Schistosoma, other helminth infections, and associated risk factors in preschool-aged children in urban Tanzania.

Said, Khadija; Hella, Jerry; Knopp, Stefanie; Nassoro, Tatu; Shija, Neema; Aziz, Fatma; Mhimbira, Francis; Schindler, Christian; Mwingira, Upendo; Mandalakas, Anna M; Manji, Karim; Tanner, Marcel; Utzinger, Jürg; Fenner, Lukas (2017). Schistosoma, other helminth infections, and associated risk factors in preschool-aged children in urban Tanzania. PLoS neglected tropical diseases, 11(11), e0006017. Public Library of Science 10.1371/journal.pntd.0006017

Preview

Text Said PLoSNeglTropDis 2017.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview

BACKGROUND

Despite the high prevalence of helminth infections among preschool-aged children, control programs in sub-Saharan countries primarily focus on school-aged populations. We assessed the prevalence of helminth infections and determined risk factors for infection among preschool-aged children in the urban setting of Dar es Salaam, Tanzania.

METHODOLOGY

Starting in October 2015, we conducted a 12-month prospective study among tuberculosis (TB)-exposed children under the age of 5 years and unexposed controls from neighboring households. At the time of recruitment, we collected medical histories, assessed development and cognitive functions, and performed medical examinations. We performed full blood cell counts and screened for HIV and malaria. Point-of-care circulating cathodic antigen (POC-CCA), urine filtration, Kato-Katz, FLOTAC, and Baermann tests were employed to detect helminth infections in urine and stool. Helminth infections were stratified for Schistosoma and other helminths to identify risk factors, using logistic regression.

PRINCIPAL FINDINGS

We included 310 children with a median age of 26 months (inter quartile range 17-42 months) in the study. Among these, 189 were TB-exposed and 121 TB-unexposed. Two thirds of the children were anemic (hemoglobin level <11 g/dl) and the HIV prevalence was 1.3%. Schistosoma spp. was the predominant helminth species (15.8%; 95% confidence interval [CI] 12.1-20.3%). Other helminth infections were less frequent (9.0%, 95% CI 6.3-12.8%). Poor hygiene, use of household water sources, and TB-exposure were not associated with helminth infection. Development and cognitive scores did not significantly differ in helminth-infected and uninfected peers, but hemoglobin levels were significantly lower in helminth-infected children (10.1 g/dl vs. 10.4 g/dl, p = 0.027).

CONCLUSIONS/SIGNIFICANCE

In Dar es Salaam, a city with more than 4 million inhabitants, the prevalence of Schistosoma spp. infection among preschool-aged children was unexpectedly high. Setting-specific interventions that target preschool-aged children and urban settlements should be considered to reduce the transmission of Schistosoma and other helminth infections and to improve children's health.

Interest & Impact

Downloads

175 since deposited on 09 Jan 2018
16 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item