Residence time, water contact, and age-driven Schistosoma mansoni infection in hotspot communities in Uganda

Arinaitwe, M., Adriko, M., Kibwika, B., Tukahebwa, E. M., Faust, C. L. and Lamberton, P. H. L. (2021) Residence time, water contact, and age-driven Schistosoma mansoni infection in hotspot communities in Uganda. American Journal of Tropical Medicine and Hygiene, 105(6), pp. 1772-1781. (doi: 10.4269/ajtmh.21-0391) (PMID:34662868) (PMCID:PMC8641335)

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Abstract

Schistosomiasis is the second most important parasitic infection after malaria in terms of its socioeconomic impact and is endemic in 78 countries. It affects more than 240 million people worldwide, with 90% of cases occurring in sub-Saharan Africa. In Uganda, Schistosomamansoni is the most common species, with more than seven million people infected and 17 million living at risk despite mass drug administration (MDA) of praziquantel initiated more than 16 years ago. There has been a shift in the WHO schistosomiasis goals from controlling morbidity to elimination as a public health problem. Understanding the drivers of infection in persistent transmission hotspots despite ongoing control interventions is paramount. We conducted a cross-sectional epidemiological study of 381 individuals in Bugoto community, Mayuge district, Eastern Uganda, along with a structured survey to ascertain drivers of S. mansoni infection. Bugoto has had community-wide MDA since 2004. We detected a S. mansoni prevalence of 52% across the whole community and a prevalence of 71% in school-age children. This qualifies Bugoto as a highly endemic community according to WHO guidelines. Using a multivariate logistic regression, we found that S. mansoni infection was best explained by age group, longer residence times, and any daily contact with lake water. Schistosomamansoni infection remains a large burden across this community. This study identifies opportunities for interventions that reduce lake water contact, expand treatment eligibility to all at risk, and improve MDA coverage for long-term residents in these settings to control schistosomiasis in persistent transmission hotspots.

Item Type:Articles
Additional Information:Fieldwork was funded by PHLL’s European Research Council Starting Grant (680088 SCHISTO_PERSIST). PHLL and EMT are also supported by a Medical Research Council Global Challenges Research Fund (MRC GCRF) Foundation award (MR/P025447/1). PHLL is also supported by Engineering and Physical Sciences Research Council Global Challenges Research Fund (EPSRC GCRF) awards (EP/T003618/1 and EP/R01437X/1).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Faust, Christina and Lamberton, Professor Poppy
Authors: Arinaitwe, M., Adriko, M., Kibwika, B., Tukahebwa, E. M., Faust, C. L., and Lamberton, P. H. L.
College/School:College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
Journal Name:American Journal of Tropical Medicine and Hygiene
Publisher:American Society of Tropical Medicine and Hygiene
ISSN:0002-9637
ISSN (Online):1476-1645
Published Online:18 October 2021
Copyright Holders:Copyright © 2021 by The American Society of Tropical Medicine and Hygiene
First Published:First published in American Journal of Tropical Medicine and Hygiene 105(6): 1772-1781
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
172876SCHISTO-PERSISTPoppy LambertonEuropean Research Council (ERC)680088Institute of Biodiversity, Animal Health and Comparative Medicine
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
306568Mathematical tools to inform sustainable interventions against schistosomiasis infections in UgandaPoppy LambertonEngineering and Physical Sciences Research Council (EPSRC)88608 (EP/T003618/1)HW - Health Economics and Health Technology Assessment
300573Novel low cost diagnostic tools and their impact in AfricaJonathan CooperEngineering and Physical Sciences Research Council (EPSRC)EP/R01437X/1ENG - Biomedical Engineering