Transmission Dynamics of Schistosoma haematobium among School-Aged Children: A Cohort Study on Prevalence, Reinfection and Incidence after Mass Drug Administration in the White Nile State of Sudan

Abstract

The reinfection rate of schistosomiasis after mass drug administration (MDA) has not been documented in Sudan. We aimed to explore the transmission dynamics of urogenital schistosomiasis after MDA, targeting school-aged children in the White Nile State of Sudan, assessing the prevalence, reinfection rate, and incidence. A single dose of praziquantel (40 mg/kg) was administered to 1951 students in five primary schools from January to February 2018 immediately after a baseline survey, and follow-up surveys were performed at 2 weeks and 6 months after treatment. We examined Schistosoma haematobium eggs by centrifugation methods. The overall reinfection rate at 6 months after treatment was 9.8% (95% confidence interval: 0.5–17.4%). By school, the reinfection rate was highest in the Al Hidaib school, whose prevalence was highest at baseline. The reinfection rate was significantly higher in high-infection areas than low-infection areas (p = 0.02). Of the prevalence at 6 months in high-infection areas, 41% of cases were due to reinfection. MDA interventions are decided upon and undertaken at the district level. A more targeted treatment strategy should be developed with a particular focus on tracking high-risk groups, even within a school or a community.

Effects of paediatric schistosomiasis control programmes in sub-Saharan Africa: A systematic review

“…There were five longitudinal intervention studies [ 25 , 35 , 37 , 40 , 42 ], seven cluster randomized trials [ 23 , 24 , 27 – 29 , 32 , 35 ], one case control study [ 6 ], seven cross sectional studies [ 18 , 29 , 31 , 36 , 38 , 41 , 43 , 44 ], three prospective studies [ 15 , 19 , 33 , 39 ], two repeated cross sectional studies [ 24 , 34 ], longitudinal pre- and post- test design [ 16 ], one interventive prospective study [ 17 ] as shown in Fig 3 . Tanzania and Kenya had the most intervention studies, they each had five intervention studies included in this review whilst Zimbabwe and Ethiopia have four intervention studies, Cote’ d Ivoire has three intervention studies, Senegal and Nigeria had two intervention studies and Madagascar, Sudan, Niger, Angola and Togo each had one.…”

Programmatic Implications for Schistosomiasis Elimination Based on Community-Based Survey in the Blue Nile, North Kordofan, and Sennar States, Sudan

“…Identifying hotspots is critical for the interruption of transmission. After 10 years of continuous MDA interventions in the White Nile state, the prevalence of schistosomiasis has remained high in some villages and schools due to persistent reinfection [33][34][35]. As part of the SENSE project, snail control and sanitation improvements through community-led total sanitation (CLTS) complement the existing MDA program.…”

Establishing a single-sex controlled human Schistosoma mansoni infection model for Uganda: protocol for safety and dose-finding trial

“…Repeated praziquantel dosing may thus be required to achieve a full cure. Mass drug administration, used in endemic settings, does not prevent reinfection and in exposed populations, the disease prevalence returns to its original level within 6–8 months [ 11 ]. There are also concerns about the possible emergence of drug resistance following repeated intervention with a single drug [ 12 ].…”