scholarly journals Prevalence and correlates of intestinal schistosomiasis infection among school-aged children in North-Western Tanzania

PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0228770
Author(s):  
Rajabu Hussein Mnkugwe ◽  
Omary S. Minzi ◽  
Safari M. Kinung'hi ◽  
Appolinary A. Kamuhabwa ◽  
Eleni Aklillu
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Andreas Mueller ◽  
Antje Fuss ◽  
Uwe Ziegler ◽  
Godfrey M. Kaatano ◽  
Humphrey D. Mazigo

Abstract Background Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children and does not include neither adult individuals nor other public health measures. The Ijinga schistosomiasis project examines the impact of an intensified treatment protocol with praziquantel MDA in combination with additional public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly endemic African setting using an integrated community-based approach. In preparation of this project, we report about baseline data on S.mansoni prevalence, intensity of infection, related hepatosplenic morbidities and their associated factors. Methods A cross sectional study was conducted among 930 individuals aged 1–95 years living at Ijinga Island, north-western Tanzania in September 2016. Single stool and urine samples were collected from each study participant and processed using Kato Katz (KK) technique and point-of-care Circulating Cathodic (POC-CCA) antigen test for detection of S.mansoni eggs and antigen respectively. Ultrasonographical examination for S.mansoni hepatosplenic morbidities was done to all participants. For statistical analyses Fisher’s exact test, chi-square test, student-t-test, ANOVA and linear regression were used where applicable. Results Overall based on KK technique and POC-CCA test, 68.9% (95%CI: 65.8–71.8) and 94.5% (95%CI: 92.8–95.8) were infected with S.mansoni. The overall geometrical mean eggs per gram (GMepg) of faeces was 85.7epg (95%CI: 77.5–94.8). A total of 27.1, 31.2 and 51.9% of the study participants had periportal fibrosis (PPF-grade C-F), splenomegaly and hepatomegaly. Risk factors for PPF were being male (aRR = 1.08, 95%CI: 1.02–1.16, P < 0.01), belong to the age group 16–25 years (aRR = 1.23, 95%CI: 105–1.44, P < 0.01), 26–35 years (aRR = 1.42, 95%CI: 1.21–1.67, P < 0.001), 36–45 years (aRR = 1.56, 95%CI:1.31–1.84, P < 0.001) and ≥ 46 years (aRR = 1.64, 95%CI:1.41–1.92, P < 0.001). The length of the left liver lobe was associated with being female (P < 0.03), belong to the age group 1–5 years (P < 0.013), 6–15 years (P < 0.04) and S.mansoni intensity of infection (P < 0.034). Male sex (aRR = 1.15, 95%CI:1.06–1.24, P < 0.001) and belonging to the age groups 16–25 years (aRR = 1.27, 95%CI:1.05–1.54, P < 0.02) or 26–35 years (aRR = 1.32, 95%CI:108–1.61, P < 0.01) were associated with splenomegaly. Conclusion Schistosoma mansoni infection and its related morbidities (hepatomegaly, splenomegaly, periportal fibrosis) are common in the study area. Age, sex and intensity of infection were associated with periportal fibrosis. The prevalence of S.mansoni was above 50% in each age group and based on the observed prevalence, we recommend MDA to the entire community.


2019 ◽  
Author(s):  
Andreas Mueller ◽  
Antje Fuss ◽  
Uwe Ziegler ◽  
Godfrey M. Kaatano ◽  
Humphrey D. Mazigo

Abstract Background: Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using praziquantel is the mainstay of control. MDA covers only school aged children and does not include other public health measures. The Ijinga schistosomiasis project examines the impact of an intensified MDA protocol combined with additional public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly endemic African setting using an integrated community-based approach. We report baseline data on S.mansoni prevalence, intensity of infection, related hepatosplenic morbidities and their associated factors. Methods: A cross sectional study was conducted among 930 individuals aged 1-95 years on Ijinga Island, north-western Tanzania in September 2016. Single stool and urine samples were collected and processed using Kato Katz (KK) technique and point-of-care Circulating Cathodic (POC-CCA) antigen test for detection of S.mansoni eggs and antigen respectively. All participants received ultrasonography for S.mansoni hepatosplenic morbidities. For statistical analyses Fisher’s exact test, chi-square test, student-t-test, ANOVA and linear regression were used where applicable. Results: Based on KK technique and POC-CCA test, 68.9% and 94.5% respectively were infected with S.mansoni . The overall geometrical mean eggs per gram (GMepg) of faeces was 85.7epg. A total of 27.1%, 31.2% and 51.9% of the participants had periportal fibrosis (PPF-grade C-F), splenomegaly and hepatomegaly. Risk factors for PPF were being male (aRR=1.08, P <0.01), belong to the age group 16-25 years (aRR=1.23, P <0.01), 26-35 years (aRR=1.42, P <0.001), 36-45 years (aRR=1.56, P <0.001) and ≥ 46 years (aRR=1.64, P <0.001). The length of the left liver lobe was associated with being female ( P <0.03), the age group 1-5 years ( P <0.013), 6-15 years ( P <0.04) and S.mansoni intensity of infection ( P <0.034). Male sex (aRR=1.15, P <0.001) and the age groups 16-25 years (aRR=1.27, P <0.02) or 26-35 years (aRR=1.32, P <0.01) were associated with splenomegaly. Conclusion : Schistosoma mansoni infection and related morbidities are common in the study area. Age, sex and intensity of infection were associated with periportal fibrosis. With a prevalence of >50% in each age group we recommend MDA to the entire community.


2019 ◽  
Author(s):  
Andreas Mueller ◽  
Antje Fuss ◽  
Uwe Ziegler ◽  
Godfrey M. Kaatano ◽  
Humphrey D. Mazigo

Abstract Background: Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children and does not include neither adult individuals nor other public health measures. The Ijinga schistosomiasis project aims to introduce an intensified treatment protocol using a MDA approach combined with other public health interventions to demonstrate the feasibility of eliminating intestinal schistosomiasis in a highly endemic African setting. In preparation of this project, we report about baseline data on S.mansoni prevalence, intensity of infection, related hepatosplenic morbidities and their associated factors. Methods: A cross sectional study was conducted among 930 individuals aged 3-95 years living at Ijinga Island, north-western Tanzania. Single stool and urine samples were collected from each study participant and processed using Kato Katz (KK) technique and point-of-care Circulating Cathodic (POC-CCA) antigen test for detection of S.mansoni eggs and antigen. Ultrasonographical examination for S.mansoni hepatosplenic morbidities was done to all participants. Results: Overall based on KK technique and POC-CCA test, 68.9% (95%CI: 65.8-71.8) and 94.5% (95%CI: 92.8-95.8) were infected with S.mansoni. The overall geometrical mean eggs per gram (GMepg) of faeces was 85.7epg (95%CI: 77.5-94.8). A total of 27.1%, 31.2% and 51.9% of the study participants had periportal fibrosis (PPF-grade C-F), splenomegaly and hepatomegaly. Risk factors for PPF were being male (aRR=1.08, 95%CI: 1.02-1.16, P<0.01), belong to the age group 16-25 years (aRR=1.23, 95%CI: 105-1.44, P<0.01), 26-35 years (aRR=1.42, 95%CI: 1.21-1.67, P<0.001), 36-45 years (aRR=1.56, 95%CI:1.31-1.84, P<0.001) and ≥ 46 years (aRR=1.64, 95%CI:1.41-1.92, P<0.001). The length of the left liver lobe was associated with being female (P<0.03), belong to the age group 1-5 years (P<0.013), 6-15 years (P<0.04) and S.mansoni intensity of infection (P<0.034). Similarly, being male (aRR=1.15, 95%CI:1.06-1.24, P<0.001), belonging to the age group 16-25 years (aRR=1.27, 95%CI:1.05-1.54, P<0.02), 26-35 years (aRR=1.32, 95%CI:108-1.61, P<0.01) were associated with splenomegaly. Conclusion: Schistosoma mansoni infection and its related morbidities are common in the study area. The prevalence of S.mansoni was above 50% in each age group and based on the observed prevalence, we recommend MDA to the entire community.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029749 ◽  
Author(s):  
Humphrey D Mazigo ◽  
Laurence Kirway ◽  
Emmanuela Ausebio Ambrose

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.


2019 ◽  
Author(s):  
Andreas Mueller ◽  
Antje Fuss ◽  
Uwe Ziegler ◽  
Godfrey M. Kaatano ◽  
Humphrey D. Mazigo

Abstract Background: Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using praziquantel is the mainstay of control. MDA covers only school aged children and does not include other public health measures. The Ijinga schistosomiasis project examines the impact of an intensified MDA protocol combined with additional public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly endemic African setting using an integrated community-based approach. We report baseline data on S.mansoni prevalence, intensity of infection, related hepatosplenic morbidities and their associated factors. Methods: A cross sectional study was conducted among 930 individuals aged 1-95 years on Ijinga Island, north-western Tanzania in September 2016. Single stool and urine samples were collected and processed using Kato Katz (KK) technique and point-of-care Circulating Cathodic (POC-CCA) antigen test for detection of S.mansoni eggs and antigen respectively. All participants received ultrasonography for S.mansoni hepatosplenic morbidities. For statistical analyses Fisher’s exact test, chi-square test, student-t-test, ANOVA and linear regression were used where applicable. Results: Based on KK technique and POC-CCA test, 68.9% and 94.5% respectively were infected with S.mansoni . The overall geometrical mean eggs per gram (GMepg) of faeces was 85.7epg. A total of 27.1%, 31.2% and 51.9% of the participants had periportal fibrosis (PPF-grade C-F), splenomegaly and hepatomegaly. Risk factors for PPF were being male (aRR=1.08, P <0.01), belong to the age group 16-25 years (aRR=1.23, P <0.01), 26-35 years (aRR=1.42, P <0.001), 36-45 years (aRR=1.56, P <0.001) and ≥ 46 years (aRR=1.64, P <0.001). The length of the left liver lobe was associated with being female ( P <0.03), the age group 1-5 years ( P <0.013), 6-15 years ( P <0.04) and S.mansoni intensity of infection ( P <0.034). Male sex (aRR=1.15, P <0.001) and the age groups 16-25 years (aRR=1.27, P <0.02) or 26-35 years (aRR=1.32, P <0.01) were associated with splenomegaly. Conclusion : Schistosoma mansoni infection and related morbidities are common in the study area. Age, sex and intensity of infection were associated with periportal fibrosis. With a prevalence of >50% in each age group we recommend MDA to the entire community.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Caitlin Sheehy ◽  
Heather Lawson ◽  
Emmanuel H. Andriamasy ◽  
Hannah J. Russell ◽  
Alice Reid ◽  
...  

AbstractSchool-aged children (SAC) have a considerable burden of intestinal schistosomiasis in Madagascar yet its burden in pre-school aged children (PSAC) is currently overlooked. To assess the at-risk status of PSAC, we undertook a pilot epidemiological survey in June 2019 examining children (n = 89), aged 2–4-years of balanced gender, in six remote villages in Marolambo District, Madagascar. Diagnosis included use of urine-circulating cathodic antigen (CCA) dipsticks and coproscopy of stool with duplicate Kato-Katz (K-K) thick smears. Prevalence of intestinal schistosomiasis by urine-CCA was 67.4% (95% confidence interval [CI]: 56.5–77.2%) and 35.0% (95% CI: 24.7–46.5%) by K-K. The relationship between faecal eggs per gram (epg) and urine-CCA G-scores (G1 to G10) was assessed by linear regression modelling, finding for every increment in G-score, epg increased by 20.4 (6.50–34.4, P = 0.006). Observed proportions of faecal epg intensities were light (78.6%), moderate (17.9%) and heavy (3.6%). Soil-transmitted helminthiasis was noted, prevalence of ascariasis was 18.8% and trichuriasis was 33.8% (hookworm was not reported). Co-infection of intestinal schistosomiasis and soil-transmitted helminthiasis occurred in 36.3% of PSAC. These results provide solid evidence highlighting the overlooked burden of intestinal schistosomiasis in PSAC, and they also offer technical  guidance for better surveillance data for the Madagascan national control programme.


Author(s):  
Amal Farahat Allam ◽  
Aziza Salem ◽  
Amel Elsheredy ◽  
Musaad Mohammed Dewair ◽  
Heba Said Ibrahim ◽  
...  

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