Abstract
BackgroundPreventive chemotherapy against schistosomiasis has been implemented since 2005 in Mali, targeting school-age children and adults at high risk. A cross-sectional survey was conducted in 2010 to evaluate the impact of repeated treatment among school-age children in the highly-endemic region of Segou.Methodology/Principal FindingsThe survey was conducted in six sentinel schools in three highly-endemic districts, and 640 school children aged 7–14 years were examined. Infections with Schistosoma haematobium and S. mansoni were diagnosed with the urine filtration and the Kato-Katz method respectively. Overall prevalence of S. haematobium infection was 61.7%, a significant reduction of 30% from the baseline in 2004 (p<0.01), while overall prevalence of S. mansoni infection was 12.7% which was not significantly different from the baseline. Overall mean intensity of S. haematobium and S. mansoni infection was 180.4 eggs/10 ml of urine and 88.2 epg in 2004 respectively. These were reduced to 33.2 eggs/10 ml of urine and 43.2 epg in 2010 respectively, a significant reduction of 81.6% and 51% (p<0.001). The proportion of heavy S. haematobium infections was reduced from 48.8% in 2004 to 13.8% in 2010, and the proportion of moderate and heavy S. mansoni infection was reduced from 15.6% in 2004 to 9.4% in 2010, both significantly (p<0.01). Mathematical modelling suggests that the observed results were in line with the expected changes.Conclusions/SignificanceSignificant reduction in intensity of infection on both infections and modest but significant reduction in S. haematobium prevalence were achieved in highly-endemic Segou region after repeated chemotherapy. However, persistent prevalence of both infections and relatively high level of intensity of S. mansoni infection suggest that more intensified control measures be implemented in order to achieve the goal of schistosomiasis elimination. In addition, closer monitoring and evaluation activities are needed in the programme to monitor the drug tolerance and to adjust treatment focus.
Highlights
Schistosomiasis or bilharzia, caused by infection with Schistosoma spp, is one of the major neglected tropical diseases (NTDs)
The current paper presents the parasitological impact of repeated treatment on schistosomiasis in the highly endemic region of Segou and the recommendations for future control efforts
In 2010, overall prevalence of S. haematobium infection was 61.7%, a significant reduction of 30% from the baseline in 2004 (p,0.01), while overall prevalence of S. mansoni infection was 12.7% which was not significantly different from the baseline in 2004 (p.0.05)
Summary
Schistosomiasis or bilharzia, caused by infection with Schistosoma spp, is one of the major neglected tropical diseases (NTDs). It remains a major cause of morbidity in developing countries, especially in sub-Saharan Africa. The aim is to reduce morbidity due to schistosomiasis through regular treatment. Praziquantel is safe and efficacious against both Schistosoma haematobium (causing urogenital schistosomiasis) and S. mansoni (causing intestinal schistosomiasis), two major human species in sub-Saharan Africa. Usually as an annual regular treatment, can reduce infection and associated morbidity [6,7,8,9]. WHO recently estimated that about 237 million people, including 109 million school-age children, globally require annual treatment for schistosomiasis, of which 220 million. A cross-sectional survey was conducted in 2010 to evaluate the impact of repeated treatment among school-age children in the highly-endemic region of Segou
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