Diagnosis and treatment of schistosomiasis in children in the era of intensified control

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.
Expert Review of Anti-infective Therapy (Impact Factor: 3.46). 10/2013; 11(11). DOI: 10.1586/14787210.2013.844066
Source: PubMed


In the current era of intensified and integrated control against schistosomiasis and other neglected tropical diseases, there is a need to carefully rethink and take into consideration disease-specific issues pertaining to the diagnosis, prevention, control and local elimination. Here, we present a comprehensive overview about schistosomiasis including recent trends in the number of people treated with praziquantel and the latest developments in diagnosis and control. Particular emphasis is placed on children. Identified research needs are offered for consideration; namely, expanding our knowledge about schistosomiasis in preschool-aged children, assessing and quantifying the impact of schistosomiasis on infectious and noncommunicable diseases, developing new antischistosomal drugs and child-friendly formulations, designing and implementing setting-specific control packages and developing highly sensitive, but simple diagnostic tools that are able to detect very light infections in young children and in people living in areas targeted for schistosomiasis elimination.

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    • "It acts via increased cell-membrane calcium penetration, leading to paralysis and immune clearance by the host. Standard treatment is sometimes supplemented with a second dose (40 mg/kg) 6 weeks after the first treatment (Knopp et al. 2013; Poggensee and Feldmeier 2001; Zwang and Olliaro 2014 "
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    ABSTRACT: Male genital schistosomiasis (MGS) is a neglected manifestation of Schistosoma haematobium infection with ignored implications on reproductive health and a differential diagnosis to sexually transmitted infections in endemic regions. MGS may have associations with HIV transmission and acquisition, and treatment could be a neglected chance of HIV prevention. This review summarizes current knowledge on epidemiology, clinical manifestations, diagnosis and treatment of MGS as a hypothesized risk factor for HIV transmission. Future research areas of global interest are suggested. PubMed published literature was reviewed based on the MOOSE guidelines. All publications on MGS were included regardless of publication year and study design. Furthermore, all publications were searched for information on possible HIV association. The 40 identified publications related to MGS were dominated by case reports and observational studies. No randomized clinical trials have been conducted to date, and very scant information related to possible associations with HIV transmission was presented. Clinical, randomized studies and epidemiological studies covering the possible association between MGS and HIV are urgently needed. Furthermore, field diagnostic tools should be developed and future mass treatment programs should include adults to reduce morbidity and prevent HIV acquisition. CRD42015016252.
    International Journal of Public Health 08/2015; 60(7). DOI:10.1007/s00038-015-0714-7 · 2.70 Impact Factor
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    • "Invasive infections due to typhoidal and particularly non-typhoidal S. enterica strains are endemic to sub-Saharan Africa [19] [20] and constitute the second most common pathogen in the present study. Hence, our findings underscore previous calls for indepth investigations to elucidate the epidemiology of S. enterica in Africa [21], with a particular focus on multidrugresistant strains, potential human-to-human transmission and complex interactions with highly co-endemic infections such as HIV and schistosomiasis [22]. "
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    ABSTRACT: Bacterial bloodstream infections (BSI) account for considerable morbidity worldwide, but epidemiological data from resource-constrained tropical settings are scarce. We analysed 293 blood cultures from patients presenting to a regional referral hospital in Bouaké, central Côte d’Ivoire, to determine the aetiology of community-onset BSI. The prevalence of bacteraemia was 22.5%, with children being most commonly affected. Enterobacteriaceae (predominantly Klebsiella pneumoniae and Salmonella enterica) accounted for 94% of BSI. Staphylococcus aureus was the only relevant Gram-positive pathogen. Clinical signs and symptoms were not significantly associated with blood culture positivity after controlling for malaria.
    07/2015; 7. DOI:10.1016/j.nmni.2015.06.009
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    • "Ultrasensitive diagnosis is a prerequisite for delineating the spatial distribution of S. mekongi and S. japonicum infections. Furthermore , sensitivity is imperative in the elimination stage, where the role of low-level infections play a critical role (Knopp et al., 2013; Rollinson et al., 2013; van Dam et al., 2014). This has convincingly been shown in Africa (Colley et al., 2013) and recently in P.R. "
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    ABSTRACT: In Asia, Schistosoma japonicum is the predominant schistosome species, while Schistosoma mekongi is confined to limited foci in Cambodia and Lao People's Democratic Republic. While the People's Republic of China has been successful in controlling schistosomiasis, the disease remains a major public health issue in other areas. In order to prioritise intervention areas, not only accurate diagnosis is important but also other factors, such as practicallity, time-efficiency and cost-effectiveness, since they strongly influence the success of control programmes. To evaluate the highly specific urine-based assays for the schistosome circulating cathodic antigen (CCA) and the circulating anodic antigen (CAA), banked urine samples from Cambodia (n=106) and the Philippines (n=43) were examined by the upconverted phosphor CAA lateral flow (UCP-LF CAA) assay and the point-of-care (POC)-CCA urine assay. Based on 250 μl urine samples, UCP-LF CAA sensitivity outcomes surpassed a single stool examination by the Kato-Katz technique. The banked urine samples in the current study did not allow the evaluation of larger volumes, which conceivably should deliver considerably higher readings. The sensitivity of a single urine POC-CCA was in the same order as that of a single Kato-Katz thick smear examination, while the sensitivity approached that of triplicate Kato-Katz when a combination of both CAA and CCA assays was used. The promising results from the current proof-of-concept call for larger studies that will determine the accuracy of the urine-based CCA and CAA assays for S. mekongi and S. japonicum diagnosis.
    Acta Tropica 09/2014; 141(Pt B). DOI:10.1016/j.actatropica.2014.09.003 · 2.27 Impact Factor
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