Prevalence and intensity of Schistosoma mansoni infection in pediatric populations on antiretroviral therapy in north-western Tanzania: a cross-sectional study.

Autor:	Mazigo HD; Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania humphreymazigo@gmail.com., Kirway L; Department of Pediatricts and Child Health, Bugando Medical Centre, Mwanza, United Republic of Tanzania., Ambrose EA; Department of Biomedical Sciences, Bishop Nicodemus Hhando College of Health Scineces, Manyara, United Republic of Tanzania.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2019 Jul 24; Vol. 9 (7), pp. e029749. Date of Electronic Publication: 2019 Jul 24.
DOI:	10.1136/bmjopen-2019-029749
Abstrakt:	Background: In areas where HIV and intestinal schistosomiasis are highly endemic, co-infections of the two diseases in a single human host are frequent. Evidence in adult populations indicates that HIV and intestinal schistosomiasis are associated with negative health impacts. However, the topic of HIV and schistosomiasis in paediatric populations has received little attention. The present study determined the prevalence and intensity of Schistosoma mansoni infection in a paediatric population on antiretroviral therapy (ART) in north-western Tanzania. Design, Settings and Participants: A cross-sectional study was conducted among HIV-infected children aged 1-16 years on ART attending a Care and Treatment Clinic at Ukerewe Designated District Hospital, north-western Tanzania. Main Outcome Measures: Single stool and urine samples were collected and screened for S. mansoni eggs and circulating cathodic antigen (CCA), using the Kato-Katz (KK) technique and point-of-care CCA (POC-CCA) rapid urine test, respectively. Results: A total of 134 children with a median age of 10 years (IQR 7-12 years) participated in the study. Of these, 44.8% (60/134) and 55.2% (74/134) were female and male, respectively. The overall prevalence of S. mansoni based on the KK technique and POC-CCA rapid test were 10.7% (95% CI 5.9% to 18.4%) and 33.8% (95% CI 26.2% to 42.4%), respectively. The overall geometrical mean eggs per gram of faeces was 293.9 GM-epg (95% CI 123.3 to 700.9). A small proportion of the children had moderate (4.9%, 5/103) and heavy (3.8%, 4/103) intensity of infection. Conclusion: Paediatric populations on ART are co-infected with S. mansoni infection. Screening and treatment of intestinal schistosomiasis at initiation of ART is recommended to reduce the risk of developing hepatosplenic disease, schistosomiasis-related immune reconstitution inflammatory syndrome and the possible adverse effect of schistosomiasis on outcome of ART. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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