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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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Related in: MedlinePlus

Raised urine albumin levels (> 40 mg/L) in relation to egg-patent infection with S. haematobium reveal underlying urinary tract pathology in young children.
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Figure 5: Raised urine albumin levels (> 40 mg/L) in relation to egg-patent infection with S. haematobium reveal underlying urinary tract pathology in young children.

Mentions: 38 mothers and 17 children had turbid urine upon visual inspection. This was significantly associated with egg patent S. haematobium infection in both mothers and children (OR 8.1 CI95 4.2 – 15.3). Only 4 mothers and 2 children presented with macrohaematuria; all of these were egg-patent for S. haematobium. Reagent strip testing demonstrated microhaematuria in 45 women (40.0% [CI95 32.5-47.5] and 57 children (24.4% [CI9518.3-30.4] haematuria). The presence of microhaematuria was significantly associated with egg patent S. haematobium infection in all participants (OR 15.5 CI95 7.8 – 30.9) and clearly increased with child age, Figure 4A & B. Elevated urine albumin levels (>40 mg/l) were seen in 26.7% of mothers and 17.3% of children, with no significant difference between boys and girls. The mean levels of urine-albumin related to results of diagnostic methods for S. haematobium are shown in Table 1; significantly higher levels of urine-albumin were associated with infection with urogenital schistosomiasis. A box-plot of the relationship between urine-albumin and egg-patent infection with S. haematobium is shown in Figure 5.


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)

Raised urine albumin levels (> 40 mg/L) in relation to egg-patent infection with S. haematobium reveal underlying urinary tract pathology in young children.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Raised urine albumin levels (> 40 mg/L) in relation to egg-patent infection with S. haematobium reveal underlying urinary tract pathology in young children.
Mentions: 38 mothers and 17 children had turbid urine upon visual inspection. This was significantly associated with egg patent S. haematobium infection in both mothers and children (OR 8.1 CI95 4.2 – 15.3). Only 4 mothers and 2 children presented with macrohaematuria; all of these were egg-patent for S. haematobium. Reagent strip testing demonstrated microhaematuria in 45 women (40.0% [CI95 32.5-47.5] and 57 children (24.4% [CI9518.3-30.4] haematuria). The presence of microhaematuria was significantly associated with egg patent S. haematobium infection in all participants (OR 15.5 CI95 7.8 – 30.9) and clearly increased with child age, Figure 4A & B. Elevated urine albumin levels (>40 mg/l) were seen in 26.7% of mothers and 17.3% of children, with no significant difference between boys and girls. The mean levels of urine-albumin related to results of diagnostic methods for S. haematobium are shown in Table 1; significantly higher levels of urine-albumin were associated with infection with urogenital schistosomiasis. A box-plot of the relationship between urine-albumin and egg-patent infection with S. haematobium is shown in Figure 5.

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