Abstract
Currently, impact of schistosomiasis control programs in Schistosoma mansoni–endemic areas is monitored primarily by assessment of parasitologic indicators only. Our study was conducted to evaluate the use of antibody responses as a way to measure the impact of schistosomiasis control programs. A total of 3,612 serum samples collected at three time points from children 1–5 years of age were tested for antibody responses to two schistosome antigens (soluble egg antigen [SEA] and Sm25) by multiplex bead assay. The overall prevalence of antibody responses to SEA was high at baseline (50.0%). After one round of mass drug administration (MDA), there was minimal change in odds of SEA positivity (odds ratio [OR] = 1.02, confidence interval [CI] = 0.79–1.32, P = 0.89). However, after two rounds of treatment, there was a slight decrease in odds of SEA positivity (OR = 0.80, CI = 0.63–1.02, P = 0.08). In contrast to the SEA results, prevalence of antibody responses to Sm25 was lowest at baseline (14.1%) and higher in years 2 (19.8%) and 3 (18.4%). After one round of MDA, odds of Sm25 positivity increased significantly (OR = 1.51, CI = 1.14–2.02, P = 0.005) and remained significantly higher than baseline after two rounds of MDA (OR = 1.37, CI = 1.07–1.76, P = 0.01). There was a significant decrease in the proportion of 1-year-olds with positive SEA responses from 33.1% in year 1 to 13.2% in year 3 and a corresponding decrease in the odds (OR = 3.25, CI = 1.75–6.08, P < 0.001). These results provide preliminary evidence that schistosomiasis program impact can be monitored using serologic responses.
Highlights
Schistosomiasis, caused by infection with Schistosoma spp., affects more than 200 million people worldwide.[1]
Our findings were consistent with previous reports of high rates of S. mansoni infection among schoolaged children (SAC) in this subcounty,[22] this study provides unique data on preschool-aged children (PSAC)
At baseline, using the relatively insensitive Kato-Katz method on a single stool sample, nearly 30% of PSAC were identified as infected with a parasite that is often considered to be of little public health importance in this age group
Summary
Schistosomiasis, caused by infection with Schistosoma spp., affects more than 200 million people worldwide.[1]. Chronic schistosomiasis is associated with anemia and malnutrition and can compromise growth and cognitive development.[2] Because of the influence schoolaged children (SAC) have on transmission of schistosomiasis, mass treatment of this age group with praziquantel (PZQ) has been the cornerstone of schistosomiasis control activities.[3] Until recently, disease burden and morbidity among preschool-aged children (PSAC) have remained understudied. Schistosomiasis-associated morbidity among PSAC is still not well defined, documented effects include fecal occult bleeding,[9,10] anemia,[11,12] and ultrasound abnormalities[13]; discriminating these symptoms from other potential infectious causes remains a challenge.
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