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Wiegand RE, Odiere MR, Kinung’hi S, N'Goran EK, Mwinzi P, Secor WE. Age-group associations of schistosomiasis prevalence from trial data, Côte d'Ivoire, Kenya and the United Republic of Tanzania. Bull World Health Organ 2024; 102:265-275. [PMID: 38562204 PMCID: PMC10976868 DOI: 10.2471/blt.23.289843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/11/2023] [Accepted: 01/16/2024] [Indexed: 04/04/2024] Open
Abstract
Objective To determine if the prevalence of schistosomiasis in children aged 9-12 years is associated with the prevalence in 5-8-year-olds and adults after preventive chemotherapy in schools or the community. Methods We combined data from four community-randomized, preventive chemotherapy trials in treatment-naïve populations in Côte d'Ivoire, Kenya and the United Republic of Tanzania during 2010-2016 according to the number of praziquantel treatments and the delivery method. Schistosoma mansoni infection was sought on two slides prepared from each participant's first stool using the Kato-Katz technique. We assessed associations between S. mansoni prevalence in 9-12-year-olds and 5-8-year-olds and adults in the community before and after treatment using Bayesian regression models. Findings Stool samples from 47 985 5-8-year-olds, 81 077 9-12-year-olds and 20 492 adults were analysed. We found associations between the prevalence in 9-12-year-olds and that in 5-8-year-olds and adults after preventive treatment, even when only school-age children were treated. When the prevalence in 9-12-year-olds was under 10%, the prevalence in 5-8-year-olds was consistently under 10%. When the prevalence in 9-12-year-olds was under 50%, the prevalence in adults after two or four rounds of preventive chemotherapy was 10%-15% lower than before chemotherapy. Post-chemotherapy age-group associations were consistent with pre-chemotherapy associations in this analysis and previous studies. Conclusion The prevalence of S. mansoni infection in 9-12-year-olds was associated with the prevalence in other age groups and could be used to guide community treatment decisions.
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Affiliation(s)
- Ryan E Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS H24-5, Atlanta, Georgia, GA30329, United States of America
| | - Maurice R Odiere
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Safari Kinung’hi
- National Institute for Medical Research, Mwanza Centre, Mwanza, United Republic of Tanzania
| | | | - Pauline Mwinzi
- Expanded Special Programme for Elimination of Neglected Tropical Diseases, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - W Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS H24-5, Atlanta, Georgia, GA30329, United States of America
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Goyal S, Gerardin J, Cobey S, Son C, McCarthy O, Dror A, Lightner S, Ezike NO, Duffus WA, Bennett AC. SARS-CoV-2 Infection Among Pregnant People at Labor and Delivery and Changes in Infection Rates in the General Population: Lessons Learned From Illinois. Public Health Rep 2022; 137:672-678. [PMID: 35510756 PMCID: PMC9257515 DOI: 10.1177/00333549221091826] [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] [Indexed: 12/15/2022] Open
Abstract
Objectives: The Illinois Department of Public Health (IDPH) assessed whether increases in the SARS-CoV-2 test positivity rate among pregnant people at labor and delivery (L&D) could signal increases in SARS-CoV-2 prevalence in the general Illinois population earlier than current state metrics. Materials and Methods: Twenty-six birthing hospitals universally testing for SARS-CoV-2 at L&D voluntarily submitted data from June 21, 2020 through January 23, 2021, to IDPH. Hospitals reported the daily number of people who delivered, SARS-CoV-2 tests, and test results as well as symptom status. We compared the test positivity rate at L&D with the test positivity rate of the general population and the number of hospital admissions for COVID-19–like illness by quantifying correlations in trends and identifying a lead time. Results: Of 26 633 reported pregnant people who delivered, 96.8% (n = 25 772) were tested for SARS-CoV-2. The overall test positivity rate was 2.4% (n = 615); 77.7% (n = 478) were asymptomatic. In Chicago, the only region with a sufficient sample size for analysis, the test positivity rate at L&D (peak of 5% on December 7, 2020) was lower and more stable than the test positivity rate of the general population (peak of 14% on November 13, 2020) and lagged hospital admissions for COVID-19–like illness (peak of 118 on November 15, 2020) and the test positivity rate of the general population by about 10 days (Pearson correlation = 0.73 and 0.75, respectively). Practice Implications: Trends in the test positivity rate at L&D did not provide an earlier signal of increases in Illinois’s SARS-CoV-2 prevalence than current state metrics did. Nonetheless, the role of universal testing protocols in identifying asymptomatic infection is important for clinical decision making and patient education about infection prevention and control.
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Affiliation(s)
- Sonal Goyal
- Tribal, Local and Territorial Support Task Force, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Illinois Department of Public Health, Chicago, IL, USA
| | - Jaline Gerardin
- Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, IL, USA
| | - Sarah Cobey
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | - Crystal Son
- Healthcare Analytics, Civis Analytics, Chicago, IL, USA
| | - Owen McCarthy
- Healthcare Analytics, Civis Analytics, Chicago, IL, USA
| | - Arielle Dror
- Healthcare Analytics, Civis Analytics, Chicago, IL, USA
| | - Shannon Lightner
- Office of Women's Health and Family Services, Illinois Department of Public Health, Chicago, IL, USA
| | - Ngozi O Ezike
- Illinois Department of Public Health, Chicago, IL, USA
| | - Wayne A Duffus
- Tribal, Local and Territorial Support Task Force, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Illinois Department of Public Health, Chicago, IL, USA
| | - Amanda C Bennett
- Office of Women's Health and Family Services, Illinois Department of Public Health, Chicago, IL, USA.,Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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