Prevalence of Schistosoma mansoni infection and the therapeutic efficacy of praziquantel among school children in Manna District, Jimma Zone, southwest Ethiopia

Praziquantel efficacy, urinary and intestinal schistosomiasis reinfection - a systematic review

Praziquantel (PZQ) has been extensively used as the drug of choice for the treatment of schistosomiasis on account of its safety and effectiveness against all major forms of schistosomiasis. However, low cure rate, reduced susceptibility of Schistosoma mansoni to PZQ and treatment failures in S. haematobium infections have been reported, raising concerns about its efficacy. Using the search terms, 'praziquantel efficacy, schistosomiasis, school children, reinfection' as well as defined inclusion criteria, and guided by the PRISMA guidelines, articles from 2001 to 2022 were selected from the PubMed and Google Scholar databases and reviewed to assess their importance to the research question. This review assessed the efficacy of PZQ against schistosomiasis and reinfection rates following treatment of Schistosoma infections in children. Majority of both intestinal and urinary schistosomiasis studies reported comparable egg reduction rates (ERRs) of 94.2% to 99.9% and 91.9% to 98%, respectively. However, ERRs suggestive of sub-optimal PZQ efficacy as well as generally high and comparable cure rates for intestinal (81.2%-99.1%) and urinary (79%-93.7%) schistosomiasis studies were reported. Schistosomiasis reinfection rates varied widely for urinary (8.1%-39.6%) and intestinal (13.9%-63.4%) studies within eight to 28 weeks following PZQ treatment. Praziquantel treatment of urinary and intestinal schistosomiasis should be accompanied by the provision of potable water, toilet, and recreational facilities to reduce reinfection and egg reduction rates and increase cure rate to expedite schistosomiasis elimination.

Schistosoma mansoni Epidemiology Among Snails, Rodents and Children: A One Health Approach

Background

Schistosoma is one of the prevalent parasitic infection in humans and animals. Schistosomiasis in children is particularly serious and results in liver and spleen enlargement, anemia, stunting, reduced ability to learn and death. The aim of this study was to measure the prevalence and distribution of schistosomiasis in children, rodents and snail populations in Aleffa and Takusa districts, north-west Ethiopia.

Methods

Disease status and exposure were simultaneously measured from December 2020 to December 2021. School children's stool specimens were collected for schistosomiasis examination by Kato Katz and formal-ether techniques. Live rodents and snails were trapped and collected in search of adult schistosoma, eggs, and cercariae, respectively. Multiple logistic regression analytic technique by using SPSS version 20 was conducted.

Results

Of 460 stool specimens examined, 116 (25.22) were found positive for S. mansoni infection. In the present finding, the possible determinants for the occurrence of intestinal schistosomiasis in school children were female sex (AOR = 1.09, 95% CI: 1.37–2.96); working with bare foot (AOR = 1.21, 95% CI: 1.08–1.52); skin cut/abrasion history (AOR = 3.6, 95% CI: 1.08–7.43) and swimming habit (AOR = 1.58, 95% CI: 1.33–1.99). The overall (n = 108) rodent prevalence of S. mansoniwas 23 (21.3%). Only 6 snails were shedding the infective stage of schistosoma cercariae.

Conclusion

The study revealed that there is a moderate prevalence of schistosomiasis in different hosts. Thus, multi-host intervention is crucial to achieving the goal of interrupting transmission of schistosomiasis in the study area. Further research to better understand and exploit the broader environmental, ecological context and encompassing dynamic interactions between all hosts over time will be crucial for building predictive models beyond the known fact of having or not having reservoirs/hybridization of schistosoma in our study area.

Efficacy of Praziquantel Treatment and Schistosoma Mansoni Infection among Primary School Children in Kemisse Town, Northeast Ethiopia

Background

Schistosoma mansoni infection is endemic in Ethiopia. The epidemiology of S. mansoni and the efficacy of praziquantel among schoolchildren have not been well documented in different parts of the country including our study area. Therefore, this study aimed to determine the status of S. mansoni infection and evaluate the therapeutic efficacy of praziquantel among school children in northeast Ethiopia.

Methods

A comparative cross-sectional study was conducted among 499 children of two preschool children. Stool specimens were collected and microscopically examined using Kato-Katz (41.7 gram) methods. Positive children were treated with a single oral dose of praziquantel at 40 mg/kg body weight. Egg reduction and cure rates were assessed 4 weeks post-treatment to evaluate the therapeutic efficacy of praziquantel against S. mansoni infection.

Results

The overall prevalence of S. mansoni infection among the schoolchildren was 52.1% with a mean intensity of 546 eggs per gram of stool. Majorities of the S. mansoni infections were moderate to heavy intensity, with only 5.0% light infections. Praziquantel administered at a single oral dose of 40 mg/kg achieved a cure rate of 91.7% and reduced the egg rate by 86.8%. Twenty-one schoolchildren remained infected at 4 weeks post-treatment, among which 6 and 15 children had moderate and light infections, respectively.

Conclusions

S. mansoni prevalence among primary school children in Northeast Ethiopia was high, highlighting the need to implement school-based chemotherapy with annual frequency. The efficacy of praziquantel at 40 mg/kg is sufficient to permit continued use in treating S. mansoni-infected schoolchildren.

Performance of loop-mediated isothermal amplification (LAMP) for detection of Schistosoma mansoni infection compared with Kato–Katz and real-time PCR

The performance of loop-mediated isothermal amplification (LAMP) for detection of Schistosoma mansoni DNA from stool and urine samples in comparison with Kato–Katz and real-time polymerase chain reaction (PCR) was studied. After obtaining informed consent, 50 children participated in the present study and agreed to submit stool and urine samples. Stool samples were examined by Kato–Katz. Both real-time PCR and LAMP techniques were applied on stool and urine samples. The overall prevalence of S. mansoni was 46% in stool and urine samples as detected by the employed techniques, and 90% of cases had light infection intensity. The highest percentage of infection was diagnosed by real-time PCR (44%), followed by Kato–Katz (42%) and LAMP in the stool (36%), while the lowest percentages of infection were diagnosed by real-time PCR and LAMP in urine samples (24% and 14%, respectively). Kato–Katz, real-time PCR and LAMP showed 100% specificity where the sensitivity was 91.3%, 95.7% and 78.3%, respectively, in stool samples. Real-time PCR and LAMP showed lower sensitivity in urine samples. The LAMP assay is a promising technique for S. mansoni diagnosis in endemic countries of moderate and high-intensity infection. Yet, it needs further optimization, particularly in urine samples.

Prevalence of soil-transmitted helminths infections among preschool and school-age children in Ethiopia: a systematic review and meta-analysis

BACKGROUND

There is a lack of comprehensive national data on prevalence, geographical distribution of different species, and temporal trends in soil-helminthiasis (STHs). Therefore, this study aimed to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia.

METHODS

The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar on data published between 1997 to February 2020 for studies describing the rate of STHs infection among preschool and school-age in Ethiopian. We followed the Patient, Intervention, Comparison, and Outcome (PICO) approach to identify the studies. Meta-regression was performed to understand the trends and to summarize the prevalence using the "metaprop" command using STATA software version 14.0 RESULTS: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48% (95% CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95% CI: 31-58%) in SNNPR, 34% (95% CI: 28-41%) in Amhara region, 31% (95% CI: 19-43%) in Oromia region and 10% (95% CI: 7-12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI: 30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI: 25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A lumbricoides was the predominant species with a prevalence of 17%.

CONCLUSION

Southern Nations Nationalities and Peoples Region, Amhara, and Oromia regions carry the highest-burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring MDA once annually with Albendazole or Mebendazole. The prevalence of STHs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia. The high prevalence of STHs observed in this review, underscores the need for better control and prevention strategies in Ethiopia.

Prevalence, intensity and endemicity of intestinal schistosomiasis and soil-transmitted helminthiasis and its associated factors among school-aged children in Southern Ethiopia

Preventive chemotherapy (PC), the main strategy recommended by the World Health Organization to eliminate soil-transmitted helminthiasis (STH) and schistosomiasis (SCH), should be strengthened through identification of the remaining SCH transmission foci and evaluating its impact to get a lesson. This study was aimed to assess the prevalence of STH/SCH infections, the intensity of infections, and factors associated with STH infection among school-aged children (SAC) in Uba Debretsehay and Dara Mallo districts (previously not known to be endemic for SCH) in southern Ethiopia, October to December 2019. Structured interview questionnaire was used to collect household data, anthropometric measurements were taken and stool samples collected from 2079 children were diagnosed using the Kato-Katz technique. Generalize mixed-effects logistic regression models were used to assess the association of STH infections with potential predictors. A P-value less than 0.05 was considered statistically significant. The prevalence of Schistosoma mansoni in the Dara Mallo district was 34.3% (95%CI 30.9–37.9%). Light, moderate, and heavy S. mansoni infections were 15.2%, 10.9%, and 8.2% respectively. The overall prevalence of any STH infection was 33.2% with a 95% confidence interval (CI) of 31.1–35.3%. The intensity of infections was light (20.9%, 11.3% & 5.3%), moderate (1.1%, 0.1% & 0.4%) and heavy (0.3%, 0% & 0%) for hookworm, whipworm and roundworms respectively. The overall moderate-to-heavy intensity of infection among the total diagnosed children was 2% (41/2079). STH infection was higher among male SAC with Adjusted Odds Ratio (AOR) of 1.7 (95%CI 1.4–2.1); occupation of the household head other than farmer or housewife (AOR = 0.5; 95%CI 0.3–0.8), middle [AOR = 1.1; 95%CI 1.0–1.3] or high [AOR = 0.7; 95%CI 0.5–0.9] socioeconomic status. Dara Mallo district was moderate endemic for S. mansoni; and it needs sub-district level mapping and initiating a deworming campaign. Both districts remained moderate endemic for STH. Evidence-based strategies supplementing existing interventions with the main focus of the identified factors is important to realize the set targets.

Prevalence of Schistosoma mono- and co-infections with multiple common parasites and associated risk factors and morbidity profile among adults in the Taabo health and demographic surveillance system, South-Central Côte d'Ivoire

Background

Schistosomiasis remains an important public health problem, also among adults, and infected individuals not treated serve as a reservoir for continued transmission. Despite this fact, evidence on the epidemiology of schistosomiasis in adults in Côte d’Ivoire is scanty. This study aimed to determine the prevalence and risk factors of Schistosoma infection and co-infection with other helminth species and Plasmodium among adults in the Taabo region in the south-central part of Côte d’Ivoire.

Methods

A cross-sectional survey was carried out in April and May 2017 in the frame of the “Côte d’Ivoire Dual Burden of Disease Study” (CoDuBu). A total of 901 randomly selected individuals, aged 18–90 years, provided blood, stool and urine samples for the diagnosis of malaria and helminth infections. Stool samples were subjected to the Kato-Katz technique for detection of Schistosoma mansoni and soil-transmitted helminth eggs, while urine samples were examined for eggs of Schistosoma haematobium and circulating cathodic antigen of S. mansoni. Risk factors and morbidity profiles were assessed using health examination and questionnaires. Multinomial logistic regressions were employed to identify risk factors and morbidity patterns associated with S. mansoni mono- and co-infections.

Results

The prevalence of S. mansoni and S. haematobium was 23.2% and 1.0%, respectively. Most S. mansoni were mono-infections (81.3%). Independent determinants of S. mansoni infection were young age, low socioeconomic status (mono- and co-infection) and poor hygiene practices (co-infection) (P < 0.05). S. mansoni infection was independently associated with higher pain and symptom scores (mono-infection), poor self-rated health and low healthcare use (co-infection) (P < 0.05).

Conclusions

This study showed that adults represent a substantial reservoir of S. mansoni. To sustain schistosomiasis control and improve people’s wellbeing, it is important to expand preventive chemotherapy from school-aged children to adults, coupled with hygiene and health education.

Efficacy of Praziquantel for the Treatment of Human Schistosomiasis in Ethiopia: A Systematic Review and Meta-Analysis

Background

Schistosomiasis is one of the neglected tropical diseases causing a serious human health problem in Ethiopia. Praziquantel is the only drug that has been used for the treatment of human schistosomiasis in the country. In line with this, the efficacy of praziquantel has been evaluated in a few interventional studies in the country, but there is a lack in systematically gathered and analyzed information for policymakers. The aim of this systematic review and meta-analysis was to provide a summary of the efficacy of praziquantel for the treatment of human schistosomiasis in Ethiopia.

Methods

We conducted a literature search from ScienceDirect, PubMed/Medlin, and Google Scholar databases. A total of 140 articles published in English from 1980 to June 2021 were accessed and 15 of them were eligible for this meta-analysis. The meta-analysis was conducted using Stata 14 software, "metan command." The heterogeneities among studies were evaluated using I ² test.

Results

A total of 140 articles were reviewed, but only 15 of them fulfilled the inclusion criteria. The polled cure rate of 40 mg/kg praziquantel was 89.2% (95% CI: 85.4-93.1) and 93.6% (95% CI: 80.6-106) among Schistosoma mansoni and S. haematobium, respectively. Similarly, the mean egg reduction rates of 40 mg/kg praziquantel were 90.2% and 85% among S. mansoni and S. haematobium infected subjects, respectively. The common adverse events observed after receiving praziquantel include abdominal pain, vomiting, headache, diarrhea, and bloody stool.

Conclusion

This systematic review and meta-analysis has indicated that praziquantel is still an appropriate drug for the treatment of human schistosomiasis in Ethiopia.

Does the presence of praziquantel-related adverse events affect the health community's perception toward the mass chemopreventive program in the highest prevalence area of Schistosomiasis in Indonesia? Study in Dodolo village, Napu Valley, Central Sulawesi

OBJECTIVE

This study was to determine the relationship between a praziquantel-related adverse event with the health community perception to chemopreventive of Schistosomiasis in Dodolo village, Napu Valley, Central Sulawesi.

METHODS

A cross-sectional study was conducted among the 79 residents of Dodolo village, who following praziquantel-mass drug administration. A-questionnaire was used to collect demographic information of the subject who participated in the study, the presence of treatment-related symptoms, and community perception. The health perception was based on the health belief model (HBM) framework. Data were analyzed using Chi-square.

RESULT

The incidence of praziquantel-related adverse events was 92% (73), with the highest frequency were nausea (69%), vomit (57%), and headache (47%). The total number of treatments related to symptoms was significantly correlated with age (p 0.030). 78% (62) of participants had a supportive perceived susceptibility, 71% (56) participants had a supportive perceived severity, 63% (50) participants had supportive perceived benefits, meanwhile 58% (46) had a not supportive perceived barrier to praziquantel mass drug administration. The presence of praziquantel-related adverse events was significantly correlated with a perceived barrier of the participant to the chemopreventive program.

CONCLUSION

The Dodolo community had a supportive health perception for the success of the Schistosomiasis elimination program, despite the high frequency of adverse events after praziquantel consumption.

Prevalence of Schistosoma mansoni infection among children in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia. Schistosoma mansoni is a major public health problem in Ethiopia especially among children. This review is aimed to indicate the prevalence of Schistosoma mansoni among children at the national and regional levels.

METHODS AND MATERIAL

The PRISMA guidelines were followed. An electronic search of PubMed, Google Scholar, Web of Science, Scopus, MEDLINE, and Google search were carried out using key terms. Articles published from the proceeding of professional associations such as the Ethiopian medical laboratory association, the Ethiopian public health association, and annual national research conferences were also searched to find additional eligible studies. Data were extracted independently by two investigators, and cross-checked by a third reviewer. The quality of included studies was assessed using JBI quality assessment criteria. Data were extracted using Microsoft excel and finally analyzed using STATA version 12. The pooled prevalence was done using a random-effects model.

RESULT

Overall 49 studies involving 20,493 children (10,572 male and 9, 921 females) were included in this meta-analysis. The pooled prevalence of Schistosoma mansoni infection was 37.13% (95%CI:30.02-44.24). High heterogeneity was observed with I2 of 99.4%, P < 0.000. According to subgroup analysis, the pooled prevalence was high in the SNNPR (41.49%: 95%CI: 19.52-63.46) followed by the Amhara region (41.11%: 95%CI: 30.41-51.8), the Tigray region (31.40%: 95%CI:11.72-51.09), and the Oromia region (28.98%: 95%CI: 18.85-39.1). Year from 2011 to 2015 contributed to the highest prevalence of Schistosoma mansoni infection among children (46.31%: 95%:34.21-59.05).

CONCLUSION

This study revealed a 37.13% prevalence of Schistosoma mansoni infection among children. This is an alert to improve and implement appropriate control strategies such as mass drug administration in Ethiopia.

Prevalence, intensity and associated risk factors of Schistosoma mansoni infections among schoolchildren around Lake Tana, northwestern Ethiopia

BACKGROUND

Schistosomiasis is one of the widely distributed neglected tropical diseases. It is a serious public health problem in sub-Saharan Africa. The disease is highly prevalent and widely distributed in Ethiopia due to suitable environmental factors and human activities. The prevalence and infection intensity varied from locality to locality in the country. This study aimed to assess the prevalence and intensity of S. mansoni infection and associated risk factors among schoolchildren around Lake Tana.

METHODS

A school-based cross-sectional study was conducted among 710 schoolchildren from February to April 2021 in eight selected primary schools around Lake Tana. A questionnaire was used to collect data on socio-demographic information and potential risk factors of S. mansoni infection. After collecting socio-demographic information, students were requested to bring about 2grams of stool specimens for parasitological examination. The collected stool samples were processed using a single Kato-Katz and Ritchie's concentration techniques. The data were analyzed using SPSS software version 23 and factors with a p-value < 0.05 were considered as statistically significant.

RESULTS

The overall prevalence of S. mansoni was 34.9% (95% CI: 31.4-38.7) among schoolchildren in the study area. The eggs per gram (EPG) of stool ranged from 24 to 1659 with arithmetic and geometric mean values of 138.1 EPG and 85.1 EPG, respectively. The majority of S. mansoni infections (61.4%) were classified as low infection intensity. Among the different determinant factors being male (AOR = 1.74; 95%CI = 1.233-2.457; P-value = 0.002), bathing habits (AOR = 1.494; 95%CI = 1.013-2.199; P-value = 0.043) and students attending at Qunzela primary school (AOR = 10.545; 95%CI = 3.264-34.067; P-value = 0.001), Alabo primary school (AOR = 3.386; 95%CI = 1.084-10.572; P-value = 0.036) were significantly associated with S. mansoni infection.

CONCLUSION

This study revealed that more than one-third of schoolchildren were infected by S. mansoni in the study area. The majority of the infections were classified as low infection intensity. Being male, bathing habits and schools in which students attended were independent explanatory factors for S. mansoni infection. Therefore, integrated control strategies are needed to improve the health conditions of schoolchildren in the study area.

Schistosomiasis with a Focus on Africa

Schistosomiasis is a common neglected tropical disease of impoverished people and livestock in many developing countries in tropical Africa, the Middle East, Asia, and Latin America. Substantial progress has been made in controlling schistosomiasis in some African countries, but the disease still prevails in most parts of sub-Saharan Africa with an estimated 800 million people at risk of infection. Current control strategies rely primarily on treatment with praziquantel, as no vaccine is available; however, treatment alone does not prevent reinfection. There has been emphasis on the use of integrated approaches in the control and elimination of the disease in recent years with the development of health infrastructure and health education. However, there is a need to evaluate the present status of African schistosomiasis, primarily caused by Schistosoma mansoni and S. haematobium, and the factors affecting the disease as the basis for developing more effective control and elimination strategies in the future. This review provides an historical perspective of schistosomiasis in Africa and discusses the current status of control efforts in those countries where the disease is endemic.

Prevalence and factors associated with intestinal schistosomiasis and human fascioliasis among school children in Amhara Regional State, Ethiopia

Background

Schistosomiasis and fascioliasis are digenean parasitic infections and are among the neglected tropical diseases that have both medical and veterinary importance. They are found mainly in areas having limited access to safe water supply and improved sanitation.

Methods

A cross-sectional study was conducted to determine the prevalence of Schistosoma mansoni and Fasciola species infections and to identify associated risk factors among school children in Amhara Regional State, Ethiopia. Stool specimens were collected from 798 children (419 males, 379 females) and processed using Kato-Katz and formol-ether concentration techniques. A semi-structured questionnaire was used to collect socio-demographic and other exposure information to explore potential risk factors for the infections.

Results

The overall prevalence of S. mansoni and Fasciola species infections was 25.6% (95% confidence interval (CI): 22.5-28.6) and 5.5% (95% CI: 3.9-7.1), respectively. S. mansoni was present in all surveyed schools with the prevalence ranging from 12.8% (16/125; 95% CI = 5.6-20.0) to 39.7% (64/161; 95% CI = 32.2-47.2) while Fasciola species was identified in five schools with the prevalence ranging from 2.5% (4/160; 95% CI = 0.001–4.9) to 9.8% (13/133; 95% CI = 4.7–14.8). The prevalence of S. mansoni infection was significantly associated with swimming in rivers (Adjusted odds ratio (AOR): 1.79, 95% CI, 1.22–2.62; P=0.003), bathing in open freshwater bodies (AOR, 2.02; 95% CI, 1.39–2.94; P<0.001) and engaging in irrigation activities (AOR, 1.69; 95% CI, 1.19-2.39; P=0.004), and was higher in children attending Addis Mender (AOR, 2.56; 95% CI, 1.20–5.46; P=0.015 ) and Harbu schools (AOR, 3.53; 95% CI, 1.64–7.59; P=0.001). Fasciola species infection was significantly associated with consumption of raw vegetables (AOR, 2.47; 95% CI, 1.23-4.97; P=0.011) and drinking water from unimproved sources (AOR, 2.28; 95% CI, 1.11–4.70; P=0.026).

Conclusion

Both intestinal schistosomiasis and human fascioliasis are prevalent in the study area, affecting school children. Behaviors and access to unimproved water and sanitation are among significant risk factors. The findings are instrumental for targeted interventions.

Prevalence of Schistosomiasis (S. mansoni and S. haematobium) and its association with gender of school age children in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Schistosomiasis (S. mansoni and S. haematobium) is an important neglected tropical disease in sub-Saharan Africa including Ethiopia. In Ethiopia, Schistosomiasis has been prioritized as neglected tropical disease and remained among major public health burden on school age children of the country. Few studies conducted on the association between prevalence of Schistosomiasis and gender of school age children have inconclusive finding about the association between these two variables. Therefore, this systematic review and meta-analysis was done to determine the pooled prevalence of Schistosomiasis and its association with gender of school age children in Ethiopia.

METHODS

In this systematic review and meta-analysis, databases such as: Medline/PubMed, EMBASE, CINAHL, Cochrane Central library, Google Scholar, and HINARI were systematically searched. STATA version 14 was used to estimate pooled prevalence of Schistosomiasis using random effects model with 95% confidence interval. The results were presented by using forest plot and statistical heterogeneity was checked by using the Cochran Q test (chi-squared statistic), I2 test statistic and by visual examination of the forest plot.

RESULTS

From the total of 427 studies identified for this review, 50 studies were included in the final analysis. The analysis noted that pooled prevalence of Schistosomiasis in Ethiopia was 28.78% (95% CI: 23.81, 33.74). The subgroup analysis indicated that extreme variability was observed in the prevalence of Schistosomiasis across the regions of the country. The highest (39.77%) prevalence of Schistosomiasis was reported from the southern region, whereas the lowest (14.95%) prevalence of Schistosomiasis was reported from Afar region. Male school age children were 58% more likely infected with Schistosomiasis than female school age children in Ethiopia (OR: 1.58, 95% CI: 1.33, 1.83).

CONCLUSIONS

The Prevalence of Schistosomiasis was higher than the 2018 report of the Ethiopian federal ministry of health. The prevalence of Schistosomiasis was predominant among male gender of the school age children. Therefore, sustainable control of Schistosomiasis requires the approaches that must go beyond current deworming program. Complementary prevention strategies including health education, safe water and adequate sanitary facilities provision should be simultaneously implemented. The underlining causes of variation in risk factors of Schistosomiasis among males and females should be further studied.

Prevalence of Schistosoma mansoni infection in Ethiopia: a systematic review and meta-analysis

Background

Schistosomiasis is a common helminthic infection in the tropics and subtropics, particularly in sub-Saharan African countries including Ethiopia. In these counties, Schistosoma mansoni infection is a significant public health problem due to the risk of reinfection and recurrent disease despite implementing several rounds preventive chemotherapy. This systematic review and meta-analysis aimed at assessing the pooled prevalence of schistosomiasis in Ethiopia.

Methods

The PRISMA guidelines were followed to perform the systematic review and meta-analysis. Published studies from January 1999 to June 2020 were searched in Medline, PubMed, Google Scholar, EMBASE, HINARI, and Cochrane Library using key words including: “prevalence”, “incidence”, “schistosomiasis” “Bilharziasis”, “Bilharzia”, “S. mansoni “, “Ethiopia”. Heterogeneity of included studies was assessed using Cochran’s Q test and I² test statistics while publication bias was assessed using Egger’s test.

Results

Ninety-four studies were included in the systematic review and meta-analysis. The pooled prevalence of S. mansoni in Ethiopia was 18.0% (95%CI: 14.0–23.0). The southern region of Ethiopia had a higher S. mansoni prevalence of 25.9% (995% CI, 14.9–41.1) than the national prevalence. The burden of S. mansoni infection was also higher than the national average in rural areas and among men with pooled prevalence of 20.2% (95% CI, 13.2–28.5) and 28.5% (95%CI, 22.7,35.1), respectively. The trend analysis showed that the prevalence of S. mansoni infection in Ethiopia decreased over the past 15 years, potentially because of the repeated preventive chemotherapy.

Conclusion

The review unveiled a moderate prevalence of S. mansoni infection in Ethiopia. Targeted treatment of at-risk population groups ad high burden areas coupled with implementation of integrated vector control strategies are critical to address the burden of Schistosomiasis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40794-020-00127-x.

Prevalence, Intensity, and Correlates of Schistosomiasis and Soil-Transmitted Helminth Infections after Five Rounds of Preventive Chemotherapy among School Children in Southern Ethiopia

Preventive chemotherapy (PC) is a WHO-recommended strategy to control and eliminate schistosomiasis and soil-transmitted helminths (STHs). We assessed the prevalence, intensity, and correlates of schistosomiasis and STH infection after five rounds of PC in southern Ethiopia. A total of 3162 school children from four schools in Wondo Gennet and Hawella Tula districts were screened for Schistosoma mansoni and STHs infection. The overall prevalence of S. mansoni infection was 25.8% (range between schools 11.6% to 54.1%), with light (19.1%), moderate (5.3%), and heavy (1.4%) infection intensities. A total of 61.6% S. mansoni-infected children were STH co-infected. The overall prevalence of STHs infection was 54.7% (range between schools 30.6-71.0%), with moderate-to-heavy intensity infections being 16.3%. Ascaris lumbricoides was the most prevalent 45% (95% CI, 43.5-47) followed by Trichuris trichiura 25.3% (95% CI, 23.8-26.9) and hookworm 6.1% (95% CI, 5.3-7). A total of 33.7% of STHs-infected children had A. lumbricoides and T. trichiura co-infections. S. mansoni infection was significantly associated with school and STHs co-infection (p < 0.001). STH infection was correlated with school and younger age (p < 0.001). Despite repeated PC, S. mansoni and STH infection remain significant health problems, and the WHO target to control schistosomiasis and eliminate STH by 2020 may not be achieved. Intensified control and prevention measures, including drug efficacy surveillance, is recommended.

Prevalence of Schistosoma mansoni Infection and Associated Risk Factors among School Children in Jiga Town, Northwest-Ethiopia: A Cross-Sectional Study

BACKGROUND

Schistosomiasis, one of the 20 Neglected Tropical Diseases, is a human disease which is caused by infection with Schistosoma spp. In Ethiopia, the intestinal form of schistosomiasis (caused by Schistosoma mansoni) is widely distributed. This study is aimed at assessing the prevalence of S. mansoni and associated risk factors among schoolchildren in Jiga town and its surrounding rural "Kebeles", Northwest Ethiopia (Kebele = the smallest administrative unit in Ethiopia).

METHODS

A cross-sectional study was carried out among children from three schools in Jiga town and its surrounding rural "Kebeles". The schools were selected mainly according to their proximity to water bodies that were likely to have been used by the children. A total of 362 randomly selected children were screened for S. mansoni infection. Samples of stool were collected from each pupil and examined by the concentration and microscopic techniques. Semistructured interview questionnaires were administered to the study subjects to identify the possible risk factors of infection with S. mansoni. Data analysis was performed using SPSS version 20 software.

RESULTS

The overall prevalence of S. mansoni was 15.2%. A higher proportion of S. mansoni infection (30.3%) was observed at Chifarit primary school children followed by Tikur Wuha primary school children (17.3%) and Jiga 01 primary school children (10.2%). The habit of contact with river water (AOR, 4.86; 95% CI, 0.991-23.8; P = 0.051) and the irregular wearing of shoes (AOR, 6.06; 95% CI, 2.61-14.13; P = 0.001) were risk factors for S. mansoni infection.

CONCLUSION

S. mansoni infection remains a public health problem in the study area. Snail control, mass deworming, and health promotion are recommended.

Prevalence of Intestinal Schistosomiasis and Associated Factors among School Children in Wondo District, Ethiopia

Background

Human schistosomiasis is one of the neglected tropical diseases caused by Schistosoma mansoni. Children in the developing countries live in areas with poor sanitation and most often spend time swimming or bathing in the water bodies contaminated with cercariae, the infective stages of schistosomiasis, which results in growth retardation and poor school performance. Thus, having effective control of the disease requires assessment of prevalence and risk factors.

Objective

This study was aimed at assessing the prevalence of S. mansoni and its associated factors among primary schoolchildren in Wondo district, West Arsi Zone, Ethiopia, 2018.

Methods

A cross-sectional study was carried out between January and March 2018. Stool samples from 298 schoolchildren, who were selected by simple random sampling, were examined for the ova of S. mansoni using Kato–Katz technique. Information on sociodemographic factors and other risk factors was obtained using questionnaires. The data were cleaned, coded, and entered into SPSS 22.0 statistical software and analyzed. Bivariable and multivariable logistic regression analysis was done to identify factors associated with S. mansoni infection. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was calculated, and the level of significance was declared at p values of less than 0.05. The result was presented using tables, figures, and text form.

Result

A total of 298 study participants were involved in this study resulting in a response rate of 96.4% (298/309). The prevalence of S. mansoni infection was 11.4% (34/298). The prevalence was 8% (12/140) among males while it was 13% (22/158) among females. Swimming in rivers or ponds (AOR: 9.592; 95% CI: 1.972–46.655; P=0.005), latrine availability at household level (AOR: 0.075; 95% CI: 0.13–0.422; P=0.003), and awareness about schistosomiasis (AOR: 0.058; 95% CI: 0.004–0.409; P=0.007) were the factors independently associated with S. mansoni infection at p value < 0.05.

Conclusion

The prevalence of S. mansoni was moderate as per the World Health Organization standard, since it was in the range of 10%–50%. This implies that schistosomiasis is still among major health problems. Thus, intensified effort is needed to address risk factors contributing to infection and control disease. Additionally, biannual mass drug administration with praziquantel is required according to the WHO standard.

Epidemiology of Schistosoma mansoni infection and associated risk factors among school children attending primary schools nearby rivers in Jimma town, an urban setting, Southwest Ethiopia

Background

Schistosomiasis is one of the most neglected tropical parasitic disease which is common in Ethiopia. It is disease of rural areas for decades but now days there are reports of schistosomiasis from urban settings. Therefore, this study aimed to determine epidemiology of Schistosoma mansoni (S. mansoni) infection and associated determinant factors among school children attending primary schools nearby rivers in Jimma town, an urban setting, southwest Ethiopia.

Methodology

A cross sectional study was conducted among 328 school children aged between 7–17 years in selected primary schools nearby rivers in Jimma town from March to April 2017. For the diagnosis of S. mansoni, a single stool sample was obtained from each child and processed using double Kato Katz thick smear for quantification of S. mansoni ova examined using light microscope. A questionnaire was used to collect socio demographic data and associated determinant factors for S. mansoni infection. Data were analyzed using SPSS version 20.0. Variables with P-value < 0.05 were significantly associated with S. mansoni infection.

Results

The overall prevalence of S. mansoni infection was found to be 28.7%. Majority of infection intensities were categorized as light with maximum egg per gram of stool (epg) was 1728. The geometric mean of infection intensity was 102.3epg. Schools distance from river (p = 0.001), swimming habit in rivers (p = 0.001) and crossing river on bare foot (p = 0.001) were independent risk factors for S. mansoni infection.

Conclusions

The study revealed S. mansoni infection is prevalent in Jimma town. The school children were at moderate risk of morbidity caused by S. mansoni (prevalence ≥ 10% and < 50% according to WHO threshold), hence a biannual mass drug administration with praziquantel is required once every two years in the study area and promote health information on prevention, control, transmission and risk factors for S. mansoni infection.

Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: a systematic review and meta-analysis

BACKGROUND

Numerous studies have been carried out on assessing the prevalence of intestinal parasites infections (IPIs) amongpreschool and school-age children in Ethiopia, but there is lack of study systematically gathered and analyzedinformation for policymakers. Therefore, the aim of this systematic review and meta-analysis was to provide a summary on prevalence, geographical distribution and trends of IPIs among preschool and school-age childrenin Ethiopia.

METHODS

The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar from 1996to July2019 for studies describing prevalence of IPIs among preschooland school-age children. We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14.

RESULTS

Eighty-three(83) studies examining 56,786 fecal specimens were included. The prevalence of IPIs was 48%(95%CI: 42 to 53%) and showedsignificantly decreasing trends 17% (95% CI: 2.5 to 32%) for each consecutive 6 years) and was similar in males and females. The pooled prevalence in years 1997-2002, 2003-2008, 2009-2014 and > 2014 was 71% (95% CI: 57 to 86%), 42% (95% CI: 27 to 56%), 48% (95% CI: 40 to 56%) and 42% (95% CI: 34 to 49%), respectively. Poly-parasitism was observed in 16% (95% CI: 13 to 19%,) of the cases.

CONCLUSION

Intestinal parasite infections are highly prevalent among preschool and school-age children and well distributed across the regional states of Ethiopia. Southern and Amhara regional states carry the highest burden. We observed significant decreasing trends in prevalence of IPIs among preschool and school-ageEthiopian children over the last two decades. Therefore, this study is important to locate the geographical distribution and identified high risk areas that should be prioritized further interventions, which complement global efforts towards elimination of IPIs infections by 2020.

The magnitude of Schistosoma mansoni and its associated risk factors among Sebatamit primary school children, rural Bahir Dar, Northwest Ethiopia: a cross-sectional study

OBJECTIVE

The aim of this study was to determine the magnitude of Schistosoma mansoni and its associated risk factors in the study area.

RESULTS

Of 422 school children, 223 (52.8%) and 199 (47.2%) were males and females, respectively. The Overall prevalence of Schistosoma mansoni infection was 24.9% (105/422). Seventy-five out of 422 (71.4%) of the infected individuals showed light infections. The overall mean intensity of Schistosoma mansoni in the study was 106.16 eggs per gram of stool. Age (p = 0.013), swimming habit (p = 0.001), participating in irrigational activities (p = 0.03) and washing clothes in the river (p = 0.039) were factors associated with Schistosoma mansoni infection.

Helminth infections in light of an ongoing intervention in endemic areas of Guragae zone, Southern Ethiopia: an implication for neglected tropical diseases elimination in Ethiopia by 2020

Introduction

Helminth infections are among the major public health problems in developing countries. Considerable efforts have been made towards the control of morbidity caused by infection with helminths in Ethiopia. The national control program is designed to achieve the elimination of helminth infections as a major public health problem by 2020.

Objective

The objective of this study was to determine the current status and infection intensity of helminths in the endemic area of Guragae zone, Southern Ethiopia.

Methods

An institutional based cross-sectional study was carried out between April and June 2017 in Gurage zone. School-aged children (SAC) were selected using a multistage sampling method and invited to participate in the study. Parasitological test examination was done using the Kato-Katz technique in Wolkite University parasitology laboratory. SPSS version 21 was used for data management and analysis.

Results

A total of 597 (98% compliance rate) participants were able to provide complete data. The study revealed that 21.6% (129/597) SAC were infected with one or more species of helminth. S. mansoni was the most prevalent helminth (12.9%) followed by hookworms (4.3%). The overall infection intensity expressed as geometric mean for A. lumbricoides, T. trichiura, hookworms, and S. mansoni were 301, 31,103, and 158 eggs per gram of stool, respectively. The multivariable logistic regression model estimated that being in the age group of 5–9 years (AOR = 1.43, 95% CI 0.4–0.9), washing raw food and vegetables using river water (AOR = 2.4, 95% CI 0.16–0.75), and a regular bathing habit in river (AOR = 2.14, 95% CI 0.3–0.9) were independent predictors of helminth infections.

Conclusion

Despite the fact that Ethiopia planned to eliminate helminth infection-related morbidity by 2020, this study showed that helminth infection is prevalent in the study area. Efforts should be made to improve hygienic practices of the schoolchildren in addition to school-based deworming. Moreover, the deworming program should also focus on reaching those SAC who do not attend school through communal social places to achieve the targeted goal in the study area in particular and nationwide in general.

Prevalence and Reinfection Rates of Schistosoma mansoni and Praziquantel Efficacy against the Parasite among Primary School Children in Sanja Town, Northwest Ethiopia

BACKGROUND

Schistosomiasis is among the most widespread chronic infections in the world. The magnitude of the infection may show variations across different areas with respect to time. Praziquantel is a first line drug of choice for the treatment of schistosomiasis although its low cure rate has been reported in different parts of the world. Thus, an assessment of the magnitude of the diseases, the efficacy of currently available drugs, and reinfection rates is crucial.

OBJECTIVE

Our principal objective is to determine the prevalence and reinfection rates of Schistosoma mansoni and to evaluate the efficacy of PZQ against Schistosoma mansoni.

METHOD

A school-based cross-sectional study was conducted on Sanja Elementary Schools, Sanja town, northwest Ethiopia. Stool specimens were examined using Kato-Katz method. Schoolchildren who tested positive for intestinal schistosomiasis and fulfilled the inclusion criteria took part in the efficacy and reinfection study. Positive participants were treated with 40 mg/kg of Praziquantel. Cure and egg reduction rates were evaluated three weeks after treatment. The intensity of infection was determined following the WHO's guideline. Moreover, the reinfection rate of those who were cured was evaluated after a six-month posttreatment period. Data were analyzed using SPSS version 20.

RESULTS

At baseline, 130 (35%) of the 372 schoolchildren were found infected with Schistosoma mansoni. Out of the 130 infected schoolchildren, 112 (86.2%) had moderate infection intensity. Among the S. mansoni positive schoolchildren, 80 were included as study participants for the evaluation of PZQ efficacy, based on the inclusion criteria established by WHO. The cure and egg reduction rates were found to be 90% (72/80) and 99.5%, respectively. Of the seventy-two schoolchildren considered for the determination of reinfection rate, after 6 months of posttreatment, 13.9% were found to be reinfected.

CONCLUSION

The schoolchildren in the three primary schools of Sanja are at moderate risk of the infection caused by S. mansoni. Although the therapeutic potency of PZQ at 40 mg/kg was efficient against S. mansoni, a high rate of reinfection was reported in the study site, suggesting the need for integrated schistosomiasis control measures.

A review on the occurrence of companion vector-borne diseases in pet animals in Latin America

Companion vector-borne diseases (CVBDs) are an important threat for pet life, but may also have an impact on human health, due to their often zoonotic character. The importance and awareness of CVBDs continuously increased during the last years. However, information on their occurrence is often limited in several parts of the world, which are often especially affected. Latin America (LATAM), a region with large biodiversity, is one of these regions, where information on CVBDs for pet owners, veterinarians, medical doctors and health workers is often obsolete, limited or non-existent. In the present review, a comprehensive literature search for CVBDs in companion animals (dogs and cats) was performed for several countries in Central America (Belize, Caribbean Islands, Costa Rica, Cuba, Dominican Republic, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Puerto Rico) as well as in South America (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, French Guiana, Guyana (British Guyana), Paraguay, Peru, Suriname, Uruguay, Venezuela) regarding the occurrence of the following parasitic and bacterial diseases: babesiosis, heartworm disease, subcutaneous dirofilariosis, hepatozoonosis, leishmaniosis, trypanosomosis, anaplasmosis, bartonellosis, borreliosis, ehrlichiosis, mycoplasmosis and rickettsiosis. An overview on the specific diseases, followed by a short summary on their occurrence per country is given. Additionally, a tabular listing on positive or non-reported occurrence is presented. None of the countries is completely free from CVBDs. The data presented in the review confirm a wide distribution of the CVBDs in focus in LATAM. This wide occurrence and the fact that most of the CVBDs can have a quite severe clinical outcome and their diagnostic as well as therapeutic options in the region are often difficult to access and to afford, demands a strong call for the prevention of pathogen transmission by the use of ectoparasiticidal and anti-feeding products as well as by performing behavioural changes.

Transmission of Schistosoma mansoni in Yachi areas, southwestern Ethiopia: new foci

Background

Schistosoma mansoni, causing intestinal schistosomiasis, is widely distributed in Ethiopia and new transmission foci are continually reported. Here we report new transmission sites and prevalence of S.mansoni infection among school children in Yachi areas, southwestern Ethiopia.

Methods

A cross-sectional survey was conducted among school children of Yachi Yisa and Yachi Efo elementary schools, southwestern Ethiopia, from April 2017 to June 2017. Three hundred seventeen school children aged six to 15 years were randomly selected to provide stool specimens for helminth infection examination by Kato-Katz and formol-ether concentration techniques. Snail survey was carried out to assess schistosome infection in Biomphalaria pfeifferi. Laboratory bred mice were also exposed to schistosome cercariae shed by B. pfeifferi en masse for definite identification of Schistosoma species.

Results

From the 317 stool specimens examined using double Kato-Katz thick smear and single formol-ether concentration techniques, 224 (70.7%) were found positive for at least one intestinal helminth species. The most prevalent parasite was S. mansoni (42.9%) followed by Trichuris trichiura (34.1%) and Ascaris lumbricoides (14.2%). The prevalence of S. mansoni infection was significantly higher among the children attending Yachi Yisa School (49.4%) than those in Yachi Efo School (35.6%) (P = 0.002). The study also revealed that there was a significantly higher prevalence of S.mansoni infection among males (51.2%) than females (33.1%) (P < 0.001). However, the prevalence of S.mansoni infection was not significantly associated with age categories (P = 0.839). B. pfeifferi snails infected with schistosomes were collected from the water bodies found in the study area. After six weeks post exposure, adult S. mansoni worms were harvested from the mesenteric veins of laboratory bred mice.

Conclusions

The study revealed establishment of new S. mansoni transmission foci and moderate prevalence of schistosomiasis in Yachi areas. Hence, treatment of all school-age children once every two years is recommended. Snail control and non-specific control approaches including provision of clean water supply and health education should also complement mass drug administration of praziquantel.

Electronic supplementary material

The online version of this article (10.1186/s40249-018-0513-5) contains supplementary material, which is available to authorized users.

Prevalence of schistosomiasis and associated risk factors among school children in Um-Asher Area, Khartoum, Sudan

Objective

Schistosomiasis remains one of the most common parasitic diseases worldwide. This is a cross-sectional study aimed to determine the prevalence of schistosomiasis and its associated risk factors among primary school children in Um-Asher area. The study was conducted among 170 primary school students in Um-Asher area from November 2017 to February 2018. Urine and stool samples were collected and examined for schistosomiasis infections. Moreover, data on sociodemographic characteristics and associated risk factors were obtained using a questionnaire.

Results

The overall prevalence of Schistosoma haematobium was 12.9%, whereas that of Schistosoma mansoni was 2.95%. Additionally, the males had higher prevalence (60%) of S. mansoni than females (40%). However, both gender were equally infected with S. haematobium (50%). With regard to risk factors, distance of residence from water source and source of drinking water are relatively associated with the infection.

Quality of anthelminthic medicines available in Jimma Ethiopia

Soil-transmitted helminthiasis and schistosomiasis are major public health problems in Ethiopia. Mass deworming of at-risk population using a single dose administration of 400mg albendazole (ABZ) or 500mg mebendazole (MBZ) for treatment of common intestinal worms and 40mg of praziquantel (PZQ) per kg body weight for treatment of schistosomiasis is one of the strategies recommended by World Health Organization (WHO) in order to control the morbidity of soil-transmitted helminthiasis and schistosomiasis. Since storage condition, climate, way of transportation and distribution route could all affect the quality of medicines, regular assessment by surveys is very critical to ensure the therapeutic outcome, to minimize risk of toxicity to the patient and resistance of parasites. Therefore, this study was conducted to assess the pharmaceutical quality of ABZ, MBZ and PZQ tablet brands commonly available in Jimma town (south west Ethiopia). Retail pharmacies (n=10) operating in Jimma town were selected using simple random sampling method. Samples of anthelminthic medicines available in the selected pharmacies were collected. Sample information was recorded and encompassed trade name, active ingredient name, manufacturer's name and full address, labeled medicine strength, dosage form, number of units per container, dosage statement, batch/lot number, manufacturing and expiry dates, storage information and presence of leaflets/package insert. Moreover, a first visual inspection was performed encompassing uniformity of color, uniformity of size, breaks, cracks, splits, embedded surface spots or visual contaminations. Finally, physico-chemical quality attributes investigated encompassed mass uniformity, quantity of active pharmaceutical ingredient (API), disintegration and dissolution, all following Pharmacopoeial test methods The physical characteristics of dosage form, packaging and labeling information of all samples complied with criteria given in the WHO checklists. The mass uniformity of tablets of each brand of ABZ, MBZ and PZQ complied with the pharmacopoeial specification limits, i.e no more than 2 individual masses >5% of average tablet weight, and none deviate by more than 10%. The quantity of APIs in all investigated tablet brands were within the 90-110% label claim (l.c.) limits, ranging between 95.05 and 110.09% l.c. Disintegration times were in line with the pharmacopoeial specification limit for immediate release (IR) tablets, ranging between 0.5 and 13min. However, the dissolution results (mean±SD, n=6) of one ABZ brand (i.e. Wormin^®, Q=59.21±0.99% at 30min) and two PZQ brands (i.e. Bermoxel^®, Q=63.43%±0.7 and Distocide^®, Q=62.43%±1.67, at 75min) showed poor dissolution, failing the United States Pharmacopoeia (USP) dissolution specification limit.

Prevalence and intensity of Schistosoma mansoni infections among schoolchildren attending primary schools in an urban setting in Southwest, Ethiopia

Objective

To determined both prevalence and intensity of Schistosoma mansoni infections among schoolchildren attending primary schools in Jimma town, an urban setting, Southwest, Ethiopia.

Results

The prevalence of S. mansoni infections was 8.4%. S. mansoni infections were found in all 17 schools, but the school prevalence ranged from 1.7 to 26.7%. This variation in prevalence could be explained by the proximity of the schools to the river crossing the town and water bodies near the schools. Boys were more infected compared to girls (χ² = 31.587, P value = 0.001; 95% CI), and the infection rate increased as a function of age (χ² = 21.187; P value = 0.001; 95 %CI). The majority of the infection intensities were of low intensity (57%), the mean number of eggs per stool equal to 17 eggs per gram of stool. Based on the prevalence (8.4%) school children in Jimma Town is considered as a low risk of morbidity caused by S. mansoni (prevalence ≤ 10% according to WHO threshold), for which it is recommended to implement MDA once every 3 years which should be supplemented with health information to create awareness about Schistosomiasis transmission. Male students were more infected than females with majority of the infection intensity were low.

Electronic supplementary material

The online version of this article (10.1186/s13104-017-3023-9) contains supplementary material, which is available to authorized users.