Baseline prevalence and intensity of schistosomiasis at sentinel sites in Madagascar: Informing a national control strategy

Abstract

BackgroundSchistosomiasis affects more than 800 million people, mostly in sub-Saharan Africa. A baseline sentinel site study was conducted in the Western half of Madagascar to determine the prevalence and intensity of schistosomiasis and soil-transmitted helminth (STH) infections prior to mass drug administration, and to explore the associations between infection and school attendance, and access to water, sanitation and hygiene (WASH) facilities.MethodsA three-stage, cluster-randomised cross-sectional study was conducted in 29 sentinel sites in October 2015. Twenty school attending and 4 non-attending children in each of the age groups from 7 to 10 years old were randomly selected at each site for detection of Schistosoma haematobium eggs in a single urine slide by filtration, and of S. mansoni, Ascaris lumbricoides, Trichuris trichiura and hookworm eggs in duplicate Kato-Katz slides from a single stool sample. School attendance was registered individually, and school-level access to WASH facilities was scored through pre-defined observed and reported factors. Logistic regression analysis was performed, adjusting for gender, age and study site. School-level WASH status was analysed using Spearman’s rank correlation coefficient.ResultsA total of 1,958 children were included. The prevalence of S. haematobium infection and heavy-intensity infection was 30.5 % and 15.1 %, respectively. The prevalence of S. mansoni infection and heavy-intensity infection was 5.0 % and 0.9 %, respectively. The prevalence of any STH infection was 4.7 %. There was no significant difference in prevalence of infection or heavy-intensity infection of either schistosome species between attending and non-attending children, apart from heavy-intensity S. mansoni infection that was significantly more common in children who did not attend school regularly (aOR = 7.5 (95 % CI = 1.1-49.5); p = 0.037). Only a minority of schools had adequate access to WASH facilities, and in this study, we found no significant association between school-level WASH status and schistosomiasis.ConclusionsThis study found an alarmingly high prevalence and intensity of schistosomiasis, and the results warrant urgent scale-up of the national NTD control programme that will need to include both non-attending and attending school-age children in order to reach WHO roadmap targets for the control of schistosomiasis by 2020.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-016-1337-4) contains supplementary material, which is available to authorized users.

Urogenital Schistosomiasis among Schoolchildren and the Associated Risk Factors in Selected Rural Communities of Kwara State, Nigeria

“…Our analysis of risk factors revealed a significant relationship between prevalence of infection and many factors such as lack of knowledge of infection, occupation, and source of water supply. This conforms to several reports in different ecological regions of Nigeria and sub-Saharan Africa [ 6 , 14 , 20 , 22 , 24 , 36 – 38 ]. Unemployment status of the parent was observed as a significant predictor of schistosomiasis, and it remained an important risk factor in the multivariate logistic regression analysis (aOR = 2.23).…”

High burden of Schistosoma mansoni infection in school-aged children in Marolambo District, Madagascar

“…However, the annual need for PC varies between districts according to their prevalence, therefore a national approach should be guided by the differing needs for PC throughout the country. A recent paper reported on very high prevalence rates and infection intensities of both urogenital and intestinal schistosomiasis in areas of western Madagascar left untreated for over five years [ 25 ], indicating the need for urgent up-scaling of national control initiatives to 100% of the districts requiring PZQ . There have also been detailed publications on high schistosomiasis prevalence rates from the central highlands and western Madagascar [ 4 , 26 , 27 ].…”

Prevalence and pattern of waterborne parasitic infections in eastern Africa: A systematic scoping review

“…Prevalence has been estimated ranging from 17 to 33% in Burundi ( Gryseels, 1991 ), 1.9 to 73.9% in Ethiopia ( Wondimagegnehu et al, 1992 ; Abebe et al, 2014 ; Nyantekyi et al, 2014 ; Tadege and Shimelis, 2017 ; Shumbej and Girum, 2019 ), 2.1 to 18% in Kenya ( Handzel et al, 2003 ; Mwandawiro et al, 2013 ; Won et al, 2017 ), 7.2 to 88.6% in Uganda ( Kabatereine et al, 1992 ; Kabatereine et al, 2004 ; Tukahebwa et al, 2013 ), 22.9 to 86.3% in Tanzania ( Poggensee et al, 2005 ; Kaatano et al, 2015 ). Schistosomiasis has also been reported in Somalia (27.2–65.8%) ( Arfaa, 1975 ; Koura et al, 1981 ), Mauritius (15 > 50%) ( Cowper, 1953 ), Eritrea (2.4%) ( Ministry of Education, 2002 ; Lai et al, 2015 ) and Madagascar (5.0–93.7%) ( Rasoamanamihaja et al, 2016 ; Spencer et al, 2017 ).…”

“…Soil-transmitted helminths have been diagnosed commonly using Kato-Katz technique. Prevalence have ranged from 41.7 to 52.4% in Ethiopia ( Emana et al, 2015 ; Tadege and Shimelis, 2017 ), 32.4 to 40.7% in Kenya ( Mwandawiro et al, 2013 ; Davis et al, 2014 ; Freeman et al, 2015 ), 9997 cases in Rwanda ( Stone and Ndagijimana, 2018 ), 85.0% in Somalia ( Ilardi et al, 1987 ), 4.7% in Madagascar ( Rasoamanamihaja et al, 2016 ) and 1.1 to 84% in Seychelles ( Kitua et al, 1988 ; Albonico et al, 1996 ). In all countries, Ascaris lumbricoides , Trichuris trichiura and hookworms were the most common helminths detected.…”

“…Despite the small number of studies conducted on waterborne parasitic diseases in eastern Africa over the past seven decades, available information highlights that, prevalence of important parasitic diseases is still high in recent years. These include schistosomiasis ( Rasoamanamihaja et al, 2016 ; Tadege and Shimelis, 2017 ; Won et al, 2017 ; Spencer et al, 2017 Shumbej and Girum, 2019 ), amoebiasis ( Ekou et al, 2012 ; Niyizurugero et al, 2013 ; Gedle et al, 2017 ; Gadisa and Jote, 2019 ; Sisay and Lemma, 2019 ), giardiasis ( Kipyegen et al, 2012 ; de Lucio et al, 2016 ; Gedle et al, 2017 ; Gadisa and Jote, 2019 ; Sisay and Lemma, 2019 ) and STHs ( Mwandawiro et al, 2013 ; Davis et al, 2014 ; Freeman et al, 2015 ; Emana et al, 2015 ; Tadege and Shimelis, 2017 ; Stone and Ndagijimana, 2018 ). Most of these diseases are transmitted in poor water and sanitation environments.…”