Current status of schistosomiasis in school-aged children in Mwanga district, Tanzania: impact of two decades of annual Mass Drug Administration programme

Parasitology. 2024 Sep;151(11):1254-1259. doi: 10.1017/S0031182024001045. Epub 2024 Oct 21.

Abstract

Schistosomiasis is a neglected tropical disease with significant health implications, particularly among children. A cross-sectional study was conducted among school-aged children (SAC) in Mwanga district, Tanzania, a region known to be co-endemic for S. haematobium and S. mansoni infection and where annual mass drug administration (MDA) has been conducted for 20 years. In total, 576 SAC from 5 schools provided a urine sample for the detection of Schistosoma circulating anodic antigen using the upconverting particle-based lateral flow (UCP-LF CAA) test. Additionally, the potential of the point-of-care circulating cathodic antigen (POC-CCA) and microhaematuria dipstick test as field-applicable diagnostic alternatives for schistosomiasis were assessed and the prevalence outcome compared to UCP-LF CAA. Risk factors associated with schistosomiasis was assessed based on UCP-LF CAA. The UCP-LF CAA test revealed an overall schistosomiasis prevalence of 20.3%, compared to 65.3% based on a combination of POC-CCA and microhaematuria dipstick. No agreement was observed between the combined POC tests and UCP-LF CAA. Factors associated with schistosomiasis included age (5–10 years), involvement in fishing, farming, swimming activities and attending 2 of the 5 primary schools. Our findings suggest a significant progress in infection control in Mwanga district due to annual MDA, although not enough to interrupt transmission. Accurate diagnostics play a crucial role in monitoring intervention measures to effectively combat schistosomiasis.

Keywords: Mwanga; POC-CCA; Tanzania; UCP-LF CAA; diagnosis; microhaematuria dipstick; microscopy; schistosomiasis; school-aged children.

MeSH terms

  • Adolescent
  • Animals
  • Anthelmintics* / administration & dosage
  • Anthelmintics* / therapeutic use
  • Antigens, Helminth / urine
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Glycoproteins
  • Helminth Proteins
  • Humans
  • Male
  • Mass Drug Administration*
  • Praziquantel / therapeutic use
  • Prevalence
  • Risk Factors
  • Schistosoma haematobium / isolation & purification
  • Schistosoma mansoni / isolation & purification
  • Schistosomiasis haematobia* / drug therapy
  • Schistosomiasis haematobia* / epidemiology
  • Schistosomiasis mansoni* / drug therapy
  • Schistosomiasis mansoni* / epidemiology
  • Schistosomiasis* / drug therapy
  • Schistosomiasis* / epidemiology
  • Schools
  • Tanzania / epidemiology

Substances

  • Antigens, Helminth
  • Anthelmintics
  • circulating anodic antigen, Schistosoma mansoni
  • Praziquantel
  • Glycoproteins
  • Helminth Proteins