Morbidity associated with Schistosoma mansoni infection in north-eastern Democratic Republic of the Congo

Background Reducing morbidity is the main target of schistosomiasis control efforts, yet only rarely do control programmes assess morbidity linked to Schistosoma sp. infection. In the Democratic Republic of Congo (DRC), and particularly in north-eastern Ituri Province, little is known about morbidity associated with Schistosoma mansoni infection. For this reason, we aimed to assess intestinal and hepatosplenic morbidity associated with S. mansoni infection in Ituri Province. Methods/Principal findings In 2017, we conducted a cross-sectional study in 13 villages in Ituri Province, DRC. S. mansoni infection was assessed with a Kato-Katz stool test (2 smears) and a point-of-care circulating cathodic antigen (POC-CCA) urine test. A questionnaire was used to obtain demographic data and information about experienced intestinal morbidity. Each participant underwent an abdominal ultrasonography examination to diagnose hepatosplenic morbidity. Of the 586 study participants, 76.6% tested positive for S. mansoni. Intestinal morbidity reported in the two preceding weeks was very frequent, and included abdominal pain (52.7%), diarrhoea (23.4%) and blood in the stool (21.5%). Hepatosplenic morbidity consisted of abnormal liver parenchyma patterns (42.8%), hepatomegaly (26.5%) and splenomegaly (25.3%). Liver pathology (adjusted odds ratio [aOR] 1.20, 95% confidence interval [CI] 1.06–1.37, p = 0.005) was positively and significantly associated with S. mansoni infection. Hepatomegaly (aOR 1.52, 95% CI 0.99–2.32, p = 0.053) and splenomegaly (aOR 1.12, 95% CI 0.73–1.72, p = 0.619) were positively but not significantly associated with S. mansoni infection at the individual level. At the village level, S. mansoni prevalence was positively associated with the prevalence of hepatomegaly and splenomegaly. High-intensity S. mansoni infections were associated with diarrhoea, blood in the stool, hepatomegaly, splenomegaly, and liver parenchyma (C, D, E and F pathology patterns). Four study participants were diagnosed with ascites and five reported hematemesis. Conclusions/Significance Our study documents a high burden of intestinal and hepatosplenic morbidity associated with S. mansoni infection status in Ituri Province. The findings call for targeted interventions to address both S. mansoni infection and related morbidity.

Download Full-text

Morbidity associated with Schistosoma mansoni infection in northeastern Democratic Republic of the Congo

10.1101/2020.05.23.20108654 ◽

2020 ◽

Author(s):

Maurice M Nigo ◽

Peter Odermatt ◽

David Wully Nigo ◽

Georgette B. Salieb-Beugelaar ◽

Manuel Battegay ◽

...

Keyword(s):

Schistosoma Mansoni ◽

Democratic Republic ◽

Point Of Care ◽

Liver Parenchyma ◽

Cross Sectional Study ◽

Sectional Study ◽

Abdominal Ultrasonography ◽

Cross Sectional ◽

Study Participants ◽

Spleen Enlargement

AbstractBackgroundControlling morbidity is the main target of schistosomiasis control. Yet, only rarely do we assess morbidity linked to Schistosoma sp. infection. In the Democratic Republic of Congo (DRC), and particularly in the northeastern Ituri province, morbidity associated with Schistosoma mansoni infection is unknown. For this reason, we aimed to assess intestinal and hepatosplenic morbidity associated with S. mansoni infection in Ituri province.Methods / Principal FindingsIn 2017, we conducted a cross-sectional study in 13 villages in Ituri province, DRC. S. mansoni infection was assessed with a Kato-Katz stool test (2 smears) and a point-of-care circulating cathodic antigen (POC-CCA) test in urine. A questionnaire was used to obtain demographic data and information about experienced intestinal morbidity. Each participant underwent an abdominal ultrasonography examination to diagnose hepatosplenic morbidity. Of the 586 study participants, 76.6% tested positive for S. mansoni. Intestinal morbidity, such as abdominal pain (52.7%), diarrhoea (23.4%) and blood in the stool (21.5%) in the previous two weeks, was very frequent, as was hepatosplenic morbidity, such as splenomegaly (60.1%), hepatomegaly (23.2%) and abnormal liver parenchyma pattern (52.6%). Hepatomegaly (adjusted odds ratio [aOR] 2.04, 95% confidence interval [CI] 1.27–3.26, P=0.003) and splenomegaly (aOR 1.69, 95% CI 1.17–2.45, P=0.005) were positively associated with S. mansoni infection at the individual level. At the village level, S. mansoni prevalence was positively associated with the prevalence of hepatomegaly and splenomegaly. Higher S. mansoni infection intensities were associated with diarrhoea, blood in the stool, hepatomegaly, splenomegaly and with liver parenchyma, pathology pattern D-E. Four study participants were diagnosed with ascites and five reported hematemesis.Conclusions/SignificanceOur study documents a high burden of intestinal and hepatosplenic morbidity associated with S. mansoni infection status in Ituri province. The results call for targeted interventions to address both S. mansoni infection and related morbidity.Author SummarySchistosomiasis caused by Schistosoma mansoni is of great public health importance in sub-Saharan Africa. The World Health Organisation (WHO) recommends that control efforts aim to reduce morbidity through large scale intervention programmes. However, intestinal and liver morbidity is rarely assessed in such control programmes. Hence, little is known about (i) the magnitude of the intestinal and liver morbidity burden in a given community, or about (ii) the morbidity associated with S. mansoni infection, specifically. We conducted a (cross-sectional) study in which we assessed intestinal morbidity by questionnaire and liver morbidity by abdominal ultrasonography. Further, we determined the infection status of the study participants using standard diagnostic procedures (Kato-Katz technique and point-of-care cathodic circulating S. mansoni antigen [POC-CCA] test in urine). Among 586 study participants, six years and older, from 13 villages in Ituri province, DRC, we observed a high degree of intestinal (e.g. 23.4% with diarrhoea, 21.5% with blood in stool) and hepatosplenic morbidity (e.g. 60.1% with enlarged spleen, 23.2% with enlarged liver). S. mansoni infection was associated with liver and spleen enlargement. Likewise, S. mansoni infection intensity was linked to diarrhoea, to liver and spleen enlargement and to pathological changes in the liver parenchyma. At village level, we observed that the prevalence of enlarged liver and spleen among patients increased with the prevalence of S. mansoni infection. We conclude that the population of Ituri province carries an alarming burden of intestinal, liver and spleen morbidity associated with S. mansoni infection. Therefore, a comprehensive control programme to address this infection and disease burden is urgently required.

Download Full-text

Direct and Indirect Proof of SARS-CoV-2 Infections in Indigenous Wiwa Communities in North-Eastern Colombia—A Cross-Sectional Assessment Providing Preliminary Surveillance Data

Vaccines ◽

10.3390/vaccines9101120 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1120

Author(s):

Gustavo Concha ◽

Hagen Frickmann ◽

Anke Oey ◽

Monika Strengert ◽

Lothar Kreienbrock ◽

...

Keyword(s):

Point Of Care ◽

Indigenous Communities ◽

Serum Samples ◽

Cross Sectional ◽

Vaccination Programs ◽

Point Of Care Test ◽

North Eastern ◽

Nasal Swabs ◽

Study Participants ◽

Rapid Antibody

To provide initial data on local SARS-CoV-2 epidemiology and spread in indigenous communities in north-eastern Colombia, respiratory swabs and serum samples from volunteers of indigenous communities were examined in March and April 2021. Samples from non-indigenous Colombians from the same villages were included as well. While previous exposure to SARS-CoV-2 was assessed by analysing serum samples for IgG and IgM with a rapid antibody point-of-care-test (POCT), screening for active infections was carried out with an antigen POCT test and real-time PCR from nasal swabs. In 380 indigenous and 72 non-indigenous volunteers, 61 (13.5%) active infections and an additional 113 (25%) previous infections were identified using diagnostic serology and molecular assays. Previous infections were more frequent in non-indigenous volunteers, and relevant associations of clinical features with active or previous SARS-CoV-2 infections were not observed. Symptoms reported were mild to moderate. SARS-CoV-2 was frequent in the assessed Colombian indigenous communities, as 38.5% of the study participants showed signs of exposure to SARS-CoV-2, which confirms the need to include these indigenous communities in screening and vaccination programs.

Download Full-text

Prevalence, Intensity, and Associated Factors of Schistosoma mansoni among School Children in Northwest Ethiopia

Journal of Parasitology Research ◽

10.1155/2020/8820222 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Ayalew Jejaw Zeleke ◽

Ayenew Addisu ◽

Yalewayker Tegegne

Keyword(s):

Risk Factors ◽

Schistosoma Mansoni ◽

Grade Level ◽

Neglected Tropical Diseases ◽

Multivariate Logistic Regression Analysis ◽

Sampling Technique ◽

Northwest Ethiopia ◽

Moderate Intensity ◽

Cross Sectional ◽

Study Participants

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 ), 5th-8th 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.

Download Full-text

Prevalence ofSchistosoma mansoniInfection in Four Health Areas of Kisantu Health Zone, Democratic Republic of the Congo

Advances in Medicine ◽

10.1155/2016/6596095 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

R. Khonde Kumbu ◽

K. Mbanzulu Makola ◽

Lu Bin

Keyword(s):

Public Health ◽

Schistosoma Mansoni ◽

Health Problem ◽

Democratic Republic ◽

Infection Intensity ◽

Public Health Problem ◽

Cross Sectional Study ◽

Cross Sectional ◽

Republic Of The Congo ◽

Health Zone

Background. Schistosomiasis is a public health problem in Democratic Republic of the Congo but estimates of its prevalence vary widely. The aim of this study was to determine prevalence ofSchistosoma mansoniinfection and associated risk factors among children in 4 health areas of Kisantu health zone.Methods. A cross-sectional study was carried out in 4 health areas of Kisantu health zone. 388 children randomly selected were screened forS. mansoniusing Kato Katz technique and the sociodemographic data was collected. Data were entered and encoded using software EpiData version 3.1. Analysis was performed using SPSS version 21 software.Results. The prevalence ofS. mansoniwas 26.5% (103); almost two-thirds (63) (61.2%) had light infection intensity. A significant association was found betweenS. mansoniinfection and age (p=0.005), educational level (p=0.001), and practices of swimming/bathing (p<0.001) and using water from river/lake/stream for domestic use (p<0.001). Kipasa health area had high prevalence of schistosomiasis (64.6%) (64/99; 95% CI 54.4–74.0) compared to other health areas.Conclusion.Schistosoma mansoniinfection still remains a public health problem in these areas. There is a need to promote health education and promote behavioral changes in children towards schistosomiasis.

Download Full-text

Anatomical Variations of Frontal Sinuses Among The Male and Female Genders Living in Karachi

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2019098 ◽

2019 ◽

Vol 10 (1) ◽

pp. 44-48

Author(s):

Quratulain Javaid ◽

Ambreen Usmani ◽

Aisha Qamar

Keyword(s):

Demographic Data ◽

Anatomical Variations ◽

Cross Sectional Study ◽

Radiology Department ◽

Research Subjects ◽

Cross Sectional ◽

Male And Female ◽

Frontal Sinuses ◽

The Right ◽

Study Participants

Objective: To determine morphology and variation in dimensions of frontal air sinuses in male and female genders living in Karachi. Study Design and Setting: It was a cross sectional study and was conducted at Radiology Department, JPMC. Methodology: The total number of study participants were 216. The research subjects were divided into two equal groups of males and females each having 108 members. The mean age of the participants was calculated to be 35.14 ± 8.68 years. The study subjects were recruited from Radiology Department, JPMC, Karachi. After taking written informed consent, Water’s (occipito-mental) view radiography was done to measure the parameters of height, width and area of the frontal air sinuses. The included variables were the demographic data and the physical examination to exclude facial anomalies. All the measurements were recorded and the measurements were saved by the help of Radiant DICOM digital software. Results: The parameters of height, width and the area of frontal sinuses showed highly significant variability on both the right and the left sides. All the dimensions were highly significantly greater in the males as compared to the female study participants (p=0.000). The Independent-Samples T Test was applied to compare the two gender groups. Conclusion: The parameters of height, width and area of frontal sinuses were greater in the males as compared to the females on both the left and the right sides

Download Full-text

Frequency distribution of IL-17A G197A (rs2275913) and IL-17F A7488G (rs763780) polymorphisms among healthy Sudanese population

10.21203/rs.3.rs-31741/v3 ◽

2020 ◽

Author(s):

Nouh Saad Mohamed ◽

Emmanuel E. Siddig ◽

Abdallah E. Ahmed ◽

Musab MA. Albsheer ◽

Hanadi Abdelbagi ◽

...

Keyword(s):

Frequency Distribution ◽

Demographic Data ◽

Molecular Study ◽

P Value ◽

Cross Sectional ◽

History Of ◽

Males And Females ◽

Study Participants ◽

Frequent Allele ◽

Healthy Participants

Abstract Objectives: IL-17A G197A and IL-17F A7488G polymorphisms has been identified to be associated with the susceptibility to many diseases. This study aimed to investigate the frequency distribution of IL-17A G197A and IL-17F A7488G polymorphisms among healthy Sudanese population. A descriptive cross-sectional hospital-based molecular study conducted in different sites throughout Sudan. Two ml blood samples were collected from 717 healthy participants. Demographic data and the medical history of the participants were collected.Results: Of the 717 participants, 355 (49.5%) were males and 362 (50.5%) were females, their mean age was 30.2±17.2 and 32.2±16.5, respectively. For IL-17A, the most frequent genotype detected among males and females was IL-17A heterozygote allele (AG); 215 (60.6%) and 194 (53.6%), respectively. Whereas, for IL-17F, the most frequent allele among males and females was the homozygote allele (AA); 298 (83.9%) for males and 322 (89.0%) for females. HWE for genotype distributions of IL-17A was showing statistical insignificance for IL-17A among males and females, P value 0.614. While HWE for IL-17F reached the equilibrium level, P value 0.048. The most frequent age group was those aged between 21 to 40 years; 281 (39.2%). Arab constituted the major ethnicity of the study participants; 418 (58.3%), P value 0.034.

Download Full-text

Frequency distribution of IL-17A G197A (rs2275913) and IL-17F A7488G (rs763780) polymorphisms among healthy Sudanese population

10.21203/rs.3.rs-31741/v2 ◽

2020 ◽

Author(s):

Nouh Saad Mohamed ◽

Emmanuel E. Siddig ◽

Abdallah E. Ahmed ◽

Musab MA. Albsheer ◽

Hanadi Abdelbagi ◽

...

Keyword(s):

Frequency Distribution ◽

Demographic Data ◽

Molecular Study ◽

P Value ◽

Cross Sectional ◽

History Of ◽

Males And Females ◽

Study Participants ◽

Frequent Allele ◽

Healthy Participants

Download Full-text

Evaluation of iron intake in preschool children in a setting with high anemia burden

International Health ◽

10.1093/inthealth/ihz106 ◽

2020 ◽

Author(s):

Maria G Dunn ◽

Ryan M Close ◽

Steven G McKee ◽

Ramona Cordero ◽

Ingrid F Japa ◽

...

Keyword(s):

Point Of Care ◽

Cross Sectional Study ◽

Deficiency Anemia ◽

Iron Intake ◽

Cross Sectional ◽

Targeted Interventions ◽

Resource Limited ◽

High Prevalence ◽

Study Team ◽

Daily Allowance

Abstract Background Iron deficiency anemia affects millions of children worldwide. Iron intake assessments can inform targeted interventions. Methods This cross-sectional study describes diet and hemoglobin levels of children 1–5 y of age in a resource-limited setting in the Dominican Republic. The study team performed meal observations and measurements, dietary questionnaires, and point-of-care hemoglobin testing. Results Iron intake and bioavailability were low, with liberal estimates indicating that not more than 40% of subjects consumed the recommended daily allowance for iron. Forty of 80 children had anemia, with 23% demonstrating moderate or severe anemia. Conclusions Poor observed iron intake likely contributes to the high prevalence of anemia in this population.

Download Full-text

Prevalence of asymptomatic malaria, submicroscopic parasitaemia and anaemia in Korogwe District, north-eastern Tanzania

Malaria Journal ◽

10.1186/s12936-021-03952-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Paul M. Hayuma ◽

Christian W. Wang ◽

Edwin Liheluka ◽

Vito Baraka ◽

Rashid A. Madebe ◽

...

Keyword(s):

Venous Blood ◽

Small Subunit ◽

Asymptomatic Malaria ◽

Cross Sectional ◽

Rural Villages ◽

Targeted Interventions ◽

Increased Risk ◽

Significant Difference ◽

North Eastern ◽

Pcr Targeting

Abstract Background Asymptomatic malaria infections largely remain undetected and act as a reservoir for continuous transmission. The study assessed the prevalence of submicroscopic asymptomatic malaria infections and anaemia in two rural low (300 m above sea level) and highland (700 m asl) settings of Korogwe District north-eastern Tanzania. Methods A cross-sectional malariometric survey involving individuals aged 0–19 years was conducted in June 2018 in the two rural villages. Venous blood was collected from eligible study participants for estimation of haemoglobin level, detection of malaria by rapid diagnostic test (RDT), quantification of malaria parasitaemia by microscopy, as well as dried blood spot (DBS) for determining submicroscopic infections by PCR targeting the small subunit of the ribosomal ribonucleic acid (ssrRNA) of human Plasmodium. Results Out of 565 individuals tested, 211 (37.3%) were malaria positive based on RDT, whereas only 81 (14.3%) were positive by microscopy. There was no significant difference in the prevalence between the highland and the lowland village, p = 0.19 and p = 0.78 microscopy and RDT, respectively. Three out of 206 (1.5%) RDT/microscopy negative samples were P. falciparum positive by PCR. Of the 211 RDT and 81 microscopy positive, 130 (61.6%) and 33 (40.7%), respectively, were defined as being asymptomatic. Of the 565 individuals, 135 (23.9%) were anaemic (haemoglobin < 11 g/dL) out of which 5.2% were severely anaemic. The risk of being anaemic was significantly higher among individuals with asymptomatic malaria as compared to those without malaria as confirmed by RDT (AOR = 2.06 (95% CI 1.32–3.20) while based on microscopic results there was no significant differences observed (AOR = 2.09, 95% CI 0.98–4.47). Age and altitude had no effect on the risk of anaemia even after adjusting for asymptomatic malaria. Conclusions Asymptomatic malaria is associated with an increased risk of having anaemia in the study communities. The findings highlight the need for targeted interventions focusing on asymptomatic infections which is an important risks factor for anaemia in the community and act as a source of continued transmission of malaria in the study area.

Download Full-text

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

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009486 ◽

2021 ◽

Vol 15 (12) ◽

pp. e0009486

Author(s):

Maurice M. Nigo ◽

Peter Odermatt ◽

Georgette B. Salieb–Beugelaar ◽

Oleksii Morozov ◽

Manuel Battegay ◽

...

Keyword(s):

Risk Factors ◽

Schistosoma Mansoni ◽

Geographical Distribution ◽

Democratic Republic ◽

Control Measures ◽

Water Bodies ◽

Sub Saharan Africa ◽

Health Concern ◽

Infection Prevalence ◽

North Eastern

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.

Download Full-text