Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

Abstract

Abstract. Schistosomiasis control programs aim to reduce morbidity but are evaluated by infection prevalence and intensity reduction. We present baseline cross-sectional data from a nested cohort study comparing indicators of morbidity for measuring program impact. Eight hundred twenty-two schoolchildren 7-8 years of age from Nyanza Province, Kenya, contributed stool for diagnosis of Schistosoma mansoni and soil-transmitted helminths (STH) and blood smears for malaria, and were evaluated for anemia, quality of life, exercise tolerance, anthropometry, and ultrasound abnormalities. Schistosoma mansoni, STH, and malaria infection prevalence were 69%, 25%, and 8%, respectively. Only anemia and S. mansoni infection (adjusted odds ratio [aOR] = 1.70; confidence interval [CI] = 1.03-2.80), and hepatomegaly and heavy S. mansoni infection (aOR = 2.21; CI = 1.19-4.11) were associated. Though anemia and hepatomegaly appeared most useful at baseline, additional morbidity indicators may be sensitive longitudinal measures to evaluate schistosomiasis program health impact.

Morbidity Associated with Schistosomiasis Before and After Treatment in Young Children in Rusinga Island, Western Kenya

“…IPB, considered in adults to represent a possible intermediate stage in development of schistosomiasis-associated hepatic fibrosis, was not primarily attributable to schistosomiasis in our sample-consistent with recent findings in slightly older children 46 -and in fact appears more closely related to malaria infection. The biological significance of IPB is not known; it may represent a common pathway for multiple abnormal hepatic processes.…”

The Effect of a Health Communication Campaign on Compliance with Mass Drug Administration for Schistosomiasis Control in Western Kenya—The SCORE Project

“…E-mail: was4@cdc.gov design of which has been described elseswhere. 9,21 As part of the eligibility criteria, study villages had a Schistosoma mansoni infection prevalence 25% in 13-and 14-year-old schoolchildren at baseline. The communities are mainly in rural parts of western Kenya, and the residents are predominantly involved in subsistence farming and fishing activities.…”

High Schistosoma mansoni Disease Burden in a Rural District of Western Zambia

“…The milder form (LIP C) of portal fibrosis is normally seen in younger age groups. 6,35 In endemic areas, most people infected with S. mansoni present with LIP C and D forms of fibrosis, 36 whereas severe disease characterized with advanced fibrosis (LIPs E and F) is only observed in 5-10% of the people. 37 In our study population, advanced fibrosis characterized with LIPs E and F was recorded in 4.8% and 1.2% of the participants, respectively.…”

“…5 Although schistosomiasis-related mortality is low compared with mortality caused by human immunodeficiency virus (HIV) or malaria, morbidity is high and often underreported. 6 Infections with schistosomes result in two main forms of the disease, namely urinary schistosomiasis caused by Schistosoma haematobium and intestinal schistosomiasis caused by either S. mansoni or S. japonicum. S. mansoni is responsible for bloody diarrhea and hepatosplenomegaly in 4.4 and 8.5 million people, respectively.…”