Impact of Praziquantel Mass Drug Administration Campaign on Prevalence and Intensity of Schistosoma haemamtobium Check for this Species in other Resources among Schoolchildren in Bahi District; Tanzania

As part of the Tanzania National Schistosomiasis Control Programme; Bahi district in central Tanzania; received two annual rounds of praziquantel mass drug administration (MDA) to control urinary schistosomiasis in schoolchildren. The objectives of this study were to assess the impact of the two rounds of MDA on prevalence and intensity of Schistosoma haemamtobium and the impact of MDA campaigns on knowledge of urinary schistosomiasis; safe water use and contact with potentially unsafe water bodies. A quantitative crosssectional study was carried out among schoolchildren in March and April; 2013. A structured questionnaire was used to collect information on MDA uptake; knowledge of schistosomiasis; sources of water for domestic and other uses. Urine samples were collected from each pupil to examine prevalence and intensity of S. haematobium. Transmission of schistosomiasis was assessed by sampling Bulinus spp snails for cercarial shedding. Uptake of MDA was 39.5 in 2011 and 43.6 in 2012. Prevalence of S. haematobium significantly dropped by 50.0 from 26 in 2011 to 15 in 2012 (p = 0.000). Prevalence of S. haematobium was significantly low in MDA participating (3.1) than non-participating (28.5) schoolchildren (p = 0.000). MDA campaigns had significant impact on knowledge of the disease (p = 0.02) and borderline impact on safe water use (p = 0.04) but had no impact on avoidance of contact with unsafe water bodies (p = 0.06). Bulinus spp. snails were found shedding schistosome cercariae indicating environmental contamination with viable S. haematobium eggs. In conclusion; though MDA significantly reduced prevalence of S. haematobium; uptake was below 50.0 and below the World Health Assembly resolution 54.19 target of 75.0 for 2010. Non-participation in MDA was the likely source of S. haematobium eggs in the environment hence the observed 15.0 prevalence of S. haematobium infection; and cercarial shedding Bulinus spp. snails indicating continuity of transmission hence the need for further health promotion campaigns

A simple approach improving the performance of urine reagent strips for rapid diagnosis of urinary schistosomiasis in Nigerian schoolchildren

In Nigeria, schistosomiasis, caused predominantly by the species Schistosoma haematobium, is highly endemic in resource-poor communities. We performed a school-based survey in two rural communities in Osun State (Southwestern Nigeria) and assessed macrohaematuria, microhaematuria and proteinuria as indirect indicators for the presence of disease. Urine samples were inspected macroscopically for haematuria and screened for microhaematuria and proteinuria using urine reagent strips. The microscopic examination of schistosome eggs was used as the gold standard for diagnosis. In total, 447 schoolchildren were included in this study and had a 51 percent prevalence of urinary schistosomiasis. The sensitivity of microhaematuria (68 percent) and proteinuria (53 percent) for infection with S. haematobium was relatively low. In patients with a heavy infection (>500 eggs/10 mL), the sensitivity of microhaematuria was high (95 percent). When the presence of macrohaematuria and the concomitant presence of microhaematuria and proteinuria were combined, it revealed a sensitivity of 63 percent, a specificity of 93 percent and a positive predictive value of 91 percent. Macrohaematuria also showed high specificity (96 percent) and a positive predictive value of 92 percent, while sensitivity was < 50 percent. These data show that combining urine reagent strip tests (presence of proteinuria and microhaematuria) and information on macrohaematuria increased the accuracy of the rapid diagnosis of urinary schistosomiasis in an endemic rural West African setting. This simple approach can be used to increase the quality of monitoring of schistosomiasis in schoolchildren.

Two practical and cost effective methods for urinary schistosomiasis screening in Yemeni Schoolchildren

The study was conducted to estimate and compare the validity and performance of two screening methods for urinary schistosomiasis: the interview - reporting blood in urine - and detecting microhematuria by reagent strip. In year 2003, 515 schoolchildren from five schools in Abyan and Taiz governorates in Yemen, were interviewed by healthworker for hematuria, and then urine samples were collected and tested for microhematuria by urine strip and for the presence and count of Schistosoma hematobium by filtration method. Validity and performance indicators were estimated and compared for the two methods using the filtration method as the reference -standard - test. The mean age of the schoolchildren was 10.7 +/- 2.5 years. Boys represented 65% of the sample. The prevalence of the infection as determined by filtration, interview and reagent strip methods was 21.4%, 22.15, and 30.9%, respectively. Sensitivity, specificity, PPV, NPV of the urine strip was higher than the same indicators for the interview method. Combining the results of both screening methods increased all validity and performance indicators. A statistically significant [P<0.001] association was found between urine strip positivity level and infection intensity. The urine strip had higher validity and performance indicators than the interview method. For its low-cost, simple and rapid application, we recommend using it for screening infected schoolchildren in area endemic with S.hematobium in combination with the interview method to enhance its performance

Urinary Schistosomiasis in the Danjarima Community in Kano; Nigeria

Background: Studies in northern Nigeria have suggested a linear relationship between urinary schistosomiasis and individual water-related activities. Knowledge of the perceptions of the local populace about schistosomoasis and of gender and cultural restrictions could be beneficial to control programmes. We studied the prevalence of urinary schistosomoasis and the socio-demographic factors associated with the disease in Danjarima community of Kano; northern Nigeria. Methodology: A cross-sectional survey involving 890 subjects was conducted in the community. Urine samples were collected and examined for ova of Schistosoma haematobium using sedimentation technique. A semi-structured questionnaire was administered to the subjects in order to determine their knowledge and perceptions about urinary schistosomiasis in relation to their cultures. Results: Eggs of S. haematobium were demonstrated in 370 (41.6) of the urine sampled examined. The highest prevalence rate of 54.4infection with S. haematobium was recorded in Zaura sub-village while the lowest rate of 6.4was observed in Sabon-Fegi. More males (55.9) were infected than females (3.7) and the difference between the infection rate in males and females was statistically significant (P = 0.01). The age group 10 to 14 years recorded the highest rate of infection (P = 0.05) in both males (80.9) and females (10.3). Conclusion: The lack of adequate perception on the cause of urinary schistosomiasis and exposure to water bodies were responsible for the high prevalence of infection in Danjarima

[Blood and urinary parasitosisi8 among non resident students in Tunisia]

The authors present the results of blood and urinary parasitological check-up carried out among non resident students in Tunisia, between 1990 and 2006 in the laboratory of Parasitology-Mycology of la Rabta-s Hospital. It-s a retrospective study having interested 4016 foreign and Tunisian students having stayed in Africa [52%], in the Maghreb [26.64%], in the Middle East [15.91%], in the Far East [3.43%], in Europe [1.96%] and in America [0.05%]. Three parasitosisis were determined: malaria, urinary schistosomiasis and filariasis. One hundred twenty eight cases of malaria were diagnosed among 3476 blood smears and thick smears carried out. Plasmodium falciparum was found in 59 cases and Plasmodium malaria in 4 cases. The remaining 65 cases were of Plasmodium sp. Thirty eight cases of urinary schistosomiasis were diagnosed among 3932 urinary parasitological check-up. Eight cases of filariasis were found: 3 of Loa loa, 3 of Mansonella perstans and in the remaining 2 cases, we had a combination of these two micrifilariaes. In Tunisia, there has been no local transmission of malaria and urinary schistosomiasis since 1979 and 1984 respectively. Although these diseases had been eradicated, their re-emergence is not considered impossible. The authors insist on the necessity of systematic screening of these parasitosisis among non resident students in Tunisia as well as an early and effective treatment of the parasitic patients

Schistosoma haematobium and urinary tract pathogens co-infections in a rural community of Edo State, Nigeria.

A survey of S. haematobium and other urinary tract pathogens co-infection was carried out among 198 volunteers in Ihieve, Ogben, a rural community in Owan East Local Government Area of Edo State, Nigeria. Of these, 118 (59.5%) had S. haematobium ova in their urine samples. Light infection (< or =50 ova/l0 ml) occurred among 49 (24.7%) volunteers and 59 (29.8%) inhabitants had heavy infections (> 50 ova/10 ml). The children 68 (64.2%) were more infected their the adults 50 (54.3%). This difference was statistically significant at (chi2 = 60.37, P < 0.05). The prevalence of S. haematobium among the males 80 (71.4%) was higher than their female counterparts 38 (41.9%) and this difference is statistically significant at (t = 1.28) Bacteriuria and bacterial isolates occurred among 60 (30.3%) with S haematobium infection. Three nitrate reducing bacterial isolates namely; Klebsiella sp and Staphylococcus aureus, Escherichia coli and a fungus; Candida albicans were reported in their urine cultures. Multiple infections were observed among 43 S. haematobium infected persons. The antibiogram of the isolates indicated that Nitrofurantoin, Gentamycin and otramax were the most effective drugs for the management of bacterial infections among these volunteers. All the bacterial isolates were resistant to Cloxacillin and Augmentum. The C. albicans were sensitive to Diflucan, Nizoral, Gynotravogen, Gynotrosydovule, Gyno-daktarin and Mycostatin.

Long-term outcomes of school-based treatment for control of urinary schistosomiasis: a review of experience in Coast Province, Kenya

Urinary schistosomiasis remains a significant burden for Africa and the Middle East. The success of population-based control programs will depend on their impact, over many years, on Schistosoma haematobium reinfection and associated disease. In a multi-year (1984-1992) control program in Kenya, we examined risk for S. haematobium reinfection and late disease during and after annual school-based treatment. In this setting, long-term risk of new infection was independently associated with location, age, hematuria, and incomplete treatment, but not with sex or frequency of water contact. Thus, very local environmental features and age-related factors played an important role in S. haematobium transmission, such that population-based control programs should optimally tailor their efforts to local conditions on a village-by-village basis. In 2001-2002, the late benefits of earlier participation in school-based antischistosomal therapy were estimated in a cohort of formerly-treated adult residents compared to never-treated adults from the same villages. Among age-matched subjects, current infection prevalence was lower among those who had received remote therapy. In addition, prevalence of bladder abnormality was lower in the treated group, who were free of severe bladder disease. Treatment of affected adults resulted in rapid resolution of infection and any detectable bladder abnormalities. We conclude that continued treatment into adulthood, as well as efforts at long-term prevention of infection (transmission control) are necessary to achieve optimal morbidity control in affected communities.

The perception, beliefs and practices toward genitourinary schistosomiasis by inhabitants of selected endemic areas (Edo/Delta States) in south-eastern Nigeria

Um questionário bem estruturado sobre a percepção e práticas e crenças sobre a esquistossomose genito-urinária foi administrado e explicado em dialetos locais: Igbo Esan Ezon Itshekiri e Bini a 33815 habitantes de áreas endêmicas selecionadas no sudeste da Nigéria, de janeiro de 1999 a dezembro de 2001. Deste total, 3815 (11,3) foram preenchidos adequadamente e devolvidos. Cerca de 42,0 dos habitantes admitiram conhecer a doença, enquanto 14 (0,4) conheciam o agente etiológico. Cerca de 181 (5,0) dos que responderam admitiram ter procurado tratamento, enquanto 100 (5,0) não procuraram tratamento de qualquer tipo. A relação entre as coleçäes de águas e atividades humanas e infecção foram discutidas. Entre os que admitiram conhecer a doença mas não o seu agente etiológico não procuraram nenhum tratamento, mas acreditam que a doença é um fenômeno natural nos estágios de desenvolvimento e portanto não apresentam morbidade e mortalidade. A análise laboratorial da urina, fezes, semen e HVS foi empregada para as respostas dos questionários e em alguns casos o exame físico foi utilizado para aumentar a análise laboratorial e confirmar o diagnóstico urinário. Hematúria foi diretamente relacionada a contagem de ovos na primeira parte da vida. As mulheres foram significativamente mais hematúricas e excretaram mais ovos que os homens (p < 0,05). Dor de cabeça (43,0) e febre (31,0) foram os maiores sinais clínicos enquanto dores sexuais (22,0) foram os menores.

Studies on the biology of schistosomiasis with emphasis on the Senegal river basin

The construction of the Diama dam on the Senegal river, the Manantali dam on the Bafing river, Mali and the ensuing ecological changes have led to a massive outbreak of Schistosoma mansoni in Northern Senegal, associated with high intensity of infections, due to intense transmission, and the creation of new foci of S. haematobium. Data on the vectorial capacity of Biomphalaria pfeifferi from Ndombo, near Richard Toll, Senegal are presented with sympatric and allopatric (Cameroon) S. mansoni. Comparisons are made on infectivity, cercarial production, chronobiology of cercarial emergence and longevity of infected snails. Recent data on the intermediate host specificity of different isolates of S. haematobium from the Lower and Middle Valley of the Senegal river basin (SRB) demonstrate the existence of at least two strains of S. haematobium. The role of Bulinus truncatus in the transmission of S. haematobium in the Lower and Middle Valleys of the SRB is reviewed. Both S. haematobium and S. mansoni are transmitted in the same foci in some areas of the SRB

The impact of repeated treatment with praziquantel of schistosomiasis in children under six years of age living in an endemic area for Schistosoma haematobium infection

Praziquantel was given every eight weeks for two years to children aged under six years of age, living in a Schistosoma haematobium endemic area. Infection with S. haematobium and haematuria were examined in urine and antibody profiles (IgA, IgE, IgM, IgG1, IgG2, IgG3, and IgG4) against S. haematobium adult worm and egg antigens were determined from sera collected before each treatment. Chemotherapy reduced infection prevalence and mean intensity from 51.8 percent and 110 eggs per 10 ml urine, respectively, before starting re-treatment programme to very low levels thereafter. Praziquantel is not accumulated after periodic administration in children. Immunoglobulin levels change during the course of treatment with a shift towards 'protective' mechanisms. The significant changes noted in some individuals were the drop in 'blocking' IgG2 and IgG4 whereas the 'protecting' IgA and IgG1 levels increased. The antibody profiles in the rest of the children remained generally unchanged throughout the study and no haematuria was observed after the second treatment. The removal of worms before production of large number of eggs, prevented the children from developing morbidity

Survey of urinary schistosomiasis and trichomoniasis in a rural community in Edo State, Nigeria.

Survey of urinary schistosomiasis and trichomoniasis was conducted among 830 inhabitants of Ikao village, in Owan local government area of Edo State, Nigeria Between October, 1999 and February, 2000. Of these, 178 (21.4%) excreted Schistosoma haematobium ova in their urine. School children were more infected than the farmers and petty traders. Males were more infected than the female counterparts, These differences were statistically significant using Chi-square test analysis (chi 2). Most of the inhabitants had light infections. In all, urinary schistosomiasis and trichomoniasis co-infection occurred in the genito-urinary tract of 14 (6.3%) females inhabitants. The highest Trichomonas vaginalis infection 16 (40.0%) occurred in female subjects within 20-25 years old.

Esquistosomiasis urinaria, a propósito de un caso importado en el Ecuador

Reportamos aquí un caso confirmado parasitológicamente de esquistosomiasis urinaria, causado por Schistosoma haematobium, en un hombre inglés de 29 años que posiblemente adquireió el parásito durante sus viajes a Egipto o Malawi hace tres meses. Hasta donde conocemos este es el primer caso confirmado en el país. Su importancia radica en el hecho de que el Ecuador es un país ecológicamente megadiverso por lo tanto turístico, rico en flora y fauna, siendo posible la introducción de enfermedades transmitidas por vectores desde otras altitudes. Además, este caso alerta la posibilidad de diagnósticos y manejos de patologías exóticas no conocidas en el Ecuador.

Prevalência, comportamentos de risco e níveis de informaçäo sobre a esquistossomose urinária em escolares da Area de Saúde 1§ de Junho, na Cidade de Maputo, Moçambique / Prevalence, risk behavior, and level of information associated with vesical schistosomiasis in primary school students from the Primeiro de Junho health district, Maputo, Mozambique

Para determinar a prevalência, identificar os comportamentos de risco e os níveis de informaçäo sobre a esquistossomose urinária, realizou-se um estudo transversal, entre outubro e novembro de 1996, em três escolas primárias da Area de Saúde 1§ de Junho, na cidade de Maputo, Moçambique. Efetuaram-se inquéritos epidemiológicos e recolheram-se amostras únicas de urina de 434 escolares de ambos os sexos, selecionados ao acaso, da segunda a quinta classes. A idade média foi de 11,3 anos (amplitude 6-16). A prevalência encontrada foi de 11,3 por cento (49/434). O grupo etário de 15 e mais anos apresentou a prevalência mais elevada (13,6 por cento), enquanto o de 10 a 14 anos, a maior intensidade de infecçäo (204 ovos/10 ml de urina). Apenas 18,9 por cento dos escolares já tinham ouvido falar na doença. Destes, só 19,5 por cento (16/82) sabiam como esta se manifestava. Cerca de 50 por cento dos escolares reportaram contatos freqüentes com potenciais focos de transmissäo de esquistossomose. Os resultados sugerem que a esquistossomose urinária é um problema de saúde pública nas escolas da Area de Saúde 1§ de Junho.

Schistosomiasis as a possible cause of female infertility

This study was conducted on 1625 infertile women selected for laparoscopy over a two-year period. All the patients were subjected to urinalysis, hysterosalpingography, endometrial biopsy in addition to semen analysis of their husbands. Laparoscopic guided biopsy of suspicious lesions of genital organs was taken. Histopathological evidence of schistosomiasis was proved in 27 cases. Twenty cases of them had only tubal affection, ten cases had hydrosalpinx and ten had granulomata on the outer surface of the tube. Three had peritubal small cysts formation. Two had tubo-ovarian masses and two cases showed peritoneal nodules. The histopathology of all lesions showed the characteristic of bilharzial ova

Cost effectiveness analysis of reduction of schistosomiasis haematobium morbidity-using different screening and therapeutic interventions

This study was conducted on 16 small villages around Assiut City, Middle Egypt. A total number of 11962 subjects living in 1279 houses were examined. The villages were divided into four matched groups. Urinary bladder morbidity [UBM] was quantitated by ultrasound [US] using the previously suggested score. Every household was visited once annually [in November through July] for three consecutive years. Cost-effectiveness ratios were computed for each of the study options [as a ratio between costs and effectiveness of each alternative]. There was a significant reduction in UB morbidity score in total cases covered in the study and in all study options. On the other hand, there were no significant changes in the control group. The study option of total coverage was the most cost effective method of reduction UB morbidity, followed by the option of school age group. Chemotherapy alone may not be enough for the control of Schistosomiasis. The results can be valuable for health planners

Morbidity of schistosomiasis in relation to family construction [environment] among school children in an Egyptian rural community

Schistosomiasis is an endemic disease of high prevalence rate in the most rural areas [communities] in developing countries. This work is aiming to know the magnitude of this problem, its relation to family construction [environment] and the effect of mass treatment. For that, a cross-sectional study was done on a sample of [2800] school children aging 6-18 years in an Egyptian village. All of them were examined for S. haematobium and only 1000 for S. Mansoni. The results denoted that the prevalence rate of S. haematobium, S. Mansoni and mixed infection were 1.6%, 4.9% and 0.8% respectively. The prevalence rate of S.haematobium was not affected by sex of the pupils, level of education of their fathers and mothers [parents], occupation of their fathers, family size, no. of housing room, source of water supply, type of family and presence of animals inside the house. The prevalence of S. Mansoni was affected by age of pupils, no. of housing rooms, presence of bathrooms and sharing their fathers in agriculture. The curative rate by praziquentel was 95.6%, it is recommended that, upgrading of socioeconomic standards of rural families, continuous medical surveys on rural population and reevaluation after health education and mass treatment by praziquentel

Prevalence of schistosoma haematobium for 35 villages in six chiefdoms in the Kanema District; Eastern Province of Sierra Leone

The study of the prevalence of schistosoma haematobium was conducted in July; 1990 in the Kenama District; Eastern Province of Sierra Leone. The crude prevalence was 32.6 per cent. The over-all prevalence was signicantly higher in females than in males but the age-specific prevalence was significantly higher in the 1-10 years cohort of males that female counterparts