Reduction patterns of prevalence and intensity of Schistosoma haematobium infection after MDA with praziquantel between regions with and without previous intervention in Sudan

2019 ◽  
Author(s):  
Seungman Cha ◽  
Sung-Tae Hong ◽  
Jin-Su Lee ◽  
Hoo-Gn Jeong ◽  
In-Sun Kwon ◽  
...  
Keyword(s):  
Schistosoma Haematobium ◽  
Geometric Mean ◽  
Reduction Rate ◽  
Infection Intensity ◽  
Urine Samples ◽  
Baseline Survey ◽  
Cross Sectional Survey ◽  
Urogenital Schistosomiasis ◽  
Cross Sectional ◽  
White Nile

Abstract Background: Mass drug administration (MDA) with praziquantel has been the mainstay for schistosomiasis control in endemic countries. To evaluate the effects of repeated MDA, we compared urogenital schistosomiasis prevalence at two localities in White Nile State, Sudan: Al Jabalain with previous MDA and El Salam without previous MDA. Methods: A cross-sectional survey was carried out to examined the prevalence and intensity of Schistosoma haematobium infection using urine samples from 10,644 primary school-aged children (SAC) of two localities at the baseline survey, and then a single dose of 40 mg/kg praziquantel was mass administered to whole SAC of both localities. Of the total, 3,197 SAC of sentinel schools were examined urine samples at 8 months after the MDA. Results: The overall prevalence of S. haematobium infection was 5.5% in Al Jabalain and 27.5% in El Salam at the baseline survey. In sentinel schools, the prevalences in Al Jabalain and El Salam were significantly reduced after MDA, 80.3% and 84.4% respectively, not significant between two localities. The geometric mean intensity (GMI) of egg counts from the infected children at the baseline survey was 14.5 eggs per 10 mL of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam. At the follow-up survey, the GMI reduction rate was significantly reduced, 51.0% in Al Jabalain and 39.5% in El Salam, however the infection intensity after MDA was reduced significantly less in SAC who had higher baseline prevalence and infection intensity. The overall intensity of infection was significantly reduced after MDA in girls, but not in boys. Conclusions: Single MDA produces a similar prevalence reduction regardless of endemicity but less reduction of infection intensity in highly endemic populations. It is necessary to implement repeated MDAs to eliminate urogenital schistosomiasis in endemic regions..

scholarly journals Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

2020 ◽  
Vol 58 (4) ◽  
pp. 421-430 ◽  
Author(s):  
Seungman Cha ◽  
Sung-Tae Hong ◽  
Jin-Su Lee ◽  
Hoo Gn Jeong ◽  
In-Sun Kwon ◽  
...  
Keyword(s):  
Primary Schools ◽  
Schistosoma Haematobium ◽  
Geometric Mean ◽  
Infection Intensity ◽  
Baseline Survey ◽  
Relative Reduction ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
White Nile

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

scholarly journals Urinary Concentrations of Metals and Metalloids in Malaysian Adults

2021 ◽  
Author(s):  
Zurahanim Fasha Anual ◽  
Noraishah Mohammad Sham ◽  
Rashidah Ambak ◽  
Fatimah Othman ◽  
Rafiza Shaharudin
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Inductively Coupled Plasma ◽  
Geometric Mean ◽  
Urine Samples ◽  
Cross Sectional ◽  
Metals And Metalloids ◽  
High Exposure ◽  
Academic Qualification ◽  
Metal Levels

AbstractExposure to environmental pollutants in humans can be conducted through direct measurement of biological media such as blood, urine or hair. Assessment studies of metals and metalloids in Malaysia is very scarce although cross-sectional nationwide human biomonitoring surveys have been established by the USA, Canada, Germany, Spain, France, and Korea. This study aims to assess urinary metal levels namely cadmium (Cd), nickel (Ni), lead (Pb) and arsenic (As) among Malaysian adults. This was a cross-sectional study involving 1440 adults between the age of 18 and 88 years old. After excluding those with 24 h urine samples of less than 500 ml, urine creatinine levels < 0.3 or > 3.0 g/L and those who refuse to participate in the study, a total of 817 respondents were included for analysis. A questionnaire with socio-demographic information such as age, gender, occupation, ethnic, academic qualification and medical history was administered to the respondents. Twenty-four-hour urine samples were collected in a container before being transported at 4 °C to the laboratory. Samples were then aliquoted into 15 ml tubes and kept at − 80 °C until further analysis. Urine was diluted ten-fold with ultrapure water, filtered and analysed for metals and metalloids using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The geometric mean of urinary As, Ni, Cd and Pb concentrations among adults in Malaysia was 48.21, 4.37, 0.32, and 0.80 µg/L, respectively. Males showed significantly higher urinary metal concentrations compared to females for As, Cd and Pb except for Ni. Those who resided in rural areas exhibited significantly higher As, Cd and Pb urinary concentrations than those who resided in urban areas. As there are no nationwide data on urinary metals, findings from this study could be used to identify high exposure groups, thus enabling policy makers to improve public health strategically.

scholarly journals Impact of seven years of mass drug administration and recrudescence of Schistosoma haematobium infections after one year of treatment gap in Zanzibar: Repeated cross-sectional studies

2021 ◽  
Vol 15 (2) ◽  
pp. e0009127
Author(s):  
Lydia Trippler ◽  
Shaali Makame Ame ◽  
Jan Hattendorf ◽  
Saleh Juma ◽  
Salum Abubakar ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Odds Ratio ◽  
Schistosoma Haematobium ◽  
Treatment Gap ◽  
Urogenital Schistosomiasis ◽  
Cross Sectional ◽  
Reagent Strips ◽  
One Year ◽  
Low Prevalence

Background Considerable progress towards the elimination of urogenital schistosomiasis was made by the Zanzibar Elimination of Schistosomiasis Transmission project from 2012 till 2016, when biannual praziquantel mass drug administration (MDA) alone or with additional snail control or behaviour change interventions were implemented. Annual MDA was continued in 2017 and 2018, but not in 2019, imposing a 16-month treatment gap. We monitored the Schistosoma haematobium prevalence from 2012 till 2020 and assessed recrudescence patterns with focus on 2020. Methodology Repeated cross-sectional surveys were conducted from 2011/12 till 2020 in 90 communities and 90 schools in Zanzibar. Annually, around 4,500 adults and up to 20,000 schoolchildren were surveyed. The S. haematobium prevalence was detected by urine filtration and reagent strips. In 2020, risk factors for infection were investigated using generalized estimated equation models. Principal findings In adults, the apparent S. haematobium prevalence was 3.9% in 2011 and 0.4% in 2020. In schoolchildren, the prevalence decreased from 6.6% in 2012 to 1.2% in 2019 with vicissitudes over the years. Prominent recrudescence of infection from 2.8% in 2019 to 9.1% (+225%) in 2020 was observed in 29 schools with historically moderate prevalences (≥10%). Compared with 2019, reinfection in 2020 was particularly striking in boys aged 9–16 years. Being male was a risk factor for infection in 2020 (adults: odds ratio (OR): 6.24, 95% confidence interval (95% CI): 1.96–19.60; schoolchildren: OR: 2.06, 95% CI: 1.52–2.78). Living near to a natural freshwater body significantly increased the odds of infection in adults (OR: 2.90, CI: 1.12–7.54). Conclusions/Significance After 11 rounds of MDA over 7 years and a 16-month treatment gap, the urogenital schistosomiasis prevalence considerably rebounded in hotspot areas. Future elimination efforts in Zanzibar should focus on re-intensifying MDA plus additional interventions in hotspot areas. In low-prevalence areas, the strategy might be adapted from MDA to targeted surveillance-response.

scholarly journals The contribution of domestic animals to the transmission of schistosomiasis japonica in the Lindu Subdistrict of the Central Sulawesi Province, Indonesia

2019 ◽  
Vol 12 (10) ◽  
pp. 1591-1598 ◽  
Author(s):  
Novericko Ginger Budiono ◽  
Fadjar Satrija ◽  
Yusuf Ridwan ◽  
Ekowati Handharyani ◽  
Sri Murtini
Keyword(s):  
Infection Intensity ◽  
Primary Source ◽  
Domestic Animal ◽  
Laboratory Method ◽  
Schistosomiasis Japonica ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
The Government ◽  
Central Sulawesi

Background and Aim: Schistosomiasis is endemic in Indonesia and is found in three remote areas in Central Sulawesi Province. Non-human mammals serve as reservoir hosts, meaning the disease is zoonotic. The previous schistosomiasis studies in animals from the Lindu Subdistrict did not determine which domestic animal species can serve as the primary source of transmission. No animals have been treated in Indonesia to control the disease; therefore, the parasite's life cycle is not blocked entirely. This study aimed to determine the prevalence and identify the risk factors associated with, Schistosoma japonicum infection in animals, and identify animals' relative contributions to S. japonicum transmission in the Lindu Subdistrict. Materials and Methods: A cross-sectional survey of S. japonicum infected animals was conducted in five villages of the Lindu Subdistrict. Fecal samples were collected from 134 selected animals (13 cattle, 26 buffaloes, 28 horses, 59 pigs, and 8 dogs). S. japonicum infection and infection intensity were determined using the Danish Bilharziasis Laboratory method. Environmental contamination with schistosome eggs was measured. The data were analyzed using a Chi-square test. Results: The overall prevalence of schistosomiasis was 32.9%, with the prevalence of infection in each species of animal at 61.5% in cattle, 42.3% in buffaloes, 25.0% in horses, 35.6% in pigs, and 12.5% in dogs. Free-range pigs were 8.667 times more likely to have S. japonicum infection than pigs kept in cages. Buffaloes, cattle, and horses were the primary sources of S. japonicum egg contamination, with relative transmission indices of 59.15%, 22.80%, and 10.61%, respectively. Conclusion: Bovines and horses are the main contributors to schistosomiasis transmission in the Lindu Subdistrict. In conjunction with other schistosomiasis control programs, the government should treat infected animals living within endemic areas where there are high infection rates of S. japonicum.

scholarly journals Elevation of C-reactive protein, P-selectin and Resistin as potential inflammatory biomarkers of urogenital Schistosomiasis exposure in preschool children

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Theresa N. Chimponda ◽  
Caroline Mushayi ◽  
Derick N. M. Osakunor ◽  
Arthur Vengesai ◽  
Eyoh Enwono ◽  
...  
Keyword(s):  
Preschool Children ◽  
Adult Worm ◽  
Infection Intensity ◽  
Inflammatory Biomarkers ◽  
C Reactive Protein ◽  
Urogenital Schistosomiasis ◽  
Cross Sectional ◽  
Antigen Preparation ◽  
Reactive Protein ◽  
Potential Biomarker

Abstract Background Schistosomiasis is known to induce inflammatory immune responses. C-reactive protein (CRP), resistin and P-selectin are serological inflammatory markers that rise during the acute stages of infection. Here, we propose such inflammatory biomarkers have a potential for use in urogenital schistosomiasis diagnostic screening for exposure and infection in preschool-aged children. Methods As part of a larger study on urogenital schistosomiasis, 299 preschool children aged 1–5 years were included in this cross-sectional study. Parasitological diagnosis was conducted using urine filtration for Schistosoma haemtobium infection, and Kato Katz for S. mansoni infection. Serum levels of P-selectin, resistin, CRP, and antibodies against S. haematobium cercarial antigen preparation (CAP) and soluble worm antigen preparation (SWAP) were measured by ELISA. Results Of the 299 participants, 14% were egg positive for S. haematobium. Serology showed 46 and 9% of the participants to have been exposed to S. haematobium cercarial antigens and adult worm antigens, respectively. Levels of P-selectin were significantly higher in participants infected with S. haematobium (egg-positive) than in uninfected participants (p = 0.001). Levels of P-selectin were also higher in those exposed to cercarial antigen than in unexposed participants (p = 0.019). There was a positive correlation between P-selectin and infection intensity (r = 0.172; p = 0.002), as well as with IgM responses to CAP and SWAP (r = 0.183; p = 0.001); (r = 0.333; p < 0.0001) respectively. CRP significantly correlated with IgM responses to CAP (r = 0.133; p = 0.029) while resistin correlated with IgM responses to CAP and SWAP (r = 0.127; p = 0.016); (r = 0.197; p = 0.0004). CRP levels were higher in those exposed to cercarial and adult worm antigens than unexposed participants (p = 0.035); (p = 0.002) respectively, while resistin was higher in participants exposed to cercarial antigen than unexposed participants (p = 0.024). Conclusion In this preschool population, P-selectin is significantly associated with urogenital schistosome infection and intensity; hence a potential biomarker for infection diagnosis and disease monitoring. The inflammatory biomarkers (P-selectin, Resistin and CRP) were significantly higher in participants exposed to cercarial antigens than unexposed individuals indicating an underlying inflammatory environment.

scholarly journals Splenomegaly in relation to Schistosoma mansoni egg counts: a population based study

1986 ◽  
Vol 28 (6) ◽  
pp. 389-394 ◽  
Author(s):  
Maria Fernanda Furtado de Lima e Costa ◽  
R. S. Bocha ◽  
Naftale Katz
Keyword(s):  
Geometric Mean ◽  
Age Groups ◽  
Individual Case ◽  
Population Based ◽  
Control Analysis ◽  
Ecological Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Individual Analysis ◽  
The Individual

A cross: sectional survey on schistosomiasis was done in Comercinho (Minas Gerais State, Brazil), a town with 1474 inhabitants. Stool (Kato-Katz method) and physical examinations were done on 90% of the population and on 84% of the individuals over 2 years of age, respectively. The ecological and individual (case-control) analysis were used to investigate the relation between splenomegaly and S. mansoni egg counts in different age groups. In the ecological analysis there was a clearly correspondence between higher geometric mean of eggs and higher percentage of splenomegaly in the age groups 5-9 and 10-12 years. In the individual analysis it was found that only in the youngest individuals (5-8 or 5-9 years old) the splenomegaly was related with higher mean egg counts in the feces, having been a tendency to the decrease of excretion of eggs in patients with splenomegaly as the age increased. These results strongly suggest that the ecological data are' better indicator of the severity of schistosomiasis in endemic areas, as the decrease of the egg excretion in patients with splenomegaly may be a confounding variable for the individual analysis.

scholarly journals A cross-sectional study of periportal fibrosis and Schistosoma mansoni infection among school-aged children in a hard-to-reach area of Madagascar

2020 ◽  
Vol 114 (4) ◽  
pp. 315-322
Author(s):  
Hannah J Russell ◽  
James M StJ Penney ◽  
Cortland Linder ◽  
Elizabeth C Joekes ◽  
Amaya L Bustinduy ◽  
...  
Keyword(s):  
Schistosoma Mansoni ◽  
Infection Intensity ◽  
Cross Sectional Study ◽  
Older Children ◽  
Cross Sectional Survey ◽  
Sonographic Examination ◽  
Cross Sectional ◽  
School Aged Children ◽  
Periportal Fibrosis ◽  
The Uk

Abstract Background A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo district of the Atsinanana region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis. Methods School-aged children (5–14 y) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video-clips of liver views were recorded with a SonoSite iViz and interpreted in the UK by comparison with standardised images (WHO protocol). Results The prevalence of schistosomiasis according to CCA testing was 97.8% (269/275) and 73.8% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31/275). The youngest children with fibrosis were aged 6 y. Fibrosis was more common in older children (p=0.03) but was not associated with either infection intensity category (p=0.07) or gender (p=0.67). Conclusions Findings of periportal fibrosis among children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities to understand the true extent of disease burden in endemic countries.

scholarly journals Mean Dietary Salt Intake in Vanuatu: A Population Survey of 755 Participants on Efate Island

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 916
Author(s):  
Katherine Paterson ◽  
Nerida Hinge ◽  
Emalie Sparks ◽  
Kathy Trieu ◽  
Joseph Alvin Santos ◽  
...  
Keyword(s):  
Salt Intake ◽  
Urine Samples ◽  
World Health ◽  
Dietary Salt ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Dietary Salt Intake ◽  
Spot Urine ◽  
Salt Consumption

Non-communicable diseases are responsible for 63% of global deaths, with a higher burden in low- and middle-income countries. Hypertension is the leading cause of cardiovascular-disease-related deaths worldwide, and approximately 1.7 million deaths are directly attributable to excess salt intake annually. There has been little research conducted on the level of salt consumption amongst the population of Vanuatu. Based on data from other Pacific Island countries and knowledge of changing regional diets, it was predicted that salt intake would exceed the World Health Organization’s (WHO) recommended maximum of 5 g per day. The current study aimed to provide Vanuatu with a preliminary baseline assessment of population salt intake on Efate Island. A cross-sectional survey collected demographic, clinical, and urine data from participants aged 18 to 69 years in rural and urban communities on Efate Island in October 2016 and February 2017. Mean salt intake was determined to be 7.2 (SD 2.3) g/day from spot urine samples, and 5.9 (SD 3.6) g/day from 24-h urine samples, both of which exceed the WHO recommended maximum. Based on the spot urine samples, males had significantly higher salt intake than females (7.8 g compared to 6.5 g; p < 0.001) and almost 85% of the population consumed more than the WHO recommended maximum daily amount. A coordinated government strategy is recommended to reduce salt consumption, including fiscal policies, engagement with the food industry, and education and awareness-raising to promote behavior change.

scholarly journals Intestinal Schistosomiasis among Primary Schoolchildren in Two On-Shore Communities in Rorya District, Northwestern Tanzania: Prevalence, Intensity of Infection and Associated Risk Factors

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
David Z. Munisi ◽  
Joram Buza ◽  
Emmanuel A. Mpolya ◽  
Safari M. Kinung’hi
Keyword(s):  
Risk Factors ◽  
Control Strategies ◽  
Geometric Mean ◽  
Infection Intensity ◽  
Risk Groups ◽  
Public Health Importance ◽  
Cross Sectional ◽  
Level Of Education ◽  
Treatment History ◽  
Associated Risk Factors

In Tanzania,Schistosoma mansoniis of great public health importance. Understanding the prevalence and infection intensity is important for targeted, evidence-based control strategies. This study aimed at studying the prevalence, intensity, and risk factors ofS. mansoniamong schoolchildren in the study area. A cross-sectional study was conducted in Busanga and Kibuyi villages. Sampled 513 schoolchildren provided stool specimens which were examined using kato-katz method. Pretested questionnaire was used to collect sociodemographic data and associated risk factors. The prevalence ofS. mansoniinfection was 84.01%, with geometric mean egg intensity of 167.13 (95% CI: 147.19–189.79) eggs per gram of stool (epg). Other parasites detected wereAscaris lumbricoides(1.4%) and hookworms (1.4%). The geometric mean infection intensity in Busanga and Kibuyi were 203.70 (95% CI: 169.67–244.56) and 135.98 (95% CI: 114.33–161.73) epg, respectively. Light, moderate, and heavy infection intensities were 34.11%, 39.91%, and 25.99%, respectively. Village of residence, parent’s level of education, toilet use, and treatment history were predictors of infection. The high prevalence and infection intensity in this study were associated with village, parent’s level of education, inconsistent toilet use, and treatment history. To control the disease among at-risk groups, these factors need to be considered in designing integrated schistosomiasis control interventions.

Urinary schistosomiasis on Zanzibar: application of two novel assays for the detection of excreted albumin and haemoglobin in urine

2005 ◽  
Vol 79 (3) ◽  
pp. 199-206 ◽  
Author(s):  
D. Rollinson ◽  
E.V. Klinger ◽  
A.F. Mgeni ◽  
I.S. Khamis ◽  
J.R. Stothard
Keyword(s):  
Infection Intensity ◽  
Upper Urinary Tract ◽  
Control Programme ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Urinary Schistosomiasis ◽  
Predictive Values ◽  
Urine Albumin ◽  
Blood Haemoglobin ◽  
Sensitivity Specificity

AbstractAs part of a urinary schistosomiasis control programme on Zanzibar, an aged cross-sectional survey of 305 children from three schools on Unguja was conducted to investigate the relationships between levels of excreted albumin and haemoglobin in urine and Schistosoma haematobium infection status. Diagnosis was determined by standard parasitological methods, dipstick reagents for microhaematuria, visual inspection for macrohaematuria as well as collection of case-history questionnaire data for self-diagnosis. Prevalence of infection as determined by parasitology was 53.9% and approximately, one quarter of the children examined were anaemic (<11 g dl−1). A statistically significant negative association of blood haemoglobin levels of boys and S. haematobium infection intensity status was observed (rs=−0.23, P=0.005). Through sensitivity analysis of urine-albumin values it was determined that a concentration of above >40 mg l−1, as measured with the HemoCue urine-albumin photometer, had sensitivity, specificity, positive and negative predictive values of 0.90, 0.83, 0.86 and 0.89 respectively against ‘gold-standard’ parasitology. There was a clear association of reported pain upon micturition for children with elevated urine-albumin levels, with an odds ratio of 20 to 1. Levels of excreted blood in urine were quantified with the HemoCue Plasma/Low Hb photometer. However, dipsticks remain the method of choice for urine-haemoglobin of 0.1 g l−1 and below. Urine parameters over a 24-h period were assessed in a small sub-sample. Reductions in both albumin and haemoglobin excretion were observed in 11 children 54 days after praziquantel treatment. It was concluded that these rapid, high-through-put, portable HemoCue assays could play a role in better describing and monitoring the occurrence, severity and evolution of urinary schistosomiasis disease. The urine-albumin assay has particular promise as a biochemical marker of S. haematobium induced kidney- and upper urinary tract-morbidity.

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