Background Urogenital schistosomiasis is endemic in Mali and is a major cause of serious morbidity in large parts of the world. This disease is responsible for many socio-economic and public health issues. The aim of this study was to investigate the impact of the disease on morbidity and to describe demographic and socioeconomic factors in relation to the status of children with urogenital schistosomiasis in Mali. Methods We conducted a cross-sectional study in November 2021 of 971 children aged 6 to 14 years selected at random from six schools in three districts in the Kayes Region of Mali. Demographic and socioeconomic data were collected on survey forms. Clinical data were collected following a medical consultation. Hematuria was systematically searched for through the use of strips. The search for Schistosoma haematobium eggs in urine was done via the filtration method. The urinary tract was examined by ultrasound. Associations between each of these variables and disease infection were tested using multivariate logistic regression. Results The overall prevalence of urinary schistosomiasis detected was 50.2%. The average intensity of infection was 36 eggs/10 ml of urine. The associated risk factors for urogenital schistosomiasis showed that children who bathed, used the river/pond as a domestic water source, and who habitually urinated in the river/pond were more affected (P < 0.05). Children with farming parents were most affected (P = 0.032). The collection of clinical signs revealed that boys had more pollakiuria (58.6%) and dysuria (46.4%) than girls. Ultrasound data showed that focal lesion rates were recorded in all villages with the lowest rate in Diakalel (56.1%). Ultrasound and parasitological findings showed that irregularity and thickening were strongly associated with urinary schistosomiasis (P < 0.0001). Conclusions Schistosoma haematobium infection was still endemic in the study site despite more than a decade of mass treatment with praziquantel. However, the high percentage of symptoms associated with high intensity reinforces the idea that further studies in terms of schistosomiasis-related morbidity are still needed.
Background:Urogenital schistosomiasis is endemic in Mali and a major cause of morbidity in large parts of the world. It is of great socioeconomic and public health importance and has important consequences. The aim of our work was to study the risk factors and ultrasound aspects associated with urogenital schistosomiasis. Methods: We conducted a cross-sectional study in November 2021 with 971 children aged 6 to 14 years randomly recruited in six schools in three districts in the Kayes region. Demographic, socioeconomic and clinical data were collected. Hematuria was systematically searched by strips and Schistosoma haematobium eggs in urine detected by the filtration method. The urinary tract was examined by ultrasound. Associations between each of these variables and disease infection were analyzed using multivariate logistic regression. Results: The overall prevalence was 50.2% with an average intensity of 36 eggs (1 to 1020 eggs)/10mL of urine. Urogenital schistosomiasis infection did not vary according to sex or age group. There is no correlation between risk factors and the urogenital schistosomiasis infection. Hematuria was strongly associated with urogenital schistosomiasis infection (p<0.0001). Among the 240 children who participated to the ultrasound examinations, focal lesion on bladder was observed, while ultrasound findings of the urethra and kidneys revealed a very low rate of dilatation. Conclusion: This work shows that parasitological findings and ultrasound signs, especially bladder lesions, were strongly associated with urinary schistosomiasis (p<0.0001). Despite of mass drug administration based on Praziquantel urogenital schistosomiasis infection is still endemic in the study site.
Background - Although schistosomiasis is a public health issue in Mali, little is known about the genetic profile. The purpose of this study was to analyze the genetic profile of the schistosomes of Schistosoma haematobium group in school aged children in various sites of Mali. Methods - Urine samples were collected from 07 to 21 November 2021 and subjected to a filtration method for the presence S. haematobium eggs. The study took place in two schistosomiasis endemic villages, qualified as hotspots according to the World Health Organization (WHO) definition Fangouné Bamanan and Diakalel in Kayes’ region. Molecular biology (Cox1 and ITS2/18S) was used as eggs taxonomic parameters. Results - A total of 789 miracidium were collected individually from 63 school aged children and stored on Whatman Find The Agent (FTA) cards for molecular analysis. After genotyping for species and hybrid identification using rapid diagnostic multiplex mitochondrial Cox1 Polymerase chain reaction (PCR) and Amplification-refractory mutation system -ARMS_PCR analysis of the nuclear Internal Transcribed spacer - ITS2 and 18S regions, 338 (42.8%) and 45) (57.2%) of miracidium revealed S. bovis and S. haematobium profiles for Cox1, respectively; 749 (94.9%) and 40 (5.1%) revealed S. haematobium and S. haematobium/S. curassoni profiles for ITS/18S genes, respectively. There was a significant difference in the Cox1 and ITS2/18S profiles distribution between the two villages (p<0.0001). Overall, there was 360 (45.6%) cases of hybrids of which 322 (72.0%) were from Fangouné Bamanan. Three hybrids profiles [(Sb_ShxSc) with 2.3%); (Sb_ShxSh with 40,9%) ; (Sh_ShxSc with 2.8%) and one pure profile [Sh_ShxSh with 54.5%) were identified. The hybrid Sb_ShxSh appeared to be more frequent in Fangouné Bamanan (68%) whereas Sh_Sh/Sc was lightly represented in Diakalel (5.8%). Conclusions - Our findings show for the first time the presence of introgressive hybridization between S. haematobium and S. bovis/S. curassoni in humans at a large scale. More studies are needed on population genetics of schistosomes at the human and animal interface to evaluate the parasite’s gene flow and its consequences on epidemiology of the disease as well as the transmission to humans.
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