Schistosomiasis in pre-school-age children and their mothers in Chikhwawa district, Malawi with notes on characterization of schistosomes and snails

Parasit Vectors. 2014 Apr 1;7:153. doi: 10.1186/1756-3305-7-153.

Abstract

Background: To complement ongoing schistosomiasis control within national control programmes (NCPs) that administer praziquantel to school-age children, assessing the risk and extent of schistosomiasis in pre-school-age children (PSAC) is important.

Methods: In June 2012, schistosomiasis in Chikhwawa district, Malawi was assessed across 12 villages examining pre-school-age children (PSAC) and their mothers by serological and parasitological diagnosis, as supplemented with urine-antigen and questionnaire-interview methods. Urinary tract morbidity was inferred by haematuria and albuminuria assays.

Results: In total, 49.5% (CI₉₅ 42.6-56.4) of 208 PSAC and 94.5% (CI₉₅ 90.9-98.1) of 165 mothers were seropositive for schistosomiasis, in 2 villages seroprevalence exceeded 75% in PSAC. Egg-patent urogenital and intestinal schistosomiasis was observed; 17.7% (CI₉₅ 12.4-23.2) of PSAC and 45.1% (CI₉₅ 37.4-52.8) of mothers having active schistosomiasis by parasitological and urine-antigen testing combined. PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria. As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni. Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.

Conclusions: Both PSAC and their mothers appear to be at significant risk of schistosomiasis and should be considered for treatment within the NCP of Malawi.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aging
  • Animals
  • Anthelmintics / administration & dosage
  • Anthelmintics / therapeutic use
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Malawi / epidemiology
  • Male
  • Middle Aged
  • Praziquantel / administration & dosage
  • Praziquantel / therapeutic use
  • Prevalence
  • Schistosoma / classification
  • Schistosoma / genetics*
  • Schistosomiasis / drug therapy
  • Schistosomiasis / epidemiology*
  • Snails / classification*
  • Snails / parasitology
  • Snails / physiology

Substances

  • Anthelmintics
  • Praziquantel