Factors Associated with Acute Respiratory Infections in Children Aged 0 - 5 Years in the Yénawa District of Cotonou (Benin) in 2023

Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in children 0 to 5 years old in Yénawa, Cotonou in 2023. Subjects and Method: It was an analytical cross-sectional study of children aged 0 - 5 years and their mothers in Yénawa, selected by four-degree random sampling. The sampling size, calculated using the Schwartz formula, was 126 children and 126 mothers. The dependent variable was the occurrence of acute respiratory infections. The independent variables were classified into four groups: socio-demographic and economic characteristics, behavioral factors, child-related factors, and environmental factors. Data collected by observation and questionnaire survey were analyzed using STATA version 15 software. Associated factors were investigated by bivariate analysis and multiple logistic regression, at the 5% significance level. Results: A total of 126 children aged 0 - 5 years and 126 mothers were surveyed, aged 23.5 (11 - 36) months and 30 (18 - 48) years respectively. The prevalence of acute respiratory infections was 74.60% (CI95% = 66.89 to 82.30). The associated factors were the mother’s age between 18 and 28 (OR = 10.77;CI95% = 1.89 to 61.27;p = 0.007), the use of charcoal/wood for cooking (OR = 7.36;IC = 1.99 to 27.10;p = 0.003)), children's poor personal hygiene (OR = 8.87;IC = 2.92 to 26.97;p 0.001)), and cohabitation with domestic animals (OR = 7.27;IC = 1.67 to 31.71;p = 0.015). Conclusion: Communicating with mothers about the factors identified will help reduce the prevalence of acute respiratory infections in children aged 0 to 5.

Risk Factors for Geo-Helminthiasis in Children Aged 6 - 36 Months in a Rural Health District in Cameroon

Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.

Epidemio-Clinical Profile and Factors Associated with Performance Indicators of Integrated Management of Severe Acute Malnutrition in Children Aged 6 - 59 Months Hospitalized at the Kalaban Coro Reference Health Center

Introduction: Malnutrition is an important reason for consultation in Mali’s health facilities and remains a major public health problem. The aim of this study was to describe the epidemioclinical profile and associated factors with performance indicators of integrated management of severe acute malnutrition in children aged 06 to 59 months. Methodology: this was a cross-sectional study with retrospective data collection (January 2021 to December 2022). All children hospitalized for severe acute malnutrition in the pediatric department and whose medical records were usable were included. Data collected using a standardized questionnaire was analyzed with SPSS Version 20 software. Results: A total of 534 children were included. The 12 to 23 months age group (49.1%) and the female sex (53.18%) were the most affected. Fully vaccinated children by age represented 49.4%. The predominant form of malnutrition was marasmus (77.7%). Diarrhea/vomiting (30.3%), fever (18.4%) and cough (15.5%) were the main reasons for consultations. Cure, discontinuation and death rates were 78.5%, 2.1% and 9.2%, respectively. On univariate analysis, the factors statistically associated with performance indicators (cure, drop-out, death) were gastroenteritis (P-value Conclusion: This study reveals that the frequency of severe acute malnutrition remains high at the Kalaban Coro reference health center. Better prevention of illnesses such as malaria, gastroenteritis, and respiratory infections, as well as timely referral, could help facilitate its management.

Factors Associated with Mortality in Children Aged 1 Month to 15 Years Hospitalized in the Pediatric Ward of the Kalaban-Coro Reference Health Center: Cross-Sectional Study

Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.

Prevalence and Years Lived with Disability for Dental Caries among Children Aged 0-14 Years in China, 1990-2016

The estimate of dental caries among Chinese children at the microscale level using standard methodology remains unclear. In this study, we assessed and analyzed the disease burden of childhood dental caries in China by extracting data from the Global Burden of Disease, Injuries, and Risk Factors Study 2016 （GBD 2016）. In 2016, the number of cases, prevalence, years lived with disability （YLD）, and age-standardized YLD rate of dental caries was 93.0 million, 43.0%, 32,200 person years, and 14.8 per 100,000, respectively. Across 33 provincial units, the disease burden was highest in Hubei （YLD rate 28.6 per 100,000）, lowest in Macao （9.1 per 100,000）, while geographical clustering was not observed. Compared with 1990, the prevalence in 2016 decreased from 46.8% to 43.0%, and the YLD rate decreased from 16.5 per 100,000 to 14.8 per 100,000. Given the slight decrease in dental caries burden, the prevalence and disease burden remained high among Chinese children. Strategies for addressing the spatial inequity of childhood dental caries require geographical targeting.

Dietary Behaviors and Influencing Factors among Rural Left-behind Children Aged below 7 Years in China

Left-behind children comprise a special population inChinese rural areas. According to the 2007 China Census,the number ofleft-behind children aged≤14 years was estimated at 58 million which suggested that these childrencon stituted a

Feeding Practices, Nutritional and Hemoglobin Status of Children Aged 6 to 59 Months in the Republic of Guinea: A Case Study of the Prefecture of Fria

Malnutrition is a major public health concern in developing countries,contributing to 45%of deaths among children under five years old.In the Republic of Guinea,the prevalence of acute malnutrition is estimated at 6.7%,largely influenced by inadequate breastfeeding and complementary feeding practices.A descriptive cross-sectional study was conducted in the Prefecture of Fria to assess the impact of feeding practices on the growth and development of children aged 6 to 59 months.A sample of 450 children residing in the prefecture was included in the study.The findings revealed a prevalence of acute malnutrition of 8.9%,while 4.4%of the children were underweight,and 7.1%suffered from chronic malnutrition.

The Patterns of Complementary Feeding and Growth among 12 to 23 Month-Old Children in China

Objective This study aimed to understand the characteristics of dietary patterns among children aged12 to 23 months and discusses the relationship between dietary patterns and the growth of children.Method Cross-sectional data were selected from the National Nutrition and Health Systematic Survey for 0 to 18 year-old children in China(n=2,449)to describe the patterns of complementary feeding and the growth of children.Cluster analysis was used to analyze complementary feeding patterns,and an analysis of variance and Bonferroni test were conducted to analyze the relationship between Z scores and complementary feeding patterns.Results Four dietary patterns were identified among the children via cluster analysis.In Pattern 4(n=104,4.2%),children still consumed milk as their staple food.They displayed the lowest grain,fruit,vegetable,egg,and flesh foods consumption,a medium frequency of breast milk consumption,and a high frequency of dairy product consumption.Pattern 4 had the lowest length-for-age Z scores and weight-for-age Z scores,with-0.10±1.34 and 0.24±1.00,respectively(F=7.940,P<0.001;F=5.317,P<0.001).Conclusion Although China is undergoing rapid urbanization and economic development,there is still a phenomenon of insufficient intake of protein-rich foods and dairy-based dietary patterns at the stage of complementary food introduced among children aged 12 to 23 months.

The impact of social capital on children's (6–12) use of ICT in urban communities: A field survey from Zhengzhou City, Henan Province

Purpose： This paper focuses on the impact of social capital on urban children＇s use behavior of information communication technology （ICT）.Design/methodology/approach： Using the field survey and in-depth interviews, we interviewed 40 children aged 6 to 12 and their parents from a staff residential quarter of the Zhengzhou University--＂Shengheyuan＂ community （SHY）, and a commercial residential quarter--＂Wanfenghuicheng＂ community （WFHC） in the high-tech zone of Zhengzhou City, Henan Province. We used the social capital theory to analyze the interviewees＇ record.Findings： In urban communities, social capital is the most important factor for children （aged 6 to 12） in their ICT use. Our findings indicate that children in families with higher levels of social capital, such as internal resources, family income, parent educational backgrounds and parents＇ social network, have more-highly developed ICT skills. Personal motivation and obstacles, such as lack of access to computers on a regular basis, also have an impact on children＇s ICT use. External social capital, including schools, libraries, and public service institutes, have little impact on children＇s ICT use, if not combined with internal social capital factors.Research limitations： Our research samples were collected from two communities within the same city, which may influence the generalization of this research result.Originality/value： To explore the social capital＇s influence on children＇s ICT use, we used field observation for ICT use of children aged 6 to 12 in urban communities in China, and studied the children＇s ICT behavior from the perspective of internal and external social capital.

Impacts of Types and Degree of Obesity on Non-Alcoholic Fatty Liver Disease and Related Dyslipidemia in Chinese School-Age Children?

Objective To explore the impacts of types and degree of obesity on non‐alcoholic fatty liver disease （NAFLD） and related lipids disturbance in Chinese school‐age children. Methods A total of 1 452 school‐age Children of 7 to 17 years were recruited in Beijing with representative cluster sampling method. Data of anthropometric measurements including weight, height and waist circumference were collected from March to May of 2007. Body mass index（BMI）was calculated. Blood samples were obtained and lipid profiles including triglyceride （TG）, total cholesterol （TC）, high‐density lipoprotein cholesterol （HDL‐C） and low‐density lipoprotein cholesterol （LDL‐C） were measured, while glutamate‐pyruvate transaminase （ALT） and glutamic‐oxalacetic transaminase （AST） were determined to evaluate liver function. The liver was also scanned by sonography, and abnormal hepatic sonograms were documented. NAFLD was diagnosed according to the criteria recommended by the Fatty Liver and Alcoholic Liver Disease Study Group under the Chinese Liver Disease Association. Analysis of covariance （ANOVA）, Chi‐square test for trend and binary logistic regression analysis were performed. Results The dyslipidemia and ultrasonographic fatty liver deteriorated with the degree of obesity defined either by BMI or waist circumference. Compared with BMI, waist circumference contributed more to the development of dyslipidemia, fatty liver and NAFLD. The highest levels of TG, TC, LDL‐C, and lowest level of HDL‐C were seen in the mixed obese group followed by abdominal obese, peripheral obese and non‐obese ones. Adjusted for gender and age, the odds ratios （ORs） and their 95% confidence intervals of peripheral obesity, abdominal obesity and mixed obesity were 0, 10.93 （0.98‐121.96） and 79.16 （10.95‐572.44） for predicting NAFLD; 12.61 （1.24‐127.78）, 19.39 （5.23‐71.85）, and 93.21 （29.56‐293.90） for predicting ultrasonographic fatty liver; 1.78 （0.59‐5.44）, 3.01 （1.91‐4.77）, and 4.64 （3.52‐6.12） for predicting dyslipidemia, respectively compared with the non‐obese control group. The trend of hazards over groups was statistically significant （P0.01）. Conclusion The levels of lipid profile and the prevalence of NAFLD and dyslipidemia increased in parallel with the degree of obesity; As compared with the non‐obese control, the mixed obesity had the strongest association with NAFLD and dyslipidemia, followed by abdominal obesity and peripheral obesity in Chinese school‐age Children.

National Nutrition and Health Systematic Survey for Children 0–17 Years of Age in China

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China(CNHSC)was to collect basic data on the nutrition,development,and health status for children in different regions across China using evidence-based,reliable,and cost-effective approaches.Children and their parents or guardians from seven regions(south,southwest,north,northwest,eastern,central,and northeast China)in China were recruited.A multi-stage stratified randomized sampling method was used.Two provinces were randomly sampled from each of the seven regions,from which one urban district and one rural country were also randomly sampled,resulting in a total of 28 survey counties/districts.Dietary surveys,health examinations,laboratory testing,and questionnaires were used to collect dietary intake,nutritional status,child development,and health status information.Nutrition,health,and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice(KAP)survey.Greater than 100,000 children(38,000 children<6 years of age and 66,000 children6-17 years of age)completed the survey.The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.

Mutual Experiences of Japanese Parents and Their Children When Late School-Age Children Engage in Meal-Related Family Routines: A Qualitative Analysis of Parent and Child Dyads

Purpose: The objective of the present study was to identify the type of experiences that parents and their children have with each other when late-school age children take on roles in family routines related to daily meals. Methods: A grounded theory approach was used. The participants were children in the 4th, 5th, and 6th grades of elementary school and their main caregivers. First, 10 parent and child dyads were interviewed using a semi-structured schedule. Next, online group interviews were conducted for 17 parent and child dyads to deductively confirm the categories. Results: The average age of the subjects was 41.9 years for parents and 10.4 years for children in parent-child interviews, and 41.1 years for parents and 9.6 years for children in group interviews. Six categories emerged with nineteen subcategories. Conclusions: Experiences mutually nurtured by parents and their children included experiences in which children used negotiation and conversation skills to consensually engage in family routines related to meals. It also included experiences that socialized the children in family life and fostered good communication. The six categories will be useful for healthcare professionals and school authorities in providing health guidance that addresses health functions of late school-age children and their families.

Vitamin A supplement: a key strategy to prevent vitamin A deficiency among young children in Afghanistan

Background:Vitamin A deficiency is the main problem of public health worldwide demonstrated that 190 million population of preschool children and 122 countries(in Africa and South-East Asia)have vitamin A deficiency,according to recent estimated research.In Afghanistan,vitamin A supplementation is a key strategy to prevent vitamin A deficiency among young children.Children receive vitamin A supplements as part of National Immunization Days(NID)campaigns.Methods:In this case study,the data was collected from June 15/2015 to February 23/2016,and the final report of the Afghanistan Demographic Health Survey(AfDHS)2015 was released on February 15/2017.All 27,209 children aged 6-59 months who are living with their mothers were included in this study.Who consumed foods rich in vitamin A was not included in this study.Results:The percentages who were given vitamin A supplements in the last 6 months among all children 6-59 months aged.A total of 1,572 children aged among 6-8 months were given vitamin A supplements 670(42.6%)children and comparison with the total community of the study(27,209)children(2.46%).A total of 1,148 children aged among 9-11 months were given vitamin A supplements to 465(40.5%)children and comparison with the total community of the study(27,209)children(1.70%).Conclusion:After following up on more studies,we found that vitamin A deficiency is a public problem,thus it is better to use wheat flour fortification,vitamin A capsule(VAC)supplementation,nutrition education,source of vitamin A,and training of primary healthcare workers on the clinical to prevent and treat the vitamin A deficiency among children.Therefore,we aimed to determine the given vitamin A supplementation among children aged 6-59 months in 33 provinces in Afghanistan,in 2015.

Evaluation of the Integrated Management Program for Acute Malnutrition in the Douentza Health District, Mopti Region, Mali

Introduction: Malnutrition is a major public health problem in Mali, despite the efforts of the government, its technical and financial partners. The aim of this study was to evaluate the integrated management program for acute malnutrition (IMPAM). Methodology: This was a descriptive cross-sectional study that took place from January to December 2020 in the Douentza health district. The study included anyone with at least one malnourished child aged 6 to 59 months in their care who agreed to take part in the study, community health center staff who had given their consent, and the URENI manager at the Douentza reference health center. Data collected via questionnaires were entered into Excel and then analyzed using Epi-Info version 7 software. Results: A total of 138 acutely malnourished children aged 6 - 59 months, including 71 girls (51.45%), 138 accompanying mothers and 11 health workers, were included in our case study. Among the malnourished, 54.34% were in the 12 - 23 months age group and 69.57% had the severe form. 93% of the mothers interviewed were satisfied with the care provided, and all the health staff interviewed stated that community conflicts had an impact on IMPAM’s activities. Cure rates were 81% in Moderate Outpatient Nutritional Recovery and Education Unit (URENAM), 84% in Severe Ambulatory Nutritional Recovery and Education Unit (URENAS) and 92% in Recovery and Intensive Nutritional Education Unit (URENI). Drop-out rates were 19% in URENAM, 16% in URENAS and 0% in URENI. The death rate was 8% in URENI and 0% in URENAM and URENAS. Conclusion: This study confirms the high prevalence of malnutrition in the district (10.54%). It also reveals that factors such as inter-community conflict and insecurity have seriously affected the IMPAM program.

Solving an Age Old Problem A new law requires children to visit their aging parents

MORE than 10 years ago, the song Come Home As Often As You Can to See Your Parents became popular in China, reminding young people of their obli- gation to set aside their hectic lives and return to their hometowns to visit their aging parents. Today, the idea expressed in this song has been codified in Chinese law.

Empirical Changes in the Prevalence of Overweight and Obesity among Chinese Students from 1985 to 2010 and Corresponding Preventive Strategies

Objective To determine the extent of the obesity epidemic in school‐aged Chinese children in 2010 and track the increasing trend in different socioeconomic regions over the preceding 25 years. Strategies for preventing childhood obesity are suggested. Methods We used a dataset provided by the Chinese National Survey on Students’ Constitution and Health from 1985‐2010. Subjects were 7‐18‐year‐old students randomly selected from urban and rural areas in 30 provinces. Eight subgroups were created according to region and socioeconomic status. Results Increased rates of the epidemic （overweight and obesity combined） were greatest in large coastal cities‐32.6% and 19.1% among males and females, respectively. These rates has neared that of developed countries. Similar increases were found in all other regions, including the once poverty‐stricken rural west. The epidemic in most of the rural areas began after 2000, but has spread swiftly over the last decade. In 2010, it was estimated that 9.9% of Chinese school‐aged children and adolescents were overweight and that an additional 5.1% were obese, representing an estimated 30.43 million individuals. Conclusion The prognosis for China＇s childhood‐obesity epidemic is dire. To prevent childhood obesity, we suggest several strategies, including reasonable dietary intake, increase physical activity, a change in sedentary lifestyles and corresponding behavioral modifications.

Prevalence and risk factors of schistosomiasis and soil-transmitted helminthiases among preschool aged children (1-5 years) in rural KwaZulu-Natal, South Africa: a cross-sectional study

Background:Despite efforts to control neglected tropical diseases(NTDs),schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa.Recent data suggest that these infections are prevalent among preschool aged children(PSAC)in poor communities.Evidence of schistosomiasis and soil-transmitted helminths(STH)infection patterns and prevalence among PSAC is essential for effective treatment and control programmes.The aim of the study was to determine the prevalence,intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District,South Africa.Methods:A cross-seaional study was conducted among 1143 PSAC aged 1-5 years in 34 preschools and early childhood development(ECD)centres.Data on risk factors was collected using a semi-struaured questionnaire.A Kruskal-Wallis test was used to compare the differences in infection intensity with age.Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status,sociodemographic,household,water and sanitation variables and hygiene practices of PSAC and their caregivers.Results:We observed a low prevalence o f Schistosom a haem atobium(1.0%)and 5.m ansoni(0.9%).The prevalence of Ascaris lum bricoides(18.3%)was high compared to Trichuris trichiuro(1.2%),hookworms(1.6%)and Taenio(6.4%).The odds of schistosome infection were lowest among PSAC under younger(15-24 years)caregivers(0.1,95%CI:0.02-0.54)and those who used tap water(0.3,95%Cl:0.09-0.78)for domestic purposes.Schistosome infection was however higher among PSAC who bathed in river water(17.4,95%CI:5.96-51.04).STH infection on the other hand was lowest among PSAC who did not play in soil(0.1,95%CI:0.51-0.28),were from households that used tap water for domestic purposes(0.5,95%CI:0.27-0.80)and PSAC under the care of younger(25-35 years)caregivers(0.3,95%Cl:0.10-0.75).The risk of STH infeaion was highest among PSAC who did not wash their hands with soap(3.5,95%CI:1.04-11.67)and PSAC whose nails were not trimmed(3.6,95%CI:1.75-7.26).Conclusions:The findings show low prevalence and infection intensity of schistosomiasis and STH infection except A lum bricoides among PSAC.Factors predicting schistosomiasis and STH infection among PSAC were related to caregivers'age,educational status,water and hygiene practices.STH infection was exclusively associated with PSAC playing and handwashing habits.These findings highlight the need to include PSAC caregivers in schistosomiasis and STH prevention and control programmes.

Age norms for grating acuity and contrast sensitivity measured by Lea tests in the first three years of life

AIM： To determine age norms in the first three years of life for grating visual acuity and contrast sensitivity obtained with Lea grating test and Hiding Heidi low contrast face test. METHODS： Lea grating test was used to estimate binocular grating acuity and Hiding Heidi low contrast face test was used to estimate contrast sensitivity in 600 healthy infants and children. Age ranged from 3 to 36 mo subdivided into 12 groups subjected for full ophthalmologic and pediatric examinations.RESULTS： The grating acuity developed along the first three years of life. It ranged from 1.88±0.32 c/d at 3mo to 30.95±0.77 c/d at 36 mo. The most rapid development was during the first 12 mo and the slowest development was from 30 to 36 mo. The contrast sensitivity showed rapid development in the first two years of life. Its mean value ranged from 4.23±1.17 at 3mo to 78.26±8.21 at 24 mo. It was constant at the highest score（80） thereafter.CONCLUSION： Age norms for grating acuity along with contrast sensitivity offer a more comprehensive measure of spatial vision and should be incorporated in clinical practice for better visual assessment in preverbal and nonverbal children.

Reduced efficacy of single-dose albendazole against Ascaris lumbricoides, and Trichuris trichiura, and high reinfection rate after cure among school children in southern Ethiopia: a prospective cohort study

Background Mass drug administration(MDA)program of albendazole to at-risk populations as preventive chemo-therapy is the core public health intervention to control soil-transmitted helminths(STHs).Achieving this goal relies on drug effectiveness in reducing the parasite reservoirs in the community and preventing reinfection.We assessed the effcacy of albendazole against STH parasite infection and reinfection status after cure.Methods A total of 984 schoolchildren infected with at least one type of STH parasite(hookworm,Ascaris lumbri-coides,Trichuris trichiura)in southern Ethiopia were enrolled and received albendazole and praziquantel in MDA campaign conducted from January to March 2019.Stool exams at week-4 and at week-8 of post-MDA were done using Kato Katz technique.The primary outcome was effcacy assessed by cure rate(CR)and fecal egg reduction rates(ERRs)at four weeks of post-MDA.The secondary outcome was reinfection status defined as parasite egg positivity at eight weeks among those who were cured at 4 weeks of post-MDA.Group comparisons in CR and related factors were assessed with chi-square or Fisher's exact tests.Predictors of CR were examined through univariate and multi-variate regression analyses.Results The overall CR and ERR for hookworm infection were 97.2%(95%CI:94.6-99.4)and 97.02%,respectively.The overall CR and ERR for A.lumbricoides were 71.5%(95%CI:68.3-74.6)and 84.5% respectively.The overall CR and ERR and for T.trichiura were 49.5%(95%CI:44.8-54.2)and 68.3%,respectively.The CR among moderate T.trichiura infec-tion intensity was 28.6%.Among children cured of hookworm,A.lumbricoides and T.trichiura at week 4 post-MDA,4.6%,18.3% and 52.4% became reinfected at week-8 post-MDA,respectively.Significantly lower CR(36.6%)and higher reinfection after cure(60.6%)among A.lumbricoides and T.trichiura coinfected children than A.lumbricoides only(CR=69.6%,reinfection rate=15.1%)or T.trichiura only infected children(CR=55.6%,reinfection rate=47.1%)was observed.Pre-treatment coinfection with≥two types of STH parasites was significantly associated with re-infec-tion after cure.Conclusion Albendazole MDA is efficacious against hookworm but has reduced efficacy against A.lumbricoides and is not effective against T.trichiura.The low drug efficacy and high reinfection rate after cure underscore the need for alternative treatment and integration of other preventive measures to achieve the target of eliminating STHs as a public health problem by 2030.

Reinfection of urogenital schistosomiasis in pre-school children in a highly endemic district in Northern Zimbabwe:a 12 months compliance study

Background:In light of the shift to aiming for schistosomiasis elimination,the following are needed:data on reinfection patterns,participation,and sample submission adherence of all high-risk age groups to intervention strategies.This study was conducted to assess prevalence,reinfections along with consecutive participation,sample submission adherence,and effect of treatment on schistosomiasis prevalence in children aged five years and below in an endemic district in Zimbabwe,over one year.Methods:The study was conducted from February 2016-February 2017 in Madziwa area,Shamva district.Following community mobilisation,mothers brought their children aged 5 years and below for recruitment at baseline and also urine sample collection at baseline,3,6,9 and 12 months follow up surveys.At each time point,urine was tested for urogenital schistosomiasis by urine filtration and children found positive received treatment.Schistosoma haematobium prevalence,reinfections as well as children participation,and urine sample submission at each visit were assessed at each time point for one year.Results:Of the 535 children recruited from the five communities,169(31.6%)participated consecutively at all survey points.The highest mean number of samples submitted was 2.9 among communities and survey points.S.haematobium prevalence significantly reduced from 13.3%at baseline to 2.8%at 12 months for all participants and from 24.9%at baseline to 1.8%at 12 months(P<0.001)for participants coming at all-time points.Among the communities,the highest baseline prevalence was found in Chihuri for both the participants coming consecutively(38.5%,10/26)and all participants(20.4%,21/103).Reinfections were significantly high at 9 months follow up survey(P=0.021)and in Mupfure(P=0.003).New infections significantly decreased over time(P<0.001).Logistic regression analysis showed that the risk of acquiring schistosomiasis was high in some communities(P<0.05).Conclusions:S.haematobium infections and reinfections are seasonal and depend on micro-geographical settings.The risk of being infected with schistosomes in pre-school aged children increases with increasing age.Sustained treatment of infected individuals in a community reduces prevalence overtime.Participation compliance at consecutive visits and sample submission adherence are important for effective operational control interventions.