Countrywide reassessment of Schistosoma mansoni infection in Burundi using a urine-circulating cathodic antigen rapid test: informing the national control program.
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Published version
Author(s)
Type
Journal Article
Abstract
Following implementation of the national control program, a reassessment of Schistosoma mansoni prevalence was conducted in Burundi to determine the feasibility of moving toward elimination. A countrywide cluster-randomized cross-sectional study was performed in May 2014. At least 25 schools were sampled from each of five eco-epidemiological risk zones for schistosomiasis. Fifty randomly selected children 13-14 years of age per school were included for a single urine-circulating cathodic antigen (CCA) rapid test and, in a subset of schools, for duplicate Kato-Katz slides preparation from a single stool sample. A total of 17,331 children from 347 schools were tested using CCA. The overall prevalence of S. mansoni infection, when CCA trace results were considered negative, was 13.5% (zone range [zr] = 4.6-17.8%), and when CCA trace results were considered positive, it was 42.8% (zr = 34.3-49.9%). In 170 schools, prevalence of this infection determined using Kato-Katz method was 1.5% (zr ==0-2.7%). The overall mean intensity of S. mansoni infection determined using Kato-Katz was 0.85 eggs per gram (standard deviation = 10.86). A majority of schools (84%) were classified as non-endemic (prevalence = 0) using Kato-Katz; however, a similar proportion of schools were classified as endemic when CCA trace results were considered negative (85%) and nearly all (98%) were endemic when CCA trace results were considered positive. The findings of this nationwide reassessment using CCA rapid test indicate that Schistosoma infection is still widespread in Burundi, although its average intensity is probably low. Further evidence is now needed to determine the association between CCA rapid test positivity and low-intensity disease transmission.
Date Issued
2017-01-23
Date Acceptance
2016-10-31
Citation
American Journal of Tropical Medicine and Hygiene, 2017, 96 (3), pp.664-673
ISSN
1476-1645
Publisher
American Society of Tropical Medicine and Hygiene
Start Page
664
End Page
673
Journal / Book Title
American Journal of Tropical Medicine and Hygiene
Volume
96
Issue
3
Copyright Statement
© 2017 The American Society of Tropical Medicine and Hygiene. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor
Imperial College Trust
Bill & Melinda Gates Foundation
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/28115675
PII: ajtmh.16-0671
Grant Number
n/a
RR374-092/4945996
Subjects
Tropical Medicine
11 Medical And Health Sciences
Publication Status
Published
Coverage Spatial
United States