Dataset Information

Prevalence and intensity of Schistosoma mansoni infection in pediatric populations on antiretroviral therapy in north-western Tanzania: a cross-sectional study.

ABSTRACT:

Background

In areas where HIV and intestinal schistosomiasis are highly endemic, co-infections of the two diseases in a single human host are frequent. Evidence in adult populations indicates that HIV and intestinal schistosomiasis are associated with negative health impacts. However, the topic of HIV and schistosomiasis in paediatric populations has received little attention. The present study determined the prevalence and intensity of Schistosoma mansoni infection in a paediatric population on antiretroviral therapy (ART) in north-western Tanzania.

Design, settings and participants

A cross-sectional study was conducted among HIV-infected children aged 1-16 years on ART attending a Care and Treatment Clinic at Ukerewe Designated District Hospital, north-western Tanzania.

Main outcome measures

Single stool and urine samples were collected and screened for S. mansoni eggs and circulating cathodic antigen (CCA), using the Kato-Katz (KK) technique and point-of-care CCA (POC-CCA) rapid urine test, respectively.

Results

A total of 134 children with a median age of 10 years (IQR 7-12 years) participated in the study. Of these, 44.8% (60/134) and 55.2% (74/134) were female and male, respectively. The overall prevalence of S. mansoni based on the KK technique and POC-CCA rapid test were 10.7% (95% CI 5.9% to 18.4%) and 33.8% (95% CI 26.2% to 42.4%), respectively. The overall geometrical mean eggs per gram of faeces was 293.9 GM-epg (95%?CI 123.3 to 700.9). A small proportion of the children had moderate (4.9%, 5/103) and heavy (3.8%, 4/103) intensity of infection.

Conclusion

Paediatric populations on ART are co-infected with S. mansoni infection. Screening and treatment of intestinal schistosomiasis at initiation of ART is recommended to reduce the risk of developing hepatosplenic disease, schistosomiasis-related immune reconstitution inflammatory syndrome and the possible adverse effect of schistosomiasis on outcome of ART.

SUBMITTER: Mazigo HD

PROVIDER: S-EPMC6661605 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Prevalence and intensity of <i>Schistosoma mansoni</i> infection in pediatric populations on antiretroviral therapy in north-western Tanzania: a cross-sectional study.

Mazigo Humphrey D HD Kirway Laurence L Ambrose Emmanuela Ausebio EA

BMJ open 20190724 7

<h4>Background</h4>In areas where HIV and intestinal schistosomiasis are highly endemic, co-infections of the two diseases in a single human host are frequent. Evidence in adult populations indicates that HIV and intestinal schistosomiasis are associated with negative health impacts. However, the topic of HIV and schistosomiasis in paediatric populations has received little attention. The present study determined the prevalence and intensity of <i>Schistosoma mansoni</i> infection in a paediatri ...[more]

PMID: 31345980

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Project description:Despite growing evidence that infants and very young children can be infected with schistosomes, the epidemiological features and risk factors are not well described in this age group. We aimed to assess the prevalence of S. mansoni infection in children under two years of age from a population with a known high burden of infection in school-aged children and adults and thus inform the need for interventions in this potentially vulnerable age group. In a cross-sectional study in Mbita Sub-county, along the east coast of Lake Victoria, Western Kenya, we enrolled 361 children aged 6-23 months. The prevalence of S. mansoni infection was detected using the Kato-Katz stool examination and a point-of-care test for urinary circulating cathodic antigen (POC-CCA) (Rapid Medical Diagnostics, Pretoria, South Africa). Three-hundred and five (305) children had complete data of whom 276 (90.5%, 95%CI: 86.6-93.5) children were positive for S. mansoni by the POC-CCA test, while 11 (3.6%, 95%CI: 1.8-6.4) were positive by the Kato-Katz method. All Kato-Katz positive cases were also positive by the POC-CCA test. In multivariable analysis, only geographical area, Rusinga West (AOR = 7.1, 95%CI: 1.4-35.2, P = 0.02), was associated with S. mansoni infection using Kato-Katz test. Independent associations for POC-CCA positivity included age, (12-17 months vs 6-11 months; AOR = 7.8, 95%CI: 1.8-32.6, P = 0.002) and breastfeeding in the previous 24 hours (AOR = 3.4, 95%CI: 1.3-9.0, P = 0.009). We found a potentially very high prevalence of S. mansoni infection among children under two years of age based on POC-CCA test results in Mbita Sub-county, Kenya, which if confirmed strongly supports the need to include infants in public health strategies providing universal prophylactic treatment in high burden settings. Further research is required to determine the accuracy of diagnostic tools to detect light infection among very young children and possible long-term health impacts.

Project description:BackgroundDyslipidemia is a leading risk factor for atherosclerotic cardiovascular disease. There are few published epidemiological data regarding dyslipidemia in Africa. We determined full lipid and apolipoprotein profiles and investigated factors associated with lipid levels in urban and rural populations of north-western Tanzania and southern Uganda.MethodsWe conducted a cross-sectional survey of randomly-selected, community-dwelling adults (≥18yrs) including five strata per country: one municipality, two district towns and two rural areas. Participants were interviewed and examined using the World Health Organization STEPwise survey questionnaire. Serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and apolipoproteins were measured. Factors associated with mean lipid levels were assessed by multivariable linear regression. Framingham 10-year cardiovascular risk scores were calculated with and without lipids.ResultsOne-third of adults in the study population had dyslipidemia. Low high-density lipoprotein cholesterol affected 32-45% of rural adults. High total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found in <15% of adult population in all strata, but were more common in urban adults. Factors independently associated with higher mean low-density lipoprotein cholesterol and apolipoprotein B were female gender, older age, higher education, higher income, obesity, and hypertension. Framingham cardiovascular risk scores with and without lipids yielded similar results and 90% of study subjects in all strata were classified as "low risk". Among older adults (>55 years), 30% were classified as "high" or "very high" risk.ConclusionsDyslipidemias are common among adults in north-western Tanzania and southern Uganda affecting one third of adult population. Overall, cardiovascular risk scores are low but high risk scores are common with older adults. Health services designed and equipped to diagnose and treat dyslipidemia are urgently needed.