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

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Fenner, Lukas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1935-2727

Publisher:

Public Library of Science

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

09 Jan 2018 12:37

Last Modified:

09 Jan 2018 12:37

Publisher DOI:

10.1371/journal.pntd.0006017

PubMed ID:

29108003

BORIS DOI:

10.7892/boris.107306

URI:

https://boris.unibe.ch/id/eprint/107306

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