Schistosomiasis in African infants and preschool children: to treat or not to treat?

Stothard, J. Russell; Gabrielli, Albis-Francesco

doi:10.1016/j.pt.2007.01.005

Cited by 103 publications

(110 citation statements)

References 12 publications

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“…25,26 However, pre-school-aged children might be particularly vulnerable to the negative consequences of an early-life infection with Schistosoma, because they would not get treatment until entering school. 27 Additionally, adolescents and adults are given far less attention than the school-aged population when it comes to schistosomiasis control. Indeed, World Health Assembly (WHA) resolution 54.19 sets clear treatment coverage targets for the school-aged population, but it remains comparatively silent on other age groups.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14]28,29 It has also been discussed whether preventive chemotherapy should be extended from schoolaged to pre-school-aged children. 27,[30][31][32] However, there are a number of issues that must be addressed before policy recommendations can be made regarding the inclusion of preschoolers in preventive chemotherapy. First, what is the true extent of Schistosoma infection in pre-school-aged children in different epidemiologic settings?…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Schistosomiasis in Two High-Risk Communities of South Côte d'Ivoire with Particular Emphasis on Pre-School–Aged Children

Coulibaly¹,

N’Gbesso²,

N’Guessan³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Schistosomiasis control efforts mainly target school-aged children. We studied the epidemiology of schistosomiasis in two high-risk communities in south Cô te d'Ivoire, placing particular emphasis on pre-school-aged children. We used a suite of diagnostic techniques, including Kato-Katz, urine filtration, reagent strips, and urine circulating cathodic antigen cassettes. Risk factors for schistosomiasis were determined by focus group discussions and a structured questionnaire. The prevalence of Schistosoma mansoni in the two study villages among the pre-school-aged children (age 6 years) was 20.9% and 25.0%, whereas several-fold higher prevalences were found in school-aged children (58.7-68.4%) and adolescents/adults (59.5-61.7%). The prevalence of S. haematobium in the three age groups was 5.9-17.3%, 10.9-18.4%, and 3.8-21.3%, respectively. Most participants had light-intensity infections. Mothers' occupations and older siblings play important roles in the epidemiology of schistosomiasis in pre-schoolers. In the current epidemiologic settings, more attention is warranted on pre-school-aged children and adolescents/adults for successful schistosomiasis control.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidemiology of Schistosomiasis in Two High-Risk Communities of South Côte d'Ivoire with Particular Emphasis on Pre-School–Aged Children

Coulibaly¹,

N’Gbesso²,

N’Guessan³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…New data suggest that the Kato-Katz technique has drawbacks for screening stool samples from infants, as helminth infection intensities tend to be low and stool samples are more liquid than those collected from school-aged children or adults (Goodman et al, 2007). This issue is of considerable relevance, as recent studies suggest that infants and pre-school children are at higher risk of helminth infections and associated morbidity than previously assumed (Goodman et al, 2007;Stothard and Gabrielli, 2007).…”

Section: Discussionmentioning

confidence: 99%

FLOTAC: a new sensitive technique for the diagnosis of hookworm infections in humans

Utzinger

Rinaldi

Lohourignon

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

125

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Summary Hookworms infect more than 10% of the world's population, but current diagnostic tools have drawbacks. Our objective was to compare the diagnostic performance of three methods (Kato-Katz, ether concentration and FLOTAC techniques) for hookworm diagnosis. Stool samples were obtained from 102 schoolchildren in Côte d'Ivoire. First, a duplicate 41.7 mg Kato-Katz thick smear was prepared. Next, a small portion of stool (mean weight 1.8 g) was preserved in sodium acetate-acetic acid-formalin and forwarded to a European laboratory. These samples were split in three parts, one processed by an ether concentration technique and two by the FLOTAC technique. All samples were examined by experienced technicians for hookworm eggs using light microscopy. The observed hookworm prevalences as assessed by the FLOTAC, Kato-Katz and ether concentration techniques were 65.7%, 51.0% and 28.4%, respectively. Considering the combined results as the diagnostic 'gold' standard, the FLOTAC technique had a sensitivity of 88.2% compared with 68.4% for the Kato-Katz and 38.2% for the ether concentration techniques. The Kato-Katz method resulted in a significantly higher mean number of eggs per gram of stool (155.8 EPG) compared with the FLOTAC (37.7 EPG) and ether concentration (5.7 EPG) methods. The FLOTAC method shows promise as an important new tool for individual hookworm diagnosis and for rigorous monitoring of helminth control programmes. [Clinical Trial No. ISRCTN21782274].

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“…And although PSAC are currently not targeted by schistosomiasis control activities, it may be worthwhile for programs to consider including them in preventive chemotherapy campaigns, especially where the prevalence is high among SAC. 9,13 The use of praziquantel among young children has been hindered by a lack of safety data among children < 4 years of age, 9,23 and no widely available liquid formulation; however, recent studies in which young children have been treated with praziquantel have reported no major adverse effects. 10,11,13 We found that the sensitivity of stool exams for S. mansoni was limited, especially among PSAC; the observed difference in its performance across age groups is likely a function of infection intensity.…”

Section: 13mentioning

confidence: 99%

“…Most mass treatment programs have not been designed to include them and younger children are often not even screened for the possibility of infection. 9 However, in areas endemic for schistosomiasis, very young children are also in regular contact with water in locations where infected snails are present and infants are bathed in water where transmission is occurring. [10][11][12][13] Infections in young children may be missed because they are not usually examined or the testing method most commonly used for epidemiologic research (examination of a single stool specimen by Kato-Katz thick smears) may not be sufficiently sensitive, particularly in detecting light infections.…”

Section: Introductionmentioning

confidence: 99%

Schistosomiasis among Young Children in Usoma, Kenya

Verani¹,

Abudho²,

Montgomery³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. Although schistosomiasis burden is greatest among school-age children (SAC) (6-15 years of age), infection among preschool-age children (PSAC) (1-5 years), may be underestimated in endemic areas. We conducted a crosssectional study evaluating Schistosoma mansoni infection among children 1-15 years of age in a highly endemic community in Kenya. Diagnostic tests included stool exam (Kato/Katz technique), serum testing for schistosome-specific antibodies, and urine testing for circulating cathodic antigen (CCA). Overall, 268 SAC and 216 PSAC were enrolled; prevalence increased with age, with 14% of 1 year olds and more than 90% of children > 10 years of age infected. Stool exam was more sensitive among SAC than PSAC, but performance was similar after adjusting for infection intensity (based on CCA). Schistosomiasis poses a threat to PSAC in endemic areas, and stool exam may underestimate the prevalence of infection. Control programs in such areas should consider PSAC in addition to SAC.

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Schistosomiasis in African infants and preschool children: to treat or not to treat?

Cited by 103 publications

References 12 publications

Epidemiology of Schistosomiasis in Two High-Risk Communities of South Côte d'Ivoire with Particular Emphasis on Pre-School–Aged Children

Epidemiology of Schistosomiasis in Two High-Risk Communities of South Côte d'Ivoire with Particular Emphasis on Pre-School–Aged Children

FLOTAC: a new sensitive technique for the diagnosis of hookworm infections in humans

Schistosomiasis among Young Children in Usoma, Kenya

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