Abstract
BackgroundTo monitor the prevalence of schistosomiasis in school-aged children (SAC), the National Bilharzia Control Program (PNLB) was set up by the Senegalese authorities; however, geographically isolated Bedik ethnic groups that did not benefit from this program were found to be heavily infected with Schistosoma mansoni. This observation led us to implement a new schistosomiasis control program in 2008 under the aegis of the non-governmental organization “Le Kaïcedrat” and in partnership with the PNLB/WHO to monitor the prevalence of schistosomiasis in this area. In the village of Assoni, where 100% of SAC were infected, analysis of the stools of pre-school-aged children (PSAC) showed that they were massively infected, so we decided to focus our program on them.MethodsFrom 2008 to 2020, we (i) monitored the prevalence of S. mansoni in PSAC in Assoni using double-stool smear preparation, (ii) treated the infected PSAC with a standard dose of praziquantel 40 mg/kg, (iii) ran educational campaigns each year in the village, and (iv) built latrines to improve sanitation and reduce schistosomiasis transmission. Linear regression was used to examine the trend in the annual schistosomiasis prevalence and a two-sided of Chi-squared test was used to compare prevalence between the different age groups of PSAC.ResultsWe observed an extremely high prevalence of schistosomiasis (78%) in PSAC before implementation of the program in 2008. Contamination occurred in very young children, as 64.3% of children under 2 years old were infected. Moreover, prevalence increased with age and reached 96.8% in children 4 to < 6 years old. Our annual interventions in Assoni Village raised awareness among villagers that water bodies were areas of significant infestation, allowed the building of 88 latrines and led to a decrease in prevalence in PSAC as only 11% of these children were infected in 2020.ConclusionOur study allowed Assoni to be the first village in Senegal to treat PSAC since 2014, but only on an individual basis. It also shows that schistosomiasis is difficult to eradicate and that multi-sectorial actions are required to keep its prevalence at a low level.Graphic abstract
Highlights
To monitor the prevalence of schistosomiasis in school-aged children (SAC), the National Bilharzia Control Program (PNLB) was set up by the Senegalese authorities; geographically isolated Bedik ethnic groups that did not benefit from this program were found to be heavily infected with Schistosoma mansoni
Prevalence of intestinal schistosomiasis in pre-school-aged children (PSAC) in Assoni Since children were not allowed to be treated with praziquantel until 2014, the only way to reduce the prevalence of schistosomiasis was to avoid contamination via the water bodies
Cases of S. mansoni infestation were reported in the PSAC of Assoni from 2008 to 2020 (Fig. 3 and Additional file 1)
Summary
To monitor the prevalence of schistosomiasis in school-aged children (SAC), the National Bilharzia Control Program (PNLB) was set up by the Senegalese authorities; geographically isolated Bedik ethnic groups that did not benefit from this program were found to be heavily infected with Schistosoma mansoni. Key strategies for controlling the incidence of schistosomiasis are based on multi-sectorial actions that aim to (a) block the Schistosoma lifecycle by preventing contamination of freshwater, removing host snails and preventing human contact with infected water bodies, and (b) treat at-risk populations with praziquantel [4, 5]. To this end, many countries in Africa have initiated large-scale control programs in partnership with the World Health Organization (WHO) by providing mass drug administration (MDA) of praziquantel for school-aged children (SAC) from 6 to 14 years old. These recommendations must be accepted at the national level
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