Data on the pre-MDA and post MDA interventions for Schistosoma mansoni and Schistosoma haematobium in a co-endemic focus in Uganda: 1951-2011.

The dataset for this article contains Urinary and Intestinal Schistosomiasis from Lango region, northern Uganda which is the only known co-endemic region for S.mansoni and S.haematobium. Reported in the data, is the retrospective data review for historical information before interventions were implemented before 2003 and after interventions were implemented in 2003 by the national control program. In 2007 and 2011, parasitological surveys were conducted in the region to validate Schistosomiasis trends following World Health Organization (WHO) guidelines for surveys. In addition, malacological surveys were undertaken in 2007 to assess local transmission potential. The dataset can provide an insight into the health implications of Schistosomiasis control in co-endemic focus in Uganda, "The epidemiology of schistosomiasis in Lango region Uganda 60 years after Schwetz 1951: Can schistosomiasis be eliminated through mass drug administration without other supportive control measures?" (Adriko et al., 2018) [10].

The epidemiology of schistosomiasis in Lango region Uganda 60 years after Schwetz 1951: Can schistosomiasis be eliminated through mass drug administration without other supportive control measures?

INTRODUCTION: Lango region is the only known endemic region for urinary and intestinal schistosomiasis in Uganda. Although there has been no significant improvement in sanitation and safe water supply in the region over years, the endemicity and prevalence of Schistosoma haematobium, in particular, have declined, perhaps due to yearly mass treatment campaigns implemented since 2003. METHODS: We report the epidemiology of Urinary and Intestinal schistosomiasis in Lango since 1951-2011 determined through Microscopic examinations for S. mansoni and S. haematobium respectively. A retrospective data review from 195 to 2011 was done to establish the prevalence over the years in the region. We performed Poisson regression analysis to observe trends in epidemiology before and after control was initiated in 2002. In addition, malacological surveys were undertaken in 2007 to assess local transmission potential. FINDINGS: Contrary to earlier records, S. haematobium was low and confined to a few putative foci, with declined in infections from 28.2% in 1951 to 2.48% by 2011. Although this decline can be attributed to control, this was already much lower in 1967 than 1951, long before control interventions began suggesting that environmental changes may have made the habitat less suitable for the transmission of S. haematobium. Compared to the historical records S. mansoni prevalence first increased up immediately before control interventions in 2003, significantly declined (p=<0.001) until 2007. However, in 2007 and 2011 declined insignificant, (p = 0.656). No snail has ever been isolated shedding S. haematobium cercariae but many Bulinus snail spp. were found shedding S. bovis cercariae. CONCLUSION: This suggests that a combination of environmental and mass treatment has had a significant impact on transmission in Lango region.

Evaluation of circulating cathodic antigen (CCA) urine-cassette assay as a survey tool for Schistosoma mansoni in different transmission settings within Bugiri District, Uganda.

Diagnosis of schistosomiasis at the point-of-care (POC) is a growing topic in neglected tropical disease research. There is a need for diagnostic tests which are affordable, sensitive, specific, user-friendly, rapid, equipment-free and delivered to those who need it, and POC is an important tool for disease mapping and guiding mass deworming. The aim of present study was to evaluate the relative diagnostic performance of two urine-circulating cathodic antigen (CCA) cassette assays, one commercially available and the other in experimental production, against results obtained using the standard Kato-Katz faecal smear method (six thick smears from three consecutive days), as a 'gold-standard', for Schistosoma mansoni infection in different transmission settings in Uganda. Our study was conducted among 500 school children randomly selected across 5 schools within Bugiri district, adjacent to Lake Victoria in Uganda. Considering results from the 469 pupils who provided three stool samples for the six Kato-Katz smears, 293 (76%) children had no infection, 109 (23%) were in the light intensity category, while 42 (9%) and 25 (5%) were in the moderate and heavy intensity categories respectively. Following performance analysis of CCA tests in terms of sensitivity, specificity, negative and positive predictive values, overall performance of the commercially available CCA test was more informative than single Kato-Katz faecal smear microscopy, the current operational field standard for disease mapping. The current CCA assay is therefore a satisfactory method for surveillance of S. mansoni in an area where disease endemicity is declining due to control interventions. With the recent resolution on schistosomiasis elimination by the 65th World Health Assembly, the urine POC CCA test is an attractive tool to augment and perhaps replace the Kato-Katz sampling within ongoing control programmes.

Intestinal schistosomiasis in chimpanzees on Ngamba Island, Uganda: observations on liver fibrosis, schistosome genetic diversity and praziquantel treatment.

Despite treatment with praziquantel (PZQ) at 40 mg/kg in food, several chimpanzees on Ngamba Island Chimpanzee Sanctuary (NICS) continue to excrete eggs of Schistosoma mansoni. To monitor disease, 8 animals were closely examined under anaesthesia in March 2011 with portable ultrasonography and by rectal snip biopsy. Schistosome genetic diversity had been previously assayed within 4 of these chimpanzees, finding extensive diversity with 27 DNA barcodes encountered, although none was common to all animals. Calcified schistosome eggs were found in the rectal snips from 5 chimpanzees and liver fibrosis was clearly documented, indicative of progressive disease in 6 animals, the latter being surprisingly advanced in a younger chimpanzee. All 8 animals were treated under anaesthesia by oral gavage with PZQ at 60 mg/kg dosing that was well tolerated. These animals were again re-examined in June 2012 using stool and urine sampling. Only 1 chimpanzee appeared to be free from infection and active egg excretion was confirmed in 6 animals. If intestinal schistosomiasis is to be controlled within this setting, a long-term disease management plan is required which should combine active case-detection with an insistent treatment regime with praziquantel for these chimpanzees, exploring perhaps the performance of even higher dosing.

Performance of circulating cathodic antigen (CCA) urine-dipsticks for rapid detection of intestinal schistosomiasis in schoolchildren from shoreline communities of Lake Victoria.

ABSTRACT: For disease surveillance and mapping within large-scale control programmes, RDTs are becoming popular. For intestinal schistosomiasis, a commercially available urine-dipstick which detects schistosome circulating cathodic antigen (CCA) in host urine is being increasingly applied, however, further validation is needed. In this study, we compared the CCA urine-dipstick test against double thick Kato-Katz faecal smears from 171 schoolchildren examined along the Tanzanian and Kenyan shorelines of Lake Victoria. Diagnostic methods were in broad agreement; the mean prevalence of intestinal schistosomiasis inferred by Kato-Katz examination was 68.6% (95% confidence intervals (CIs) = 60.7-75.7%) and 71.3% (95% CIs = 63.9-78.8%) by CCA urine-dipsticks. There were, however, difficulties in precisely 'calling' the CCA test result, particularly in discrimination of 'trace' reactions as either putative infection positive or putative infection negative, which has important bearing upon estimation of mean infection prevalence; considering 'trace' as infection positive mean prevalence was 94.2% (95% CIs = 89.5-97.2%). A positive association between increasing intensity of the CCA urine-dipstick test band and faecal egg count was observed. Assigning trace reactions as putative infection negative, overall diagnostic sensitivity (SS) of the CCA urine-dipstick was 87.7% (95% CIs = 80.6-93.0%), specificity (SP) was 68.1% (95% CIs = 54.3-80.0%), positive predictive value (PPV) was 86.1% (95% CIs = 78.8-91.7%) and negative predictive value (NPV) was 71.1% (95% CIs = 57.2-82.8%). To assist in objective defining of the CCA urine-dipstick result, we propose the use of a simple colour chart and conclude that the CCA urine-dipstick is a satisfactory alternative, or supplement, to Kato-Katz examination for rapid detection of intestinal schistosomiasis.

Strongyloides stercoralis: a field-based survey of mothers and their preschool children using ELISA, Baermann and Koga plate methods reveals low endemicity in western Uganda.

To ascertain the current status of strongyloidiasis in mothers and their preschool children, a field-based survey was conducted in western Uganda using a combination of diagnostic methods: ELISA, Baermann concentration and Koga agar plate. The prevalence of other soil-transmitted helminthiasis and intestinal schistosomiasis were also determined. In total, 158 mothers and 143 children were examined from five villages within Kabale, Hoima and Masindi districts. In mothers and children, the general prevalence of strongyloidiasis inferred by ELISA was approximately 4% and approximately 2%, respectively. Using the Baermann concentration method, two parasitologically proven cases were encountered in an unrelated mother and child, both of whom were sero-negative for strongyloidiasis. No infections were detected by Koga agar plate method. The general level of awareness of strongyloidiasis was very poor ( < 5%) in comparison to schistosomiasis (51%) and ascariasis (36%). Strongyloidiasis is presently at insufficient levels to justify inclusion within a community treatment programme targeting maternal and child health. Better epidemiological screening is needed, however, especially identifying infections in HIV-positive women of childbearing age. In the rural clinic setting, further use of the Baermann concentration method would appear to be the most immediate and pragmatic option for disease diagnosis.