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Schistosomiasis in pre-school-age children and their mothers in Chikhwawa district, Malawi with notes on characterization of schistosomes and snails.

Poole H, Terlouw DJ, Naunje A, Mzembe K, Stanton M, Betson M, Lalloo DG, Stothard JR - Parasit Vectors (2014)

Bottom Line: PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria.As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni.Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. r.stothard@liv.ac.uk.

ABSTRACT

Background: To complement ongoing schistosomiasis control within national control programmes (NCPs) that administer praziquantel to school-age children, assessing the risk and extent of schistosomiasis in pre-school-age children (PSAC) is important.

Methods: In June 2012, schistosomiasis in Chikhwawa district, Malawi was assessed across 12 villages examining pre-school-age children (PSAC) and their mothers by serological and parasitological diagnosis, as supplemented with urine-antigen and questionnaire-interview methods. Urinary tract morbidity was inferred by haematuria and albuminuria assays.

Results: In total, 49.5% (CI₉₅ 42.6-56.4) of 208 PSAC and 94.5% (CI₉₅ 90.9-98.1) of 165 mothers were seropositive for schistosomiasis, in 2 villages seroprevalence exceeded 75% in PSAC. Egg-patent urogenital and intestinal schistosomiasis was observed; 17.7% (CI₉₅ 12.4-23.2) of PSAC and 45.1% (CI₉₅ 37.4-52.8) of mothers having active schistosomiasis by parasitological and urine-antigen testing combined. PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria. As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni. Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

Conclusions: Both PSAC and their mothers appear to be at significant risk of schistosomiasis and should be considered for treatment within the NCP of Malawi.

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Observed prevalence of SEA-ELISA positive results in PSAC by age group and by strength of reaction.
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Figure 2: Observed prevalence of SEA-ELISA positive results in PSAC by age group and by strength of reaction.

Mentions: 165 mothers (mean age 28 years range 18-47) and 208 children (mean age 36 months range 9-66, gender ratio 1.1 boys:girls) participated in the study. 94.5% of mothers (CI95 90.9-98.1) and 49.5% of PSAC (CI95 42.6-56.4) were seropositive for schistosomiasis by SEA-ELISA. The geographical distribution of seropositive PSAC and mothers across the 12 villages is shown in relation to the main water bodies and where Bulinus snails were encountered (Figure 1). The seroprevalence varied widely from over 50% of PSAC in Kapasule, Mpangani, Mwalija, Chikambe 3 and Santana villages to less than 5% in Chinangwa 1 and Namila, indicating a focal distribution. Both the proportion of positive SEA-ELISAs and the titre increased with increasing age of children ranging from 37.2% (CI95 22.1-52.3) in PSAC aged 1 to 78.1% (CI95 62.9-93.2) in PSAC aged 5 years (Figure 2). There was no significant difference in prevalence between boys and girls. In total, 45.1% (CI95 37.4-52.8) of mothers and 17.7% (CI95 12.4-23.2) of children were found to be infected by parasitological (urine-filtration) and/or CCA-dipstick testing.


Schistosomiasis in pre-school-age children and their mothers in Chikhwawa district, Malawi with notes on characterization of schistosomes and snails.

Poole H, Terlouw DJ, Naunje A, Mzembe K, Stanton M, Betson M, Lalloo DG, Stothard JR - Parasit Vectors (2014)

Observed prevalence of SEA-ELISA positive results in PSAC by age group and by strength of reaction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230191&req=5

Figure 2: Observed prevalence of SEA-ELISA positive results in PSAC by age group and by strength of reaction.
Mentions: 165 mothers (mean age 28 years range 18-47) and 208 children (mean age 36 months range 9-66, gender ratio 1.1 boys:girls) participated in the study. 94.5% of mothers (CI95 90.9-98.1) and 49.5% of PSAC (CI95 42.6-56.4) were seropositive for schistosomiasis by SEA-ELISA. The geographical distribution of seropositive PSAC and mothers across the 12 villages is shown in relation to the main water bodies and where Bulinus snails were encountered (Figure 1). The seroprevalence varied widely from over 50% of PSAC in Kapasule, Mpangani, Mwalija, Chikambe 3 and Santana villages to less than 5% in Chinangwa 1 and Namila, indicating a focal distribution. Both the proportion of positive SEA-ELISAs and the titre increased with increasing age of children ranging from 37.2% (CI95 22.1-52.3) in PSAC aged 1 to 78.1% (CI95 62.9-93.2) in PSAC aged 5 years (Figure 2). There was no significant difference in prevalence between boys and girls. In total, 45.1% (CI95 37.4-52.8) of mothers and 17.7% (CI95 12.4-23.2) of children were found to be infected by parasitological (urine-filtration) and/or CCA-dipstick testing.

Bottom Line: PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria.As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni.Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. r.stothard@liv.ac.uk.

ABSTRACT

Background: To complement ongoing schistosomiasis control within national control programmes (NCPs) that administer praziquantel to school-age children, assessing the risk and extent of schistosomiasis in pre-school-age children (PSAC) is important.

Methods: In June 2012, schistosomiasis in Chikhwawa district, Malawi was assessed across 12 villages examining pre-school-age children (PSAC) and their mothers by serological and parasitological diagnosis, as supplemented with urine-antigen and questionnaire-interview methods. Urinary tract morbidity was inferred by haematuria and albuminuria assays.

Results: In total, 49.5% (CI₉₅ 42.6-56.4) of 208 PSAC and 94.5% (CI₉₅ 90.9-98.1) of 165 mothers were seropositive for schistosomiasis, in 2 villages seroprevalence exceeded 75% in PSAC. Egg-patent urogenital and intestinal schistosomiasis was observed; 17.7% (CI₉₅ 12.4-23.2) of PSAC and 45.1% (CI₉₅ 37.4-52.8) of mothers having active schistosomiasis by parasitological and urine-antigen testing combined. PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria. As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni. Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

Conclusions: Both PSAC and their mothers appear to be at significant risk of schistosomiasis and should be considered for treatment within the NCP of Malawi.

Show MeSH
Related in: MedlinePlus