Prevalence and associated factors of Schistosomiasis among children in Yemen: implications for an effective control programme

Urinary schistosomiasis and anemia among school-aged children from southwestern Nigeria

Schistosomiasis and anemia, are one of the leading global public health problem among children between age 5 and 14 years in marginalized settings. In this study, we provide prevalence and intensity data for both conditions in three southwestern states of Nigeria, where such are lacking. Epidemiological assessment involving parasitological analysis of urine and blood samples was conducted among 1783 consenting school-aged children in Ondo, Osun, Ekiti States of Nigeria. Participants' age and sex data were obtained using field forms, and statistical analysis was performed in R software with a significance level of 95%. An overall prevalence of 26.8% and 29.5% was recorded for urinary schistosomiasis and anemia, respectively. Prevalence varied by location with (40.3% and 29.8%) in Ondo (34.4% and 37.5%) in Osun and (13.4% and 20.9%) in Ekiti for urinary schistosomiasis and anemia, respectively (p=0.00). Schistosoma infections were found among males (28.7%, p=0.05) and children between the age 9-11 years (30.0%, p=0.01). About 36% of children with anemia was also infected with schistosomiasis. Children who were positive for schistosomiasis (OR:1.51; 95% CI: 1.19, 1.93; p=0.001) and between the age category 15-16 years, (OR:1.86; 95% CI: 1.12, 3.09; p<0.05) were twice likely to become anemic. Our findings have shown that children infected with schistosomiasis are twice likely to become anemic than those without infection. It is important to complement ongoing MDA programmes targeted at schistosomiasis with nutrition intervention programs for example micronutrient supplementation for better impact and cost-effectiveness.

Alkuwaisi M, Zoromba MA. Prevalence of Depression and Its Associated Factors Among Hemodialysis Patients in Hodeida City, Yemen

Background

Depression has a negative impact on the health outcomes of hemodialysis (HD) patients, including decreased quality of life and increased morbidity and mortality rates. Therefore, this study aimed to determine the prevalence of depression and its associated factors among HD patients in Hodeida city, Yemen.

Methods

A cross-sectional study involving 200 HD patients at the Dialysis Center in Hodeida was conducted from February to May 2022. Data on depression were collected using the 9-item Patient Health Questionnaire (PHQ-9). Association of sociodemographic characteristics of patients with depression were assessed using chi-square, subsequently by multivariable logistic regression. Statistical significance was set at P-values <0.05.

Results

The response rate was 98% (200/204). Depression was prevalent among 63% of HD patients at the Dialysis Center in Hodeida city. Sex was significantly associated with depression, where female patients were more frequently depressed than males (82.4% vs 56.4%, P < 0.001). In addition, employment status and medical insurance were significantly associated with depression, where unemployed patients were more frequently depressed than employed patients (67.6% vs 52.5%, P = 0.041) and patients with medical insurance were less frequently depressed than their counterparts (47.1% vs 66.3%, P = 0.035).

Conclusion

Depression is highly prevalent among HD patients in Hodeida city. Female sex, unemployment and lack of medical insurance are predictors of depression among HD patients. These findings emphasize the urgent need for targeted interventions.

Implications for practice

Depression is common among HD patients, so that, psychiatric physicians and nurses are increasingly needed in HD centers to implement mental health assessment of patients for depression signs and symptoms to help in early diagnosis and management of depression in order to improve patients' quality of life and preventing negative outcomes.

Evaluating the Prevalence and Risk Factors of Schistosomiasis Amongst School-Aged Children in Low- and Middle-Income Communities: Ehlanzeni District Municipality, South Africa, 2015-2021

This study aimed to assess the prevalence and identify risk factors of schistosomiasis among school-aged children in low- and middle-income communities. A retrospective cross-sectional study was conducted to review patient records of school-age children. Data on gender, age, sub-district, area residing in, patient status, history of bilharzia, presence of blood in the urine, and schistosomiasis diagnoses were collected. The data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 27. Logistic regression was employed to determine the factors associated with schistosomiasis. The overall prevalence of schistosomiasis in the study population was 75%, with higher prevalence observed among male children (89%), children aged between 10 and 14 years (59%), urban areas (51%), and rural-dominated districts, particularly Bushbuckridge (42%) and City of Mbombela (51%). Age, especially 10-14 years old (p ˂ 0.01; 95%CI: 1.98-2.29), a history of bilharzia (p = 0.01; 95%CI: 1.15-1.96), and the presence of blood in urine (p ˂ 0.01; 95%CI: 2.02-2.40) were significantly associated with schistosomiasis while being a female child was found to be a protective factor (AOR: 0.35; CI 0.35-0.41). This study underscores the importance of implementing robust screening procedures and the necessity for health education to mitigate the high prevalence of schistosomiasis and prevent its further spread.

Effect of environmental factors in reducing the prevalence of schistosomiasis in schoolchildren: An analysis of three extensive national prevalence surveys in Brazil (1950-2018)

BACKGROUND

Over seven decades, Brazil has made admirable progress in controlling schistosomiasis, and a frequent question about the explanation for this reduction refers to the effect of improving environmental factors in the country. This article seeks to identify factors related to the change in the epidemiological situation of schistosomiasis mansoni infection by analyzing three national prevalence surveys conducted since 1950.

METHODOLOGY/PRINCIPAL FINDINGS

This is an ecological study analyzing an unbalanced panel of data based on national surveys and considering the municipality as the unit of analysis. The sample consisted of 1,721 Brazilian municipalities, in which a total of 1,182,339 schoolchildren aged 7-14 were examined during the three periods corresponding to each survey (1947-1953, 1975-1979, and 2010-2015). The percentage of municipalities with zero cases of schistosomiasis was: 45.4%, 54.2% and 73.7%, respectively for those periods. A zero-inflated Poisson regression model, with fixed and random effects, was fitted to assess the association between candidate factors and disease prevalence using a significance level of 5%. There was a significant decrease in disease prevalence between the first and last periods analyzed (RR 0.214, CI 0.184-0.249), with a protective association with access to sanitation (RR 0.996, CI 0.994-0.998), urbanization (RR 0.991, CI 0.989-0.993), and living in own households (RR 0.986, CI 0.983-0.989); and an inverse association with piped water supply (RR 1.010, CI 1.008-1.011).

CONCLUSION

The findings of this study indicate a decrease in the prevalence of schistosomiasis over seven decades in schoolchildren from the analyzed Brazilian municipalities, associated with environmental factors and social conditions. The increased access to piped water in the municipalities apparently triggers other ways of contact with unsafe water bodies, generating new transmission routes and suggesting the need for a systemic approach concerning contact with water.

Pediatric Spinal Neuroschistosomiasis in Yemen: An Overlooked Dilemma in an Endemic Region

BACKGROUND

Neurological involvement in schistosomiasis presents a significant and serious complication. While the disease is generally considered treatable during the early stages, the rarity of this condition often leads to delays in diagnosis and treatment. This study aims to report the clinical characteristics of pediatric patients with spinal neuroschistosomiasis (NS) in an endemic area to the disease.

METHODS

A retrospective cross-sectional review was conducted at Althora General Hospital in Ibb, Yemen, from January 2016 to January 2021. The study examined confirmed pediatric cases of spinal NS, analyzing their clinical characteristics, laboratory and radiological data, treatment approaches, and complications.

RESULTS

The study identified 10 cases of spinal NS with a mean age of 10.1± 3.2 years. The majority (90%) were male and from rural areas, all with a history of freshwater exposure, a known risk factor for schistosomiasis. The average time from presentation to treatment was 33.4± 45.6 days (7-150 days). Common symptoms observed in all patients were bladder dysfunction and paresthesia (100%). Intestinal dysfunction was prevalent in 90% of cases, while 80% exhibited limb weakness or inability to walk. The diagnosis was confirmed through cerebrospinal fluid (CSF) serology in 80% of cases, and stool and urine exams yielded positive results in 90% and 30% of cases, respectively. Magnetic Resonance Imaging findings revealed medullary lesions in 50% of cases, cauda equina lesions in 20%, and multiple lesions in 30%. All patients received oral praziquantel and high-dose steroids for at least three days as part of their initial treatment. During the average follow-up period of 5.6±1.7 months, one patient experienced lower extremity paraplegia, while two cases (20%) showed partial improvement with residual deficits including urinary and fecal incontinence. Complete resolution of symptoms was achieved in seven cases (70%).

CONCLUSION

Schistosomiasis should be considered in pediatric patients with myeloradicular manifestations, especially in endemic areas. Early identification can be achieved through history, prompt imaging, and CSF serology. In the absence of immediate test results, expert-guided presumptive therapy should be considered to minimize neurological complications.

Understanding the relationship between WASH and malnutrition: Analysis of anthropometric data of children attending WASH-supported schools in Ogun State, Nigeria

BACKGROUND

There has been a growing interest in better understanding the association between water, sanitation, and hygiene (WASH) and malnutrition.

AIM

We analysed anthropometric data of children attending WASH intervention schools and those from non-intervention schools in Ogun State, Nigeria.

METHODS

A total of 353 children across six schools (three interventions and three non-interventions) participated in this study. WASH conditions were assessed using WHO standardized tools and anthropometric data of children were analysed in WHO AnthroPlus and R Software.

RESULTS

The prevalence of stunting was 26.2% in the intervention group, and 29.4% in the control group (p = 0.045). Underweight was lower in the intervention group (3.9% vs. 10.1%) (p = 0.45). However, wasting was higher in the intervention group (32.3% vs. 8.2%) (p = 0.001). Of the variables included in our multivariate model (age, gender, and school category, i.e. intervention/control and class grade), only age was selected, and negatively associated with underweight, stunting and wasting (p = 0.000).

CONCLUSION

Regardless of WASH programming status, nutritional outcomes were significantly influenced by age of the children. Children are more likely to have lower z-scores as they grow older.

A Rare Case of Huge Schistosomiasis-Associated Cecal Polyp Mimicking Colon Carcinoma

Schistosomiasis is a parasitic infection caused by Schistosoma species, commonly found in tropical and subtropical regions. It affects millions of people worldwide and can lead to different clinical presentations like abdominal pain, weight loss, anemia, and chronic colonic schistosomiasis. In rare cases, chronic infection can result in the development of polyps, which can mimic colon carcinoma, posing a diagnostic challenge. Here, we present a rare case of a huge Schistosomiasis-associated cecal polyp in a patient initially suspected to have colon cancer. The patient's clinical history and the histopathological analysis confirmed the diagnosis, emphasizing the importance of considering parasitic infections in the differential diagnosis of gastrointestinal polyps in Schistosomiasis-endemic areas. This case report highlights the need for increased awareness among healthcare professionals of the potential for Schistosomiasis-associated polyps and the importance of multidisciplinary management in such cases.

Prevalence and distribution of urinary schistosomiasis among senior primary school pupils of Siphofaneni area in the low veld of Eswatini: A cross-sectional study

A cross-sectional survey of Schistosoma haematobium prevalence was conducted among senior primary school pupils of Siphofaneni area, Eswatini. This area is devoid of potable water, with a newly constructed Lubovane dam and an LUSIP irrigation scheme. The objective of the study was to investigate the distribution of urinary schistosomiasis among Siphofaneni senior primary school pupils. Using simple random sampling, 200 partcipants were enroled from four of six schools in the area. Ten millimetres (10 ml) of urine samples were obtained from each participant and examined for S. haematobium eggs. The intensity of the infection was estimated by calculating the total number of S. haematobium eggs present in 10 ml urine. Out of 200 participants, 45% (n = 91) were males, and 55% (n = 109) were females. The mean age for participants was 13 years, and almost half (47%, n = 94) were in Grade 5. Overall, the prevalence of S. haematobium infection was 16% (32/200). More than half (59%, 19/32) of the Schistosomiasis cases were from females. Positive and significant associations were observed between the number of eggs (χ²=170.9) and the presence of red blood cells (χ²=49.2) at p = 0.001. In conclusion, the prevalence of Schistosomiasis is high among pupils enrolled in Siphofaneni area primary schools that needs comprehensive treatment and education to prevent from S. haematobium infection.

Water, sanitation and schistosomiasis mansoni: a study based on the Brazilian National Prevalence Survey (2011-2015)

This study aimed to explore the association between water, sanitation, and the prevalence of schistosomiasis mansoni in students aged 7 to 17 years from all 27 federative units in Brazil. It was a cross-sectional study conducted based on data on the prevalence of schistosomiasis mansoni referring to 197,567 students from 521 Brazilian municipalities, who participated in the National Survey on the Prevalence of Schistosomiasis Mansoni and Soil-transmitted Helminth Infections (2011-2015). Univariable and multivariable generalized linear models of the negative binomial type were adjusted using 25 and 5% significance levels, respectively, considering municipalities as the unit of analysis. While a protective association was found between access to filtered water in schools and schistosomiasis mansoni prevalence, sanitation in schools was indicated as a risk factor. The collection of wastewater through a network is not universal in Brazil, and even when present, it is not necessarily carried out by the treatment of collected effluents, thus often resulting in the direct discharge of raw sewage into water resources. Regarding septic tanks, only the presence of infrastructure alone does not guarantee its correct use by the population.

Association of schistosome infection with adiposity in Tanzania

Background

Observational studies in humans have reported a link between schistosome infection and lower adiposity, but this may be explained by socioeconomic and demographic factors, intensity of infection, or common co-infections such as HIV.

Methods

This was a cross-sectional study that investigated the relationship between schistosome infection and adiposity in a large, well-described cohort of Tanzanian adults living with and without HIV. Cross-sectional data were collected among adults living in Mwanza, Tanzania who were enrolled in the Chronic Infections, Co-morbidities and Diabetes in Africa (CICADA) cohort study. Schistosome circulating anodic antigen, secreted by both Schistosoma mansoni and haematobium which are endemic to Tanzania, was quantified from stored samples. Schistosome infection diagnosed by serum circulating anodic antigen levels. The primary outcome was fat mass measured by bioimpedance analysis. Secondary outcomes included fat-free mass, waist circumference, mid-upper arm circumference, and body mass index.

Results

The study enrolled 1,947 adults, of whom 1,923 (98.8%) had serum available for schistosome testing. Of these, 873 (45.4%) had a serum circulating anodic antigen ≥30 pg/mL, indicating schistosome infection. Compared to uninfected individuals, those with schistosome infections had -1.1 kg [95% CI -1.9 to -0.3] lower fat mass after adjusting for age, sex, physical activity, tobacco use, education level, and socioeconomic status. Infected participants also had lower waist circumference, mid-upper arm circumference, and body mass index. Fat-free mass was not different between the two groups. Neither being HIV-infected, nor receiving antiretroviral therapy, modified associations between schistosome infection and adiposity. These associations were also not affected by Schistosoma worm burden.

Conclusions

Schistosome infection was associated with lower fat mass and less central adiposity without a difference in muscle mass, irrespective of confounders, HIV status, or the intensity of schistosome infection. Future studies should adjust for socioeconomic and demographic factors that are associated with schistosome infection and adiposity. Identifying mechanistic pathways by which schistosome infection reduces adiposity while preserving muscle mass could yield new strategies for obesity control and cardiovascular disease prevention.

Risk factors affecting the occurrence of urinary schistosomiasis and urinary tract infections in some communities of Ondo State, Nigeria

Schistosomiasis is one of the neglected tropical diseases, affecting about 240 million people worldwide. Urinary schistosomiasis (US) is a chronic and debilitating disease caused by blood flukes, Schistosoma haematobium, and people with US are vulnerable to secondary infections caused by bacteria. The study was designed to evaluate the risk factors involved in US and urinary tract infection (UTI) in parts of Ondo State, Nigeria. The study areas were rural communities known to be endemic for schistosomiasis, with farming as their major occupation and they depend solely on the use of the infected rivers for their day to day activities. Structured questionnaires were administered to obtain information concerning the infections. Five hundred and nine community dwellers participated in the study. The results showed that schistosomiasis was significant for gender and age (X²(1) = 23.934, p = 0.000) and (X²(7) = 85.991, p = 0.000), respectively, while UTI was not significant for age and gender. The study revealed that gender, age, contact with infected water, and duration spent in the water were risk factors associated with the development of schistosomiasis and UTI in the communities.

Intestinal Parasitic Infection Among Rural Schoolchildren in Taiz, Yemen: School-based Assessment of The Prevalence and Associated Risk Factors

Yemen is an underdeveloped country plagued by poverty, disease, and social conflicts. Furthermore, most of the population lives in rural areas and is vulnerable to intestinal parasite infections (IPI). School-based cross-sectional studies were conducted between 1 February and 31 March 2019 among schoolchildren in rural communities in the Sabir Almawadim and Almawasit districts of Taiz, southwest Yemen. A structured questionnaire collected information regarding sociodemographic characteristics and risk factors. Wet mount and formol-ether concentration techniques were used to detect and identify intestinal parasites in stool specimens. The stool specimens were collected from each study participant using a clean, leak-proof, and adequately labeled stool cup. Statistical analysis of the data was performed using SPSS version 20. Of the 478 students screened for intestinal parasites, 245 (51.26 %) had at least one parasite. The prevalence of protozoa was higher than helminths (30.3 % versus 20.9 %, respectively). The percentages of single, double, and triple infections were 37.4 %, 4.4 %, and 1.7 %, respectively. Giardia lamblia was the most prevalent pathogen (15.5 %), followed by E. hisrolyrica/dispar (14.9 %), Schistosoma mansoni (13.3 %), Ascaris lumbricoides (3.8 %), Trichuris trichiura (2.9 %), and Enterobius vermicularis (1.3 %). Multivariate analysis confirmed that practicing unwashed hands before eating, open field defecation, unwashed fruits and vegetables, and dirty unclipped fingernails were the most significant predictors of high risk of IPIs (p <0.05). Regarding Schistosoma mansoni, multivariate analysis identified the behaviors of practicing swimming in the river/ponds and practicing open defecation, especially near water sources, as independent risk factors for Schistosoma mansoni infection among schoolchildren. The current study showed that rural areas in Taiz were significantly infected with IPIs, showing that IPIs remains a significant public health problem in low-income communities. Consequently, prevention efforts should focus on treating and deworming schoolchildren regularly, promoting health education in rural schools, conducting personal hygiene inspections for students, and ensuring that schools have sanitary facilities.

Performance of Urine Reagent Strips in Detecting the Presence and Estimating the Prevalence and Intensity of Schistosoma haematobium Infection

The performance of the urine reagent strips (URS) in detecting the presence and estimating the intensity of Schistosoma haematobium infection was evaluated using urine filtration microscopy as a reference standard. Urine samples collected from 1288 school-age children living in five villages of the Afar and one village in the Gambella Regional States of Ethiopia between October 2021 and April 2022 were examined using urine filtration and URS. The prevalence of S. haematobium infection was 31.6% based on urine filtration and 32.1% using URS. Using results of the urine filtration as a reference, the sensitivity, specificity, negative predictive values, and accuracy of the URS in detecting S. haematobium egg-positive urine specimens were 73.7%, 87.8%, 87.1%, and 82.8%, respectively. Sensitivity increased significantly with an increase in the urine egg count. Specificity was greater in low prevalence settings and among children aged 5-9 years. The level of hematuria detected was trace (19.1%), weak (30.2%), moderate (36.0%), or high (14.7%). The log odds of showing higher-level hematuria significantly increased as the number of egg counts in urine increased. In conclusion, URS remains good in rapidly screening individuals for S. haematobium infection, but the sensitivity of the test could be lower, particularly when the intensity of the infection is light.

Fine-scale mapping of Schistosoma mansoni infections and infection intensities in sub-districts of Makenene in the Centre region of Cameroon

Background

Schistosomiasis control relies mainly on mass drug administration of Praziquantel (PZQ) to school aged children (SAC). Although precision mapping has recently guided decision making, the sub-districts and the epidemiological differences existing between bio-ecological settings in which infected children come from were not taken into consideration. This study was designed to fill this gap by using POC-CCA and KK to comparatively determine the prevalence and infection intensities of Schistosoma mansoni (S. mansoni) and to perform fine-scale mapping of S. mansoni infections and its infection intensities with the overarching goal of identifying sub-districts presenting high transmission risk where control operations must be boosted to achieve schistosomiasis elimination.

Methodology

During a cross- sectional study conducted in Makenene, 1773 stool and 2253 urine samples were collected from SAC of ten primary schools. S. mansoni infections were identified using the point of care circulating cathodic antigen (POC-CCA) and Kato-Katz (KK) test respectively on urine and stool samples. Geographical coordinates of houses of infected SAC were recorded using a global position system device. Schistosome infections and infection intensities were map using QGIS software.

Results

The prevalence of S. mansoni inferred from POC-CCA and KK were 51.3% and 7.3% respectively. Most infected SAC and those bearing heavy infections intensities were clustered in sub-districts of Baloua, Mock-sud and Carrière. Houses with heavily-infected SAC were close to risky biotopes.

Conclusion

This study confirms the low sensitivity of KK test compared to POC-CCA to accurately identify children with schistosome infection and bearing different schistosome burden. Fine-scale mapping of schistosome infections and infection intensities enabled to identify high transmission sub-districts where control measures must be boosted to reach schistosomiasis elimination.

Although some disparities in terms of prevalence and infection intensities have been acknowledged within and between schistosomiasis endemic areas, the current control measures did not take into consideration the disparities within endemic areas. To improve the control of schistosomiasis, a fine-scale mapping of schistosome infections and their intensities were undertaken using KK in comparison to POC-CCA to identify sub-districts with potential high transmission risk and where control operations must be boosted to achieve elimination. After the identification of schistosome infections by the point of care circulating cathodic antigen (POC-CCA) and Kato-Katz (KK) test, the geographical coordinates of each infected child’s house were recorded using a global position system device (GPS). QGIS software was used to create a map showing schistosome infections and their infection intensities. Our results showed that the majority of infected children and those bearing heavy infection intensities were clustering mostly in Baloua, Carrière and Mock-Sud sub-districts of Makenene while children with light and moderate infection intensity were widely distributed and far away from risky biotopes. The fine-scale mapping of schistosome infections and their infection intensities enable to identify hotspot transmission sites where control strategy must be boosted to achieve the elimination of intestinal schistosomiasis in Makenene.

Parasitological and malacological surveys to identify transmission sites for Schistosoma mansoni in Gomma District, south-western Ethiopia

Schistosomiasis is a neglected tropical disease that disproportionately affects the poorest people in tropical and subtropical countries. It is a major parasitic disease causing considerable morbidity in Ethiopia. Despite significant control efforts, schistosomiasis transmission is still widespread in many rural areas of the country. The aim of this study was to determine the prevalence and intensity of intestinal schistosomiasis among schoolchildren, as well as to identify schistosomiasis transmission sites in Gomma District, southwestern Ethiopia. Between October 2018 and September 2019, cross-sectional parasitological and malacological surveys were conducted in the study area. The study comprised 492 school-children aged 6 to 15 years old from four primary schools in Gomma District. To identify and quantify eggs of Schistosoma mansoni from the children, stool specimens were collected and processed using double Kato-Katz thick smears. Water bodies adjacent to human settlements in the study area were surveyed for snail intermediate hosts of S. mansoni. Morphological identification of collected snails was conducted, followed by examining their infection status using a dissecting microscope. The overall prevalence of S. mansoni infection was 73.8% (95%CI: 69.9-77.7%) and 41.6% of them had moderate-to-heavy infections. The prevalence of S. mansoni infection differed considerably by age group, with the older age groups (12-15) having a higher prevalence than the younger age groups (6-11) (p < 0.001). The prevalence of infection also varied significantly among schools; Dedo Ureche had the highest prevalence (86.9%) (p = 0.034), while Goga Kilole had relatively the lowest prevalence of S. mansoni infection (59.6%) (p = 0.003). A total of 1463 Biomphalaria pfeifferi snails were collected from 11 survey sites throughout the study area, with 357 (24.4%) of the snails shedding schistosomes cercariae. Despite intensified efforts to scale up mass drug administration in Ethiopia, this study reported high levels of S. mansoni infection among schoolchildren and snail intermediate hosts in rural communities in Gomma. Such a high infection rate warrants pressing needs for targeted and integrated interventions to control the disease in the area.

Urogenital schistosomiasis transmission, malaria and anemia among school-age children in Northern Ghana

Background

In sub-Saharan Africa, co-morbidity with malaria, schistosomiasis, and soil transmitted helminths (STH) is common among young children. The current study investigated malaria, urinary schistosomiasis and their co-infection and anemia among school-age children in an endemic community, Nakolo in the Kassena-Nankana East District of northern Ghana.

Methods

A cross-sectional survey of 336 school-age children, 5–16 years was undertaken. Urine samples were examined for Schistosoma haematobium ova using microscopy. Finger prick blood samples were examined for Plasmodium parasites using microscopy and haemoglobin concentration measured with HemoCue Hb301 photometer.

Results

The mean age was 10.52 (Standard deviation: ±2.27; range: 5–16 years), of which 50.6% (170/336) were males. The overall prevalence of urinary schistosomiasis and Plasmodium (P.) falciparum was 12.8% (43/336) and 37.8% (127/336), respectively with 6.0% (20/336) coinfection. Participants with only P. falciparum infection had 17.8% (19/107) of moderate anemia whilst 21.7% (5/23) of children infected with only S. haematobium had moderate anemia and 4.3% (1/23) had severe anemia. 5.0 % (1/20) of moderate anemia was observed in concurrent infections of P. falciparum and S. haematobium. Use of open water bodies was associated with increased risk of S. haematobium infection (OR = 1.21; 95% CI = [1.06–1.39]; p = 0.001), with females being at reduced risk (OR = 0.93; 95%CI = [0.87–0.99]; p = 0.005). Absence of self-reported haematuria had 0.81 times reduced odds of S. haematobium infection (OR = 0.81; 95%CI = [0.74–0.87]; p < 0.001).

Conclusion

This study has revealed that urinary schistosomiasis remains prevalent in Kassena-Nankana East district and suggests that urinary schistosomiasis may contribute to moderate anemia among school-age children as compared to asymptomatic malaria infection. These findings call for an evaluation of the annual mass drug administration of Praziquantel among in-school children to ascertain its impact on urinary schistosomiasis prevalence across the district.

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.

Schistosoma mansoni and soil-transmitted helminths among schoolchildren in An-Nadirah District, Ibb Governorate, Yemen after a decade of preventive chemotherapy

The Ministry of Public Health in Yemen continues the implementation of school and community–based preventive chemotherapy with praziquantel and albendazole for the control and elimination of schistosomiasis and soil-transmitted helminths (STH). The latest remapping to update the distribution of schistosomiasis and STH was conducted seven years ago. This study aimed to estimate the prevalence, intensity and associated risk factors of Schistosoma mansoni and STH among schoolchildren in An-Nadirah District, Ibb Governorate, Yemen. A cross-sectional study was carried out among schoolchildren aged 6–15 years in four selected schools. Biological, demographic, socioeconomic and environmental data were collected using a pre-tested questionnaire. S. mansoni and STH eggs were detected and counted by the microscopic examination of Kato-Katz fecal smears. Out of 417 schoolchildren, 17.0% were infected with at least one intestinal helminth. Prevalence of S. mansoni and STH were 6.5% and 9.1%, respectively. The most prevalent parasite among STH was Ascaris lumbricoides (8.4%). Unemployed fathers (Adjusted Odds Ratio (AOR) = 3.2; 95% Confidence interval (CI): 1.23, 8.52; P = 0.018), eating exposed food (AOR: 2.9; 95%CI = 1.24, 6.89; P = 0.014), not washing hands before eating and after defecation (AOR: 4.8; 95%CI = 1.77, 12.81; P = 0.002), and schools located close to water stream (AOR: 22.1; 95%CI = 5.12, 95.46; P <0.001) were independent risk factors of ascariasis. Swimming in ponds/stream (AOR: 3.9; 95%CI = 1.63, 9.55; P = 0.002), and schools close to the stream (AOR: 24.7; 95%CI = 3.05, 200.07; P = 0.003) were independent risk factors of intestinal schistosomiasis. The present study does not indicate a reduction in the prevalence of intestinal schistosomiasis in this rural area since the latest remapping conducted in 2014, although ascariasis was reduced by half. The prevalence of the two parasites was highly focal in areas close to the valley, suggesting a significant role of the stream in sustaining and accelerating the parasitic infection. Children practicing swimming and having poor hygienic practices were at high exposure to S. mansoni and A. lumbricoides, respectively. Water, Sanitation and Hygiene intervention, school–based health education, and snail control, in addition to mass drug administration, will help in the interruption of transmission of schistosomiasis and STH.

Soil-transmitted helminthes and Schistosoma mansoni infections among primary school children at Ambasame primary school, North-West Ethiopia: a cross-sectional study

BACKGROUND

Schistosomiasis and soil-transmitted helminthiasis (STHs) are the major public health problem in the world especially in school age children. Therefore, this study aimed to determine the burden of soil transmitted helminths and Schistosoma mansoni among Ambesame primary school children, North-West Ethiopia.

METHOD

A cross sectional study was carried out at Ambasame primary school children from March to May, 2019. Study participants were selected using systematic random sampling technique. Socio-demographic characteristics and other factors were collected using structured questionnaire. Moreover, stool samples were examined microscopically using wet mount and formol ether concentration techniques. Data were entered and analyzed using SPSS version 20. Logistic regression analysis was done to investigate the association between dependent and independent variables. P-value less than 0.05 was considered as statistically significant.

RESULT

The overall prevalence of intestinal parasites was 117(31.2%). The prevalence of soil-transmitted helminthes and S.mansoni was 110 (29.3%) using formol ether concentration technique. The most predominant parasite was S. mansoni (10.7%), followed by hookworm (5.6%). Multivariate logistic regression analysis revealed that, helminthic infection was associated with children less than 7 years of age (P-value = 0.019, AOR = 3.29, 95% CI (1.21-8.91)); fathers who are able to read and write (P-value< 0.001, AOR = 5.4, 95% CI (2.37-12.33)); absence of latrine (P-value = 0.016, AOR = 12.96, 95% CI (1.60-104.87)) and untrimmed nail (P-value = 0.043, AOR = 2.09, 95% CI (1.02-4.27)).

CONCLUSION

This study revealed that the prevalence of intestinal helminthes among Ambasame primary school children was relatively high. The lower educational status of father, absence of latrine and untrimmed finger nail showed statistically significant association with intestinal helminthic infection. This indicates the school community, health offices and other stakeholders should plan a strategy to tackle problems associated with sanitary condition. Furthermore, Health policy makers, healthcare workers and health extension workers should enhance their effort of awareness creation for school children, parents, school community about personal hygiene, environmental sanitation, intestinal parasites transmission, prevention and control. Moreover, mass deworming of school children and periodic screening for parasitic infection should be done.

Huge Colonic Granuloma of Schistosomiasis Mimicked Cancer in a 10-Years-Old Child: A Case Report

Introduction

Schistosomiasis is a trematodes infection more prevalent in tropical and subtropical areas such as Yemen. Giant colonic polyp manifestations of intestinal bilharziasis are uncommon, difficult to differentiate from other colonic polyps, and can mimic cancer.

Case Report

A 10-year-old child presented with chronic abdominal pain that started ten months ago. The patient had a family history of lymphoma in his brother. The computed tomography scan showed a sigmoid luminal mass measuring 10×3 cm with significant lumen narrowing and diffuse circumferential wall thickening of the sigmoid colon, hepatomegaly, and multiple perilesional, para-hepatic, and pulmonary lymph nodes enlargements. The mass was morphologically mimicked cancer and proved to be of bilharzial etiology (Schistosoma mansoni) after surgical excision.

Conclusion

Even though the bilharzial colonic polyps are rare, it is challenging to differentiate them from other malignant colonic polyps. Clinicians should have a high suspicion regarding its manifestations to avoid unnecessary surgical interventions, especially in an endemic area, even in patients with a strong family history of cancer.

Urogenital schistosomiasis prevalence and diagnostic performance of urine filtration and urinalysis reagent strip in schoolchildren, Ethiopia

Background

Urogenital schistosomiasis has been known to be endemic in several lowland areas of Ethiopia. It is caused by Schistosoma haematobium and causes considerable public health problems to schoolchildren. Ethiopia, after mapping the distribution of the disease (2013 to 2015), launched school-based mass deworming program to treat schoolchildren for schistosomiasis and soil-transmitted helminthiasis (STH) across the country since 2015. However, there is no recent information about the prevalence of the disease among schoolchildren in the current study areas. Diagnostic performance of urine filtration method and urinalysis reagent strip is also lacking. Therefore, this study aimed to determine the prevalence of urogenital schistosomiasis in schoolchildren, and to evaluate diagnostic performance of urine filtration and urinalysis reagent strip in Amibara, Kurmuk and Abobo districts, Ethiopia.

Methods

Across-sectional study was conducted involving 1,171 schoolchildren in Abobo, Amibara and Kurmuk districts from October, 2020 to January, 2021. The study participants were selected using random sampling technique. From each study participant, 10 ml urine samples were collected and examined using urine filtration method and urinalysis reagent strip. Data obtained from the survey were entered into Microsoft Excel 2010 and analysed with SPSS version 20.0. Data was summarized using descriptive statistics. Chi-square, bivariate and multivariable logistic regression and Pearson correlation test were used to measure associations between urogenital schistosomiasis, age, sex and haematuria. Odds ratio was used to measure strengths of association between variables. Agreement between urine filtration method and urinalysis reagent strip was determined using Kappa statistics. P-value < 0.05 at 95% CI was considered as statistically significant.

Results

Among the 1,171 urine samples from schoolchildren examined by urine filtration method, 143 (12.2%) were S.haematobium egg positive. Out of 143 positive children 126(88.1%) were lightly infected and 17 (11.9%) were heavily infected. Among the total of 1,171 urine samples tested by dipstick, 264(22.5%) were positive for haematuria. Prevalence of urogenital schistosomiasis by both urine filtration and urinalysis reagent strip method was higher in Abobo than Hassoba (Amibara) and Kurmuk (P< 0.001). The number of egg counts (intensity of infections) were significantly correlated with intensity of haematuria (r = 0.6, P < 0.001). Egg-positive children had significantly higher risk of having haematuria compared to S. haematobium egg negative children (OR; 6.96; 95%CI: 4.98, 8.940). Compared to urine filtration method, the sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of urinalysis reagent strip were 99.3%, 88.1%, 53.8% and 99.8%, respectively. Furthermore, its positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 8.34 and 0.008, respectively. The accuracy index and diagnostic odds ratio (DOR) of reagent strip were 0.89 and 1054, respectively. The agreement level between urine filtration methods and urinalysis reagent strip for detecting urogenital schistosomiasis was substantial (Kappa = 0.64).

Conclusion

This study showed that urogenital schistosomiasis was prevalent in schoolchildren in Abobo, Hassoba and Kurmuk districts. Urogenital schistosomiasis prevalence in Hassoba-bure and Kurmuk falls under low category whereas moderate in Abobo and is almost four times compared to Kurmuk and Hassoba-bure. Chemotherapy is needed in schoolchildren in such endemic areas and other measures like access to safe water, improved sanitation, hygiene, and health education should be implemented to control and prevent schistosomiasis effectively. The sensitivity, specificity, positive and negative predictive values of urinalysis reagent strip were higher and could serve as alternative for mass screening of urogenital schistosomiasis, for surveillance and evaluation of schistosomiasis intervention programs.

Visualizing the Knowledge Domain in Health Education: A Scientometric Analysis Based on CiteSpace

Objectives: This study aimed to visualize the evidence in the global research on health education to better improve the nation’s health literacy and to guide future research. Method: We searched the Web of Science (Core Collection) electronic databases. The search strategies: topic: (“Health Education” OR “Education, Health” OR “Community Health Education” OR “Education, Community Health” OR “Health Education, Community”) AND document: (Article) AND language:(English). Articles of evidence from January 2011 to December 2021 with those words in the title or abstract or keywords will be included in this review. We used the Citespace 5.6.R5 (64-bit) to investigate and determine the thematic patterns, and emerging trends of the knowledge domain, and presented a narrative account of the findings. Result: We analyzed 10,273 eligible articles. It showed that BMC Public Health displays the most prolific journals. Author MARCO PAHOR is highlighted in health education. The University of Sydney has published the most studies about health education. The USA plays an important role in these studies. Specifically, the visualization shows several hotspots: disease prevalence surveys and a specific population of knowledge, attitude and practice surveys, health intervention, chronic and non-communicable management, youth-health action, sexual and reproductive health, and physical activity promotion. Furthermore, document co-citation analysis indicated that there are 10 main clusters, which means the research front in health education. Meanwhile, by the citation detected, COVID-19, has achieved universal health coverage in related studies, however, public health education and the health workforce might be more popular in the coming years. Conclusion: Health education is an effective measure to shift the concept of public health and improve healthy living standards. The present study facilitates an extensive understanding of the basic knowledge and research frontiers that are pivotal for the developmental process of health education and allows scholars to visualize the identification modes and tendencies.

Prevalence of S. mansoni Infection and Associated Risk Factors among School Children in Guangua District, Northwest Ethiopia

Methods

A cross-sectional study design was employed. Four hundred twenty-two participants were selected. Data was collected through observation and interview with structured questionnaire. Stool specimens were collected and examined using two-slide Kato-Katz method. The data were analyzed using SPSS version 23. Logistic regression was fitted for analysis. Variables with p value <0.25 in the univariate logistic regression analysis were entered into the multivariable logistic regression model. Those with <0.05 were identified as significantly associated risk factors. To assure the quality of the data, training was given for data collectors and supervisors, and the tools were pretested on 5% of the sample size.

Results

404 (95.7%) school children were enrolled in the study. The overall prevalence of S. mansoni was 12.6%. School children in the age group 5-9 years old (AOR (95% CI): 22.27 (3.70-134.01), p = 0.001), age group 10-14 years old (AOR (95% CI): 4.58 (1.14-18.42), p = 0.032), grade levels 5-8 (AOR (95% CL): 14.95 (4.297-52.03), p = 0.001),who swim frequently (AOR (95% CI): 11.35 (2.33-55.33), p = 0.003), and those who cultivate near the irrigation area (AOR (95% CI): 7.10 (2.31-21.80), p = 0.001) were significantly associated with high risk of S. mansoni infection. Conclusion and Recommendation. From the finding of the current study, it can be concluded that the prevalence of Schistosoma mansoni in the study area is relatively high. Age of fourteen and younger years old, swimming in the river, and irrigation practice were the main risk factors of S. mansoni infection. Thus, therapeutic interventions as well as health education are desirable.

The Prospective Effects of Climate Change on Neglected Tropical Diseases in the Eastern Mediterranean Region: a Review

An increase in the annual daily temperature is documented and predicted to occur in the coming decades. Climate change has a direct effect and adverse impact on human health, as well as on multiple ecosystems and their species. The purpose of this paper is to review the effect of climate change on neglected tropical diseases including leishmaniasis, schistosomiasis, and lymphatic filariasis in the Eastern Mediterranean Region (EMR). A list of engine web searches was done; 280 full-text records were assessed for eligibility. Only 48 original records were included within the final selection for the review study. Most research results show an alteration of neglected diseases related to climate change influencing specifically the Eastern Mediterranean Region, in addition to the expectation of more effects at the level of vectors and reservoir whether its vector transmission route or its egg hatching and replication or even the survival of adult worms in the coming years. At the same time, not all articles related to the region interpret the direct or indirect effect of climate variations on these specific diseases. Although few studies were found describing some of climate change effects on neglected tropical diseases in the region, still, the region lacks research funding, technical, and mathematical model expertise regarding the direct effect of climate change on the ecosystems of these neglected tropical diseases.

Schistosomiasis outbreak during COVID-19 pandemic in Takum, Northeast Nigeria: Analysis of infection status and associated risk factors

BACKGROUND

Mass drug administration for schistosomiasis started in 2014 across Taraba State. Surprisingly in 2020, an outbreak of schistosomiasis was reported in Takum local government area. This epidemiological investigation therefore assessed the current status of infection, analyzed associated risk factors and arrested the outbreak through community sensitization activities and mass treatment of 3,580 persons with praziquantel tablets.

METHODS

Epidemiological assessment involving parasitological analysis of stool and urine samples were conducted among 432 consenting participants in five communities. Samples were processed using Kato-Katz and urine filtration techniques. Participants data on demography, water contact behavior and access to water, sanitation and hygiene facilities were obtained using standardized questionnaires. Data were analysed using SPSS 20.0 and significance level was set at 95%.

RESULTS

An overall prevalence of 34.7% was observed, with 150 participants infected with both species of Schistosoma parasite. By communities, prevalence was higher in Birama (57.7%), Barkin Lissa (50.5%) and Shibong (33.3%). By species', S. haematobium infection was significantly higher than S. mansoni (28.9% vs 9.5%), with higher proportion of younger males infected (p<0.05). The condition of WASH is deplorable. About 87% had no latrines, 67% had no access to improved source of potable water and 23.6% relied on the river as their main source of water. Infections was significantly associated with water contact behaviors like playing in water (OR:1.50, 95% CI: 1.01-2.25) and swimming (OR:1.55, 95% CI: 1.04-2.31).

CONCLUSION

It is important to reclassify the treatment needs of Takum LGA based on the findings of this study. Furthermore, efforts targeted at improving access to WASH, reducing snail population, improving health education and strengthening surveillance systems to identify schistosomiasis hotspots will be a step in the right direction.

GPS-based fine-scale mapping surveys for schistosomiasis assessment: a practical introduction and documentation of field implementation

BACKGROUND

Fine-scale mapping of schistosomiasis to guide micro-targeting of interventions will gain importance in elimination settings, where the heterogeneity of transmission is often pronounced. Novel mobile applications offer new opportunities for disease mapping. We provide a practical introduction and documentation of the strengths and shortcomings of GPS-based household identification and participant recruitment using tablet-based applications for fine-scale schistosomiasis mapping at sub-district level in a remote area in Pemba, Tanzania.

METHODS

A community-based household survey for urogenital schistosomiasis assessment was conducted from November 2020 until February 2021 in 20 small administrative areas in Pemba. For the survey, 1400 housing structures were prospectively and randomly selected from shapefile data. To identify pre-selected structures and collect survey-related data, field enumerators searched for the houses' geolocation using the mobile applications Open Data Kit (ODK) and MAPS.ME. The number of inhabited and uninhabited structures, the median distance between the pre-selected and recorded locations, and the dropout rates due to non-participation or non-submission of urine samples of sufficient volume for schistosomiasis testing was assessed.

RESULTS

Among the 1400 randomly selected housing structures, 1396 (99.7%) were identified by the enumerators. The median distance between the pre-selected and recorded structures was 5.4 m. A total of 1098 (78.7%) were residential houses. Among them, 99 (9.0%) were dropped due to continuous absence of residents and 40 (3.6%) households refused to participate. In 797 (83.1%) among the 959 participating households, all eligible household members or all but one provided a urine sample of sufficient volume.

CONCLUSIONS

The fine-scale mapping approach using a combination of ODK and an offline navigation application installed on tablet computers allows a very precise identification of housing structures. Dropouts due to non-residential housing structures, absence, non-participation and lack of urine need to be considered in survey designs. Our findings can guide the planning and implementation of future household-based mapping or longitudinal surveys and thus support micro-targeting and follow-up of interventions for schistosomiasis control and elimination in remote areas. Trial registration ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493.

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.

In Vitro Antileishmanial and Antischistosomal Activities of Anemonin Isolated from the Fresh Leaves of Ranunculus multifidus Forsk

Leishmaniasis and schistosomiasis are neglected tropical diseases (NTDs) infecting the world’s poorest populations. Effectiveness of the current antileishmanial and antischistosomal therapies are significantly declining, which calls for an urgent need of new effective and safe drugs. In Ethiopia fresh leaves of Ranunculus multifidus Forsk. are traditionally used for the treatment of various ailments including leishmaniasis and eradication of intestinal worms. In the current study, anemonin isolated from the fresh leaves of R. multifidus was assessed for its in vitro antileishmanial and antischistosomal activities. Anemonin was isolated from the hydro-distilled extract of the leaves of R. multifidus. Antileishmanial activity was assessed on clinical isolates of the promastigote and amastigote forms of Leishmania aethiopica and L. donovani clinical isolates. Resazurin reduction assay was used to determine antipromastigote activity, while macrophages were employed for antiamastigote and cytotoxicity assays. Antischistosomal assays were performed against adult Schistosoma mansoni and newly transformed schistosomules (NTS). Anemonin displayed significant antileishmanial activity with IC₅₀ values of 1.33 nM and 1.58 nM against promastigotes and 1.24 nM and 1.91 nM against amastigotes of L. aethiopica and L. donovani, respectively. It also showed moderate activity against adult S. mansoni and NTS (49% activity against adult S. mansoni at 10 µM and 41% activity against NTS at 1 µM). The results obtained in this investigation indicate that anemonin has the potential to be used as a template for designing novel antileishmanial and antischistosomal pharmacophores.

Epidemiology of Schistosoma mansoni infection in Ituri Province, north-eastern Democratic Republic of the Congo

BACKGROUND

Schistosomiasis, caused by Schistosoma mansoni, is of great significance to public health in sub-Saharan Africa. In the Democratic Republic of Congo (DRC), information on the burden of S. mansoni infection is scarce, which hinders the implementation of adequate control measures. We assessed the geographical distribution of S. mansoni infection across Ituri province in north-eastern DRC and determined the prevailing risk factors.

METHODS/PRINCIPAL FINDINGS

Two province-wide, community-based studies were conducted. In 2016, a geographical distribution study was carried out in 46 randomly selected villages across Ituri. In 2017, an in-depth study was conducted in 12 purposively-selected villages, across the province. Households were randomly selected, and members were enrolled. In 2016, one stool sample was collected per participant, while in 2017, several samples were collected per participant. S. mansoni eggs were detected using the Kato-Katz technique. In 2017, a point-of-care circulating cathodic S. mansoni antigen (POC-CCA) urine test was the second used diagnostic approach. Household and individual questionnaires were used to collect data on demographic, socioeconomic, environmental, behavioural and knowledge risk factors. Of the 2,131 participants in 2016, 40.0% were positive of S. mansoni infection. Infection prevalence in the villages ranged from 0 to 90.2%. Of the 707 participants in 2017, 73.1% were tested positive for S. mansoni. Prevalence ranged from 52.8 to 95.0% across the health districts visited. Infection prevalence increased from north to south and from west to east. Exposure to the waters of Lake Albert and the villages' altitude above sea level were associated with the distribution. Infection prevalence and intensity peaked in the age groups between 10 and 29 years. Preschool children were highly infected (62.3%). Key risk factors were poor housing structure (odds ratio [OR] 2.1, 95% 95% confidence interval [CI] 1.02-4.35), close proximity to water bodies (OR 1.72, 95% CI 1.1-2.49), long-term residence in a community (OR 1.41, 95% CI 1.11-1.79), lack of latrine in the household (OR 2.00, 95% CI 1.11-3.60), and swimming (OR 2.53, 95% CI 1.20-5.32) and washing (OR 1.75, 95% CI 1.10-2.78) in local water bodies.

CONCLUSIONS/SIGNIFICANCE

Our results show that S. mansoni is highly endemic and a major health concern in Ituri province, DRC. Infection prevalence and intensity, and the prevailing socioeconomic, environmental, and behavioural risk factors in Ituri reflect intense exposure and alarming transmission rates. A robust plan of action is urgently needed in the province.

Field assessment in Cameroon of a reader of POC-CCA lateral flow strips for the quantification of Schistosoma mansoni circulating cathodic antigen in urine

Background

Determining Schistosoma mansoni infection rate and intensity is challenging due to the low sensitivity of the Kato-Katz (KK) test that underestimates the true disease prevalence. Circulating cathodic antigen (CCA) excreted in urine is constantly produced by adult worms and has been used as the basis of a simple, non-invasive point of care test (POC-CCA) for Schistosoma mansoni infections. Although the abundance of CCA in urine is proportional to worm burden, the POC-CCA test is marketed as a qualitative test, making it difficult to investigate the wide range of infection intensities. This study was designed to compare the prevalence and intensity of S. mansoni by KK and POC-CCA and quantify, on fresh and frozen (<-20°C) urine samples, CCA using the visual scores and the ESEquant LR3 reader.

Methodology

Stool and urine samples were collected from 759 school-aged children. The prevalence and intensity of S. mansoni were determined using KK and POC-CCA. The degree of the positivity of POC-CCA was estimated by quantifying CCA on fresh and frozen urine samples using visual scores and strip reader. The prevalence, the infection intensity as well the relative amounts of CCA were compared.

Results

The S. mansoni infection rates inferred from POC-CCA and KK were 40.7% and 9.4% respectively. Good correlations were observed between infection intensities recorded by; i) the reader and visual scoring system on fresh (Rho = 0.89) and frozen samples (Rho = 0.97), ii) the reader on fresh urine samples and KK (epg) (Rho = 0.44). Nevertheless, 238 POC-CCA positive children were negative for KK, and sixteen of them had high levels of CCA. The correlation between results from the reader on fresh and frozen samples was good (Rho = 0.85). On frozen samples, CCA was not detected in 55 samples that were positive in fresh urine samples.

Conclusion

This study confirmed the low sensitivity of KK and the high capacity of POC-CCA to provide reliable data on the prevalence and intensity of S. mansoni infections. The lateral flow reader enabled accurate quantification of CCA under field conditions on fresh and frozen urine samples with less time and effort than KK.

Diagnosis of schistosomiasis has relied on the Kato-Katz technique which remains challenging due to its low sensitivity. To overcome this limitation, the Point-of-care-Circulating Cathodic Antigen (POC-CCA) test has been developed to detect CCA produced by adult living worm. However, this test is sold for qualitative use only because it is difficult to estimate the intensity of the positive band by eye. This study was designed with the aim of comparing the prevalence and intensity of S. mansoni infections by KK and POC-CCA and quantifying under field conditions on fresh and frozen (<-20°C) urine samples, CCA using the visual scores and the ESEquant LR3 reader. We conducted the KK and POC-CCA tests on stool and urine samples collected from SAC (5 to 4 years) in Makenene, Cameroon. Our results showed discrepancies between results from KK and POC-CCA test. The numerical values generated by the reader made it possible to avoid subjective visual interpretation of POC-CCA results. This study also identified children with high levels of CCA in their urine but without schistosome eggs in their stools. The good correlation observed between results obtained on fresh and frozen urine samples confirmed that POC-CCA test can be used on samples stored for one year at -20° C.

A cross-sectional survey of the knowledge, attitudes and practices regarding schistosomiasis among rural schoolchildren in Taiz governorate, southwestern Yemen

BACKGROUND

This cross-sectional survey aimed to assess the knowledge, attitudes and practices (KAP) towards schistosomiasis among rural schoolchildren in Taiz governorate, southwestern Yemen.

METHODS

A total of 406 children were screened for urogenital and intestinal schistosomiasis. A pretested questionnaire was used to collect the children's demographic and socio-economic information and their KAP towards schistosomiasis.

RESULTS

Overall, 73 children (18%) were found to be infected by Schistosoma mansoni. None of the children were positive for Schistosoma haematobium. The prevalence of intestinal schistosomiasis was significantly higher among boys than girls (22.1% vs 12%; p=0.010). Approximately two-thirds (63.3% [257/406]) of the children had heard about schistosomiasis, however, only 38.5%, 53.6%, 28.4% and 38.1% had correct knowledge concerning the causes, symptoms, transmission and prevention, respectively. A significantly higher level of knowledge was observed among boys and Schistosoma-infected children compared with girls and non-infected children (p<0.05). However, a better level of knowledge does not seem to translate directly into the performance of hygienic practices. Multivariate logistic regression showed that sex and infection status were the significant predictors of good knowledge.

CONCLUSIONS

Intestinal schistosomiasis is prevalent among schoolchildren in rural Yemen. The findings reveal that children's knowledge about schistosomiasis is inadequate. Therefore, besides mass drug administration, integrated control programmes should also include health education and the provision of improved drinking water and proper sanitation.

Socioeconomic determinants of Schistosoma mansoni infection using multiple correspondence analysis among rural western Kenyan communities: Evidence from a household-based study

BACKGROUND

Socioeconomic inequality including wealth distribution is a barrier to implementation of health policies. Wealth distribution can be measured effectively using household data on durable assets. Compared to other methods of analysing Socio-economic Status (SES) using durable assets, Multiple Correspondence Analysis (MCA) can create more reliable wealth quintiles. We therefore evaluated socioeconomic determinants of Schistosoma mansoni using MCA on household data among adult population in western Kenya. The hypothesis of this study was that MCA would be a useful predictor of S. mansoni prevalence and/or intensity.

METHODOLOGY

Twelve villages, 6 villages that had showed the greatest decrease in S. mansoni prevalence (Responder villages) and 6 villages that showed relatively lower decrease (Hotspot villages) between the year 2011 and 2015 were randomly selected for this study. This was according to a previous Schistosomiasis Consortium for Operational Research and Elimination (SCORE) report from western Kenya. From each village, convenience sampling was used to identify 50 adults from 50 households for inclusion in this study. An interview with a questionnaire based upon MCA indicators was conducted. One stool sample from each of the 600 adults was examined based on four slides for S. mansoni eggs using Kato Katz technique. Mean Eggs per gram(EPG) was calculated by taking the average of the readings from the four slides. A log binomial regression model was used to identify the influence of the various age-groups(<30 years, 30-60 years and >60 years), household size, wealth class, occupation, education status, main water supply, sex and sub-county of residence on S. mansoni infection. EPG was then compared across variables that were significant based on multivariate log binomial model analysis using a mixed model.

PRINCIPAL FINDINGS

Overall prevalence of S. mansoni was 41.3%. Significantly higher prevalence of S. mansoni were associated with males, those aged below 30 years, those who use unsafe water sources (unprotected wells, lakes and rivers), residents of Rachuonyo North, Hotspot villages and those earning livelihood from fishing. Only sex and household size were significant predictors in the multivariate model. Males were associated with significantly higher prevalence compared to the females (aPR = 1.37; 95% CI = 1.14-1.66). In addition, households with at least four persons had higher prevalence compared to those with less than four (aPR = 1.29; 95% CI = 1.03-1.61). However, there was no difference in prevalence between the wealth classes(broadly divided into poor and less poor categories). Intensity of infection (Mean EPG)was also significantly higher among males, younger age group, Rachuonyo North residents and Hotspot Villages.

CONCLUSION

Socioeconomic status based on an MCA model was not a contributing factor to S. mansoni prevalence and/or intensity possibly because the study populations were not sufficiently dissimilar. The use of convenience sampling to identify participants could also have contributed to the lack of significant findings.

Prevalence of intestinal parasitic infection and its associated factors among primary school students in Ethiopia: A systematic review and meta-analysis

Introduction

Intestinal parasitic infection are a major public health concern affecting both children and adolescents in Ethiopia. The aim of this systematic review and meta-analysis was to determine pooled prevalence and associated factors of intestinal parasitic infection in this target group.

Method

We systematically retrieved available articles on the prevalence of intestinal parasitic infection following database searches using PubMed, Scopus, Cochrane Library, and Science Direct between March 1 and May 27, 2020. Two authors independently extracted all relevant data using a standardized Microsoft Excel data extraction form. Heterogeneity among included studies was assessed with the Higgins I² tests. The pooled estimates and associated factors were assessed with a random-effects model using Stata/se Version 14.

Result

We retrieved 30 eligible articles with a pooled sample size of 14,445 primary school children with response rate of 97.8%. Entamoeba spp (16.11%), Ascaris lumbricoides (13.98%), hookworm (12.51%) and Giardia lamblia (9.98%) are the top causes of intestinal parasitic infection among primary school children in Ethiopia. The pooled prevalence for at least one intestinal parasitic infection was 46.09 (95% CI: 38.50, 53.68). Heterogeneity was assessed by doing subgroup analysis by study province/region. Thus, the highest prevalence of 66.6% (95% CI: 55.5, 77.7) occurred in Tigray region, which was followed by Southern Nations, Nationalities, and Peoples’ Region at 50.8% (95% CI: 33.1, 68.5). No latrine availability (OR = 4.39: 2.50,7.73), no fingernail hygiene (OR = 2.37: 1.67, 3.35), open defecation (OR = 1.67:1.64,4.36), no formal maternal education (OR = 2.02: 1.18,3.47), rural residence (OR = 1.88: 1.46, 2.41), no habit of wearing shoes (OR = 2.66: 1.79, 3.96), non-pipe source of drinking water (OR = 1.99: 1.42,2.76), no regular hand washing practices (OR = 3.45:1.85,6.47), and no habit of washing fruits and vegetables (OR = 1.59:1.01,2.49) were associated with parasitic infection.

Conclusions

The prevalence of intestinal parasitic infection was high (46%). Attention should be given to promoting personal hygiene, latrine utilization, wearing shoes, avoiding eating raw food, creating awareness for those mothers who lack formal education. Moreover, future research ideally will expand on the topic by conducting research in regions which have no prior research.

Intestinal parasitic infections are distributed virtually with high prevalence rates in many regions, especially in low and middle income countries which intimately linked to age group, poverty and inadequate access to water, sanitation and hygiene. It is now a day’s one of the neglected tropical disease. We had searched different individual studies on intestinal parasitic infections to generate the pooled effect and recommend for the concerned body. We head included 30 different articles with a sample size of 14,445 and we have found a pooled prevalence of 46.09%. This finding indicates the prevalence of parasitic infection was almost near to half. Therefore every concerned body should give emphasize to prevent and control parasitic infection infestation.

Adherence to diagnosis followed by selective treatment of schistosomiasis mansoni and related knowledge among schoolchildren in an endemic area of Minas Gerais, Brazil, prior to and after the implementation of educational actions

Introduction

Brazilian guidelines for schistosomiasis elimination recommend regular search of infection carriers and their timely treatment. This study evaluates the effect of educational actions (EAs) among schoolchildren on adherence to diagnosis and treatment, as well as on knowledge of the disease.

Methods

In April/2013, a questionnaire was applied to 6th-to-8th-grade pupils of eight public schools to evaluate prior knowledge of disease and self-reported risk behavior. Baseline parasitological survey (PS) was done in May/2013, followed by selective treatment and cure assessment. The schools were then randomly allocated to experimental (EG) and control (CG) groups, with and without EAs, respectively. EAs were conducted for 3 months from August/2013. Questionnaire was reapplied in November/2013, April/2014, October/2014, and October/2015 to evaluate changes in knowledge about the disease and self-reported risk behavior. Two further annual PSs (May/2014 and May/2015), each followed by treatment of positives, allowed to evaluate between-group differences and intra-group changes in adherence to diagnosis and treatment, and to follow-up prevalence and intensity of infection.

Results

Adherence to diagnosis did not differ significantly between EG (84.1%) and CG (81.1%) at baseline but was significantly higher in EG in subsequent PSs. Overall, adherence to treatment was higher than 90% in all three PSs; cure was 98.4%, egg-reduction was 99.8% and reinfection, 2.8%. Prevalence fell significantly in EC (from 23.5% to 6.8%) and CG (from 21.8% to 2.4%), the same occurring with intensity (from 54.2 to 4.6 epg in EG and from 38.4 to 1.3 epg in CG). Disease knowledge increased significantly in EG and CG; knowledge about disease transmission increased significantly more in the EG. Self-reported risk behavior remained above 67% and did not differ significantly between EG and CG.

Conclusion

EAs increased adherence of schoolchildren and improved knowledge about the disease, confirming that EAs are an important tool to enhance schoolchildren participation in control campaigns.

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Educational actions improved adherence to stool testing.

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Disease knowledge also improved with educational actions.

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Risk behavior stayed high despite educational actions.

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 Associated Factors of Schistosoma mansoni among School Children in Northwest Ethiopia

Background

Schistosomiasis is one of the Neglected Tropical Diseases in Ethiopia, and its burden may show variations from time to time across different regions. Thus, this study was aimed at determining the prevalence, intensity, and associated risk factors of Schistosoma mansoni (S. mansoni) among schoolchildren in Northwest Ethiopia.

Methods

A school-based cross-sectional study was conducted. A multistage sampling technique was used to select the study participants. Stool specimens were collected and examined using two-slide Kato-Katz method. Data were analyzed using SPSS version 20 software. Multivariate logistic regression analysis was used to identify risk factors. p values less than 0.05 were taken as statistically significant.

Result

A total of 786 schoolchildren were participated in this study. The prevalence of S. mansoni was 33.5%. The mean egg count of the parasite among the infected study participants was 523.665 eggs per gram (epg) of stool. Thirty-seven, 42, and 21 percent of the study participant's infection were due to light, moderate, and heavy infection intensities, respectively. Age of 8-11 years old (AOR = 1,687, 95%CI = 1.163, 2.892), 5^th-8^th grade level (AOR = 2.280, 95%CI = 1.348, 3.856), residing in Chuahit District (AOR = 95.559, 95%CI = 12.945, 705.419), and using untreated water for domestic supply (AOR = 1.724, 95%CI = 1.457, 2.148) were found to be risk factors for S. mansoni infection.

Conclusion

High prevalence of S. mansoni and relatively higher proportion of moderate intensity of infection in this study imply that schistosomiasis is still one of the major public health problems in Northwest Ethiopia. It is also highlighted that study sites, provision of water supply, age, and grade level of the schoolchildren were identified as a risk factors for the disease.

Schistosomiasis Mansoni Manifesting as Multiple Colonic Polyps

Schistosomiasis (bilharziasis) is a common parasitic disease in subtropical and tropical parts of Africa, some parts of the Middle East, South America, Asia, and some parts of the Caribbean. It is a major public health problem and associated with significant morbidity and mortality in endemic areas. We describe a 28-year-old male patient presenting with bleeding per rectum associated with mucus secretion, abdominal pain, anorexia, and weight loss. Blood investigation showed pancytopenia with macrocytic hypochromic anemia. Meanwhile, his colonoscopy showed two large polyps 10 cm and 50 cm away from the anal verge, each measuring 3 cm in size. Microscopic examination of multiple colonic biopsies confirmed Schistosoma mansoni. The patient was treated with praziquantel, which improved his condition. Colonic schistosomiasis is an important differential diagnosis in patients with a history of travel to endemic areas. Early diagnosis and medical management can avoid unnecessary invasive intervention in such cases.

Intestinal schistosomiasis: Can a urine sample decide the infection?

Intestinal schistosomiasis, one of the neglected tropical diseases whose control depends on accurate diagnosis of the disease prevalence. The use of low sensitive Kato Katz (KK) fecal egg detection method as a reference gold standard is not an accurate indication especially in low transmission areas. Latent class analysis frameworks especially the Bayesian could be used instead to compare between different diagnostic tests without the use of a gold standard method as a reference. Thus, this study compared two urine-based tests for the detection of circulating antigen and cell free DNA of Schistosoma mansoni versus KK method using the Bayesian latent class analytical framework and in two models where the trace results of point of contact - assay of circulating cathodic antigen (POC-CCA) were once estimated as positive, and as negative in the other model. The Bayesian framework in the trace CCA positive model showed an estimate of disease prevalence of 26% (95% BCI:0 to 60%). POC-CCA showed the highest sensitivity (74% with BCI: 9 to 91%) and lowest specificity for (20% with BCI: 0% to 37%) and the reverse for KK. For POC-CCA with traces considered negative, it was found that results between the three tests were moderated where the positivity for infection by Schistosoma antigen detection and PCR for cell free DNA approached that estimated by the Bayesian framework (44%), and the specificity for point of contact assay(81%; 95%BCI: 59% to 100%) rose in hand with its sensitivity(77%, 95% BCI:53% to 100%) and with results for PCR test (sensitivity = 80%; 95% BCI: 61% to 100%, specificity = 69%; 95% BIC: 47% to 100%). KK remains with the highest specificity while its sensitivity in the two models never exceeded 22%. Thus, we conclude that the use of a single urine sample could be very sensitive and highly specific in the diagnosis of intestinal schistosomiasis using either the trace negative model of point of contact assay, or conventional PCR, when compared to the fecal egg detection using duplicate KK. However, the use of a single tool restricts the management of the disease in areas of low endemicity.

Schistosoma haematobium infection and environmental factors in Southwestern Tanzania: A cross-sectional, population-based study

Schistosomiasis is a leading cause of morbidity in Africa. Understanding the disease ecology and environmental factors that influence its distribution is important to guide control efforts. Geographic information systems have increasingly been used in the field of schistosomiasis environmental epidemiology. This study reports prevalences of Schistosoma haematobium infection and uses remotely sensed and questionnaire data from over 17000 participants to identify environmental and socio-demographic factors that are associated with this parasitic infection. Data regarding socio-demographic status and S. haematobium infection were obtained between May 2006 and May 2007 from 17280 participants (53% females, median age = 17 years) in the Mbeya Region, Tanzania. Combined with remotely sensed environmental data (vegetation cover, altitude, rainfall etc.) this data was analyzed to identify environmental and socio-demographic factors associated with S. haematobium infection, using mixed effects logistic regression and geostatistical modelling. The overall prevalence of S. haematobium infection was 5.3% (95% confidence interval (CI): 5.0-5.6%). Multivariable analysis revealed increased odds of infection for school-aged children (5-15 years, odds ratio (OR) = 7.8, CI: 5.9-10.4) and the age groups 15-25 and 25-35 years (15-25 years: OR = 5.8, CI: 4.3-8.0, 25-35 years: OR = 1.6, CI: 1.1-2.4) compared to persons above 35 years of age, for increasing distance to water courses (OR = 1.4, CI: 1.2-1.6 per km) and for proximity to Lake Nyasa (<1 km, OR = 4.5, CI: 1.8-11.4; 1-2 km, OR = 3.5, CI: 1.7-7.5; 2-4 km; OR = 3.3, CI: 1.7-6.6), when compared to distances >4 km. Odds of infection decreased with higher altitude (OR = 0.7, CI: 0.6-0.8 per 100 m increase) and with increasing enhanced vegetation index EVI (OR = 0.2, CI: 0.1-0.4 per 0.1 units). When additionally adjusting for spatial correlation population density became a significant predictor of schistosomiasis infection (OR = 1.3, CI: 1.1-1.5 per 1000 persons/km2) and altitude turned non-significant. We found highly focal geographical patterns of S. haematobium infection in Mbeya Region in Southwestern Tanzania. Despite low overall prevalence our spatially heterogeneous results show that some of the study sites suffer from a considerable burden of S. haematobium infection, which is related to various socio-demographic and environmental factors. Our results could help to design more effective control strategies in the future, especially targeting school-aged children living in low altitude sites and/or crowded areas as the persons at highest need for preventive chemotherapy.

Survey of Schistosomiasis in Saint Lucia: Evidence for Interruption of Transmission

Saint Lucia at one time had levels of schistosomiasis prevalence and morbidity as high as many countries in Africa. However, as a result of control efforts and economic development, including more widespread access to sanitation and safe water, schistosomiasis on the island has practically disappeared. To evaluate the current status of schistosomiasis in Saint Lucia, we conducted a nationally representative school-based survey of 8–11-year-old children for prevalence of Schistosoma mansoni infections using circulating antigen and specific antibody detection methods. We also conducted a questionnaire about available water sources, sanitation, and contact with fresh water. The total population of 8–11-year-old children on Saint Lucia was 8,985; of these, 1,487 (16.5%) provided urine for antigen testing, 1,455 (16.2%) provided fingerstick blood for antibody testing, and 1,536 (17.1%) answered the questionnaire. Although a few children were initially low positives by antigen or antibody detection methods, none could be confirmed positive by follow-up testing. Most children reported access to clean water and sanitary facilities in or near their homes and 48% of the children reported contact with fresh water. Together, these data suggest that schistosomiasis transmission has been interrupted on Saint Lucia. Additional surveys of adults, snails, and a repeat survey among school-age children will be necessary to verify these findings. However, in the same way that research on Saint Lucia generated the data leading to use of mass drug administration for schistosomiasis control, the island may also provide the information needed for guidelines to verify interruption of schistosomiasis transmission.

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.

Gender-based differences in water, sanitation and hygiene-related diarrheal disease and helminthic infections: a systematic review and meta-analysis

BACKGROUND

Qualitative evidence suggests that inadequate water, sanitation and hygiene (WASH) may affect diarrheal and helminthic infection in women disproportionately. We systematically searched PubMed in June 2014 (updated 2016) and the WHO website, for relevant articles.

METHODS

Articles dealing with the public health relevance of helminthic and diarrheal diseases, and highlighting the role of gender in WASH were included. Where possible, we carried out a meta-analysis.

RESULTS

In studies of individuals 5 years or older, cholera showed lower prevalence in males (OR 0.56; 95% CI 0.34-0.94), while Schistosoma mansoni (1.38; 95% CI 1.14-1.67), Schistosoma japonicum (1.52; 95% CI 1.13-2.05), hookworm (1.43; 95% CI 1.07-1.89) and all forms of infectious diarrhea (1.21; 95% CI 1.06-1.38) showed a higher prevalence in males. When studies included all participants, S. mansoni and S. japonicum showed higher prevalence with males (OR 1.40; 95% CI 1.27-1.55 and 1.84; 95% CI 1.27-2.67, respectively). Prevalence of Trichiuris and hookworm infection showed effect modification with continent.

CONCLUSIONS

Evidence of gender differences in infection may reflect differences in gender norms, suggesting that policy changes at the regional level may help ameliorate gender related disparities in helminthic and diarrheal disease prevalence.

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.

Urinary Schistosomosis in Patients of Rural Medical Health Centers in Kwale County, Kenya

Urinary schistosomosis is a serious public health problem prevalent in low-income rural regions of sub-Saharan Africa, including coastal part of Kenya. Praziquantel administration to school-aged children is the prevailing tool of schistosomosis control in these regions. The aim of our study was to find out if this control strategy can lead to interruption of parasite trasmission and disease elimination. During February and March 2018, the occurrence of urinary schistosomosis in volunteers of primary health care facilities in Kwale County, Kenya was examined and the occurrence of infected intermediate hosts Bulinus globosus in local water resources was monitored. Participants completed a questionnaire concerning source of water for household purposes, type of housing and health status and were asked to provide urine samples. Diagnosis of urinary schistosomosis was established by detection of Schistosoma haematobium eggs in urine specimens microscopically, using filtration method. Infected B. globosus snails were detected using cercaria shedding tests. From the hemolymph of snails, prepatent period of infection was identified by polymerase chain reaction (PCR). The presence of urinary schistosomosis was detected in 15.07 % (69 out of 451) of study participants. Cercaria shedding test was positive in 2 particular sites of river Pengo and Tsanganyiko. Genetic material (haemolymph) of 68 B. globosus snails tested by DraI PCR revealed 7 Schistosoma spp. positive samples. Six of seven DraI positive snails were infected by S. haematobium, as it was detected by Sh110/SmS1 PCR. The study revealed, that the disease was still present in the region studied and the transmission was not interrupted. The rate of infection was significantly influenced by the water supplies used for household purposes and the type of housing.

Prevalence and Risk Factors for Schistosomiasis among Schoolchildren in two Settings of Côte d'Ivoire

Schistosomiasis is a parasitic disease affecting more than 250 million people, primarily in sub-Saharan Africa. In Côte d’Ivoire both Schistosoma haematobium (causing urogenital schistosomiasis) and Schistosoma mansoni (causing intestinal schistosomiasis) co-exist. This study aimed to determine the prevalence of S. haematobium and S. mansoni and to identify risk factors among schoolchildren in the western and southern parts of Côte d’Ivoire. From January to April 2018, a cross-sectional study was carried out including 1187 schoolchildren aged 5–14 years. Urine samples were examined by a filtration method to identify and count S. haematobium eggs, while stool samples were subjected to duplicate Kato-Katz thick smears to quantify eggs of S.mansoni and soil-transmitted helminths. Data on sociodemographic, socioeconomic, and environmental factors were obtained using a pretested questionnaire. Multivariate logistic regression was employed to test for associations between variables. We found a prevalence of S. haematobium of 14.0% (166 of 1187 schoolchildren infected) and a prevalence of S. mansoni of 6.1% (66 of 1089 schoolchildren infected). In the southern part of Côte d’Ivoire, the prevalence of S. haematobium was 16.1% with a particularly high prevalence observed in Sikensi (35.6%), while S. mansoni was most prevalent in Agboville (11.2%). Swimming in open freshwater bodies was the main risk factor for S. haematobium infection (adjusted odds ratio (AOR) = 127.0, 95% confidence interval (CI): 25.0–634.0, p < 0.001). Fishing and washing clothes in open freshwater bodies were positively associated with S. haematobium and S. mansoni infection, respectively. Preventive chemotherapy using praziquantel should be combined with setting-specific information, education, and communication strategies in order to change children’s behavior, thus avoiding contact with unprotected open freshwater.

Prevalence and Risk Factors Associated with S. haematobium Egg Excretion during the Dry Season, Six Months following Mass Distribution of Praziquantel (PZQ) in 2017 in the Bafia Health Area, South West Region Cameroon: A Cross-Sectional Study

Background

A selective population mass drug administration of PZQ involving school-aged children was carried out in the Bafia Health Area in April 2017. This study investigated the prevalence, intensity, and factors associated with S. haematobium egg excretion in this foci during the dry season, six months after the chemotherapy campaign.

Methods

A cross-sectional study including 1001 consenting individuals (aged 3-62 years) was carried out in three localities (Ikata, Bafia, and Munyenge) in the Bafia Health Area between November 2017 and January 2018. Information on sociodemographic, stream usage, and contact behaviour was documented. Schistosoma haematobium ova in urine were detected using membrane filtration technique.

Results

The prevalence of S. haematobium egg excretion was 8% with a higher level recorded in Munyenge (13.2%) than Ikata (7.5%) and Bafia (2.8%). The difference was significant (p < 0.001). Equally, Munyenge had the highest infection intensity (36.36 range: 2-200) when compared with Ikata (16.25 range: 2-57) and Bafia (8.0 range: 0-8). Although the age group (5–15 years) was significantly (p < 0.001) associated with more exposure to infested water, this group was less likely (OR: 0.42 95% CI: 0.19-0.91) associated with S. haematobium egg excretion. The risk of egg excretion increased by 4.79 times (95% CI: 2.20-10.41) and 3.68 times (95% CI: 1.59-8.54) among residents in Munyenge and Ikata, respectively. Similarly, frequency to the stream (> thrice/day) was significantly higher (χ² = 58.73; p < 0.001) in Munyenge. Frequent contact (three visits/day) with stream correlated with highest odds of egg excretion (OR: 8.43 95% CI: 3.71-19.13).

Conclusion

The prevalence of S. haematobium egg excretion was low during the dry season. This was most likely attributed to the preventive campaign with PZQ and may parallel low transmission potentials in infested waters during this period.

Toxicity of a molluscicide candidate PPU07 against Oncomelania hupensis (Gredler, 1881) and local fish in field evaluation

Schistosomiasis japonica caused by Schistosoma japonicum infection is recognized as a considerable economic and public health concern in Asia. Oncomelania hupensis is the sole intermediate host of S. japonicum. The only molluscicide recommended by World Health Organization (WHO) since 1960s is relative toxic to other aquatic species. In this article, we evaluated the novel molluscicide PPU07 in field trials on their efficiency against O. hupensis and toxicity for local fish. 25% PPU07 sulfate WP exhibited similar molluscicidal effect at 2.0 g/m² and 2.0 g/m³ in the spraying and immersion trials with the WHO recommended molluscicide niclosamide (1 g/m² and 1 g/m³). The mortality rates reached 95% and 96%, respectively. Moreover, little toxicity was observed for local fish and other aquatic organisms at the effective molluscicidal concentrations. In all, 25% PPU07 sulfate WP is a promising molluscicide for snail control, particularly in semi-commercial or commercial aquaculture ponds.

Supplementation with micronutrients and schistosomiasis: systematic review and meta-analysis

Schistosomiasis is a parasitic disease caused by helminths of the genus Schistosoma with two presentations; one intestinal and another urinary; which depend on the specie of Schistosoma. One of the species that can produce intestinal schistosomiasis is Schistosoma mansoni, and the specie that produces urinary schistosomiasis is Schistosoma haematobium. Infection can be aggravated by a deficient nutritional status, which negatively impacts the immune system and increases susceptibility to infection. The main objective of this meta-analysis is to determine if a relationship exists between multimicronutrient supplementation and the reduction of infestation with Schistosoma mansoni and Schistosoma haematobium in children and adolescents. A search was conducted through a scientific literature database, and articles that complied with the pre-established requirements were retrieved. The Review Manager (Rev Man) 5.3 computer program was used for data processing and analysis was carried out with the objective of testing whether the addition of micronutrient supplementation to treatment with broad-spectrum antiparasitic anthelmintic medication has an impact on schistosomiasis infection. Of the 257 initial articles retrieved, eight were included both quantitatively and qualitatively in the meta-analysis. Supplementation reduces infestation with Schistosoma spp 1.33 times more than placebo. In individuals infested with Schistosoma, mansoni supplementation is 1.30 times more effective than placebo and for individuals infested with Schistosoma haematobium, supplementation is 1.62 times more effective than the placebo. The results show a clear relationship between supplementation and reduction of infestation. The supplementation with micronutrients decreases the presence of Schistosoma spp in children and adolescents.