Background The goal to eliminate the parasitic disease of poverty schistosomiasis as a public health problem is aligned with the 2030 United Nations agenda for sustainable development goals, including universal health coverage (UHC). Current control strategies focus on school-aged children, systematically neglecting adults. We aimed at providing evidence for the need of shifting the paradigm of schistosomiasis control programs from targeted to generalized approaches as key element for both the elimination of schistosomiasis as a public health problem and the promotion of UHC. Methods In a cross-sectional study performed between March 2020 and January 2021 at three primary health care centers in Andina, Tsiroanomandidy and Ankazomborona in Madagascar, we determined prevalence and risk factors for schistosomiasis by a semi-quantitative PCR assay from specimens collected from 1482 adult participants. Univariable and multivariable logistic regression were performed to evaluate odd ratios. Results The highest prevalence of S. mansoni, S. haematobium and co-infection of both species was 59.5%, 61.3% and 3.3%, in Andina and Ankazomborona respectively. Higher prevalence was observed among males (52.4%) and main contributors to the family income (68.1%). Not working as a farmer and higher age were found to be protective factors for infection. Conclusions Our findings provide evidence that adults are a high-risk group for schistosomiasis. Our data suggests that, for ensuring basic health as a human right, current public health strategies for schistosomiasis prevention and control need to be re-addressed towards more context specific, holistic and integrated approaches.
Background Schistosomiasis is a high-burden parasitic disease and endemic in tropical climates, such as Madagascar. Recently it is emerging in Europe. Chronic infections lead to disabilities including loss in work productivity. Current control strategies focus on school-aged children, thereby systematically excluding adults. The goal to eliminate the disease as a public health problem is aligned with the Sustainable Development Goals agenda, including Universal Health Coverage (UHC). We aim at assessing the distribution of schistosomiasis among adults in Madagascar, in order to promote more targeted public health initiatives against the disease. Methods In a cross-sectional study, 1477 blood samples were collected at three primary health-care centers in Madagascar from 03.21 to 01.22. A semi quantitative PCR assay was used to assess the presence of Schistosoma. Positivity rates with 95% Confidence Intervals (CI) were reported by gender and age groups. Results Our study population had a balanced gender distribution with 54.2% [CI: 51.7;56.8] of females and a median age of 37 years (IQR: 24-48). Preliminary results show an overall Schistosome positivity rate of 59.5% [CI: 57.0;62.0]. Positivity was higher in males 62.4% [CI: 58.7;66.1], than in females 57.1% [CI: 53.5;60.5]. Highest positivity was seen in the 18-34 year age group with 66.2% [CI: 62.7;69.6]. Lowest positivity of 46.2% [CI: 39.2;53.2] was observed in adults aged over 55 years. Conclusions Our preliminary results provide evidence of high positivity rates of schistosomiasis among adults in a highly endemic country. Differently from many studies, males seem more affected than females. The youngest age group, representing the more active workforce of a population, shows a higher positivity rate. Our data suggests that, in the logic of UHC and health as a human right, public health strategies for schistosomiasis need to be re-addressed towards a universal coverage of affected individuals. Key messages
Background: The goal to eliminate the parasitic disease of poverty schistosomiasis as a public health problem is aligned with the 2030 United Nations agenda for Sustainable Development Goals, including Universal Health Coverage (UHC). Current control strategies focus on school-aged children, systematically neglecting adults. We aimed at providing evidence for the need of shifting the paradigm of schistosomiasis control programs from targeted to generalized approaches as key element for both the elimination of schistosomiasis as a public health problem and the promotion of UHC. Methods: In a cross-sectional study we determined prevalence and risk factors for schistosomiasis by a semi-quantitative PCR assay from specimens collected from 1,482 adult participants at three primary health-care centers in north-western and central areas of Madagascar. Results: The highest prevalence of S. mansoni, S. haematobium and co-infection of both species was 59.5%, 61.3% and 3.3%, respectively. Higher prevalence was observed among males and main contributors to the family income. Not working as a farmer and higher age were found to be protective factors for infection. Conclusions: Our findings provide evidence that adults are a high-risk group for schistosomiasis. The general focus on children and the exclusion of adults from control strategies for schistosomiasis in high endemic countries may hamper the achievement of both the schistosomiasis elimination goal and UHC. Our data suggests that, for ensuring basic health as a human right, current public health strategies for schistosomiasis prevention and control need to be re-addressed towards more context specific, holistic and integrated approaches.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.