leyte, Philippines. PLoS Negl Trop Dis 2019; 13:e0007358. [PMID: 31048882 PMCID: PMC6516667 DOI: 10.1371/journal.pntd.0007358] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 05/14/2019] [Accepted: 04/03/2019] [Indexed: 12/20/2022] Open
Abstract
Schistosomiasis is a chronic but preventable disease that affects 260 million people worldwide. In the Philippines, 860,000 people are afflicted with Schistosoma japonicum annually, and another 6.7 million live in endemic areas. The disease’s complex epidemiology as well as the influence of poverty in endemic areas demand an integrated, multi-sectoral approach to disease control. Results from behavioral or sociocultural studies on schistosomiasis could improve the content and impact of schistosomiasis control in rural villages in the Philippines. We investigated knowledge, attitudes and practices related to schistosomiasis transmission and control in an endemic village in Leyte Province, Philippines. We administered a questionnaire to 219 participants covering 1) knowledge and attitudes related to schistosomiasis, its symptoms, and its transmission; 2) attitudes and practices in relation to schistosomiasis prevention; 3) willingness to comply with public health control programs; and 4) whether the respondent had previously contracted schistosomiasis. Responses revealed fairly high measures of schistosomiasis knowledge (mean 17.0 out of 23 questions, range 6–23), but also inconsistent disease prevention behavior. A high proportion of participants (72.6%, n = 159) reported previous disease. Participant belief in the preventability of schistosomiasis was revealed to be a key attitude, as carabao owners who believed in prevention were over five times more likely to be willing to vaccinate their carabaos (OR = 5.24, 95% CI 1.20–27.68, P = 0.04). Additionally, participants who did not believe in prevention were about twice as likely to report previous disease (OR = 2.31, 95% CI 1.02–5.63, P = 0.05). Our results suggest that future public health interventions should address barriers to disease-preventing behavior, as well as maintaining community belief in disease prevention. Comprehensive disease control programs should be supplemented by sociocultural and behavioral context in order to improve their impact in endemic communities. Schistosomiasis is a chronic tropical disease caused by parasitic worms of the genus Schistosoma. In the Philippines, Schistosoma japonicum afflicts over 800,000 people annually, and another 6.7 million live in endemic areas. The current national control program based on human mass treatment has been unable to eliminate schistosomiasis on its own. This is in part due to the poverty of endemic areas as well as the parasite’s complex life cycle, which includes transmission by freshwater snails and livestock. A more comprehensive disease control strategy would include periodic treatment and vaccination of the widely used domestic water buffalo or carabao. Sociocultural and behavioral research would also inform and improve the impact of future control programs. To this end, we investigated knowledge, attitudes, and practices related to schistosomiasis in an endemic village in Leyte, Philippines. We found high levels of disease knowledge and awareness, but also inconsistencies in disease prevention habits. Belief in whether schistosomiasis could be prevented was important in this community, associated with previous disease experience as well as receptivity to new strategies like livestock vaccination. This kind of social context is vital to future public health campaigns, and highlights the importance of cross-disciplinary work to achieve successful disease control.
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Affiliation(s)
- Isabel Francisco
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, United States of America
- * E-mail:
| | - Mario Jiz
- Department of Immunology, Research Institute for Tropical Medicine, Muntinlupa, Metro Manila, Philippines
| | - Marieke Rosenbaum
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, United States of America
| | - Palmera Baltazar
- Department of Immunology, Research Institute for Tropical Medicine, Muntinlupa, Metro Manila, Philippines
| | - Jennifer A. Steele
- Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, United States of America
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Chadeka EA, Nagi S, Cheruiyot NB, Bahati F, Sunahara T, Njenga SM, Hamano S. A high-intensity cluster of Schistosoma mansoni infection around Mbita causeway, western Kenya: a confirmatory cross-sectional survey. Trop Med Health 2019; 47:26. [PMID: 31015786 PMCID: PMC6463626 DOI: 10.1186/s41182-019-0152-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/21/2019] [Indexed: 06/24/2024] Open
Abstract
In Kenya, communities residing along the shores and islands of Lake Victoria bear a substantial burden of schistosomiasis. Although there is a school-based deworming program in place, the transmission of Schistosoma mansoni varies even at a fine scale. Given the focal nature of schistosomes’ transmission, we aim to identify areas with high intensity of S. mansoni infection in Mbita, Homabay County, western Kenya, for prioritized integrated control measures. Our findings confirm a high intensity of S. mansoni infection cluster around Mbita causeway. While the current efforts to curtail morbidity due to schistosomiasis through preventive chemotherapy in schools are crucial, fine-scale mapping of risk areas is necessary for specific integrated control measures.
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Affiliation(s)
- Evans Asena Chadeka
- 1Leading program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sachiyo Nagi
- 2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Ngetich B Cheruiyot
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Felix Bahati
- Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
| | - Toshihiko Sunahara
- 3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,5Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Sammy M Njenga
- 6Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Shinjiro Hamano
- 1Leading program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,3The Joint Usage/Research Center on Tropical Diseases, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Nagasaki University, Kenya Research Station, NUITM-KEMRI Project, Nairobi, Kenya
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Comparison of Kato Katz, antibody-based ELISA and droplet digital PCR diagnosis of schistosomiasis japonica: Lessons learnt from a setting of low infection intensity. PLoS Negl Trop Dis 2019; 13:e0007228. [PMID: 30830925 PMCID: PMC6417743 DOI: 10.1371/journal.pntd.0007228] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 03/14/2019] [Accepted: 02/10/2019] [Indexed: 12/28/2022] Open
Abstract
Background Zoonotic schistosomiasis in Asia, caused by Schistosoma japonicum, remains a major public health concern in China and the Philippines. The developing epidemiological and socio-economic picture of the disease in endemic areas necessitates the development of affordable and highly accurate field diagnostics as an important component in evaluating ongoing integrated control and elimination efforts. Methods Three diagnostic methods, namely Kato-Katz (KK) stool microscopy, ELISA and droplet digital (dd) PCR assays, were compared by detecting infection in a total of 412 participants from an area moderately endemic for schistosomiasis in the Philippines. Results This comprehensive comparison further defined the diagnostic performance and features for each assay. Compared with the ddPCR assay analysing DNA from faeces (F_ddPCR), which exhibited the highest sensitivity, the SjSAP4 + Sj23-LHD-ELISA had the best accuracy (67.2%) among all five ELISA assays assessed. Schistosomiasis prevalence determined by the SjSAP4 + Sj23-LHD-ELISA and ddPCRs was similar and was at least 2.5 times higher than obtained with the KK method. However, the agreement between these assays was low. In terms of cost and logistical convenience, the SjSAP4 + Sj23-LHD-ELISA represents a cost-effective assay with considerable diagnostic merits. In contrast, although the ddPCR assays exhibited a high level of diagnostic performance, the high cost and the need for specialized equipment presents a major obstacle in their application in screening campaigns. Conclusion The SjSAP4 + Sj23-LHD-ELISA represents a cost-effective tool for the diagnosis of schistosomiasis that could prove an important component in the monitoring of integrated control measures as elimination draws closer, whereas the ddPCR assays, in addition to their high sensitivity and specificity, are capable of quantifying infection intensity. However, the high cost of ddPCR hinders its wider application in screening programs, although it could be a valuable reference in the development and improvement of other diagnostic assays. Schistosomiasis japonica remains prevalent in China and in the Philippines. The current changes in the epidemiological and socio-economic picture in the endemic areas makes it imperative that affordable and more sensitive field diagnostics are developed as an important component to evaluate ongoing integrated control and elimination efforts. Three diagnostic approaches, namely Kato-Katz stool microscopy, ELISA and droplet digital PCR assays, were compared by detecting infection in a cohort from schistosome-endemic areas in the Philippines. This comprehensive comparison further defined the diagnostic performance and features for each assay. Prevalence of schistosomiasis determined by the SjSAP4 + Sj23-LHD-ELISA and ddPCRs was at least 2.5 times higher than that by the KK method. The prevalence determined by the SjSAP4 + Sj23-LHD-ELISA and ddPCRs was similar, but low agreements between these assays were evident. The ddPCR assays showed considerable diagnostic performance but the high associated costs and the need for specialized equipment present major obstacles in their application in screening campaigns although they can serve as reference standards for evaluating other diagnostic assays. The SjSAP4 + Sj23-LHD-ELISA represents a cost-effective tool for the diagnosis of schistosomiasis japonica and this assay could prove an important monitoring tool to evaluate the impact of integrated control measures over time.
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Publication output of the new integrated strategy for schistosomiasis japonica control in China: a PubMed-based bibliometric assessment. GLOBAL HEALTH JOURNAL 2019. [DOI: 10.1016/j.glohj.2019.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Weerakoon KG, Gordon CA, Williams GM, Cai P, Gobert GN, Olveda RM, Ross AG, Olveda DU, McManus DP. Co-parasitism of intestinal protozoa and Schistosoma japonicum in a rural community in the Philippines. Infect Dis Poverty 2018; 7:121. [PMID: 30526666 PMCID: PMC6287361 DOI: 10.1186/s40249-018-0504-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023] Open
Abstract
Background Co-parasitism is a frequent occurrence in impoverished communities in the tropics resulting in a considerable disease burden. While there are extensive reports of intestinal helminthiases, including schistosomiasis japonica, the occurrence and extent of diseases caused by intestinal protozoa (IP) have yet to be investigated in depth in the Philippines. We present a detailed analysis of polyparasitism in a rural community of Northern Samar, focusing on co-infections of IP with Schistosoma japonicum. Methods A descriptive cross sectional study was carried out in 2015 across 18 barangays (villages) endemic for S. japonicum in Northern Samar, the Philippines to assess the burden of human schistosomiasis and IP infections. Faecal samples collected from 412 participants from the 18 barangays were included in the final molecular analysis. A multiplex quantitative PCR assay was developed and used for the detection of Blastocystis spp., Entamoeba histolytica, Cryptosporidium spp. and Giardia duodenalis in stool samples. The findings were combined with previous results of droplet digital PCR diagnosis of individuals from the same 18 barangays infected with S. japonicum determined using the same stool samples for analysis. Results Mean age of the study participants was 40.3 years (95% CI: 38.8–41.8) with 53% (n = 218) being males. Prevalence of S. japonicum (74.5%) and Blastocystis spp. (58.7%) was significantly higher compared to other infections, with E. histolytica having the lowest prevalence (12.1%). A majority of individuals were infected with more than one parasite with two infections being most common (n = 175, 42.5%). The prevalence of individuals with two parasites was significantly higher than all others with 27.9% (n = 115) subjects harbouring a single parasite species. Of individuals with two infections, S. japonicum and Blastocystis spp. were the most common combination (n = 110, 62.9%). Examining age within the population, 58.5% (n = 38) of school-aged children and 60.1% (n = 14) of women of child bearing age harboured at least two parasite species. Conclusions The study revealed that polyparasitism with IP infections and schistosomiasis japonica is highly prevalent in individuals in Northern Samar which likely contributes to the significant public health and socio-economic burden suffered by this population. More generally, the findings are of relevance when considering implementation of integrated control strategies for intestinal parasites. Electronic supplementary material The online version of this article (10.1186/s40249-018-0504-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kosala Gayan Weerakoon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia. .,School of Public Health, The University of Queensland, Brisbane, 4006, Australia. .,Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka.
| | - Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia
| | - Gail M Williams
- School of Public Health, The University of Queensland, Brisbane, 4006, Australia
| | - Pengfei Cai
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia
| | - Geoffrey N Gobert
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia.,School of Biological Sciences, Queen's University Belfast, Belfast, BT9 7BL, UK
| | - Remigio M Olveda
- Research Institute for Tropical Medicine, Department of Health, Manila, 1781, Philippines
| | - Allen G Ross
- Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222, Australia
| | - David U Olveda
- Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia.
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Egesa M, Lubyayi L, Jones FM, van Diepen A, Chalmers IW, Tukahebwa EM, Bagaya BS, Hokke CH, Hoffmann KF, Dunne DW, Elliott AM, Yazdanbakhsh M, Wilson S, Cose S. Antibody responses to Schistosoma mansoni schistosomula antigens. Parasite Immunol 2018; 40:e12591. [PMID: 30239012 PMCID: PMC6492298 DOI: 10.1111/pim.12591] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/04/2018] [Indexed: 02/06/2023]
Abstract
While antigens from Schistosoma schistosomula have been suggested as potential vaccine candidates, the association between antibody responses with schistosomula antigens and infection intensity at reinfection is not well known. Schistosoma mansoni-infected individuals were recruited from a schistosomiasis endemic area in Uganda (n = 372), treated with 40 mg/kg praziquantel (PZQ) and followed up at five weeks and at one year post-treatment. Pre-treatment and five weeks post-treatment immunoglobulin (Ig) E, IgG1 and IgG4 levels against recombinant schistosomula antigens rSmKK7, rSmLy6A, rSmLy6B and rSmTSP7 were measured using ELISA. Factors associated with detectable pre-treatment or post-treatment antibody response against the schistosomula antigens and the association between five-week antibody responses and one year post-treatment reinfection intensity among antibody responders were examined. Being male was associated with higher pre-treatment IgG1 to rSmKK7, rSmLy6a and AWA. Five weeks post-treatment antibody responses against schistosomula antigens were not associated with one year post-treatment reinfection intensity among antibody responders' antibody levels against rSmKK7, rSmLy6B and rSmTSP7 dropped, but increased against rSmLy6A, AWA and SEA at five weeks post-treatment among antibody responders. S. mansoni-infected individuals exhibit detectable antibody responses to schistosomula antigens that are affected by treatment. These findings indicate that schistosomula antigens induce highly varied antibody responses and could have implications for vaccine development.
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Affiliation(s)
- Moses Egesa
- Department of Medical MicrobiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | - Lawrence Lubyayi
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | | | - Angela van Diepen
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Iain W. Chalmers
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | | | - Bernard S. Bagaya
- Department of Immunology and Molecular BiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
| | - Cornelis H. Hokke
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Karl F. Hoffmann
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | - David W. Dunne
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Alison M. Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
- Department of Clinical ResearchLondon School of Hygiene & Tropical MedicineLondonUK
| | - Maria Yazdanbakhsh
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Shona Wilson
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
- Department of Clinical ResearchLondon School of Hygiene & Tropical MedicineLondonUK
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Egesa M, Lubyayi L, Tukahebwa EM, Bagaya BS, Chalmers IW, Wilson S, Hokke CH, Hoffmann KF, Dunne DW, Yazdanbakhsh M, Labuda LA, Cose S. Schistosoma mansoni schistosomula antigens induce Th1/Pro-inflammatory cytokine responses. Parasite Immunol 2018; 40:e12592. [PMID: 30239006 PMCID: PMC6492251 DOI: 10.1111/pim.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/15/2018] [Accepted: 09/04/2018] [Indexed: 12/16/2022]
Abstract
Larvae of Schistosoma (schistosomula) are highly susceptible to host immune responses and are attractive prophylactic vaccine targets, although cellular immune responses against schistosomula antigens in endemic human populations are not well characterized. We collected blood and stool from 54 Schistosoma mansoni-infected Ugandans, isolated peripheral blood mononuclear cells and stimulated them for 24 hours with schistosome adult worm and soluble egg antigens (AWA and SEA), along with schistosomula recombinant proteins rSmKK7, Lymphocyte Antigen 6 isoforms (rSmLy6A and rSmLy6B), tetraspanin isoforms (rSmTSP6 and rSmTSP7). Cytokines, chemokines and growth factors were measured in the culture supernatants using a multiplex luminex assay, and infection intensity was determined before and at 1 year after praziquantel (PZQ) treatment using the Kato-Katz method. Cellular responses were grouped and the relationship between groups of correlated cellular responses and infection intensity before and after PZQ treatment was investigated. AWA and SEA induced mainly Th2 responses. In contrast, rSmLy6B, rSmTSP6 and rSmTSP7 induced Th1/pro-inflammatory responses. While recombinant antigens rSmKK7 and rSmLy6A did not induce a Th1/pro-inflammatory response, they had an association with pre-treatment infection intensity after adjusting for age and sex. Testing more schistosomula antigens using this approach could provide immune-epidemiology identifiers necessary for prioritizing next generation schistosomiasis vaccine candidates.
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Affiliation(s)
- Moses Egesa
- Department of Medical MicrobiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | - Lawrence Lubyayi
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
| | | | - Bernard S. Bagaya
- Department of Immunology and Molecular BiologySchool of Biomedical SciencesMakerere University College of Health SciencesKampalaUganda
| | - Iain W. Chalmers
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | - Shona Wilson
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Cornelis H. Hokke
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Karl F. Hoffmann
- Institute of Biological, Environmental & Rural SciencesAberystwyth UniversityAberystwythUK
| | - David W. Dunne
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Maria Yazdanbakhsh
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Lucja A. Labuda
- Department of ParasitologyLeiden University Medical CenterLeidenThe Netherlands
| | - Stephen Cose
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research UnitEntebbeUganda
- Department of Clinical ResearchLondon School of Hygiene & Tropical MedicineLondonUK
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Qian C, Zhang Y, Zhang X, Yuan C, Gao Z, Yuan H, Zhong J. Effectiveness of the new integrated strategy to control the transmission of Schistosoma japonicum in China: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2018; 25:54. [PMID: 30444486 PMCID: PMC6238655 DOI: 10.1051/parasite/2018058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/04/2018] [Indexed: 12/30/2022]
Abstract
Since 2004, the national schistosomiasis control strategy in China has shifted from the morbidity control strategy (conventional strategy) to an integrated strategy (new strategy). We investigated the effectiveness of the new strategy and compared it against the conventional strategy. We retrieved from electronic databases the literature regarding the new strategy published from 2000 to 2017. The effect of the new or conventional strategy on infection by Schistosoma japonicum of humans and snails (Oncomelania hupensis) was evaluated with pooled log relative risk (logRR). A total of only eight eligible publications were included in the final meta-analysis. The results showed that implementation of the new strategy reduced the infection risk by 3–4 times relative to the conventional strategy. More specifically, the conventional strategy caused a reduction in both human (logRR = 0.56, 95% CI: 0.12–0.99) and snail infections (logRR = 0.34, 95% CI: −0.69–1.37), while the new strategy also significantly reduced both human (logRR = 1.89, 95% CI: 1.33–2.46) and snail infections (logRR = 1.61, 95% CI: 1.06–2.15). In contrast to the conventional strategy, the new strategy appeared more effective to control both human (logRR difference = 1.32, 95% CI: 0.78–1.86) and snail infections (logRR difference = 1.53, 95% CI: 0.76–2.31). Our data demonstrate that the new integrated strategy is highly effective to control the transmission of S. japonicum in China, and this strategy is recommended for schistosomiasis elimination in other affected regions across the world, with adaptation to local conditions.
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Affiliation(s)
- Chunyan Qian
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China - School of Life Sciences, Fudan University, Shanghai 200433, PR China
| | - Yuefeng Zhang
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China
| | - Xinyan Zhang
- Department of Clinical Laboratory, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200001, PR China
| | - Chao Yuan
- Shanghai Skin Disease Hospital, Shanghai 200443, PR China
| | - Zhichao Gao
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China
| | - Hong Yuan
- Yuhang Branch, The Second Affiliated Hospital of Zhejiang University, Hangzhou 311100, Zhejiang Province, PR China
| | - Jiang Zhong
- School of Life Sciences, Fudan University, Shanghai 200433, PR China
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Cai P, Mu Y, Olveda RM, Ross AG, Olveda DU, McManus DP. Circulating miRNAs as footprints for liver fibrosis grading in schistosomiasis. EBioMedicine 2018; 37:334-343. [PMID: 30482723 PMCID: PMC6286190 DOI: 10.1016/j.ebiom.2018.10.048] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/03/2018] [Accepted: 10/18/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Chronic infection with Schistosoma japonicum or S. mansoni results in hepatic fibrosis of the human host. Staging fibrosis is crucial for the prognosis and to determine the rapid need of treatment in patients with schistosomiasis. METHODS To establish whether there is a correlation between circulating microRNA (miRNA) level and fibrosis progression in schistosomiasis, ten miRNAs were selected to assess their potential in grading schistosomiasis liver fibrosis. This was done firstly in two mouse strains (C57BL/6 and BALB/c) to determine the temporal expression profiles in serum over the course of S. japonicum infection, and then within a cohort of 163 schistosomiasis japonica patients with different grades of liver fibrosis. FINDING Four miRNAs (miR-150-5p, let-7a-5p, let-7d-5p and miR-146a-5p) were able to distinguish patients with mild versus severe fibrosis. The level of serum miR-150-5p showed the most promising potential for grading hepatic fibrosis in schistosomiasis. The diagnostic performance of miR-150-5p in discriminating mild from severe fibrosis is comparable with that of the ELF test and serum HA level. In addition, the serum levels of the four miRNAs rebounded in infected C57BL/6 mice, after 6 months post treatment, following the regression of liver fibrosis, thereby providing further support for the utility of these miRNAs in grading schistosomal hepatic fibrosis. INTERPRETATION Circulating miRNAs can be a supplementary tool for assessing hepatic fibrosis in human schistosomiasis. FUND: National Health and Medical Research Council (NHMRC) of Australia (APP1102926, APP1037304 and APP1098244).
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Affiliation(s)
- Pengfei Cai
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Yi Mu
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, Philippines
| | - Allen G Ross
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; icddr b, Dhaka, Bangladesh
| | - David U Olveda
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
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42
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Inobaya MT, Chau TN, Ng SK, MacDougall C, Olveda RM, Tallo VL, Landicho JM, Malacad CM, Aligato MF, Guevarra JB, Ross AG. Mass drug administration and the sustainable control of schistosomiasis: an evaluation of treatment compliance in the rural Philippines. Parasit Vectors 2018; 11:441. [PMID: 30064469 PMCID: PMC6069569 DOI: 10.1186/s13071-018-3022-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/17/2018] [Indexed: 12/22/2022] Open
Abstract
Background Preventive chemotherapy is the current global control strategy for schistosomiasis. The WHO target coverage rate is at least 75% for school-aged children. In the Philippines, the reported national coverage rate (43.5%) is far below the WHO target. This study examined the factors associated with non-compliance to mass drug administration. Methods A cross-sectional survey was conducted in 2015 among 2189 adults in the province of Northern Samar, the Philippines using a structured face-to-face survey questionnaire. Results The overall rate of non-compliance to mass drug administration (MDA) in the last treatment round was 27%. Females (aOR = 1.67, P = 0.033) were more likely to be non-compliant. Respondents who believed that schistosomiasis was acquired by open defecation and poor sanitation (aOR = 1.41, P = 0.015), and by drinking unclean water (aOR = 2.09, P = 0.001) were more likely to refuse treatment. Uncertainties on whether schistosomiasis can be treated (aOR = 2.39, P = 0.033), their fear of adverse reactions to praziquantel (aOR = 1.94, P = 0.021), misconceptions about alternative forms of treatment (aOR = 1.45, P = 0.037), and that praziquantel is used for purposes other than deworming (aOR = 2.15, P = 0.021) were all associated with a higher odd of non-compliance. In contrary, being a farmer (aOR = 0.62, P =0.038), participation in past MDA (aOR = 0.30, P < 0.001), informed about impending MDA (aOR = 0.08, P < 0.001), and having heard of schistosomiasis (aOR = 0.22, P = 0.045) were all significantly associated with reduced non-compliance. Conclusions To improve drug compliance for schistosomiasis there is an urgent need for intensive health education campaigns before conducting MDA that would not only provide disease specific information, but also deal with prevailing misconceptions about transmission, prevention, treatment, and drug side-effects.
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Affiliation(s)
- Marianette T Inobaya
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Thao N Chau
- Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Shu-Kay Ng
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Colin MacDougall
- Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Veronica L Tallo
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Jhoys M Landicho
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Carol M Malacad
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Mila F Aligato
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Jerric B Guevarra
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Allen G Ross
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
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43
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Coulibaly JT, Ouattara M, Barda B, Utzinger J, N'Goran EK, Keiser J. A Rapid Appraisal of Factors Influencing Praziquantel Treatment Compliance in Two Communities Endemic for Schistosomiasis in Côte d'Ivoire. Trop Med Infect Dis 2018; 3:tropicalmed3020069. [PMID: 30274465 PMCID: PMC6073597 DOI: 10.3390/tropicalmed3020069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/09/2018] [Accepted: 06/14/2018] [Indexed: 01/12/2023] Open
Abstract
Over the past decade, a significant reduction in the prevalence of schistosomiasis has been achieved, partially explained by the large-scale administration of praziquantel. Yet, the burden of schistosomiasis remains considerable, and factors influencing intervention coverage are important. This study aimed to deepen the understanding of low treatment coverage rates observed in two schistosomiasis-endemic villages in Côte d’Ivoire. The research was conducted in August 2015, in Moronou and Bigouin, two villages of Côte d’Ivoire that are endemic for Schistosoma haematobium and S. mansoni, respectively. After completion of a clinical trial, standard praziquantel treatment (single 40 mg/kg oral dose) was offered to all village inhabitants by community health workers using a house-to-house approach. Factors influencing treatment coverage were determined by a questionnaire survey, randomly selecting 405 individuals. The overall treatment coverage rate was only 47.6% (2730/5733) with considerable intervillage heterogeneity (27.7% in Bigouin (302/1091) versus 52.3% in Moronou (2428/4642)). Among the 200 individuals interviewed in Moronou, 50.0% were administered praziquantel, while only 19.5% of the 205 individuals interviewed in Bigouin received praziquantel. The main reasons for low treatment coverage were work-related (agricultural activities), the bitter taste of praziquantel and previous experiences with adverse events. The most suitable period for treatment campaigns was reported to be the dry season. More than three-quarter of the interviewees who had taken praziquantel (overall, 116/140; Moronou, 84/100; Bigouin, 32/40) declared that they would not participate in future treatments (p < 0.001). In order to enhance praziquantel treatment coverage, careful consideration should be given to attitudes and practices, such as prior or perceived adverse events and taste of praziquantel, and appropriate timing, harmonized with agricultural activities. Without such understanding, breaking the transmission of schistosomiasis remains a distant goal.
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Affiliation(s)
- Jean T Coulibaly
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Beatrice Barda
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 01 BP 770, Abidjan 01, Côte d'Ivoire.
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire.
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, P.O. Box, CH-4001 Basel, Switzerland.
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44
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Mass drug administration and the global control of schistosomiasis: successes, limitations and clinical outcomes. Curr Opin Infect Dis 2018; 29:595-608. [PMID: 27584590 DOI: 10.1097/qco.0000000000000312] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. Despite the well known short-term benefits of treating patients for schistosomiasis, the impact of mass drug administration (MDA) campaigns to control the disease in the long term remains unresolved. RECENT FINDINGS Many studies have advocated the success of MDA programs in order to attract donor funds for elimination efforts but such successes are often short-lived given the drug does not alter the life cycle of the organism or prevent reinfection. Within a matter of months to years after halting treatment, the prevalence, intensity of infection and morbidity of disease return to baseline levels. Other mitigating factors contribute to the failings of MDA campaigns namely: poverty, poor drug coverage, poor drug compliance, and, in the case of Asiatic schistosomiasis, zoonotic transmission. Genetic and innate and acquired immunologic mechanisms complicate the epidemiologic picture of schistosomiasis globally, and may contribute indirectly to MDA shortcomings. The possibility of drug resistance is an ever present concern because of the sole reliance on one drug, praziquantel. SUMMARY Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. The short-term benefits of MDA campaigns are well documented but the long-term benefits are questionable.
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45
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Wiegand RE, Mwinzi PNM, Montgomery SP, Chan YL, Andiego K, Omedo M, Muchiri G, Ogutu MO, Rawago F, Odiere MR, Karanja DMS, Secor WE. A Persistent Hotspot of Schistosoma mansoni Infection in a Five-Year Randomized Trial of Praziquantel Preventative Chemotherapy Strategies. J Infect Dis 2017; 216:1425-1433. [PMID: 28968877 PMCID: PMC5913648 DOI: 10.1093/infdis/jix496] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 09/13/2017] [Indexed: 12/28/2022] Open
Abstract
Background Persistent hotspots have been described after mass drug administration (MDA) for the control of schistosomiasis, but they have not been studied during the course of a multiyear MDA program. Methods In data from a 5-year study of school-based and village-wide preventive chemotherapy strategies for Schistosoma mansoni, spatial scan statistics were used to find infection hotspots in 3 populations: 5- to 8-year-olds, 9- to 12-year-olds, and adults. Negative binomial regression was used to analyze changes from baseline, and receiver operating characteristic analyses were used to predict which villages would reach prevalence and intensity endpoints. Results We identified a persistent hotspot, not associated with study arm, where S. mansoni infection prevalence and intensity did not decrease as much as in villages outside the hotspot. Significant differences from baseline were realized after 1 year of MDA: we did not identify factors that moderated this relationship. Villages meeting specified endpoints at year 5 were predicted from prior year data with moderately high sensitivity and specificity. Conclusions The MDA strategies were less effective at reducing prevalence and intensity in the hotspot compared with other villages. Villages that reached year 5 endpoints could be detected earlier, which may provide the opportunity to amend intervention strategies.
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Affiliation(s)
- Ryan E Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pauline N M Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Susan P Montgomery
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Kennedy Andiego
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Martin Omedo
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Geoffrey Muchiri
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Michael O Ogutu
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Fredrick Rawago
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Maurice R Odiere
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - Diana M S Karanja
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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46
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Donohue RE, Mashoto KO, Mubyazi GM, Madon S, Malecela MN, Michael E. Biosocial Determinants of Persistent Schistosomiasis among Schoolchildren in Tanzania despite Repeated Treatment. Trop Med Infect Dis 2017; 2:E61. [PMID: 30270918 PMCID: PMC6082061 DOI: 10.3390/tropicalmed2040061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/21/2017] [Accepted: 11/23/2017] [Indexed: 01/19/2023] Open
Abstract
Schistosomiasis is a parasitic disease endemic to Tanzania and other countries of the global south, which is currently being addressed through preventive chemotherapy campaigns. However, there is growing recognition that chemotherapy strategies will need to be supplemented to sustainably control and eventually eliminate the disease. There remains a need to understand the factors contributing to continued transmission in order to ensure the effective configuration and implementation of supplemented programs. We conducted a cross-sectional questionnaire, to evaluate the biosocial determinants facilitating the persistence of schistosomiasis, among 1704 Tanzanian schoolchildren residing in two districts undergoing a preventive chemotherapeutic program: Rufiji and Mkuranga. A meta-analysis was carried out to select the diagnostic questions that provided a likelihood for predicting infection status. We found that self-reported schistosomiasis continues to persist among the schoolchildren, despite multiple rounds of drug administration.Using mixed effects logistic regression modeling, we found biosocial factors, including gender, socio-economic status, and water, sanitation, and hygiene (WASH)-related variables, were associated with this continued schistosomiasis presence. These findings highlight the significant role that social factors may play in the persistence of disease transmission despite multiple treatments, and support the need not only for including integrated technical measures, such as WASH, but also addressing issues of poverty and gender when designing effective and sustainable schistosomiasis control programs.
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Affiliation(s)
- Rose E Donohue
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA.
| | - Kijakazi O Mashoto
- National Institute for Medical Research, P.O. Box 9653, 3 Barack Obama Drive, 11101 Dar es Salaam, Tanzania.
| | - Godfrey M Mubyazi
- National Institute for Medical Research, P.O. Box 9653, 3 Barack Obama Drive, 11101 Dar es Salaam, Tanzania.
| | - Shirin Madon
- Department of International Development, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK.
- Department of Management, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK.
| | - Mwele N Malecela
- Tanzania Commission for Science and Technology (COSTECH), P.O. Box 4302, Ali Hassan Mwinyi Road, Kijitonyama, 14113 Dar es Salaam, Tanzania.
| | - Edwin Michael
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA.
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Mass drug administration and the sustainable control of schistosomiasis: Community health workers are vital for global elimination efforts. Int J Infect Dis 2017; 66:14-21. [PMID: 29128644 DOI: 10.1016/j.ijid.2017.10.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Schistosomiasis control is centred on preventive chemotherapy through mass drug administration (MDA). However, endemic countries continue to struggle to attain target coverage rates and patient compliance. In the Philippines, barangay health workers (BHWs) play a vital role in the coordination of MDA, acting as advocates, implementers, and educators. The aim of this study was to determine whether BHW knowledge and attitudes towards schistosomiasis and MDA is sufficient and correlated with resident knowledge and drug compliance. METHODS A cross-sectional survey was conducted in 2015 among 2186 residents and 224 BHWs in the province of Northern Samar, the Philippines using a structured survey questionnaire. RESULTS BHWs showed good familiarity on how schistosomiasis is acquired and diagnosed. Nevertheless, both BHWs and residents had poor awareness of the signs and symptoms of schistosomiasis, disease prevention, and treatment options. There was no correlation between the knowledge scores of the BHWs and the residents (r=0.080, p=0.722). Kruskal-Wallis analysis revealed significant differences in BHW knowledge scores between the low (3.29, 95% confidence interval 3.16-3.36), moderate (3.61, 95% confidence interval 3.49-3.69), and high (4.05, 95% confidence interval 3.77-4.13) compliance village groups (p=0.002), with the high compliance areas having the highest mean knowledge scores. CONCLUSIONS This study highlights the importance of community health workers in obtaining the World Health Organization drug coverage rate of 75% and improving compliance with MDA in the community. Investing in the education of community health workers with appropriate disease-specific training is crucial if disease elimination is ultimately to be achieved.
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48
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Gordon CA, Kurscheid J, Jones MK, Gray DJ, McManus DP. Soil-Transmitted Helminths in Tropical Australia and Asia. Trop Med Infect Dis 2017; 2:E56. [PMID: 30270913 PMCID: PMC6082059 DOI: 10.3390/tropicalmed2040056] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 12/21/2022] Open
Abstract
Soil-transmitted helminths (STH) infect 2 billion people worldwide including significant numbers in South-East Asia (SEA). In Australia, STH are of less concern; however, indigenous communities are endemic for STH, including Strongyloides stercoralis, as well as for serious clinical infections due to other helminths such as Toxocara spp. The zoonotic hookworm Ancylostoma ceylanicum is also present in Australia and SEA, and may contribute to human infections particularly among pet owners. High human immigration rates to Australia from SEA, which is highly endemic for STH Strongyloides and Toxocara, has resulted in a high prevalence of these helminthic infections in immigrant communities, particularly since such individuals are not screened for worm infections upon entry. In this review, we consider the current state of STH infections in Australia and SEA.
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Affiliation(s)
- Catherine A Gordon
- QIMR Berghofer Medical Research Institute, Molecular Parasitology Laboratory, Queensland 4006, Australia.
| | - Johanna Kurscheid
- Australian National University, Department of Global Health, Research School of Population Health, Australian Capital Territory 2601, Australia.
| | - Malcolm K Jones
- School of Veterinary Science, University of Queensland, Brisbane, QLD 4067, Australia.
| | - Darren J Gray
- Australian National University, Department of Global Health, Research School of Population Health, Australian Capital Territory 2601, Australia.
| | - Donald P McManus
- QIMR Berghofer Medical Research Institute, Molecular Parasitology Laboratory, Queensland 4006, Australia.
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49
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Liwanag HJ, Uy J, Bataller R, Gatchalian JR, De La Calzada B, Uy JA, Dayrit M. Soil-Transmitted Helminthiasis and Schistosomiasis in Children of Poor Families in Leyte, Philippines: Lessons for Disease Prevention and Control. J Trop Pediatr 2017; 63:335-345. [PMID: 28115576 DOI: 10.1093/tropej/fmw078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Neglected tropical diseases (NTDs) continue to be a public health problem in the Philippines. We assessed the association of soil-transmitted helminthiasis (STH) and schistosomiasis with selected health-related and socioeconomic variables in four villages in Leyte, Philippines. METHODS Stool specimens from 418 adults and 533 of their children from 209 families were examined through the Kato-Katz technique. RESULTS STH and schistosomiasis were present in 64.6% and 12.5%, respectively, of study participants. Analysis through the generalized linear mixed model revealed a number of associations between infection in parents and their children. Findings indicate that years of disease prevention and control efforts in these areas have been unable to bring down prevalence in children and their parents. Eliminating NTDs as public health problems will require a systems thinking approach beyond implementation of vertical control programs alone.
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Affiliation(s)
- Harvy Joy Liwanag
- Ateneo Center for Health Evidence, Action, and Leadership (A-HEALS), Ateneo de Manila University, Ortigas Campus, 1605 Pasig City, Metro Manila, Philippines.,Ateneo School of Medicine and Public Health, Ateneo de Manila University, Ortigas Campus, 1605 Pasig City, Metro Manila, Philippines
| | - Jhanna Uy
- Ateneo Center for Health Evidence, Action, and Leadership (A-HEALS), Ateneo de Manila University, Ortigas Campus, 1605 Pasig City, Metro Manila, Philippines
| | - Ramil Bataller
- Department of Mathematics, School of Science and Engineering, Ateneo de Manila University, Loyola Heights Campus, 1108 Quezon City, Metro Manila, Philippines
| | - Janis Ruth Gatchalian
- Ateneo Center for Health Evidence, Action, and Leadership (A-HEALS), Ateneo de Manila University, Ortigas Campus, 1605 Pasig City, Metro Manila, Philippines
| | - Betty De La Calzada
- Schistosomiasis Research and Training Center, Department of Health Regional Office 8, 6501 Palo, Leyte, Philippines
| | - Justine Alessandra Uy
- Department of Pathology and Laboratory Medicine, The Medical City, Ortigas Avenue, 1605 Pasig City, Metro Manila, Philippines
| | - Manuel Dayrit
- Ateneo Center for Health Evidence, Action, and Leadership (A-HEALS), Ateneo de Manila University, Ortigas Campus, 1605 Pasig City, Metro Manila, Philippines.,Ateneo School of Medicine and Public Health, Ateneo de Manila University, Ortigas Campus, 1605 Pasig City, Metro Manila, Philippines
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50
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Weerakoon KG, Gordon CA, Williams GM, Cai P, Gobert GN, Olveda RM, Ross AG, Olveda DU, McManus DP. Droplet Digital PCR Diagnosis of Human Schistosomiasis: Parasite Cell-Free DNA Detection in Diverse Clinical Samples. J Infect Dis 2017; 216:1611-1622. [DOI: 10.1093/infdis/jix521] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/22/2017] [Indexed: 11/12/2022] Open
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