Control and Elimination of Schistosomiasis as a Public Health Problem: Thresholds Fail to Differentiate Schistosomiasis Morbidity Prevalence in Children

Ryan E. Wiegand*, W. Evan Secor, Fiona M. Fleming, Michael D. French, Charles H. King, Susan P. Montgomery, Darin Evans, Jürg Utzinger, Penelope Vounatsou, Sake J. De Vlas

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
18 Downloads (Pure)

Abstract

Background: Current World Health Organization guidelines utilize prevalence of heavy-intensity infections (PHIs), that is, ≥50 eggs per 10 mL of urine for Schistosoma haematobium and ≥400 eggs per gram of stool for S. mansoni, to determine whether a targeted area has controlled schistosomiasis morbidity or eliminated schistosomiasis as a public health problem. The relationship between these PHI categories and morbidity is not well understood. Methods: School-age participants enrolled in schistosomiasis monitoring and evaluation cohorts from 2003 to 2008 in Burkina Faso, Mali, Niger, Tanzania, Uganda, and Zambia were surveyed for infection and morbidity at baseline and after 1 and 2 rounds of preventive chemotherapy. Logistic regression was used to compare morbidity prevalence among participants based on their school's PHI category. Results: Microhematuria levels were associated with the S. haematobium PHI categories at all 3 time points. For any other S. haematobium or S. mansoni morbidity that was measured, PHI categories did not differentiate morbidity prevalence levels consistently. Conclusions: These analyses suggest that current PHI categorizations do not differentiate the prevalence of standard morbidity markers. A reevaluation of the criteria for schistosomiasis control is warranted.

Original languageEnglish
Article numberofab179
JournalOpen Forum Infectious Diseases
Volume8
Issue number7
DOIs
Publication statusPublished - Jul 2021

Bibliographical note

Role of the Funding Sources:
The sponsors of this study played no role in the design, collection, analysis, interpretation, or composition of this report. All
authors contributed to the decision to submit for publication.

Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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