Prevalence, Intensity, and Correlates of Schistosomiasis and Soil-Transmitted Helminth Infections after Five Rounds of Preventive Chemotherapy among School Children in Southern Ethiopia

Abstract

Preventive chemotherapy (PC) is a WHO-recommended strategy to control and eliminate schistosomiasis and soil-transmitted helminths (STHs). We assessed the prevalence, intensity, and correlates of schistosomiasis and STH infection after five rounds of PC in southern Ethiopia. A total of 3162 school children from four schools in Wondo Gennet and Hawella Tula districts were screened for Schistosoma mansoni and STHs infection. The overall prevalence of S. mansoni infection was 25.8% (range between schools 11.6% to 54.1%), with light (19.1%), moderate (5.3%), and heavy (1.4%) infection intensities. A total of 61.6% S. mansoni-infected children were STH co-infected. The overall prevalence of STHs infection was 54.7% (range between schools 30.6–71.0%), with moderate-to-heavy intensity infections being 16.3%. Ascaris lumbricoides was the most prevalent 45% (95% CI, 43.5–47) followed by Trichuris trichiura 25.3% (95% CI, 23.8–26.9) and hookworm 6.1% (95% CI, 5.3–7). A total of 33.7% of STHs-infected children had A. lumbricoides and T. trichiura co-infections. S. mansoni infection was significantly associated with school and STHs co-infection (p < 0.001). STH infection was correlated with school and younger age (p < 0.001). Despite repeated PC, S. mansoni and STH infection remain significant health problems, and the WHO target to control schistosomiasis and eliminate STH by 2020 may not be achieved. Intensified control and prevention measures, including drug efficacy surveillance, is recommended.

Prevalence, Intensity, and Correlates of Soil-Transmitted Helminth Infections among School Children after a Decade of Preventive Chemotherapy in Western Rwanda

“…The high prevalence of coinfection between T. trichiura and A. lumbricoides (49.3%) found in this study is consistent with a recent report that most of the dual STH infections observed in Ethiopia involve A. lumbricoides and T. trichiura [20]. In line with the report from Ethiopia [20], we also found a significant correlation between schistosomiasis and STH The study findings revealed that 32% of the children were stunted, which is in line with Rwanda Demographic and Health Survey's national data, reporting 38% of children were stunted in 2015 [15]. A recent study from Tanzania [16] reported that 29% of schoolchildren were stunted.…”

“…Stunting due to STH infection may contribute to delayed intellectual development, diminished physical fitness, growth retardation, and cognition [ 5 , 19 ]. The high prevalence of coinfection between T. trichiura and A. lumbricoides (49.3%) found in this study is consistent with a recent report that most of the dual STH infections observed in Ethiopia involve A. lumbricoides and T. trichiura [ 20 ]. In line with the report from Ethiopia [ 20 ], we also found a significant correlation between schistosomiasis and STH coinfection ( Table 4 ).…”

“…It is well recognized that the WHO intervention strategy and implementation of the global NTD program have contributed to reducing the disease burden. However, the long-term intervention measures taken so far by many endemic countries in sub-Saharan Africa, including Rwanda, have not managed to control and eliminate STH and other NTDs as a public health problem by 2020 [ 16 , 20 , 30 , 31 ]. Several factors may have contributed to this shortcoming [ 32 ].…”

Effect of Pharmacogenetics Variations on Praziquantel Plasma Concentrations and Schistosomiasis Treatment Outcomes Among Infected School-Aged Children in Tanzania

“…In 2017, approximately 99 million people of whom 81.1 million were school-aged children, received treatment worldwide ( WHO, 2018 ). The WHO target is to control (heavy infections <5%) and eliminate (heavy infections <1%) the disease as a public health problem by the year 2025 ( Gebreyesus et al, 2020 ).…”

Comparative Assessment of the Pharmacovigilance Systems within the Neglected Tropical Diseases Programs in East Africa—Ethiopia, Kenya, Rwanda, and Tanzania

“…Community- or school-based large-scale distribution of drugs at regular intervals to all at-risk populations without prior diagnosis is WHO’s core intervention strategy to control morbidity and to interrupt transmission, hence stopping the spread of infection and thereby reducing the suffering of the affected poor communities [ 9 , 10 , 11 , 12 ]. MDA aims to reduce the burden of selected NTDs, and it has already contributed significantly to improving global health, with the potential for further successes, especially when combined with other interventions, such as sanitation and education programs [ 8 , 13 , 14 , 15 ]. Globally, one billion people, including 418 million people in Africa, received treatment for at least one NTD in 2017 [ 1 , 16 ].…”