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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    • "Achieving and maintaining high MDA coverage and compliance at national and local level and additionally treating infected individuals in health facilities are therefore crucial to avoid a rebound of S. haematobium infection. Highly sensitive diagnostic tests and additional control measures such as snail control and behaviour change interventions will be needed to interrupt transmission completely[18,44,49,50]. The possibility of emerging drug resistance in Zanzibar, where praziquantel has been distributed regularly for more than 10 years, needs to be clarified and hopefully ruled out in future studies assessing praziquantel efficacy. "
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    ABSTRACT: Background: Biannual mass drug administration (MDA) with praziquantel and additional interventions to eliminate urogenital schistosomiasis has been implemented on the Zanzibar islands, United Republic of Tanzania, since 2012. We aimed to assess the coverage of school-based treatment (SBT) and community-wide treatment (CWT), to validate the coverage reported by the Zanzibar Ministry of Health (MoH) and to identify reasons for non-compliance. Methods: We conducted a post-MDA cross-sectional survey in 93 schools and 92 communities on Pemba and Unguja islands in early 2014, 3-5 months after the last MDA round. Pupils and adults were asked whether they had received and taken the praziquantel treatment provided in the last SBT or CWT, respectively, and the observed and reported coverage were compared. Reasons for non-compliance were recorded in a pretested questionnaire and assessed in qualitative interviews. Urine samples of participants were examined for Schistosoma haematobium eggs with a single urine filtration. Results: Around 8000 pupils and 4000 adults were included in the analysis. Our survey revealed a SBT coverage of 85.2 % in Pemba and of 86.9 % in Unguja, which was in line with MoH reports from Pemba (84.3 %) and higher than reports from Unguja (63.9 %). However, 15 among the 48 schools surveyed in Unguja had not received SBT. Among the interviewed adults, 53.6 % in Pemba and 64.9 % in Unguja had received praziquantel during CWT, which was less than the 59.0 % and 67.7 %, respectively, indicated by MoH reports. Moreover, only 43.8 % and 54.0 % of adults in Pemba and Unguja, respectively, had taken all the tablets as recommended. The main reasons for not receiving or taking praziquantel were absence during CWT, no drug distributor coming, being busy, fear of adverse events, pregnancy, breastfeeding or feeling healthy. Conclusion: To increase coverage and compliance in Zanzibar, SBT should target all schools and mobilization, sensitization and implementation of the CWT need to be improved. To reach elimination of urogenital schistosomiasis transmission in Zanzibar and elsewhere, a very high treatment coverage and compliance at national and local level is key and additional control measures such as snail control and behaviour change interventions will need to be implemented area wide.
    Full-text · Article · Dec 2016 · Parasites & Vectors
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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.
    Full-text · Article · Aug 2015 · International Journal of Public Health
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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.
    Full-text · Article · Jul 2015
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