Advocacy, policies and practicalities of preventive chemotherapy campaigns for African children with schistosomiasis

Urinary schistosomiasis among preschool-age children in an endemic area of Kinondoni municipality, Dar es Salaam, Tanzania 2016

“…Since infection acquired in early childhood is not treated, it will worsen the longterm clinical picture of the disease in the individual children as soon as they start schooling, hence there is need to revise policy including preschoolers in praziquantel preventive chemotherapy campaigns [8,29]. School children covered by praziquantel preventive chemotherapy are also likely to be at risk of reinfection if they continue to make contact with potentially infected water bodies that are frequented by mothers or caregivers in the company of their infected young children [10].…”

“…The notion that urinary schistosomiasis is not a health problem may negatively affect national control efforts [14]. The intensive praziquantel preventive chemotherapy campaign seems to induce positive perceptions that anybody can get urinary schistosomiasis disease and that cross-points are the common sites of making contact with cercariae infested water bodies [3,10]. It is for the same reasons that the large majority could express that young children can also get schistosomiasis through all practices that can expose them to cercariae infested waters like bathing with freshly drawn environmental water, either at the water's source or at home representing passive rather active exposure through the practices of their mothers or caregivers [30].…”

“…Despite the high coverage of school-aged children with praziquantel preventive chemotherapy with significant reductions in morbidity among school age children, infants, preschool-age children and other community groups living in close proximity to potentially infected water bodies are likely to be infected and be the source of shedding S. haematobium eggs in the environment and continuity of transmission [5,6]. Hence, there is need to consider the groups left out in the praziquantel preventive chemotherapy campaigns [7][8][9][10]. The frequency of schistosome infections among infants and young children is increasingly being recognized, a situation previously overlooked partly because of emphasizing on school children, low output of parasite egg and the low sensitivity of the currently used diagnostic methods [8].…”

Changing Policy and Practice in the Control of Pediatric Schistosomiasis

“…Field studies have demonstrated that young children do experience significant passive exposure to infective water, however. 2,6,28 Thus, direct observation and questionnaires in exposure studies missed significant amounts of the exposure behavior in preschool-aged children. This limitation was confirmed by studies using GPS logging of children's water contact behavior.…”

“…Other researchers have also demonstrated that young children in several African countries (including Nigeria, Cote d'Ivoire, Kenya, Mali, Uganda, and Zimbabwe) are infected with schistosomes. 2,17,[30][31][32][33] In addition, in some areas, their infection levels are as high as those in their caregivers; these caregivers, however, were eligible for treatment, while the infected children remain untreated for several years (as reviewed by Stothard et al 28 ). Furthermore, the limited investigations describing and quantifying morbidity in this age group have shown that these infections in young children are clinically significant.…”