Patterns of concurrent hookworm infection and schistosomiasis in schoolchildren in Tanzania

Lwambo, N. J. S.; Siza, Julius E.; Brooker, Simon; Bundy, Donald; Guyatt, Helen

doi:10.1016/s0035-9203(99)90349-8

Cited by 96 publications

(116 citation statements)

References 13 publications

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“…It is notable that these schools were confined to the lakeshore. This strict relationship between S.mansoni prevalence and proximity to the lakeshore has been discussed elsewhere around Lake Victoria (18) and is attributed to the distribution of the intermediate snail hosts.…”

Section: Discussionsupporting

confidence: 57%

Epidemiology of single and multiple species of helminth infections among school children in Busia District, Kenya

Brooker¹,

Miguel²,

Moulin³

et al. 2009

E Af Med Jrnl

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Objective: To describe the patterns of single and multiple helminth infection in school children from Busia District, Kenya. Design: A cross-sectional school survey using a randomly selected sample, forming part of an evaluation study of an ongoing deworming project. Setting: Budalangi and Funyula divisions of Busia District, Western Province, Kenya. Subjects: One thousand seven hundred and thirty eight school children aged 8-20 years randomly selected from those enrolled in standards 3-8 in 25 randomly selected primary schools. Results: Overall, 91.7% of children were infected with either hookworm, Ascaris lumbricoides, Trichuris trichiura or Schistosoma mansoni. Infection prevalence of each species varied considerably among schools, being most marked for S. mansoni, where prevalence was highest in lakeshore schools. Children were typically infected with two or more species of helminth. Infection intensity of each geohelminth species was higher in school children infected with multiple species than in school children with single species infections, and intensity increased with the number of concurrent infections. Conclusion: Helminth infections are exceptionally common among school children in Busia district, thus confirming the good sense of the school-based approach adopted by the control programme. The study also shows that there is an association between concurrent infection and the intensity of infection, which may have consequences for nutritional and educational status.

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Section: Discussionsupporting

confidence: 57%

Epidemiology of single and multiple species of helminth infections among school children in Busia District, Kenya

Brooker¹,

Miguel²,

Moulin³

et al. 2009

E Af Med Jrnl

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“…The parasitological analysis of the 60 schools sampled is given in detail in Lwambo et al (1999). A total of 52 schools, which The relationship between the prevalence of reported blood in urine and the prevalence of S. haematobium infection in the 52 schools in Magu District.…”

Section: Resultsmentioning

confidence: 99%

“…The selection of these schools is outlined in detail in Lwambo et al (1999). The research team visited each school, and each child recruited to the study was asked to provide both a urine and stool sample which were preserved using formalin and examined in the laboratory.…”

Section: Study Population and Investigationsmentioning

confidence: 99%

The performance of school‐based questionnaires of reported blood in urine in diagnosing Schistosoma haematobium infection: patterns by age and sex

Guyatt

Brooker

Lwambo

et al. 1999

Tropical Med Int Health

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SummaryThis study investigates the performance of school-based questionnaires of reported blood in urine as an indicator of the prevalence of Schistosoma haematobium infection in schools and the presence of infection in individuals. In most schools (87%), the prevalence of reported blood in urine underestimates the prevalence of S. haematobium infection. Predictive value analysis suggests that a threshold of 30% reported blood in urine would identify most of the high prevalence schools (i.e. those with 50% or more children infected with S. haematobium). Although the prevalence of S. haematobium infection was greater in males than females, girls reported a lower prevalence of blood in urine than boys even at comparable levels of infection. Reported blood in urine in females was more specific (identifying 10% more uninfected girls than the sign in boys), but was far less sensitive (identifying less than 20% of infected girls than boys). The sensitivity of reported blood in urine was also related to age, being significantly lower in girls over 14 years of age. The proportion of infected children who reported blood in urine was also lower in schools where the prevalence of reported blood in urine is less than 30%. The results suggest that the selective treatment of children based on reported blood in urine in low prevalence schools would miss a high proportion of infected children, particularly girls. It remains unclear whether other rapid assessment techniques, such as the use of reagent strips, would offer greater cost-effectiveness.keywords Schistosoma haematobium, questionnaires, school-based, diagnosis, sensitivity, specificity, positive predictive value, negative predictive value, Tanzania

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“…While both intestinal schistosomiasis (S. mansoni) and urinary schistosomiasis (S. haematobium) are endemic in Tanzania (Lwambo, 1988) it is the latter that is most prevalent in Morogoro region. The World Health Organization estimates that approximately two billion people are infected with soil-transmitted helminths globally and are also endemic throughout Tanzania (Lwambo et al, 1999;WHO, 2014).…”

Section: Rejection Of Mass Drug Administration In Tanzania S17mentioning

confidence: 99%

“…Schistosomosa heamatobium infection involves pathological changes to the renal and reproductive organs (Blum et al, 1998;Hatz, 2001;Gryseels et al, 2006). Both schistosomiasis and soil-transmitted helminths -particularly hookworm -can result in chronic iron deficiency anaemia due to blood loss (Lwambo et al, 1999;Hotez et al, 2005).…”

Section: Rejection Of Mass Drug Administration In Tanzania S17mentioning

confidence: 99%

Rumours, Riots and the Rejection of Mass Drug Administration for the Treatment of Schistosomiasis in Morogoro, Tanzania

Hastings

2016

J. Biosoc. Sci.

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SummaryIn 2008 in Morogoro region, Tanzania, mass drug administration (MDA) to school-aged children to treat two neglected tropical diseases (NTDs) – urinary schistosomiasis and soil-transmitted helminths – was suspended by the Ministry of Health and Social Welfare after riots broke out in schools where drugs were being administered. This article discusses why this biomedical intervention was so vehemently rejected, including an eyewitness account. As the protest spread to the village where I was conducting fieldwork, villagers accused me of bringing medicine into the village with which to ‘poison’ the children and it was necessary for me to leave immediately under the protection of the Tanzanian police. The article examines the considerable differences between biomedical and local understandings of one of these diseases, urinary schistosomiasis. Such a disjuncture was fuelled further by the apparent rapidity of rolling out MDA and subsequent failures in communication between programme staff and local people. Rumours of child fatalities as well as children’s fainting episodes and illnesses following treatment brought about considerable conjecture both locally and nationally that the drugs had been either faulty, counterfeit, hitherto untested on humans or part of a covert sterilization campaign. The compelling arguments by advocates of MDA for the treatment of NTDs rest on the assumption that people suffering from these diseases will be willing to swallow the medicine. However, as this article documents, this is not always the case. For treatment of NTDs to be successful it is not enough for programmes to focus on economic and biomedical aspects of treatment, rolling out ‘one size fits all’ programmes in resource-poor settings. It is imperative to develop a biosocial approach: to consider the local social, biological, historical, economic and political contexts in which these programmes are taking place and in which the intended recipients of treatment live their lives. If this is not done, the world’s poor will continue to be neglected.

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Patterns of concurrent hookworm infection and schistosomiasis in schoolchildren in Tanzania

Cited by 96 publications

References 13 publications

Epidemiology of single and multiple species of helminth infections among school children in Busia District, Kenya

Epidemiology of single and multiple species of helminth infections among school children in Busia District, Kenya

The performance of school‐based questionnaires of reported blood in urine in diagnosing Schistosoma haematobium infection: patterns by age and sex

Rumours, Riots and the Rejection of Mass Drug Administration for the Treatment of Schistosomiasis in Morogoro, Tanzania

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