An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi
Abstract Background Intestinal schistosomiasis was not considered endemic in Lake Malawi until November 2017 when populations of Biomphalaria pfeifferi were first reported; in May 2018, emergence of intestinal schistosomiasis was confirmed. This emergence was in spite of ongoing control of urogenita...
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2020-08-01
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Series: | Infectious Diseases of Poverty |
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Online Access: | http://link.springer.com/article/10.1186/s40249-020-00736-w |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sekeleghe A. Kayuni Angus M. O’Ferrall Hamish Baxter Josie Hesketh Bright Mainga David Lally Mohammad H. Al-Harbi E. James LaCourse Lazarus Juziwelo Janelisa Musaya Peter Makaula J. Russell Stothard |
spellingShingle |
Sekeleghe A. Kayuni Angus M. O’Ferrall Hamish Baxter Josie Hesketh Bright Mainga David Lally Mohammad H. Al-Harbi E. James LaCourse Lazarus Juziwelo Janelisa Musaya Peter Makaula J. Russell Stothard An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi Infectious Diseases of Poverty Emergence Schistosoma mansoni Urine CCA-dipstick Faecal occult blood Co-infection Morbidity |
author_facet |
Sekeleghe A. Kayuni Angus M. O’Ferrall Hamish Baxter Josie Hesketh Bright Mainga David Lally Mohammad H. Al-Harbi E. James LaCourse Lazarus Juziwelo Janelisa Musaya Peter Makaula J. Russell Stothard |
author_sort |
Sekeleghe A. Kayuni |
title |
An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi |
title_short |
An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi |
title_full |
An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi |
title_fullStr |
An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi |
title_full_unstemmed |
An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi |
title_sort |
outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of lake malawi, mangochi district, malawi |
publisher |
BMC |
series |
Infectious Diseases of Poverty |
issn |
2049-9957 |
publishDate |
2020-08-01 |
description |
Abstract Background Intestinal schistosomiasis was not considered endemic in Lake Malawi until November 2017 when populations of Biomphalaria pfeifferi were first reported; in May 2018, emergence of intestinal schistosomiasis was confirmed. This emergence was in spite of ongoing control of urogenital schistosomiasis by preventive chemotherapy. Our current study sought to ascertain whether intestinal schistosomiasis is transitioning from emergence to outbreak, to judge if stepped-up control interventions are needed. Methods During late-May 2019, three cross-sectional surveys of primary school children for schistosomiasis were conducted using a combination of rapid diagnostic tests, parasitological examinations and applied morbidity-markers; 1) schistosomiasis dynamics were assessed at Samama (n = 80) and Mchoka (n = 80) schools, where Schistosoma mansoni was first reported, 2) occurrence of S. mansoni was investigated at two non-sampled schools, Mangochi Orphan Education and Training (MOET) (n = 60) and Koche (n = 60) schools, where B. pfeifferi was nearby, and 3) rapid mapping of schistosomiasis, and B. pfeifferi, conducted across a further 8 shoreline schools (n = 240). After data collection, univariate analyses and Chi-square testing were performed, followed by binary logistic regression using generalized linear models, to investigate epidemiological associations. Results In total, 520 children from 12 lakeshore primary schools were examined, mean prevalence of S. mansoni by ‘positive’ urine circulating cathodic antigen (CCA)-dipsticks was 31.5% (95% confidence interval [CI]: 27.5–35.5). Upon comparisons of infection prevalence in May 2018, significant increases at Samama (relative risk [RR] = 1.7, 95% CI: 1.4–2.2) and Mchoka (RR = 2.7, 95% CI: 1.7–4.3) schools were observed. Intestinal schistosomiasis was confirmed at MOET (18.3%) and Koche (35.0%) schools, and in all rapid mapping schools, ranging from 10.0 to 56.7%. Several populations of B. pfeifferi were confirmed, with two new eastern shoreline locations noted. Mean prevalence of urogenital schistosomiasis was 24.0% (95% CI: 20.3–27.7). Conclusions We notify that intestinal schistosomiasis, once considered non-endemic in Lake Malawi, is now transitioning from emergence to outbreak. Once control interventions can resume after coronavirus disease 2019 (COVID-19) suspensions, we recommend stepped-up preventive chemotherapy, with increased community-access to treatments, alongside renewed efforts in appropriate environmental control. |
topic |
Emergence Schistosoma mansoni Urine CCA-dipstick Faecal occult blood Co-infection Morbidity |
url |
http://link.springer.com/article/10.1186/s40249-020-00736-w |
work_keys_str_mv |
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doaj-16cfb2f481e344ddace34cfe73fb2dc82020-11-25T03:02:40ZengBMCInfectious Diseases of Poverty2049-99572020-08-019111010.1186/s40249-020-00736-wAn outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, MalawiSekeleghe A. Kayuni0Angus M. O’Ferrall1Hamish Baxter2Josie Hesketh3Bright Mainga4David Lally5Mohammad H. Al-Harbi6E. James LaCourse7Lazarus Juziwelo8Janelisa Musaya9Peter Makaula10J. Russell Stothard11Department of Tropical Disease Biology, Liverpool School of Tropical MedicineDepartment of Tropical Disease Biology, Liverpool School of Tropical MedicineDepartment of Tropical Disease Biology, Liverpool School of Tropical MedicineDepartment of Tropical Disease Biology, Liverpool School of Tropical MedicineLaboratory Department, Mangochi District HospitalMalawi Liverpool Wellcome Trust Programme of Clinical Tropical Research, Queen Elizabeth Central Hospital, College of MedicineMinistry of HealthDepartment of Tropical Disease Biology, Liverpool School of Tropical MedicineNational Schistosomiasis and STH Control Programme, Ministry of HealthMalawi Liverpool Wellcome Trust Programme of Clinical Tropical Research, Queen Elizabeth Central Hospital, College of MedicineResearch for Health Environment and DevelopmentDepartment of Tropical Disease Biology, Liverpool School of Tropical MedicineAbstract Background Intestinal schistosomiasis was not considered endemic in Lake Malawi until November 2017 when populations of Biomphalaria pfeifferi were first reported; in May 2018, emergence of intestinal schistosomiasis was confirmed. This emergence was in spite of ongoing control of urogenital schistosomiasis by preventive chemotherapy. Our current study sought to ascertain whether intestinal schistosomiasis is transitioning from emergence to outbreak, to judge if stepped-up control interventions are needed. Methods During late-May 2019, three cross-sectional surveys of primary school children for schistosomiasis were conducted using a combination of rapid diagnostic tests, parasitological examinations and applied morbidity-markers; 1) schistosomiasis dynamics were assessed at Samama (n = 80) and Mchoka (n = 80) schools, where Schistosoma mansoni was first reported, 2) occurrence of S. mansoni was investigated at two non-sampled schools, Mangochi Orphan Education and Training (MOET) (n = 60) and Koche (n = 60) schools, where B. pfeifferi was nearby, and 3) rapid mapping of schistosomiasis, and B. pfeifferi, conducted across a further 8 shoreline schools (n = 240). After data collection, univariate analyses and Chi-square testing were performed, followed by binary logistic regression using generalized linear models, to investigate epidemiological associations. Results In total, 520 children from 12 lakeshore primary schools were examined, mean prevalence of S. mansoni by ‘positive’ urine circulating cathodic antigen (CCA)-dipsticks was 31.5% (95% confidence interval [CI]: 27.5–35.5). Upon comparisons of infection prevalence in May 2018, significant increases at Samama (relative risk [RR] = 1.7, 95% CI: 1.4–2.2) and Mchoka (RR = 2.7, 95% CI: 1.7–4.3) schools were observed. Intestinal schistosomiasis was confirmed at MOET (18.3%) and Koche (35.0%) schools, and in all rapid mapping schools, ranging from 10.0 to 56.7%. Several populations of B. pfeifferi were confirmed, with two new eastern shoreline locations noted. Mean prevalence of urogenital schistosomiasis was 24.0% (95% CI: 20.3–27.7). Conclusions We notify that intestinal schistosomiasis, once considered non-endemic in Lake Malawi, is now transitioning from emergence to outbreak. Once control interventions can resume after coronavirus disease 2019 (COVID-19) suspensions, we recommend stepped-up preventive chemotherapy, with increased community-access to treatments, alongside renewed efforts in appropriate environmental control.http://link.springer.com/article/10.1186/s40249-020-00736-wEmergenceSchistosoma mansoniUrine CCA-dipstickFaecal occult bloodCo-infectionMorbidity |