Background Urogenital schistosomiasis is endemic in Mali and is a major cause of serious morbidity in large parts of the world.This disease is responsible for many socio-economic and public health issues.The aim of th...Background Urogenital schistosomiasis is endemic in Mali and is a major cause of serious morbidity in large parts of the world.This disease is responsible for many socio-economic and public health issues.The aim of this study was to investigate the impact of the disease on morbidity and to describe demographic and socioeconomic factors in relation to the status of children with urogenital schistosomiasis in Mali.Methods We conducted a cross-sectional study in November 2021 of 971 children aged 6 to 14 years selected at random from six schools in three districts in the Kayes Region of Mali.Demographic and socioeconomic data were collected on survey forms.Clinical data were collected following a medical consultation.Hematuria was systematically searched for through the use of strips.The search for Schistosoma haematobium eggs in urine was done via the filtration method.The urinary tract was examined by ultrasound.Associations between each of these variables and disease infection were tested using multivariate logistic regression.Results The overall prevalence of urinary schistosomiasis detected was 50.2%.The average intensity of infection was 36 eggs/10 ml of urine.The associated risk factors for urogenital schistosomiasis showed that children who bathed,used the river/pond as a domestic water source,and who habitually urinated in the river/pond were more affected(P<0.05).Children with farming parents were most affected(P=0.032).The collection of clinical signs revealed that boys had more pollakiuria(58.6%)and dysuria(46.4%)than girls.Ultrasound data showed that focal lesion rates were recorded in all villages with the lowest rate in Diakalel(56.1%).Ultrasound and parasitological findings showed that irregularity and thickening were strongly associated with urinary schistosomiasis(P<0.0001).Conclusions Schistosoma haematobium infection was still endemic in the study site despite more than a decade of mass treatment with praziquantel.However,the high percentage of symptoms associated with high intensity reinforces the idea that further studies in terms of schistosomiasis-related morbidity are still needed.展开更多
Background Mali is known to be a schistosomiasis-endemic country with a limited supply of clean water.This has forced many communities to rely on open freshwater bodies for many human-water contact(HWC)activities.Howe...Background Mali is known to be a schistosomiasis-endemic country with a limited supply of clean water.This has forced many communities to rely on open freshwater bodies for many human-water contact(HWC)activities.However,the relationship between contact with these water systems and the level of schistosome infection is cur-rently receiving limited attention.This study assessed human-water interactions including cercarial emergence pat-tern and their influences on urinary schistosomiasis transmission in two communities in the Kayes district of Mali.Methods We carried out a parasitological study frst in children in September 2021,then a cross-sectional study of quantitative observations of human-water contact activities in the population,and finally a study of snail infectiv-ity at contact points in September 2022.The study took place in two communities,Fangoune Bamanan and Diakalel in the Kayes region of western Mali.The chronobiological study focused on cercarial release from naturally infected snails.Released cercariae were molecularly genotyped by targeting the cox1 region,and the ITS and 18S ribosmal DNA gene(18S rDNA)regions of the DNA.Links between sociodemographic parameters,human water-contact points and hematuria were established using multivariate statistical analysis or the logistic regression model.Results The main factor predisposing the 97 participants to water contact was domestic activity(62.9%).Of the 378 snails collected at 14 sampling sites,27(7.1%)excreted schistosome cercariae,with 15.0%(19/126)at Fangoune Bamanan and 3.3%(8/252)at Diakalel.The release of Schistosoma cercariae shows three different patterns in Fangoune Bamanan:(i)an early release peak(6:00-8:00 AM),(i)a mid-day release peak(10:00 AM-12:00 PM)and(ili)a double peak:(6:00-8:00 AM)and(6:00-8:00 PM)cercariae release;and two release patterns in Diakalel:early release(6:00-8:00 AM)and(il)mid-day release(12:00-2:00 PM).All cercariae released during early diurnal(6:00-8:00 AM)or nocturnal emission patterns(6:00-8:00 PM)were hybrids parasite having an cox1 S.bovis or S.curassoni associ-ated with an ITS and 18S rDNA of S.haematobium while the cercariae released during diurnal,or mid-day patterns(8:00AM-6:00PM)werepure S.haematobium.Conclusions Our study showed that domestic activity is the main source of exposure in the Kayes region.Two and three cercariae emission patterns were observed at Diakalel and Fangoune Bamanan respectively.These results suggest that the parasite adapts to the human-water contact period in order to increase its infectivity.展开更多
文摘Background Urogenital schistosomiasis is endemic in Mali and is a major cause of serious morbidity in large parts of the world.This disease is responsible for many socio-economic and public health issues.The aim of this study was to investigate the impact of the disease on morbidity and to describe demographic and socioeconomic factors in relation to the status of children with urogenital schistosomiasis in Mali.Methods We conducted a cross-sectional study in November 2021 of 971 children aged 6 to 14 years selected at random from six schools in three districts in the Kayes Region of Mali.Demographic and socioeconomic data were collected on survey forms.Clinical data were collected following a medical consultation.Hematuria was systematically searched for through the use of strips.The search for Schistosoma haematobium eggs in urine was done via the filtration method.The urinary tract was examined by ultrasound.Associations between each of these variables and disease infection were tested using multivariate logistic regression.Results The overall prevalence of urinary schistosomiasis detected was 50.2%.The average intensity of infection was 36 eggs/10 ml of urine.The associated risk factors for urogenital schistosomiasis showed that children who bathed,used the river/pond as a domestic water source,and who habitually urinated in the river/pond were more affected(P<0.05).Children with farming parents were most affected(P=0.032).The collection of clinical signs revealed that boys had more pollakiuria(58.6%)and dysuria(46.4%)than girls.Ultrasound data showed that focal lesion rates were recorded in all villages with the lowest rate in Diakalel(56.1%).Ultrasound and parasitological findings showed that irregularity and thickening were strongly associated with urinary schistosomiasis(P<0.0001).Conclusions Schistosoma haematobium infection was still endemic in the study site despite more than a decade of mass treatment with praziquantel.However,the high percentage of symptoms associated with high intensity reinforces the idea that further studies in terms of schistosomiasis-related morbidity are still needed.
文摘Background Mali is known to be a schistosomiasis-endemic country with a limited supply of clean water.This has forced many communities to rely on open freshwater bodies for many human-water contact(HWC)activities.However,the relationship between contact with these water systems and the level of schistosome infection is cur-rently receiving limited attention.This study assessed human-water interactions including cercarial emergence pat-tern and their influences on urinary schistosomiasis transmission in two communities in the Kayes district of Mali.Methods We carried out a parasitological study frst in children in September 2021,then a cross-sectional study of quantitative observations of human-water contact activities in the population,and finally a study of snail infectiv-ity at contact points in September 2022.The study took place in two communities,Fangoune Bamanan and Diakalel in the Kayes region of western Mali.The chronobiological study focused on cercarial release from naturally infected snails.Released cercariae were molecularly genotyped by targeting the cox1 region,and the ITS and 18S ribosmal DNA gene(18S rDNA)regions of the DNA.Links between sociodemographic parameters,human water-contact points and hematuria were established using multivariate statistical analysis or the logistic regression model.Results The main factor predisposing the 97 participants to water contact was domestic activity(62.9%).Of the 378 snails collected at 14 sampling sites,27(7.1%)excreted schistosome cercariae,with 15.0%(19/126)at Fangoune Bamanan and 3.3%(8/252)at Diakalel.The release of Schistosoma cercariae shows three different patterns in Fangoune Bamanan:(i)an early release peak(6:00-8:00 AM),(i)a mid-day release peak(10:00 AM-12:00 PM)and(ili)a double peak:(6:00-8:00 AM)and(6:00-8:00 PM)cercariae release;and two release patterns in Diakalel:early release(6:00-8:00 AM)and(il)mid-day release(12:00-2:00 PM).All cercariae released during early diurnal(6:00-8:00 AM)or nocturnal emission patterns(6:00-8:00 PM)were hybrids parasite having an cox1 S.bovis or S.curassoni associ-ated with an ITS and 18S rDNA of S.haematobium while the cercariae released during diurnal,or mid-day patterns(8:00AM-6:00PM)werepure S.haematobium.Conclusions Our study showed that domestic activity is the main source of exposure in the Kayes region.Two and three cercariae emission patterns were observed at Diakalel and Fangoune Bamanan respectively.These results suggest that the parasite adapts to the human-water contact period in order to increase its infectivity.
