Mass Drug Distribution Strategy Efficacy for Schistosomiasis Control in Mali (West Africa)

Abstract

Background - Schistosomiasis is a water-based parasitic disease caused by blood flukes of the genus Schistosoma. Mass Drug Distribution (MDD) with Praziquantel is periodically recommended in schistosomiasis-endemic countries to prevent morbidity. In Mali, schistosomiasis still remains endemic, especially in Senegal and Niger rivers basin, although the strategy has been adopted since 2005. Our study aimed to assess the impact of annual school-based MDD. Materials and methods – The study was conducted at twelve sentinel sites across Kayes and Koulikoro regions. A cross-sectional study design was performed in April 2018 after four-or five-years post treatment with praziquantel (PZQ) depending on the statute of sites. At baseline (2014-2015) and for the control year (2018), 734 (386 boys and 347 girls) and 1708 (844 boys and 864 girls) school children of 7-14 years of age, were successfully examined respectively. Infections with Schistosoma haematobium and S. mansoni were diagnosed with the urine filtration and the Kato-Katz method respectively. Results – From eight schools treated in 2014, the four annual rounds of MDD with PZQ were associated with a significant decrease in S. haematobium prevalence in five sites (p<0,001) and a significant increase in one site (p<0,001). Of them, the prevalence of high-intensity (≥50 eggs/10mL of urine) significantly decreased in four previous sites but not in Diakalele where it increased ((p<0.001). In all the four sites treated in 2015, S. haematobium prevalence increased significantly in Kokoun and Samaya (P<0.05). The heavy infection increased slightly in Dougourakoro and Samaya (P>0.05). The prevalence of S. mansoni significantly decreased in three sites (p<0.001), increased in three and remains zero in the six others sites. Conclusion – Our findings show that five of the twelve sentinel sites have achieved the criterion of elimination of schistosomiasis due to Schistosoma haematobium as a major public health problem (Prevalence of heavy infection <1%); three have achieved the criterion of morbidity control (Prevalence of heavy infection <5%), whereas two sites remain confined below the control criterion. These results call for a strong improvement in the therapeutic coverage associating, education and provision of safe water, sanitation and hygiene to interrupt the transmission cycle of the schistosome.

Risk factors and ultrasound aspects associated with Urogenital Schistosomiasis among primary school children in Mali (West Africa)

“…The results of Our study demonstrated an average prevalence of 50.1% of urogenital schistosomiasis infection in Kayes region, Mali. This prevalence is higher than that previously reported 26.8% in the same region (21). In our study, the sex of the patient did not in uence the prevalence of infection.…”

“…The in uence of the host sex on urogenital schistosomiasis infection shows contrasting results with previously reported data. Female was observed to be more infected compare to male in Bandanyenje region (Zimbabwe) (22), the opposite was observed in Oromia regions (Ethiopia) (23) and no difference was observed in Kayes region (Mali) (21) or in South Nigeria (13). The effect of patient's sex on schistosome prevalence was recently reviewed and statistically analyzed using meta-analytical approach (24).…”

Endemicity of Urogenital Schistosomiasis and Its Associated Risk Factors among Children in Danbatta, Northwestern Nigeria

“…Higher S. haematobium infection prevalence among the Tsangaya (almajiris) children than their Primary (conventional) School children is similar to the report of urogenital schistosomiasis prevalence among vulnerable children in Safana, Katsina State, where schistosomiasis was significantly almajiris-biased (Auta et al, 2020). The very high prevalence (92.6%) of S. haematobium infection among the Tsnagaya children is similar to the high prevalence of 96.8% reported for Babaroto in Mali (Dabo et al, 2021). The extremely high prevalence reported in this study, among the Tsangaya children (almajiris) could be associated with the exclusion of children in the Tsangaya schools in the implementations of Mass Drug Administration/Mass Administration of Medicine (MDA/MAM) program using praziquantel in Kano, which is a common challenge in the national programme.…”

Trichomonas vaginalis and Mycoplasma co-infection among women received in a microbiology laboratory in Dakar

“…The results are sometimes higher in women, for example, in the Bandanyenje region (Zimbabwe) [18], and sometimes lower, such as in the Oromia region (Ethiopia) [19,20]. In the Kayes region (Mali) [21] or in southern Nigeria [22], there was no difference in disease prevalence between genders. The differences between genders in terms of prevalence or intensity could be explained more by behavioral differences (nature and intensity of water contact activities) than by immunological differences, according to a meta-analytical approach based on data from 23 schistosomiasis-endemic countries [23].…”