Evidence for a long-term effect of a single dose of praziquantel on Schistosoma mansoni-induced hepatosplenic lesions in northern Uganda.

Frenzel, Katrin; Grigull, Lorenz; Odongo-Aginya, EI; Ndugwa, Christopher M.; Loroni-Lakwo, Tom; Schweigmann, Ulrich; Vester, Udo; Spannbrucker, N.; Doehring, E

doi:10.4269/ajtmh.1999.60.927

Cited by 59 publications

(31 citation statements)

References 18 publications

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“…36 An important unmeasured confounder could be secular changes in the exposure to, as well as potential treatment of, malaria infections, which influence both Hb and splenomegaly. 5 However, our study presented plausible evidence of the impact of the intervention since we observed significant changes in infection and morbidity in randomly sampled children in 37 schools across different transmission settings in the country, after adjusting estimates for age and sex differences and potentially confounding variables. Additionally, there was a close agreement between the observed impact and mathematical model predictions of programme effectiveness.…”

Section: Limitations and Plausibilitymentioning

confidence: 71%

“…Clinical trials have demonstrated that praziquantel is a safe and efficacious treatment against both species, and that repeated chemotherapy decreases infection and related morbidity. [1][2][3][4][5][6][7] One of the main control methods is treating schoolchildren with praziquantel together with albendazole as part of school health programmes. As this method uses the existing school infrastructure and provides easy accessibility to children, it is a cost-effective public health strategy, 8 and many pilot programmes have demonstrated its feasibility, affordability and effectiveness.…”

Section: Introductionmentioning

confidence: 99%

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Impact on a national helminth control programme on infection and morbidity in Ugandan schoolchildren

Kabatereine

Brooker

Koukounari

et al. 2007

Bull World Health Organ

169

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Objective We aimed to assess the health impact of a national control programme targeting schistosomiasis and intestinal nematodes in Uganda, which has provided population-based anthelmintic chemotherapy since 2003. Methods We conducted longitudinal surveys on infection status, haemoglobin concentration and clinical morbidity in 1871 randomly selected schoolchildren from 37 schools in eight districts across Uganda at three time points -before chemotherapy and after one year and two years of annual mass chemotherapy. Findings Mass treatment with praziquantel and albendazole led to a significant decrease in the intensity of Schistosoma mansoni -70% (95% confidence interval (CI): 66-73%) after one year and 82% (95% CI: 80-85%) after two years of treatment. Intensity of hookworm infection also decreased (75% and 93%; unadjusted). There was a significant increase in haemoglobin concentration after one (0.135 g/dL (95% CI: 0.126-0.144)) and two years (0.303 g/dL (95% CI: 0.293-0.312)) of treatment, and a significant decrease in signs of early clinical morbidity. The impact of intervention on S. mansoni prevalence and intensity was similar to that predicted by mathematical models of the impact of chemotherapy on human schistosomiasis. Improvements in haemoglobin concentration were greatest among children who were anaemic or harbouring heavy S. mansoni infection at baseline. Conclusion Anthelmintic treatment delivered as part of a national helminth control programme can decrease infection and morbidity among schoolchildren and improve haemoglobin concentration. Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español.

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Section: Limitations and Plausibilitymentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Impact on a national helminth control programme on infection and morbidity in Ugandan schoolchildren

Kabatereine

Brooker

Koukounari

et al. 2007

Bull World Health Organ

169

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“…47,48 The current study complements and expands previous ultrasonography-based studies within Africa on a number of issues. First, although previously published surveys 17,[49][50][51][52][53][54] have used ultrasongraphy to measure schistosomiasisassociated morbidity both in children and in adults, which is indicative of long-term chronic infections, we assessed ultrasonography in monitoring schistosomiasis morbidity in control programs focused on children. Although we recognize that measuring only children might be a limitation, if one considers the overall aim of this study, our results still contribute to assessing the suitability of ultrasonography for more recent infections and targeting age groups for future disease control programs.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Ultrasound Morbidity Indicators of Schistosomiasis in the Context of Large-Scale Programs Illustrated With Experiences From Malian Children

Koukounari

Sacko²,

Kéita³

et al. 2006

The American Journal of Tropical Medicine and Hygiene

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Abstract. We assessed morbidity indicators for both Schistosoma haematobium and Schistosoma mansoni infections and evaluated the appropriateness of the World Health Organization (WHO) guidelines for ultrasound in schistosomiasis in the context of large-scale control interventions. Abdominal and urinary tract ultrasonography was performed on 2,247 and 2,822 school children, respectively, from 29 randomly selected schools in Mali before the implementation of mass anthelminthic drug administration. Using two-level logistic regression models, we examined associations of potential factors with the risk of having a positive ultrasound global score (morbidity indicative of S. haematobium infection), abnormal image pattern scores, dilatation of the portal vein, and/or enlarged liver (morbidity indicative of S. mansoni infection). The WHO protocol was found useful for detection of S. haematobium pathology but overestimated the risk of portal vein dilatation and left liver lobe enlargement associated with S. mansoni infection. We conclude that ultrasonography should be included in large-scale control interventions, where logistics allow, but cautiously.

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“…A rate of nearly 30% was reported from one stretch of the river (Nelson, reported in WHO, 1987). Along another part of the river, a prevalence of over 80% was found in the early 1990s, but this declined to 30% following treatment with praziquantel (Frenzel et al, 1999;Odongo-Aginya et al, 2002). Similar figures were again reported for the same area of the Nile between 2005(Odongo-Aginya et al, 2010.…”

Section: Introductionmentioning

confidence: 99%

Low Prevalence of Intestinal Schistosomiasis Among Fisherfolk Living Along the River Nile in North-Western Uganda: A Biosocial Investigation

Pearson

2016

J. Biosoc. Sci.

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SummaryMass drug administration has been less successful as a technique for controlling intestinal schistosomiasis (S. mansoni) than anticipated. In Uganda, the mass distribution of praziquantel has been provided to populations at risk of infection since the early 2000s, but prevalence mostly remains high. This is the case, for example, at locations in north-western and south-eastern Uganda. However, there is a remarkable exception. Among Madi fishing populations and their immediate neighbours, living close to the border with South Sudan, the rate of infection has dropped dramatically. A parasitological survey carried out at twelve fishing sites in 2013 identified only three cases of S. mansoni among 383 adults tested. This article asks: why is the prevalence of S. mansoni so low among fisherfolk in northern Uganda? Taking a biosocial approach, it suggests that the mass distribution of drugs, free of charge, has had an impact. However, the low prevalence of infection cannot be attributed to this alone. Other important factors may also have contributed to the decline in infection. These include changing fishing livelihoods, local attitudes to public health interventions, access to water and sanitation facilities, hygiene practices and the use of anti-malarial treatments. Above all, the article highlights the importance of investigating both social and biological dimensions of infection simultaneously, and of recognizing the local complexities of sustainably treating this debilitating parasitic disease.

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Evidence for a long-term effect of a single dose of praziquantel on Schistosoma mansoni-induced hepatosplenic lesions in northern Uganda.

Cited by 59 publications

References 18 publications

Impact on a national helminth control programme on infection and morbidity in Ugandan schoolchildren

Impact on a national helminth control programme on infection and morbidity in Ugandan schoolchildren

Assessment of Ultrasound Morbidity Indicators of Schistosomiasis in the Context of Large-Scale Programs Illustrated With Experiences From Malian Children

Low Prevalence of Intestinal Schistosomiasis Among Fisherfolk Living Along the River Nile in North-Western Uganda: A Biosocial Investigation

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