Abstract
.Saint Lucia at one time had levels of schistosomiasis prevalence and morbidity as high as many countries in Africa. However, as a result of control efforts and economic development, including more widespread access to sanitation and safe water, schistosomiasis on the island has practically disappeared. To evaluate the current status of schistosomiasis in Saint Lucia, we conducted a nationally representative school-based survey of 8–11-year-old children for prevalence of Schistosoma mansoni infections using circulating antigen and specific antibody detection methods. We also conducted a questionnaire about available water sources, sanitation, and contact with fresh water. The total population of 8–11-year-old children on Saint Lucia was 8,985; of these, 1,487 (16.5%) provided urine for antigen testing, 1,455 (16.2%) provided fingerstick blood for antibody testing, and 1,536 (17.1%) answered the questionnaire. Although a few children were initially low positives by antigen or antibody detection methods, none could be confirmed positive by follow-up testing. Most children reported access to clean water and sanitary facilities in or near their homes and 48% of the children reported contact with fresh water. Together, these data suggest that schistosomiasis transmission has been interrupted on Saint Lucia. Additional surveys of adults, snails, and a repeat survey among school-age children will be necessary to verify these findings. However, in the same way that research on Saint Lucia generated the data leading to use of mass drug administration for schistosomiasis control, the island may also provide the information needed for guidelines to verify interruption of schistosomiasis transmission.
Highlights
In the mid-20th century, inhabitants of Saint Lucia, an island nation in the eastern Caribbean, demonstrated high levels of infection with S. mansoni
In the same way that research on Saint Lucia generated the data leading to use of mass drug administration for schistosomiasis control, the island may provide the information needed for guidelines to verify interruption of schistosomiasis transmission
Considering the totality of the results from the series of tests performed in these surveys, we were unable to confirm infection with S. mansoni infection for any of the children who participated in the study
Summary
In the mid-20th century, inhabitants of Saint Lucia, an island nation in the eastern Caribbean, demonstrated high levels of infection with S. mansoni. In 2006, an epidemiological survey was conducted in 554 schoolchildren from the southern part of the island, and four cases (0.6%) of S. mansoni were found using the Kato-Katz stool microscopy assay.[7] Between 2006 and 2015, primarily through mandatory stool screening of those in the hospitality industry, 36 individuals were diagnosed with schistosomiasis. Most of these were adults who were screened by thick stool smear. A first step is to assess the current state of S. mansoni infection on Saint Lucia
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