Background:Among parasitic infections,schistosomiasis ranks second after malaria in terms of worldwide morbidity.Despite efforts to contain transmission,more than 230 million people are infected,of which 85%live in Su...Background:Among parasitic infections,schistosomiasis ranks second after malaria in terms of worldwide morbidity.Despite efforts to contain transmission,more than 230 million people are infected,of which 85%live in Sub-Saharan Africa.While the epidemiologic characteristics of schistosomiasis have been extensively studied across endemic settings,social factors have been paid less attention.The current study assesses community knowledge of schistosomiasis causes,transmission,signs,symptoms and prevention,as well as healthcare-seeking behaviours in two West African settings,with the aim of strengthening schistosomiasis control interventions.Methods:From August 2014 to June 2015,we conducted two cross-sectional surveys in Korhogo,Cote d’Ivoire and Kaedi,Mauritania.We applied a questionnaire to collect quantitative data at the household level in Korhogo(n=1456)and Kaedi(n=1453).Focus group discussions(Korhogo:n=32,Kaedi:n=32)and participatory photography(photovoice)(Korhogo:n=16,Kaedi:n=16)were conducted within the communities to gather qualitative data.In addition,semi-structured interviews were used to discuss with key informants from control programmes,nongovernmental organizations and health districts(Korhogo:n=8,Kaedi:n=7).Results:The study demonstrated that schistosomiasis is not well known by the communities;64.1%claimed to know the causes of the disease,but the reality is different.This knowledge is more from cultural than biomedical source.It was observed that social construction of the disease is different from the biomedical definition.In Korhogo,schistosomiasis was often associated with several other diseases,notably stomach ulcer and gonorrhoea.The populations believe that schistosomiasis is caused by exposure to goat or dog urine in the environment.In Kaedi,schistosomiasis is considered as a disease transmitted by environmenal elements such as sunshine and dirty water.In both settings,the care-seeking pathways were found to be strongly influenced by local customs and self-medication acquired from the informal sector.Conclusions:This study revealed that knowledge about the aetiology,transmission,symptoms,prevention and treatment of schistosomiasis among the populations in Korhogo and Kaedi is based on their local culture.Deep-rooted habits could therefore pose a significant obstacle to the elimination of schistosomiasis.展开更多
countries in West Africa remain a hotspot for malaria with all age groups at risk.Asymptomatic carriers of Plasmodium spp.are important sources of infections for malaria vectors and thus contribute to the anchoring of...countries in West Africa remain a hotspot for malaria with all age groups at risk.Asymptomatic carriers of Plasmodium spp.are important sources of infections for malaria vectors and thus contribute to the anchoring of the disease in favourable eco-epidemiological settings.The objective of this study was to assess the asymptomatic malaria case rates in Korhogo and Kaedi,two urban areas in northern Côte d’Ivoire and southern Mauritania,respectively.Methods:Cross-sectional surveys were carried out during the rainy season in 2014 and the dry season in 2015 in both settings.During each season,728 households were randomly selected and a household-based questionnaire was implemented to collect demographic and epidemiological data,including of malaria preventive methods used in communities.Finger-prick blood samples were obtained for biological examination using microscopy and rapid diagnostic tests(RDTs).Results:Overall,2672 households and 15858 consenting participants were surveyed.Plasmodium spp.infection was confirmed in 12.4%(n=832)and 0.3%(n=22)of the assessed individuals in Korhogo and Kaedi,respectively.In Korhogo,the prevalence of asymptomatic malaria was 10.5%(95%CI:9.7-11.2)as determined by microscopy and 9.3%(95%CI:8.6-10.0%)when assessed by RDT.In Kaedi,asymptomatic malaria prevalence was 0.2%(95%CI:0.1-0.4%)according to microscopy,while all RDTs performed were negative(n=8372).In Korhogo,asymptomatic malaria infection was significantly associated with age and season,with higher risk within the 5-14 years-old,and during the rainy season.In Kaedi,the risk of asymptomatic malaria infection was associated with season only(higher during the dry season;crude OR(cOR):6.37,95%CI:1.87-21.63).P.falciparum was the predominant species identified in both study sites representing 99.2%(n=825)in Korhogo and 59.1%(n=13)in Kaedi.Gametocytes were observed only in Korhogo and only during the rainy season at 1.3%(95%CI:0.7-2.4%).Conclusions:Our findings show a low prevalence of clinical malaria episodes with a significant proportion of asymptomatic carriers in both urban areas.National policies for malaria infections are focused on treatment of symptomatic cases.Malaria control strategies should be designed for monitoring and managing malaria infections in asymptomatic carriers.Additional measures,including indoor residual spraying,effective use of long-lasting insecticidal nets is strongly needed to reduce the number of Plasmodium spp.infections in Korhogo and Kaedi.展开更多
基金This project received financial support from the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases(TDR)and the Canadian International Development Research Centre(IDRC)(grant no.NB20283 to Dr.Brama Koné)The funders had no role in the study design,data collection and analyses,decision to publish,or preparation of the paper.
文摘Background:Among parasitic infections,schistosomiasis ranks second after malaria in terms of worldwide morbidity.Despite efforts to contain transmission,more than 230 million people are infected,of which 85%live in Sub-Saharan Africa.While the epidemiologic characteristics of schistosomiasis have been extensively studied across endemic settings,social factors have been paid less attention.The current study assesses community knowledge of schistosomiasis causes,transmission,signs,symptoms and prevention,as well as healthcare-seeking behaviours in two West African settings,with the aim of strengthening schistosomiasis control interventions.Methods:From August 2014 to June 2015,we conducted two cross-sectional surveys in Korhogo,Cote d’Ivoire and Kaedi,Mauritania.We applied a questionnaire to collect quantitative data at the household level in Korhogo(n=1456)and Kaedi(n=1453).Focus group discussions(Korhogo:n=32,Kaedi:n=32)and participatory photography(photovoice)(Korhogo:n=16,Kaedi:n=16)were conducted within the communities to gather qualitative data.In addition,semi-structured interviews were used to discuss with key informants from control programmes,nongovernmental organizations and health districts(Korhogo:n=8,Kaedi:n=7).Results:The study demonstrated that schistosomiasis is not well known by the communities;64.1%claimed to know the causes of the disease,but the reality is different.This knowledge is more from cultural than biomedical source.It was observed that social construction of the disease is different from the biomedical definition.In Korhogo,schistosomiasis was often associated with several other diseases,notably stomach ulcer and gonorrhoea.The populations believe that schistosomiasis is caused by exposure to goat or dog urine in the environment.In Kaedi,schistosomiasis is considered as a disease transmitted by environmenal elements such as sunshine and dirty water.In both settings,the care-seeking pathways were found to be strongly influenced by local customs and self-medication acquired from the informal sector.Conclusions:This study revealed that knowledge about the aetiology,transmission,symptoms,prevention and treatment of schistosomiasis among the populations in Korhogo and Kaedi is based on their local culture.Deep-rooted habits could therefore pose a significant obstacle to the elimination of schistosomiasis.
基金This project received financial support from the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases(TDR)and the Canadian International Development Research Centre(IDRC)grant no.NB20283(Dr.Kone Brama)The funders had no role in study design,data collection and analyses,decision to publish,or preparation of the manuscript.
文摘countries in West Africa remain a hotspot for malaria with all age groups at risk.Asymptomatic carriers of Plasmodium spp.are important sources of infections for malaria vectors and thus contribute to the anchoring of the disease in favourable eco-epidemiological settings.The objective of this study was to assess the asymptomatic malaria case rates in Korhogo and Kaedi,two urban areas in northern Côte d’Ivoire and southern Mauritania,respectively.Methods:Cross-sectional surveys were carried out during the rainy season in 2014 and the dry season in 2015 in both settings.During each season,728 households were randomly selected and a household-based questionnaire was implemented to collect demographic and epidemiological data,including of malaria preventive methods used in communities.Finger-prick blood samples were obtained for biological examination using microscopy and rapid diagnostic tests(RDTs).Results:Overall,2672 households and 15858 consenting participants were surveyed.Plasmodium spp.infection was confirmed in 12.4%(n=832)and 0.3%(n=22)of the assessed individuals in Korhogo and Kaedi,respectively.In Korhogo,the prevalence of asymptomatic malaria was 10.5%(95%CI:9.7-11.2)as determined by microscopy and 9.3%(95%CI:8.6-10.0%)when assessed by RDT.In Kaedi,asymptomatic malaria prevalence was 0.2%(95%CI:0.1-0.4%)according to microscopy,while all RDTs performed were negative(n=8372).In Korhogo,asymptomatic malaria infection was significantly associated with age and season,with higher risk within the 5-14 years-old,and during the rainy season.In Kaedi,the risk of asymptomatic malaria infection was associated with season only(higher during the dry season;crude OR(cOR):6.37,95%CI:1.87-21.63).P.falciparum was the predominant species identified in both study sites representing 99.2%(n=825)in Korhogo and 59.1%(n=13)in Kaedi.Gametocytes were observed only in Korhogo and only during the rainy season at 1.3%(95%CI:0.7-2.4%).Conclusions:Our findings show a low prevalence of clinical malaria episodes with a significant proportion of asymptomatic carriers in both urban areas.National policies for malaria infections are focused on treatment of symptomatic cases.Malaria control strategies should be designed for monitoring and managing malaria infections in asymptomatic carriers.Additional measures,including indoor residual spraying,effective use of long-lasting insecticidal nets is strongly needed to reduce the number of Plasmodium spp.infections in Korhogo and Kaedi.
