Schistosoma haematobium infection morbidity, praziquantel effectiveness and reinfection rate among children and young adults in Gabon.

Autor: Dejon-Agobé JC; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon. jcagobe@gmail.com.; Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands. jcagobe@gmail.com., Edoa JR; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon., Honkpehedji YJ; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands., Zinsou JF; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands., Adégbitè BR; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon., Ngwese MM; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon., Mangaboula A; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon., Lell B; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.; Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, Medical University of Vienna, Vienna, Austria.; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany., Woldearegai TG; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany.; German Center for Infection Research, Tübingen, Germany., Grobusch MP; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.; Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany., Mordmüller B; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany., Adegnika AA; Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Partner Site, Tübingen, Germany.; German Center for Infection Research, Tübingen, Germany.
Jazyk: angličtina
Zdroj: Parasites & vectors [Parasit Vectors] 2019 Dec 10; Vol. 12 (1), pp. 577. Date of Electronic Publication: 2019 Dec 10.
DOI: 10.1186/s13071-019-3836-6
Abstrakt: Background: Sub-Saharan Africa carries most of the global burden of schistosomiasis. To optimize disease control and reduce morbidity, precise data are needed for control measures adapted to the local epidemiological situation. The objective of this study is to provide baseline information on schistosomiasis dynamics, including praziquantel (PZQ) treatment outcome in children and young adults living in the vicinity of Lambaréné, Gabon.
Methods: Eligible volunteers were included into a prospective longitudinal study. Urine filtration technique was used to detect eggs in urine for schistosomiasis diagnosis. Subjects were treated with 60 mg of PZQ once per month for three consecutive months, and the outcome was assessed by cure rate (CR) and egg reduction rate (ERR).
Results: A total of 328 volunteers were enrolled in the study with a mean (± SD) age of 12.2 ± 4.7 years-old. The female-to-male ratio was 0.99. Out of 258 participants in total, 45% had schistosomiasis during the survey and 43% presented with heavy infections. The incidences of haematuria and schistosomiasis were 0.11 and 0.17 person-years, respectively. After the first and third dose of PZQ, overall ERR of 93% and 95% were found, respectively; while the CR were 78% and 88%, respectively. Both ERR (100 vs 88%) and CR (90 vs 68%) were higher among females than males after the first dose. The CR increased for both groups after the third dose to 95% and 80%, respectively. After the first PZQ dose, ERR was higher for heavy compared to light infections (94 vs 89%), while the CR was higher for light than for heavy infections (87 vs 59%). After the third PZQ dose, ERR increased only for light infections to 99%, while CR increased to 98% and 75% for light and for heavy infections, respectively. The reinfection rate assessed at a mean of 44.6 weeks post-treatment was 25%.
Conclusions: The prevalence of schistosomiasis is moderate in communities living in the vicinity of Lambaréné, where a subpopulation with a high risk of reinfection bears most of the burden of the disease. To improve schistosomiasis control in this scenario, we suggest education of these high-risk groups to seek themselves a one-year PZQ treatment. Trial registration clinicaltrials.gov Identifier NCT02769103. Registered 11 May 2016, retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02769013.
Databáze: MEDLINE
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