Predictive Value of School-Aged Children's Schistosomiasis Prevalence and Egg Intensity for Other Age Groups in Western Kenya

Mwinzi, Pauline N. M.; Muchiri, Geoffrey; Wiegand, Ryan E.; Omedo, Martin; Abudho, Bernard; Karanja, Diana M. S.; Montgomery, Susan P.; Secor, W. Evan

doi:10.4269/ajtmh.15-0467

Cited by 15 publications

(20 citation statements)

References 23 publications

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“…We investigated the relationship between currently available data on SAC and PSAC within the same community to determine if data from SAC, who are the current target of control programmes could be used to predict infection levels in PSAC. Previous studies have investigated using SAC as a proxy group for community-wide prevalence levels, showing that SAC prevalence is closely related to adult prevalence, and therefore this age group could be used as a proxy group [24,25]. Our findings confirm that this approach PLOS NEGLECTED TROPICAL DISEASES can be extended to quantify infection levels in PSAC.…”

Section: Discussionsupporting

confidence: 81%

Investigating a strategy for quantifying schistosome infection levels in preschool-aged children using prevalence data from school-aged children

et al. 2020

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In 2012, the World Health Organisation (WHO) set out a roadmap for eliminating schistosomiasis as a public health problem by 2025. To achieve this target, preschool-aged children (PSAC; aged 6 years and below) will need to be included in schistosomiasis treatment programmes. As the global community discusses the tools and approaches for treating this group, one of the main questions that remains unanswered is how to quantify infection in this age group to inform treatment strategies. The aim of this study was thus to determine whether a relationship exists between levels of schistosome infection in PSAC and schoolaged children (SAC), that can be used to determine unknown schistosome infection prevalence levels in PSAC. A systematic search of publications reporting schistosomiasis prevalence in African PSAC and SAC was conducted. The search strategy was formulated using the PRISMA guidelines and SPIDER search strategy tool. The published data was subjected to regression analysis to determine if a relationship exists between infection levels in PSAC and SAC. The interaction between SAC and community treatment history was also entered in the regression model to determine if treatment history significantly affected the relationship between PSAC and SAC prevalence. The results showed that a significant positive relationship exists between infection prevalence levels in PSAC and SAC for Schistosoma mansoni (r = 0.812, df (88, 1), p = <0.0001) and S. haematobium (r = 0.786, df (53, 1), p = <0.0001). The relationship was still significant after allowing for diagnostic method, treatment history, and the African sub-region where the study was conducted (S. mansoni: F = 25.63, df (88, 9), p = <0.0001; S. haematobium: F = 10.20, df (53, 10), p = <0.0001). Using the regression equation for PSAC and SAC prevalence, over 90% of the PSAC prevalence studies were placed in the correct WHO classifications category based on the SAC levels, regardless of treatment history. The study indicated that schistosome prevalence in SAC can be extended as a proxy for infection levels in PSAC, extending on its current use in the PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionsupporting

confidence: 81%

Investigating a strategy for quantifying schistosome infection levels in preschool-aged children using prevalence data from school-aged children

et al. 2020

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“…SAC are typically targeted by control programmes as they are relatively easy to reach within school settings and therefore coverage could be high. Some past field studies suggest that treating adults has required more personnel, time, and resources to find and obtain follow-up samples [ 18 ]. We note these challenges but recommend collecting adult data, at least at baseline (prior to treatment), to inform PCT and then following each round of treatment if possible.…”

Section: Discussionmentioning

confidence: 99%

The design of schistosomiasis monitoring and evaluation programmes: The importance of collecting adult data to inform treatment strategies for Schistosoma mansoni

Toor¹,

Turner²,

Truscott³

et al. 2018

PLoS Negl Trop Dis

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Monitoring and evaluation (M&E) programmes are used to collect data which are required to assess the impact of current interventions on their progress towards achieving the World Health Organization (WHO) goals of morbidity control and elimination as a public health problem for schistosomiasis. Prevalence and intensity of infection data are typically collected from school-aged children (SAC) as they are relatively easy to sample and are thought to be most likely to be infected by schistosome parasites. However, adults are also likely to be infected. We use three different age-intensity profiles of infection for Schistosoma mansoni with low, moderate and high burdens of infection in adults to investigate how the age distribution of infection impacts the mathematical model generated recommendations of the preventive chemotherapy coverage levels required to achieve the WHO goals. We find that for moderate prevalence regions, regardless of the burden of infection in adults, treating SAC only may achieve the WHO goals. However, for high prevalence regions with a high burden of infection in adults, adult treatment is required to meet the WHO goals. Hence, we show that the optimal treatment strategy for a defined region requires consideration of the burden of infection in adults as it cannot be based solely on the prevalence of infection in SAC. Although past epidemiological data have informed mathematical models for the transmission and control of schistosome infections, more accurate and detailed data are required from M&E programmes to accurately determine the optimal treatment strategy for a defined region. We highlight the importance of collecting prevalence and intensity of infection data from a broader age-range, specifically the inclusion of adult data at baseline (prior to treatment) and throughout the treatment programme if possible, rather than SAC only, to accurately determine the treatment strategy for a defined region. Furthermore, we discuss additional epidemiological data, such as individual longitudinal adherence to treatment, that should ideally be collected in M&E programmes.

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“…Monitoring of control program progress, like mapping, has traditionally been performed by measuring egg prevalence and the intensity of schistosome infections in school age children because they provide a useful barometer of the level of infection in other age groups in the community 44 . This age group also tends to have the highest intensities of infection, so decreases in their egg output would result in fewer eggs that could contaminate fresh water and infect snails.…”

Section: Adapting Programs As They Progressmentioning

confidence: 99%

Early lessons from schistosomiasis mass drug administration programs

Secor

2015

F1000Res

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Mass drug administration using praziquantel is the backbone of the current strategy for the control of schistosomiasis. As the theoretical plans have moved into practical application, certain challenges with this approach have surfaced, and it is likely that annual mass drug administration alone may not be sufficient to achieve program goals. However, mass drug administration is still the only available intervention that can be readily used in the wide variety of settings where schistosomiasis is endemic. The task then becomes how to improve this approach and identify what adjuncts to mass drug administration are effective, as programs move from morbidity control to elimination goals. Other aspects worthy of consideration include how best to employ new diagnostic tools to more easily identify where treatment is needed, and new formulations of praziquantel to extend the availability of treatment to all age groups. The aim of this review is to highlight both areas of challenge and of opportunity to improve the public health impact of schistosomiasis control programs.

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Predictive Value of School-Aged Children's Schistosomiasis Prevalence and Egg Intensity for Other Age Groups in Western Kenya

Cited by 15 publications

References 23 publications

Investigating a strategy for quantifying schistosome infection levels in preschool-aged children using prevalence data from school-aged children

Investigating a strategy for quantifying schistosome infection levels in preschool-aged children using prevalence data from school-aged children

The design of schistosomiasis monitoring and evaluation programmes: The importance of collecting adult data to inform treatment strategies for Schistosoma mansoni

Early lessons from schistosomiasis mass drug administration programs

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