Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba,Kwale

Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.

Epidemiological, Clinical and Therapeutic Aspects of Bladder Tumors in a Schistosomiasis-Endemic Country

Introduction: Bladder tumors are common in our country;Mali is a bilharzial endemic country. In our context, urinary bilharzia is common, and bladder tumors arouse particular interest in the field of urological oncology, because of their frequency, their diagnosis, their difficulty in management and their histological particularity. The objective of our work was to study the epidemiological, clinical and therapeutic aspects of bladder tumors. Materials and Methods: This is a cross-sectional, descriptive study with a retrospective and prospective collection that took place over 3 years from January 1, 2020 to December 31, 2022. Results: We identified 316 cases of bladder tumors during this period. Bladder tumors are a common pathology representing 35.95% of all hospitalized patients, and occupying the 1st rank of tumors in urology in the Urology Department of the Pr Bocar Sidy Sall University Hospital in Kati. Bladder tumors were more common in men with 56.33%. The average age of our patients was 50 years ± 25.8 years and the extreme ages were 20 and 87 years. Urinary schistosomiasis, considered a predisposing factor, was found in 66.78% of cases in our patients as a history. Transurethral resection of the bladder was performed in 100% of our patients, nephrostomy in 1.90% of cases, ureterostomy in 1.58% of cases, Bricker type urinary diversion in 1.27% of cases, and a neobladder in 0.32% of cases. Squamous cell carcinoma is the dominant histological type (88.29%). The postoperative outcome was 99% favorable after resection. Conclusion: Bladder tumors were mainly tumors infiltrating the bladder muscle. The main risk factor was urinary bilharzia. Squamous cell carcinoma is the most common histological type with a diagnostic delay, thus limiting radical treatment after resection of the bladder tumor.

Using the hierarchical ordinal regression model to analyse the intensity of urinary schistosomiasis infection in school children in Lusaka Province,Zambia

Background:Urinary schistosomiasis has been a major public health problem in Zambia for many years.However,the disease profile may vary in different locale due to the changing ecosystem that contributes to the risk of acquiring the disease.The objective of this study was to quantify risk factors associated with the intensity of urinary schistosomiasis infection in school children in Lusaka Province,Zambia,in order to better understand local transmission.Methods:Data were obtained from 1912 school children,in 20 communities,in the districts of Luangwa and Kafue in Lusaka Province.Both individual-and community-level covariates were incorporated into an ordinal logistic regression model to predict the probability of an infection being a certain intensity in a three-category outcome response:0=no infection,1=light infection,and 2=moderate/heavy infection.Random effects were introduced to capture unobserved heterogeneity.Results:Overall,the risk of urinary schistosomiasis was strongly associated with age,altitude at which the child lived,and sex.Weak associations were observed with the normalized difference vegetation index,maximum temperature,and snail abundance.Detailed analysis indicated that the association between infection intensities and age and altitude were category-specific.Particularly,infection intensity was lower in children aged between 5 and 9 years compared to those aged 10 to 15 years(OR=0.72,95%CI=0.51-0.99).However,the age-specific risk changed at different levels of infection,such that when comparing children with light infection to those who were not infected,age was associated with a lower odds(category 1 vs category 0:OR=0.71,95%CI:0.50-0.99),yet such a relation was not significant when considering children who were moderately or heavily infected compared to those with a light or no infection(category 2 vs category 0:OR=0.96,95%CI:0.45-1.64).Overall,we observed that children living in the valley were less likely to acquire urinary schistosomiasis compared to those living in plateau areas(OR=0.48,95%CI:0.16-0.71).However,category-specific effects showed no significant association in category 1(light infection),whereas in category 2(moderate/high infection),the risk was still significantly lower for those living in the valley compared to those living in plateau areas(OR=0.18,95%CI:0.04-0.75).Conclusions:This study demonstrates the importance of understanding the dynamics and heterogeneity of infection in control efforts,and further suggests that apart from the well-researched factors of Schistosoma intensity,various other factors influence transmission.Control programmes need to take into consideration the varying infection intensities of the disease so that effective interventions can be designed.

Efficacy of praziquantel in the treatment of Schistosoma haematobium infection among school-age children in rural communities of Abeokuta, Nigeria

Background:Chemotherapy with praziquantel(PZQ)has been the cornerstone of schistosomiasis control over the last two decades.Being the only available drug for the treatment of over 200 million people worldwide,continuous monitoring of PZQ efficacy under the pressure of widespread use is therefore advocated.Methods:The efficacy of taking two doses of oral PZQ for the treatment of Schistosoma haematobium was examined among school children in Nigeria.Urine specimens were collected from 350 school children and examined using the filtration technique.Blood was collected for packed cell volume(PCV)estimation,and the weight and height of each child were estimated.S.haematobium egg positive pupils were treated with two oral doses of PZQ at 40 mg/kg with a four-week interval in between.Drug efficacy was determined based on the egg reduction rate(ERR).Results:Among 350 school children,245(70.0%)-of which 132 were males and 113 were females,with an age range of 4 to 15 years-were diagnosed with S.haematobium.All the 245 infected children received a single oral dose of 40 mg/kg PZQ twice with a four-week interval in between and were followed up for 12 weeks.At four,eight and twelve weeks post treatment,the ERR was 57.1%,77.6%and 100%,respectively.The ERR was significantly higher among the children with a light infection compared to those with a heavy infection.One hundred and twenty-one children were egg negative at four weeks post treatment,among which 1(6.3)and 120(52.4%)had heavy and light infections,respectively.Following the second round of treatment,the cure rate at eight weeks and twelve weeks was 85.3%and 100%,respectively.Conclusion:This study demonstrated the efficacy of taking two doses of oral PZQ for the treatment of urinary schistosomiasis among school children in Nigeria.