Impacts of host gender on Schistosoma mansoni risk in rural Uganda—a mixed-methods approach

Trienekens, S. C.M., Faust, C. L. , Meginnis, K. , Pickering, L. , Ericsson, O., Nankasi, A., Moses, A., Tukahebwa, E. M. and Lamberton, P. H.L. (2020) Impacts of host gender on Schistosoma mansoni risk in rural Uganda—a mixed-methods approach. PLoS Neglected Tropical Diseases, 14(5), e0008266. (doi: 10.1371/journal.pntd.0008266) (PMID:32401770) (PMCID:PMC7219705)

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Abstract

Background: The World Health Organization identified Uganda as one of the 10 highly endemic countries for schistosomiasis. Annual mass drug administration (MDA) with praziquantel has led to a decline in intensity of Schistosoma mansoni infections in several areas. However, as hotspots with high (re)infection rates remain, additional research on risk factors and implementing interventions to complement MDA are required to further reduce disease burden in these settings. Through a mixed-methods study we aimed to gain deeper understanding of how gender may impact risk and reinfection in order to inform disease control programmes and ascertain if gender-specific interventions may be beneficial. Methodology/Principal findings: In Bugoto, Mayuge District, Eastern Uganda we conducted ethnographic observations (n = 16) and examined epidemiology (n = 55) and parasite population genetics (n = 16) in school-aged children (SAC), alongside a community-wide household survey (n = 130). Water contact was frequent at home, school and in the community and was of domestic, personal care, recreational, religious or commercial nature. Qualitative analysis of type of activity, duration, frequency, level of submersion and water contact sites in children showed only few behavioural differences in water contact between genders. However, survey data revealed that adult women carried out the vast majority of household tasks involving water contact. Reinfection rates (96% overall) and genetic diversity were high in boys (pre-He = 0.66; post-He = 0.67) and girls (pre-He = 0.65; post-He = 0.67), but no differences in reinfection rates (p = 0.62) or genetic diversity by gender before (p = 0.54) or after (p = 0.97) treatment were found. Conclusions/Significance: This mixed methods approach showed complementary findings. Frequent water exposure with few differences between boys and girls was mirrored by high reinfection rates and genetic diversity in both genders. Disease control programmes should consider the high reinfection rates among SAC in remaining hotspots of schistosomiasis and the various purposes and settings in which children and adults are exposed to water.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Faust, Christina and Lamberton, Dr Poppy and Trienekens, Suzan and Meginnis, Dr Keila and Pickering, Dr Lucy
Creator Roles:
Trienekens, S. C.M.Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Visualization, Writing – original draft, Writing – review and editing
Faust, C. L.Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Supervision, Visualization, Writing – original draft, Writing – review and editing
Meginnis, K.Conceptualization, Data curation, Investigation, Methodology, Project administration, Supervision, Writing – original draft, Writing – review and editing
Pickering, L.Conceptualization, Funding acquisition, Project administration, Supervision, Writing – review and editing
Lamberton, P. H.L.Conceptualization, Data curation, Funding acquisition, Investigation, Project administration, Supervision, Writing – review and editing
Authors: Trienekens, S. C.M., Faust, C. L., Meginnis, K., Pickering, L., Ericsson, O., Nankasi, A., Moses, A., Tukahebwa, E. M., and Lamberton, P. H.L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Copyright Holders:Copyright © 2020 Trienekens et al.
First Published:First published in PLoS Medicine 14(5): e0008266
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.5525/gla.researchdata.1009

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174071Cultural, social and economic influences on ongoing schistosomiasis transmission, despite a decade of mass treatment, and the potential for changePoppy LambertonMedical Research Council (MRC)MR/P025447/1Institute of Biodiversity, Animal Health and Comparative Medicine