Prevalence and intensity ofSchistosoma mansoniinfection in pediatric populations on antiretroviral therapy in north-western Tanzania: a cross-sectional study
BackgroundIn areas where HIV and intestinal schistosomiasis are highly endemic, co-infections of the two diseases in a single human host are frequent. Evidence in adult populations indicates that HIV and intestinal schistosomiasis are associated with negative health impacts. However, the topic of HIV and schistosomiasis in paediatric populations has received little attention. The present study determined the prevalence and intensity ofSchistosoma mansoniinfection in a paediatric population on antiretroviral therapy (ART) in north-western Tanzania.Design, settings and participantsA cross-sectional study was conducted among HIV-infected children aged 1–16 years on ART attending a Care and Treatment Clinic at Ukerewe Designated District Hospital, north-western Tanzania.Main outcome measuresSingle stool and urine samples were collected and screened forS. mansonieggs and circulating cathodic antigen (CCA), using the Kato-Katz (KK) technique and point-of-care CCA (POC-CCA) rapid urine test, respectively.ResultsA total of 134 children with a median age of 10 years (IQR 7–12 years) participated in the study. Of these, 44.8% (60/134) and 55.2% (74/134) were female and male, respectively. The overall prevalence ofS. mansonibased on the KK technique and POC-CCA rapid test were 10.7% (95% CI 5.9% to 18.4%) and 33.8% (95% CI 26.2% to 42.4%), respectively. The overall geometrical mean eggs per gram of faeces was 293.9 GM-epg (95% CI 123.3 to 700.9). A small proportion of the children had moderate (4.9%, 5/103) and heavy (3.8%, 4/103) intensity of infection.ConclusionPaediatric populations on ART are co-infected withS. mansoniinfection. Screening and treatment of intestinal schistosomiasis at initiation of ART is recommended to reduce the risk of developing hepatosplenic disease, schistosomiasis-related immune reconstitution inflammatory syndrome and the possible adverse effect of schistosomiasis on outcome of ART.