Efficacy of Praziquantel and Schistosomiasis Reinfection Rate Among School-Aged Children in Ondo State, Nigeria; how feasible is the WHO 2030 elimination roadmap?

Abstract

Background: Schistosomiasis, caused by blood flukes of the genus Schistosoma that depend on snail intermediate hosts for their life cycle, is a neglected tropical parasitic disease of great public health and socioeconomic significance. Most studies on Schistosomiasis are only prevalence data and not purposefully conducted for interventional programmes. There is a need to access the possible intervention impact as the Nation moves towards the elimination of Schistosomiasis. This study was designed to assess the prevalence and efficacy of PZQ and post-treatment reinfection among SAC and adolescent population in an endemic Community (Ayadi, Irele Local Government Area, Ondo State, Nigeria). Methods: A cross-sectional study was conducted among 140 School Aged Children (SAC) and adolescents at Ayadi, Irele 3 Local Government Area of Ondo State, Nigeria. Results: The prevalence of Schistosomiasis at baseline was 65% which dropped to 12.01 % following 4 weeks post-treatment and unfortunately out of the participants that tested positive at baseline and negative at 4 weeks post-treatment with PZQ, 13.75 % of them already got infected 6 months post PZQ single use. A significant Egg Reduction Rate (86.49 %) and Cure Rate (87.91 %) were obtained in this study. Conclusion: Treatment with a single dose of 40 mg/kg of PZQ produced a significant result against Schistosomiasis. However, there was a high reinfection rate due to the lack of safe water. Recommendations: The Schistosomiasis elimination program should be redesigned to accommodate double dose treatment with PZQ and also ensure treatment across all endemic wards without having to sectionalize treatment across moderately and lowly endemic wards.

Promoting Sustainable Development in Combating Schistosomiasis through Community-Centric Approaches: The Role of Social Empowerment and Education in Ondo State

“…Laboratory techniques used in the study The laboratory technique used in most studies was haematuria [41,42,23,8] either selfreported by the patients or detected using a reagent strip. This was preferred by most researchers due to its ease and convenience.…”

“…However, this indirect method of diagnosing schistosome infection is not reliable despite its ease due to the fact that other diseases (urinary tract infections, bladder cancer and kidney stones) can also result into haematuria [46]. The gold standard for the diagnosis of schistosomiasis is microscopy of urine sample concentrated by filtration, sedimentation or centrifugation over a filter paper [23,29,42,43]. This method is reliable and specific enough to diagnose the infection in Ondo state.…”

“…The major activities that increased reinfection among individuals such as schoolchildren and young adults was contact with infected rivers in their communities (fetching water, bathing, washing, swimming) [5,13,[41][42][43]. Occupational activities of individuals (fishing and farming) also meant they came in contact with these infected rivers as a source of livelihood [41].…”

“…The intervention carried out in Ondo state include parasite specific control by focusing on the host and parasite non-specific control through awareness of individuals to urogenital schistosomiasis in the community [41], administration of praziquantel to infected individuals (schoolchildren, young adults and those at risk through occupational risk) [42], examination of urinary schistosomiasis through microhamaturia by health practitioners rather than chemical reagent strips which may vary due to lack of specificity [8], health education activities implemented through collaboration with the state ministry of health in Ondo state [13] and implementing WHO strategy of treating schoolchildren and those at risk once every 2years in endemic communities [29]. Combining non-specific and parasite-specific management aims to provide a complete strategy for controlling schistosomiasis.…”