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Hailegebriel T, Nibret E, Munshea A, Ameha Z. Prevalence, intensity and associated risk factors of Schistosoma mansoni infections among schoolchildren around Lake Tana, northwestern Ethiopia. PLoS Negl Trop Dis 2021; 15:e0009861. [PMID: 34705817 PMCID: PMC8550401 DOI: 10.1371/journal.pntd.0009861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schistosomiasis is one of the widely distributed neglected tropical diseases. It is a serious public health problem in sub-Saharan Africa. The disease is highly prevalent and widely distributed in Ethiopia due to suitable environmental factors and human activities. The prevalence and infection intensity varied from locality to locality in the country. This study aimed to assess the prevalence and intensity of S. mansoni infection and associated risk factors among schoolchildren around Lake Tana. METHODS A school-based cross-sectional study was conducted among 710 schoolchildren from February to April 2021 in eight selected primary schools around Lake Tana. A questionnaire was used to collect data on socio-demographic information and potential risk factors of S. mansoni infection. After collecting socio-demographic information, students were requested to bring about 2grams of stool specimens for parasitological examination. The collected stool samples were processed using a single Kato-Katz and Ritchie's concentration techniques. The data were analyzed using SPSS software version 23 and factors with a p-value < 0.05 were considered as statistically significant. RESULTS The overall prevalence of S. mansoni was 34.9% (95% CI: 31.4-38.7) among schoolchildren in the study area. The eggs per gram (EPG) of stool ranged from 24 to 1659 with arithmetic and geometric mean values of 138.1 EPG and 85.1 EPG, respectively. The majority of S. mansoni infections (61.4%) were classified as low infection intensity. Among the different determinant factors being male (AOR = 1.74; 95%CI = 1.233-2.457; P-value = 0.002), bathing habits (AOR = 1.494; 95%CI = 1.013-2.199; P-value = 0.043) and students attending at Qunzela primary school (AOR = 10.545; 95%CI = 3.264-34.067; P-value = 0.001), Alabo primary school (AOR = 3.386; 95%CI = 1.084-10.572; P-value = 0.036) were significantly associated with S. mansoni infection. CONCLUSION This study revealed that more than one-third of schoolchildren were infected by S. mansoni in the study area. The majority of the infections were classified as low infection intensity. Being male, bathing habits and schools in which students attended were independent explanatory factors for S. mansoni infection. Therefore, integrated control strategies are needed to improve the health conditions of schoolchildren in the study area.
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Affiliation(s)
- Tamirat Hailegebriel
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Biotechnology Research Institute (BRI), Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Biotechnology Research Institute (BRI), Bahir Dar University, Bahir Dar, Ethiopia
| | - Abaineh Munshea
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
- Biotechnology Research Institute (BRI), Bahir Dar University, Bahir Dar, Ethiopia
| | - Zena Ameha
- Amhara Public Health Institute (APHI), Bahir Dar, Ethiopia
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Favre TC, Massara CL, Beck LCNH, Cabello RKSA, Pieri OS. 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. Parasite Epidemiol Control 2021; 13:e00208. [PMID: 33732914 PMCID: PMC7941185 DOI: 10.1016/j.parepi.2021.e00208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/21/2020] [Accepted: 02/25/2021] [Indexed: 11/24/2022] Open
Abstract
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. Educational actions improved adherence to stool testing. Disease knowledge also improved with educational actions. Risk behavior stayed high despite educational actions.
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Affiliation(s)
- Tereza Cristina Favre
- Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Cristiano Lara Massara
- Helmintology and Medical Malacology Research Group, René Rachou Institute, Fiocruz, Minas Gerais, Brazil
| | | | | | - Otavio Sarmento Pieri
- Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
- Corresponding author.
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Ramírez ADP, Favero V, Lindholz CG, Veríssimo CDM, Pascoal VF, Candido RRF, Morassutti AL, Graeff-Teixeira C. Schistosomiasis: an epidemiological update on Brazil's southernmost low endemic area in Esteio. Rev Soc Bras Med Trop 2020; 53:e20200411. [PMID: 33027417 PMCID: PMC7534964 DOI: 10.1590/0037-8682-0411-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/31/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Brazil's southernmost state, Rio Grande do Sul (RGS), was considered schistosomiasis-free until 1998 when a low endemic focus was identified in Esteio, a city located next to the capital of RGS. In the last two decades, the control interventions applied in the region have been apparently successful, and the absence of new cases indicated the possibility of interrupted schistosomiasis transmission. The objective of this study was to update the clinical and epidemiological data of schistosomiasis in Esteio. METHODS We reviewed all 28 individuals diagnosed with the infection since 1997 and a survey was applied to a group of 29 school-aged children residing in Vila Pedreira, one of the most affected neighborhoods. RESULTS No eggs were detected in fecal samples using the Helmintex method, and all samples were negative for serum antibodies on examination by the western blot technique using the Schistosoma mansoni microsomal antigen (MAMA- WB). In contrast, 23 individuals (79%) tested positive for the cathodic circulating antigen with the point-of-care immunochromatographic test (POC-CCA) on urine samples. Of the 28 formerly infected individuals, only eight were located, of which four tested positive, and four tested negative for serum antibodies using the MAMA-WB technique. CONCLUSIONS Current adverse conditions for S. mansoni transmission in Esteio and the absence of a confirmed diagnosis suggests that there is (i) a lack of specificity of the POC-CCA test in low endemic settings, and (ii) a high probability that interruption of schistosomiasis has been achieved in Esteio.
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Affiliation(s)
- Angélica da Paz Ramírez
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Vivian Favero
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Catieli Gobetti Lindholz
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Carolina de Marco Veríssimo
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Vanessa Fey Pascoal
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Renata Russo Frasca Candido
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil.,University of Western Australia, Department of Physics, Perth, Australia
| | - Alessandra Loureiro Morassutti
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Carlos Graeff-Teixeira
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil.,Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Patologia e Núcleo de Doenças Infecciosas, Vitória, ES, Brasil
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Lim RM, Woolhouse MEJ, Mduluza T, Chase-Topping M, Osakunor DNM, Chitsulo L, Mutapi F. Investigating a strategy for quantifying schistosome infection levels in preschool-aged children using prevalence data from school-aged children. PLoS Negl Trop Dis 2020; 14:e0008650. [PMID: 33001969 PMCID: PMC7529243 DOI: 10.1371/journal.pntd.0008650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/27/2020] [Indexed: 11/27/2022] Open
Abstract
In 2012, the World Health Organisation (WHO) set out a roadmap for eliminating schistosomiasis as a public health problem by 2025. To achieve this target, preschool-aged children (PSAC; aged 6 years and below) will need to be included in schistosomiasis treatment programmes. As the global community discusses the tools and approaches for treating this group, one of the main questions that remains unanswered is how to quantify infection in this age group to inform treatment strategies. The aim of this study was thus to determine whether a relationship exists between levels of schistosome infection in PSAC and school-aged children (SAC), that can be used to determine unknown schistosome infection prevalence levels in PSAC. A systematic search of publications reporting schistosomiasis prevalence in African PSAC and SAC was conducted. The search strategy was formulated using the PRISMA guidelines and SPIDER search strategy tool. The published data was subjected to regression analysis to determine if a relationship exists between infection levels in PSAC and SAC. The interaction between SAC and community treatment history was also entered in the regression model to determine if treatment history significantly affected the relationship between PSAC and SAC prevalence. The results showed that a significant positive relationship exists between infection prevalence levels in PSAC and SAC for Schistosoma mansoni (r = 0.812, df (88, 1), p = <0.0001) and S. haematobium (r = 0.786, df (53, 1), p = <0.0001). The relationship was still significant after allowing for diagnostic method, treatment history, and the African sub-region where the study was conducted (S. mansoni: F = 25.63, df (88, 9), p = <0.0001; S. haematobium: F = 10.20, df (53, 10), p = <0.0001). Using the regression equation for PSAC and SAC prevalence, over 90% of the PSAC prevalence studies were placed in the correct WHO classifications category based on the SAC levels, regardless of treatment history. The study indicated that schistosome prevalence in SAC can be extended as a proxy for infection levels in PSAC, extending on its current use in the adult population. SAC prevalence data could identify where there is a need to accelerate and facilitate the treatment of PSAC for schistosomiasis in Africa. Preschool-aged children (PSAC), i.e. aged ≤ 6 years, are not included in preventative chemotherapy programmes, currently advocated by the WHO for the treatment of schistosomiasis. This is due to the lack of a paediatric formulation of the drug of choice, praziquantel, and the current guidelines which requires diagnosis before treatment. As the global community prepares for the deployment of a new paediatric formulation of praziquantel, there is a need to find a strategy to quantify infection in this age group. In schistosome endemic areas, infection levels in school-aged children (SAC) are already used to inform infection levels in the community. Thus, we investigated the relationship between SAC and PSAC schistosome prevalence levels within the same community, to determine if data from SAC could be used to predict infection levels in PSAC. Our results show that PSAC prevalence levels are significantly correlated with SAC prevalence levels. Our findings are applicable to communities that have received preventative chemotherapy in SAC or in SAC and adults, as well as those that have not received any. Our study indicates that it is possible to extrapolate PSAC prevalence levels from SAC prevalence, and to make a treatment decision on that basis.
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Affiliation(s)
- Rivka M. Lim
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- * E-mail:
| | - Mark E. J. Woolhouse
- Usher Institute, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Takafira Mduluza
- Department of Biochemistry, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe
| | - Margo Chase-Topping
- Usher Institute, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- Roslin Institute, Easter Bush, Midlothian, United Kingdom
| | - Derick N. M. Osakunor
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | | | - Francisca Mutapi
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
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Faust CL, Osakunor DNM, Downs JA, Kayuni S, Stothard JR, Lamberton PHL, Reinhard-Rupp J, Rollinson D. Schistosomiasis Control: Leave No Age Group Behind. Trends Parasitol 2020; 36:582-591. [PMID: 32430274 DOI: 10.1016/j.pt.2020.04.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 01/11/2023]
Abstract
Despite accelerating progress towards schistosomiasis control in sub-Saharan Africa, several age groups have been eclipsed by current treatment and monitoring strategies that mainly focus on school-aged children. As schistosomiasis poses a threat to people of all ages, unfortunate gaps exist in current treatment coverage and associated monitoring efforts, preventing subsequent health benefits to preschool-aged children as well as certain adolescents and adults. Expanding access to younger ages through the forthcoming pediatric praziquantel formulation and improving treatment coverage in older ages is essential. This should occur alongside formal inclusion of these groups in large-scale monitoring and evaluation activities. Current omission of these age groups from treatment and monitoring exacerbates health inequities and has long-term consequences for sustainable schistosomiasis control.
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Affiliation(s)
- Christina L Faust
- Wellcome Centre for Integrative Parasitology, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK.
| | - Derick N M Osakunor
- Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, King's Buildings, Charlotte Auerbach Road, Edinburgh EH9 3FL, UK
| | - Jennifer A Downs
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA
| | - Sekeleghe Kayuni
- Department of Tropical Disease Biology, Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK; MASM Medi Clinics Limited, Medical Aid Society of Malawi (MASM), Blantyre, Malawi
| | - J Russell Stothard
- Department of Tropical Disease Biology, Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Poppy H L Lamberton
- Wellcome Centre for Integrative Parasitology, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK
| | | | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London SW7 5BD, UK
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Toor J, Turner HC, Truscott JE, Werkman M, Phillips AE, Alsallaq R, Medley GF, King CH, Anderson RM. The design of schistosomiasis monitoring and evaluation programmes: The importance of collecting adult data to inform treatment strategies for Schistosoma mansoni. PLoS Negl Trop Dis 2018; 12:e0006717. [PMID: 30296257 PMCID: PMC6175503 DOI: 10.1371/journal.pntd.0006717] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/24/2018] [Indexed: 12/02/2022] Open
Abstract
Monitoring and evaluation (M&E) programmes are used to collect data which are required to assess the impact of current interventions on their progress towards achieving the World Health Organization (WHO) goals of morbidity control and elimination as a public health problem for schistosomiasis. Prevalence and intensity of infection data are typically collected from school-aged children (SAC) as they are relatively easy to sample and are thought to be most likely to be infected by schistosome parasites. However, adults are also likely to be infected. We use three different age-intensity profiles of infection for Schistosoma mansoni with low, moderate and high burdens of infection in adults to investigate how the age distribution of infection impacts the mathematical model generated recommendations of the preventive chemotherapy coverage levels required to achieve the WHO goals. We find that for moderate prevalence regions, regardless of the burden of infection in adults, treating SAC only may achieve the WHO goals. However, for high prevalence regions with a high burden of infection in adults, adult treatment is required to meet the WHO goals. Hence, we show that the optimal treatment strategy for a defined region requires consideration of the burden of infection in adults as it cannot be based solely on the prevalence of infection in SAC. Although past epidemiological data have informed mathematical models for the transmission and control of schistosome infections, more accurate and detailed data are required from M&E programmes to accurately determine the optimal treatment strategy for a defined region. We highlight the importance of collecting prevalence and intensity of infection data from a broader age-range, specifically the inclusion of adult data at baseline (prior to treatment) and throughout the treatment programme if possible, rather than SAC only, to accurately determine the treatment strategy for a defined region. Furthermore, we discuss additional epidemiological data, such as individual longitudinal adherence to treatment, that should ideally be collected in M&E programmes. Schistosomiasis remains an endemic parasitic disease affecting millions of people around the world. The World Health Organization (WHO) has set goals of morbidity control and elimination as a public health problem for schistosomiasis defined by reaching ≤5% and ≤1% prevalence of heavy-intensity infections in school-aged children, respectively. Monitoring and evaluation (M&E) programmes are used to collect data which can inform treatment strategies required in a defined area and can also aid in assessing the progress of implemented treatment strategies. Due to programmatic and financial constraints, M&E data are typically collected from school-aged children as they are thought to be most likely to be infected. We highlight that adults should be included within M&E programmes by showing how the burden of infection in adults impacts our mathematical model recommendations of the treatment coverage levels required to reach the WHO goals for schistosomiasis. Our results highlight the importance of collecting data from a broader age-range, specifically the inclusion of adult data at baseline (prior to treatment) and throughout the treatment programme if possible. Improving M&E programmes to incorporate collection of such data will allow for more accurate determination of the optimal treatment strategy for a defined region.
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Affiliation(s)
- Jaspreet Toor
- London Centre for Neglected Tropical Disease Research and Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
- * E-mail:
| | - Hugo C. Turner
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - James E. Truscott
- London Centre for Neglected Tropical Disease Research and Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
- The DeWorm3 Project, The Natural History Museum of London, London, United Kingdom
| | - Marleen Werkman
- London Centre for Neglected Tropical Disease Research and Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
- The DeWorm3 Project, The Natural History Museum of London, London, United Kingdom
| | - Anna E. Phillips
- London Centre for Neglected Tropical Disease Research and Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
| | - Ramzi Alsallaq
- Center for Global Health and Diseases and Department of Mathematics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Graham F. Medley
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Charles H. King
- Center for Global Health and Diseases and Department of Mathematics, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Roy M. Anderson
- London Centre for Neglected Tropical Disease Research and Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, United Kingdom
- The DeWorm3 Project, The Natural History Museum of London, London, United Kingdom
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Musuva RM, Matey E, Masaku J, Odhiambo G, Mwende F, Thuita I, Kihara J, Njomo D. Lessons from implementing mass drug administration for soil transmitted helminths among pre-school aged children during school based deworming program at the Kenyan coast. BMC Public Health 2017; 17:575. [PMID: 28615011 PMCID: PMC5471907 DOI: 10.1186/s12889-017-4481-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 06/01/2017] [Indexed: 12/14/2022] Open
Abstract
Background The 2012 London declaration which committed to “sustaining, expanding and extending drug access programmes to ensure the necessary supply of drugs and other interventions to help control soil-transmitted helminths (STH) by 2020” has seen many countries in Africa roll out mass drug administration (MDA) especially among school age children. In Kenya, however, during the National school-based deworming exercise, pre-school aged children (PSAC) have to access treatment at primary schools as the pre-school teachers are not trained to carry out deworming. With studies being conducted on the effectiveness of MDAs, the experiences of key education stakeholders which could improve the programme by giving best practices, and challenges experienced have not been documented. Methods This was a cross-sectional qualitative study using Focus group discussions (FGDs) and Key informant interviews (KIIs). It was conducted in 4 sub-counties with high STH prevalence at the Kenyan coast (Matuga, Malindi, Lunga Lunga and Msambweni) to understand best practices for implementing MDA among PSAC.FGDs categorized by gender were conducted among local community members, whereas KIIs involved pre-school teachers, primary school teachers, community health extension workers (CHEWs) and opinion leaders. Participants were purposefully selected with the saturation model determining the number of interviews and focus groups. Voice data collected was transcribed verbatim then coded and analyzed using ATLAS.Ti version 6. Results Majority of the primary school teachers and CHEWs reported that they were satisfied with the method of mobilization used and the training tools. This was however not echoed by the pre-school teachers, parents and chiefs who complained of being left out of the process. Best practices mentioned included timely drug delivery, support from pre-school teachers, and management of side effects. Overcrowding during the drug administration day, complexity of the forms (for instance the ‘S form’) and long distance between schools were mentioned as challenges. Conclusion There is need to utilize better sensitization methods to include the local administration as well as the parents for better uptake of the drugs. Extending deworming training to pre-school teachers will enhance the national deworming programme. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4481-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rosemary M Musuva
- Center for Global Health Research (CGHR), Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya.
| | - Elizabeth Matey
- Center for Microbiology Research, Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
| | - Janet Masaku
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
| | - Gladys Odhiambo
- Center for Global Health Research (CGHR), Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya
| | - Faith Mwende
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
| | - Isaac Thuita
- Ministry of Education, Directorate of Basic Education, Early Childhood Education Section, P. O. Box- 30040-00100, Nairobi, Kenya
| | - Jimmy Kihara
- Ministry of Health, Division of Vector Borne Diseases, P. O. Box-20750-00202, Nairobi, Kenya
| | - Doris Njomo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, P. O. Box 54840 - 00200, Nairobi, Kenya
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Figueiredo ALC, Domingues ALC, Melo WG, Tashiro T, de Lorena VMB, Montenegro SML, Morais CNL. Receptor Antagonist of IL-13 Exerts a Potential Negative Regulation During Early Infection of Human Schistosomiasis. Scand J Immunol 2017; 84:284-290. [PMID: 27507682 DOI: 10.1111/sji.12472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 08/08/2016] [Indexed: 11/30/2022]
Abstract
The pathology of schistosomiasis is associated with the formation of granulomas, and this process is associated with liver fibrosis. Studies indicate that Th1 cytokines reduce fibrosis in schistosomiasis, while Th2 cytokines play a part in the progression of fibrosis, and IL-13 has a critical role in this process. The IL-13Rα2 receptor, known as a 'receptor antagonist' binds with high affinity to IL-13, and studies have identified that this plays a part in reducing fibrosis and the size of granulomas. The objective of this study was to evaluate the function of IL-13Rα2 and cellular immune response in hepatic fibrosis. A negative correlation between IL-13Rα2 and IL-13 was found, suggesting an increase in cytokine in early fibrosis. Initially, a negative correlation between IFN-γ and IL-13 was found in patients without fibrosis, and subsequently, this correlation was found to be positive in patients with severe fibrosis, thereby highlighting a new mechanism for regulating the progress of periportal fibrosis. There was a positive correlation between the profiles of Th1 and Th2 cytokines, suggesting the presence of both responses, thus regulating the disease. The results contribute to a better understanding of the immune mechanisms that control the process of hepatic fibrogenesis in schistosomiasis in humans.
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Affiliation(s)
| | - A L C Domingues
- Gastroenterology Outpatients Clinic, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - W G Melo
- Aggeu Magalhães Research Center, Recife, Pernambuco, Brazil
| | - T Tashiro
- Department of Physical Education, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | - C N L Morais
- Aggeu Magalhães Research Center, Recife, Pernambuco, Brazil.
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Favre TC, Fernandez MA, Beck LCNH, Guimarães RJDPS, Pieri OS, Thiengo SAC. Assessment of schistosomiasis in the semi-arid Northeast region of Brazil: the São Francisco River large-scale water transposition project. Rev Soc Bras Med Trop 2016; 49:252-7. [DOI: 10.1590/0037-8682-0243-2015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/08/2015] [Indexed: 11/21/2022] Open
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Mwinzi PNM, Muchiri G, Wiegand RE, Omedo M, Abudho B, Karanja DMS, Montgomery SP, Secor WE. Predictive Value of School-Aged Children's Schistosomiasis Prevalence and Egg Intensity for Other Age Groups in Western Kenya. Am J Trop Med Hyg 2015; 93:1311-7. [PMID: 26416108 DOI: 10.4269/ajtmh.15-0467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/20/2015] [Indexed: 11/07/2022] Open
Abstract
World Health Organization recommendations for the timing and target population for mass drug administration (MDA) for schistosomiasis are based on the prevalence of infection in school children within a given community. In a large study comparing MDA approaches for Schistosoma mansoni control, we evaluated whether prevalence of infection and egg burdens in 9- to 12-year-old students reflected infection levels in young children and adults in the same community. Cross-sectional surveys of preadolescents (9-12 years old) were compared with those of first year students (5-8 years old) in 225 villages and adults (20-55 years old) in 150 villages along the Kenyan shores of Lake Victoria. Village schistosomiasis prevalence and intensity levels in preadolescents strongly correlated (P < 0.0001) with prevalence and infection intensity for other age groups in the community. Our findings suggest that S. mansoni prevalence and intensity among 9- to 12-year-olds are valid for community sampling purposes in mapping for MDAs.
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Affiliation(s)
- Pauline N M Mwinzi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Geoffrey Muchiri
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan E Wiegand
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Martin Omedo
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bernard Abudho
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Diana M S Karanja
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan P Montgomery
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - W Evan Secor
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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Favre TC, Pereira AP, Beck LC, Galvão AF, Pieri OS. School-based and community-based actions for scaling-up diagnosis and treatment of schistosomiasis toward its elimination in an endemic area of Brazil. Acta Trop 2015; 149:155-62. [PMID: 25940353 DOI: 10.1016/j.actatropica.2015.04.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 03/25/2015] [Accepted: 04/23/2015] [Indexed: 12/25/2022]
Abstract
This study evaluated a school-based and a community-based scheme for diagnosis, treatment and follow-up of schistosomiasis mansoni among school-aged children in views of resolution CD49.R19 of the Pan American Health Organization toward the elimination of schistosomiasis as a public health problem in the Americas and subsequent commitments endorsed by the Brazilian government. The school-aged population from a representative municipality of the endemic area of Northeastern Brazil was randomly allocated to either school-based or community-based scheme. The two schemes were compared with regard to coverage of diagnosis by the Kato-Katz method (KK) at baseline, treatment of the positives for Schistosoma mansoni with praziquantel, treatment of the positives for soil-transmitted helminthes (STH) with mebendazole, as well as follow-up of treatment efficacy and reinfection assessed respectively at four and 12 months after treatment. Nutritional status of the positives for S. mansoni was assessed at baseline and re-assessed at 12 months after treatment. Coverage of diagnosis and treatment was satisfactory (>75%) in both schemes. Diagnosis coverage at baseline and at 12 months was significantly higher in the community scheme, whereas treatment coverage did not differ significantly between the two schemes either at baseline or at 12 months. The number of children covered per day was significantly higher in the schools than in the community at baseline but not at follow-up, when daily coverage was higher in the community. With regard to S. mansoni, overall treatment efficacy rate at four months was 90.8%, and reinfection rate at 12 months was 21.6%. For STH, overall treatment efficacy was 45.4% and reinfection, 32.8%. The nutritional status of the positives for S. mansoni at baseline did not change significantly at 12 months post-treatment. Actions targeted at this particularly vulnerable high-risk group should combine school-based and community-based interventions as well as preventive measures to reduce transmission.
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