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Hong ST. Review of Recent Prevalence of Urogenital Schistosomiasis in Sub-Saharan Africa and Diagnostic Challenges in the Field Setting. Life (Basel) 2023; 13:1670. [PMID: 37629527 PMCID: PMC10456001 DOI: 10.3390/life13081670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Human schistosomiasis is one of neglected tropical diseases that remain highly prevalent in sub-Saharan Africa (SSA). Human schistosomiasis is mainly caused by two species, Schistosoma haematobium and S. mansoni, leading to urogenital and intestinal schistosomiasis, respectively. The World Health Organization (WHO) recommends mass drug administration (MDA) with praziquantel as the primary method of global intervention. Currently, MDA with praziquantel covers over half of the target population in endemic SSA countries. However, an accurate diagnosis is crucial for monitoring and evaluating the effectiveness of MDA. The standard diagnosis of both urogenital and intestinal schistosomiasis relies on the microscopic identification of eggs. However, the diagnostic sensitivity of this approach is low, especially for light or ultra-light infections. This is because Schistosoma eggs are laid inside of the venous plexus of the urinary bladder or mesenteric vein, where the adult flukes live. Approximately half of the eggs circulate in the blood vessels or are packed in neighboring tissues, while the remaining half are expelled into the lumen of the urinary bladder or intestine intermittently when the blood vessels are ruptured. In the field setting, the accuracy of any diagnostic method is critical for proper management of the intervention. The present article reviews the recent prevalence of urogenital schistosomiasis in SSA and highlights the practical limitations of diagnostic methods such as urine microscopy, urine reagent strips, molecular diagnosis, and ultrasound scanning in the field setting. Despite continuous global efforts to eliminate schistosomiasis over the past 20 years, many areas still remain endemic in SSA. No single diagnostic approach achieves acceptable sensitivity and specificity in the field setting. Therefore, any field survey should employ a combination of these methods based on the purpose of the study to accurately monitor and evaluate urogenital schistosomiasis. Based on diagnostic values and a cost-benefit analysis, a urine reagent strip test can replace urine microscopy in the field setting. The WHO criteria by ultrasound diagnosis should be updated including the echogenic snow sign and contour distortion.
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Affiliation(s)
- Sung-Tae Hong
- Graduate School of International Development, Handong Global University, Pohang 37554, Republic of Korea;
- Department of Tropical Medicine and Parasitology, Institute of Endemic Diseases Medical Research Center, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
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Sow D, Sylla K, Dieng NM, Senghor B, Gaye PM, Fall CB, Goumballa N, Diallo A, Ndiaye JLA, Parola P, Sokhna C, Doucouré S, Faye B. Molecular diagnosis of urogenital schistosomiasis in pre-school children, school-aged children and women of reproductive age at community level in central Senegal. Parasit Vectors 2023; 16:43. [PMID: 36717835 PMCID: PMC9887789 DOI: 10.1186/s13071-023-05671-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Urogenital schistosomiasis is a major public health concern in sub-Saharan Africa. In Senegal, the disease is endemic in all regions of the country. Recently, WHO strongly recommended including pre-school children and women of reproductive age during a mass drug administration campaign. It is important to describe the burden of the disease in these group at risk using innovative diagnostic tools. This study aimed to assess the use of real-time PCR in the detection of schistosomiasis cases at the community level in a seasonal transmission area. METHODS A cross-sectional survey was carried out in Niakhar located in the centre of Senegal. Pre-schoolchildren, school-aged children and female adolescents and adults were invited to participate in the study in April 2018. Urine samples were collected and examined using Hemastix reagent strips, filtration technique and real-time PCR. Schistosoma haematobium was detected, identified by targeting the Dra1 gene. The prevalence of urogenital schistosomiasis was determined for each group and the performance of the real-time PCR was compared with the conventional techniques. RESULTS A total of 428 participants were enrolled in this study including 87 (20.4%) pre-school children (1-5 years), 262 (61.3%) school-aged children between (5-14 years), 17 (3.9%) adolescents (15-17 years) and 62 (14.4%) female adults. The comparison of the diagnostic techniques has shown that the prevalence of urogenital schistosomiasis is higher using molecular technique (34.6%) compared to microscopy (20.3%). The percentage rate of haematuria using Hemastix was 23.1%. School-aged children between 5 and 14 years old were the most affected with 29.0% and 43.1% under microscopy and RT-PCR, respectively. In female participants, microscopic prevalence decreases with age, from 21.4% in school-aged children to 17.6% in adolescents and 9.7% in adults. There was good correlation between the number of eggs per 10 ml and the cycle threshold range. CONCLUSION These results show the importance of using molecular tools in the surveillance of schistosomiasis particularly in pre-school children and women of reproductive age.
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Affiliation(s)
- Doudou Sow
- grid.442784.90000 0001 2295 6052Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Gaston Berger, Saint-Louis, Sénégal
| | - Khadime Sylla
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Ndeye Marème Dieng
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Bruno Senghor
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Papa Mouhamadou Gaye
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Cheikh B. Fall
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Ndiaw Goumballa
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Aldiouma Diallo
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Jean Louis A. Ndiaye
- Service de Parasitologie-Mycologie, UFR Sciences de la Santé, Université Iba Der Thiam, Thies, Sénégal
| | - Philippe Parola
- Unité VITROME, IHU Méditérannée Infection, Marseille, France
| | - Cheikh Sokhna
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Souleymane Doucouré
- grid.418291.70000 0004 0456 337XUnité VITROME Dakar, Institut de Recherche pour le Développement, Dakar, Sénégal
| | - Babacar Faye
- grid.8191.10000 0001 2186 9619Service de Parasitologie-Mycologie, FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
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Cando LFT, Perias GAS, Tantengco OAG, Dispo MD, Ceriales JA, Girasol MJG, Leonardo LR, Tabios IKB. The Global Prevalence of Schistosoma mansoni, S. japonicum, and S. haematobium in Pregnant Women: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2022; 7:354. [PMID: 36355896 PMCID: PMC9693339 DOI: 10.3390/tropicalmed7110354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 10/10/2023] Open
Abstract
Schistosomiasis is a neglected tropical disease affecting 40 million women of childbearing age worldwide. Its global disease prevalence among pregnant women is still unknown. This meta-analysis determined the pooled prevalence of schistosomiasis among pregnant women globally. Additionally, this study also determined the pooled prevalence based on infection intensity based on eggs per gram. Observational studies on the prevalence of schistosomiasis among pregnant patients were obtained from Medline, Scopus, and CINAHL from January 2001 until August 2020. A review of titles and abstracts was done independently by six reviewers. The quality of the included studies was assessed using the Newcastle-Ottawa Scale for case-control, cohort, and cross-sectional studies. A total of 27 studies were included in the meta-analysis and meta-regression. The pooled prevalence of S. haematobium was 13.44 (CI: 8.90-19.80) per 100 observations, while the pooled prevalence of S. mansoni was 12.18 (CI: 4.47-29.12) per 100 observations. The prevalence of S. japonicum infection in one study was 53.54 (CI: 43.23-63.62) per 100 observations. Our results showed a prevailing health problem of schistosomiasis during pregnancy in various countries worldwide. This strengthens the need to conduct more schistosomiasis research, prevention, and control programs in pregnant women.
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Affiliation(s)
- Leslie Faye T. Cando
- College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | | | | | - Micah D. Dispo
- Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila, Manila 1000, Philippines
| | - Jeremy A. Ceriales
- College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Mark John G. Girasol
- College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Lydia R. Leonardo
- Office of Research Coordination, University of the East, Manila 1008, Philippines
- Institute of Biology, College of Science, University of the Philippines Diliman, Manila 1101, Philippines
| | - Ian Kim B. Tabios
- Institute of Biology, College of Science, University of the Philippines Diliman, Manila 1101, Philippines
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines
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