Where will pediatric praziquantel be needed in Tanzania? Geographical variation in prevalence, and risk factors of Schistosoma mansoni in pre-school aged children in southern and north-western Tanzania

IF 2 Q3 INFECTIOUS DISEASES Parasite Epidemiology and Control Pub Date : 2024-02-01 DOI:10.1016/j.parepi.2024.e00337

Humphrey D. Mazigo , Emmanuela E. Ambrose , Upendo J. Mwingira

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Abstract

Background

Pediatric schistosomiasis has been recognized as a public health concern in schistosomiasis endemic areas of sub-Saharan Africa, including Tanzania. However, there is limited epidemiological information relating to pediatric schistosomiasis in Tanzania. Therefore, this current focused on assessing the geographical prevalence of S. mansoni infection and its associated risk factors in pre-school children (PreSAC) in southern and north-western Tanzania.

Methods

A total of 1585 PreSAC aged 1–6 years were enrolled in a cross-sectional study. A single urine and stool sample were obtained from each child and processed using point-of-care circulating cathodic (POC-CCA) antigen and Kato Katz (KK) technique. The overall prevalence of S. mansoni infection based on KK technique and POC-CCA test were 18.6% (95%CI:16.7–20.6) and 28.3% (95%CI:26.1–30.6), respectively. The overall geometrical mean eggs per gram of faeces was 110.38epg (95% CI:97.3–125.3). The age group 4–6 years had the highest prevalence (P < 0.01) of S. mansoni in both diagnostic tests and infection intensity (t = −2.8398, P < 0.005) using KK technique. On multivariable analysis, only Ukerewe district was associated with S. mansoni infection based on KK technique (aOR = 2.8 (95%CI:2.1–3.9), P < 0.001). Based on POC-CCA test, age group (4–6 years), aOR = 1.7, 95%CI:1.3–2.2, P < 0.001), Nyasa (aOR = 6.2, 95%CI:3.0–12.5, P < 0.001), Geita (aOR = 4.2, 95%CI:2.1–8.2, P < 0.001) and Ukerewe (aOR = 28.9, 95%CI:15.0–55.8, P < 0.001) districts remained independently associated with S. mansoni infection.

Conclusion

Schistosoma mansoni is a public health concern among PreSAC in the study districts and its prevalence varies from one geographical setting to another. These findings strongly support the need to include pre-school aged in preventive chemotherapy.

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坦桑尼亚哪些地方需要小儿吡喹酮治疗？坦桑尼亚南部和西北部学龄前儿童曼氏血吸虫流行率和风险因素的地域差异

背景小儿血吸虫病已被认为是包括坦桑尼亚在内的撒哈拉以南非洲血吸虫病流行地区的一个公共卫生问题。然而，坦桑尼亚有关小儿血吸虫病的流行病学资料十分有限。因此，本研究重点评估坦桑尼亚南部和西北部学龄前儿童（PreSAC）感染曼森氏杆菌的地域流行率及其相关风险因素。每个儿童都采集了一份尿液和粪便样本，并使用护理点循环阴性抗原（POC-CCA）和Kato Katz（KK）技术进行了处理。根据 KK 技术和 POC-CCA 测试，曼氏沙门氏菌的总感染率分别为 18.6% (95%CI:16.7-20.6) 和 28.3% (95%CI:26.1-30.6)。每克粪便中虫卵的总几何平均数为 110.38epg（95% CI：97.3-125.3）。在使用 KK 技术进行诊断检测和感染强度（t = -2.8398，P < 0.005）时，4-6 岁年龄组的曼氏沙门氏菌感染率最高（P < 0.01）。在多变量分析中，根据 KK 技术，只有 Ukerewe 地区与曼森氏杆菌感染有关（aOR = 2.8 (95%CI:2.1-3.9)，P < 0.001）。根据 POC-CCA 检验，年龄组（4-6 岁）、尼亚萨（aOR = 6.2，95%CI:3.0-12.5，P< 0.001）、盖塔（aOR = 4.2，95%CI:2.1-8.2，P< 0.001）和乌克雷韦（aOR = 28.9，95%CI:15.0-55.8，P< 0.结论曼氏弓形虫是研究地区 PreSAC 中的一个公共卫生问题，其流行率因地理环境而异。这些发现有力地支持了将学龄前儿童纳入预防性化疗的必要性。

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来源期刊

Parasite Epidemiology and Control Medicine-Infectious Diseases

CiteScore

5.70

自引率

3.10%

发文量

审稿时长

17 weeks

期刊介绍： Parasite Epidemiology and Control is an Open Access journal. There is an increasing amount of research in the parasitology area that analyses the patterns, causes, and effects of health and disease conditions in defined populations. This epidemiology of parasite infectious diseases is predominantly studied in human populations but also spans other major hosts of parasitic infections and as such this journal will have a broad remit. We will focus on the major areas of epidemiological study including disease etiology, disease surveillance, drug resistance and geographical spread and screening, biomonitoring, and comparisons of treatment effects in clinical trials for both human and other animals. We will also look at the epidemiology and control of vector insects. The journal will also cover the use of geographic information systems (Epi-GIS) for epidemiological surveillance which is a rapidly growing area of research in infectious diseases. Molecular epidemiological approaches are also particularly encouraged.