Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-22T12:48:32.368Z Has data issue: false hasContentIssue false

Schistosoma haematobium infection in Mauritania: two years of follow-up after a targeted chemotherapy — a life-table approach of the risk of reinfection

Published online by Cambridge University Press:  06 April 2009

J. F. Etard
Affiliation:
Département de Parasitologie et Pathologie Tropicale, Université Claude Bernard, 8 Avenue Rockefeller, 69373 Cedex 08, France Médecins sans Frontières, 3 Rue Saint-Sabin, 75011 Paris, France
E. Borel
Affiliation:
Département de Parasitologie et Pathologie Tropicale, Université Claude Bernard, 8 Avenue Rockefeller, 69373 Cedex 08, France
C. Segala
Affiliation:
Médecins sans Frontières, 3 Rue Saint-Sabin, 75011 Paris, France

Summary

Reinfection pattern among 6- to 20-year-old subjects was studied over 24 months in two Mauritanian villages of intenseSchistosoma haematobium infection after a targeted chemotherapy with praziquantel involving the whole community. Subjects received treatment according to the presence of haematuria/proteinuria and this indirect screening technique was able to identify 98–100% of the heavily infected subjects (50 + eggs/10 ml). The two villages differed with respect to their characteristics, quality of follow-up and reinfection pattern. The post-treatment 6-month cumulative incidence during the two transmission periods following the chemotherapy, estimated from a subset of 116 subjects, was 18·0% and 20·5%. Reinfection rates were higher among males (Cox-Mantel: P = 0·0015), among children 6–10 years of age than older (P = 0·0078) and among subjects with more than 50 eggs/10 ml of urine before treatment than subjects with a lower egg output (P = 0·009). A Cox proportional hazard regression model was fitted and confirmed that gender, age and pretreatment level of infection were predictors of the rate of reinfection but that there was no interaction between these predictors.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Anderson, R. M. & Medley, G. F. (1985). Community control of helminth infections of man by mass and selective chemotherapy. Parasitology 90, 629–60.CrossRefGoogle Scholar
Bensted-Smith, R., Anderson, R. M., Butterworth, A. E., Dalton, P. R., Kariuki, H. C., Koech, D., Mugambi, M., Ouma, J. H., Arap Siongok, T. K. & Sturrock, R. F. (1987). Evidence for predisposition of individual patients to reinfection with Schistosoma mansoni after treatment. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 651–4.CrossRefGoogle ScholarPubMed
Cox, D. R. (1972). Regression models and life tables (with discussion). Journal of the Royal Statistician Society, B34, 187220.Google Scholar
Davis, A., Biles, J. E., Ulrich, A.-M. & Dixon, H. (1981). Tolerance and efficacy of praziquantel in phase IIA and IIB therapeutic trials in Zambian patients. Drug Research 31, 568–74.Google Scholar
Etard, J. F. & Borel, E. (1987). Epidemiological survey of urinary schistosomiasis in southeastern Mauritania. Tropical Medicine and Parasitology 38, 2730.Google ScholarPubMed
Farooq, M. & Hairston, N. G. (1966). The epidemiology of Schistosoma haematobium and S. mansoni in the Egypt-49 Project Area. 4. Measurement of the incidence of bilharziasis. Bulletin of the World Health Organization 35, 331–8.Google ScholarPubMed
Feldmeier, H., Bienzle, U., Dietrich, M. & Sievertsen, H. J. (1979). Combination of a viability test and a quantification method for Schistosoma haematobium eggs. Tropenmedizin und Parasitologie 30, 417–22.Google Scholar
Jordan, P. & Webbe, G. (1982). Schistosomiasis— Epidemiology, Treatment and Control. London: William Heinemann Medical Books Ltd.Google Scholar
Kleinbaum, D. G., Kupper, L. L. & Morgenstein, H. (1982). Epidemiologic Research—Principles and Quantitative Methods. New York: Van Nostrand Reinhold Company.Google Scholar
Mott, K. E., Osei-Tutu, E., England, C., Ekue, K. & Tekle, A. (1985). Evaluation of reagent strips in urine tests for detection of Schistosoma haematobium infection: a comparative study in Ghana and Zambia. Bulletin of the World Health Organization 63, 125–33.Google ScholarPubMed
Stephenson, L. S., Latham, M. C., Kinoti, S. N. & Oduori, M. L. (1984). Sensitivity and specificity of reagent strips in screening of Kenyan children for Schistosoma haematobium infection. American Journal of Tropical Medicine and Hygiene 33, 862–71.CrossRefGoogle ScholarPubMed
Sturrock, R. F., Bensted-Smith, R., Butterworth, A. E., Dalton, P. R., Kariuki, H. C., Koech, D., Mugambi, M., Ouma, J. H. & Arap Siongok, T. K. (1987). Immunity after treatment of human schistosomiasis mansoni. III. Long-term effects of treatment and retreatment. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 303–14.CrossRefGoogle ScholarPubMed
Tanner, M., Holzer, B., Marti, H. P., Baladin, B. & Degremont, A. A. (1983). Frequency of haematuria and proteinuria among Schistosoma haematobium infected children of two communities from Liberia and Tanzania. Acta tropica 40, 231–7.Google ScholarPubMed
Tingley, G. A., Butterworth, A. E., Anderson, R. M., Kariuki, H. C., Koech, D., Mugambi, M., Ouma, J. H., Arap Siongok, T. K. & Sturrock, R. F. (1988). Predisposition of humans to infection with Schistosoma mansoni: evidence from the reinfection of individuals following chemotherapy. Transactions of the Royal Society of Tropical Medicine and Hygiene 82, 448–52.CrossRefGoogle ScholarPubMed
Wilkins, H. A. (1989). Reinfection after treatment of schistosome infections. Parasitology Today 5, 83–8.CrossRefGoogle ScholarPubMed
Wilkins, H. A., Blumenthal, U. J., Hagan, P., Hayes, R. J. & Tulloch, S. (1987). Resistance to reinfection after treaiment of urinary schistosomiasis. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 2935.CrossRefGoogle Scholar