Effect of preventive chemotherapy with praziquantel on schistosomiasis among school-aged children in sub-Saharan Africa: a spatiotemporal modelling study

Kokaliaris, Christos; Garba, Amadou; Matuska, Martin; Bronzan, Rachel N.; Colley, Daniel G.; Dorkenoo, Améyo Monique; Ekpo, Uwem Friday; Fleming, Fiona; French, Michael; Kaboré, Achille; Mbonigaba, Jean Bosco; Midzi, Nicholas; Mwinzi, Pauline; N’Goran, Eliézer K.; Polo, Maria Rebollo; Sacko, Moussa; Tchuenté, Louis-Albert Tchuem; Tukahebwa, Edridah M.; Uvon, Pitchouna A; Yang, Guo-Jing; Wiesner, Lisa; Zhang, Yaobi; Utzinger, Jürg; Vounatsou, Penelope

doi:10.1016/s1473-3099(21)00090-6

Cited by 95 publications

(105 citation statements)

References 27 publications

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“…These high MDA coverage rates are similar to what other recent studies carried out in Philippines [27], Ghana [34], Cote d'Ivoire, Kenya, Mozambique, Niger and Tanzania [35,36], Sierra Leone [37], Togo [38] and Zanzibar [39]. A spatiotemporal modelling review [40] have also reported that schistosomiasis prevalence in sub-Saharan Africa has decreased considerably, most likely explained by the scaleup of preventive chemotherapy.…”

Section: Discussionsupporting

confidence: 87%

Mass drug administration campaigns: Comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected southern Malawi districts

Makaula

Kayuni

Mamba

et al. 2022

Preprint

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Preventive chemotherapy using mass drug administration (MDA) is one of the key interventions recommended by WHO, to control neglected tropical diseases. In Malawi, health workers distribute anti-helminthic drugs annually with most support from donors. The mean community coverage of MDA from 2018 to 2020 were high at 87% for praziquantel and 82% for albendazole, however posing a sustainability challenge once donor support diminishes. This study was conducted to compare use of the community-directed intervention (CDI) approach with the use of health workers in delivery of MDA. It was carried out in three districts, where cross-sectional, mixed-methods approach to data collection during baseline and follow-up assessments was used. Knowledge levels were high for what schistosomiasis is (65% - 88%) and what STH are (32% - 83%); and low for what causes schistosomiasis (32% - 58%), causes of STH (7% - 37%), intermediate organisms for schistosomiasis (13% - 33%) and types of schistosomiasis (2% - 26%). At follow-up, increases in praziquantel coverage were registered in control (86% to 89%) and intervention communities (83% to 89%); decreases were recorded for control (86% to 53%) and intervention schools (79% to 59%). Assessment of the costs for implementation of the study indicated that most resources were used at community (51%), health centre (29%) and district levels (19%). The intervention arm used more resources at health centre (27%) and community levels (44%) than the control arm at 2% and 4% respectively. Health workers and community members perceived the use of the CDI approach as a good initiative and more favorable over the standard practice of delivering MDA. The use of the CDI in delivery of MDA campaigns against schistosomiasis and STH is feasible, increases coverage and is acceptable in intervention communities. This could be a way forward addressing the sustainability concern when donor support wanes.

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Section: Discussionsupporting

confidence: 87%

Mass drug administration campaigns: Comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected southern Malawi districts

Makaula

Kayuni

Mamba

et al. 2022

Preprint

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“…mansoni could be attributed in part to the effectiveness and efficacy of annual PZQ treatments of these children under the MDA campaign in Cameroon, despite the permanent risk of reinfection [ 8 ]. The success of MDA in reducing schistosomiasis prevalence in school children has recently been confirmed for 44 countries in sub-Saharan Africa [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Schistosoma mansoni infection induces plasmablast and plasma cell death in the bone marrow and accelerates the decline of host vaccine responses

et al. 2022

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Schistosomiasis is a potentially lethal parasitic disease that profoundly impacts systemic immune function in chronically infected hosts through mechanisms that remain unknown. Given the immunoregulatory dysregulation experienced in infected individuals, this study examined the impact of chronic schistosomiasis on the sustainability of vaccine-induced immunity in both children living in endemic areas and experimental infections in mice. Data show that chronic Schistosoma mansoni infection impaired the persistence of vaccine specific antibody responses in poliovirus-vaccinated humans and mice. Mechanistically, schistosomiasis primarily fostered plasmablast and plasma cell death in the bone marrow and removal of parasites following praziquantel treatment reversed the observed cell death and partially restored vaccine-induced memory responses associated with increased serum anti-polio antibody responses. Our findings strongly suggest a previously unrecognized mechanism to explain how chronic schistosomiasis interferes with an otherwise effective vaccine regimen and further advocates for therapeutic intervention strategies that reduce schistosomiasis burden in endemic areas prior to vaccination.

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“… 54 ), and global health (e.g. 55 – 60 ). These Bayesian frameworks allow, for example, for the incorporation of non-linear covariate effects using Bayesian P-splines 61 , or to incorporate complex interactions of covariates, such as two-dimensional surfaces based on the coordinates of the location.…”

Section: Methodsmentioning

confidence: 99%

An index of access to essential infrastructure to identify where physical distancing is impossible

et al. 2022

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To identify areas at highest risk of infectious disease transmission in Africa, we develop a physical distancing index (PDI) based on the share of households without access to private toilets, water, space, transportation, and communication technology and weight it with population density. Our results highlight that in addition to improving health systems, countries across Africa, especially in the western part of Africa, need to address the lack of essential domestic infrastructure. Missing infrastructure prevents societies from limiting the spread of communicable diseases by undermining the effectiveness of governmental regulations on physical distancing. We also provide high-resolution risk maps that show which regions are most limited in protecting themselves. We find considerable spatial heterogeneity of the PDI within countries and show that it is highly correlated with detected COVID-19 cases. Governments could pay specific attention to these areas to target limited resources more precisely to prevent disease transmission.

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Effect of preventive chemotherapy with praziquantel on schistosomiasis among school-aged children in sub-Saharan Africa: a spatiotemporal modelling study

Cited by 95 publications

References 27 publications

Mass drug administration campaigns: Comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected southern Malawi districts

Mass drug administration campaigns: Comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected southern Malawi districts

Schistosoma mansoni infection induces plasmablast and plasma cell death in the bone marrow and accelerates the decline of host vaccine responses

An index of access to essential infrastructure to identify where physical distancing is impossible

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