PMID- 27986092
OWN - NLM
STAT- MEDLINE
DCOM- 20171019
LR  - 20181113
IS  - 1756-3305 (Electronic)
IS  - 1756-3305 (Linking)
VI  - 9
IP  - 1
DP  - 2016 Dec 16
TI  - Urogenital schistosomiasis transmission on Unguja Island, Zanzibar: 
      characterisation of persistent hot-spots.
PG  - 646
LID - 646
AB  - BACKGROUND: Elimination of urogenital schistosomiasis transmission is a priority 
      for the Zanzibar Ministry of Health. Preventative chemotherapy together with 
      additional control interventions have successfully alleviated much of the disease 
      burden. However, a persistently high Schistosoma haematobium prevalence is found 
      in certain areas. Our aim was to characterise and evaluate these persistent 
      "hot-spots" of transmission and reinfection in comparison with low-prevalence 
      areas, to support the intervention planning for schistosomiasis elimination in 
      Zanzibar. METHODS: Prevalences of S. haematobium were annually determined by a 
      single urine filtration in schoolchildren from 45 administrative areas (shehias) 
      in Unguja in 2012, 2013 and 2014. Coverage data for biannual treatment with 
      praziquantel were available from ministerial databases and internal surveys. 
      Among the 45 shehias, five hot-spot (>/= 15 % prevalence) and two low-prevalence 
      (</= 5 %) shehias were identified and surveyed in mid-2014. Human-water contact 
      sites (HWCSs) and the presence of S. haematobium-infected and uninfected Bulinus 
      globosus, as well as safe water sources (SWSs) and their reliability in terms of 
      water availability were determined and mapped. RESULTS: We found no major 
      difference in the treatment coverage between persistent hot-spot and 
      low-prevalence shehias. On average, there were considerably more HWCSs containing 
      B. globosus in hot-spot than in low-prevalence shehias (n = 8 vs n = 2) and also 
      more HWCSs containing infected B. globosus (n = 2 vs n = 0). There was no 
      striking difference in the average abundance of SWSs in hot-spot and 
      low-prevalence shehias (n = 45 vs n = 38) and also no difference when considering 
      SWSs with a constant water supply (average: 62 % vs 62 %). The average number of 
      taps with a constant water supply, however, was lower in hot-spot shehias (n = 7 
      vs n = 14). Average distances from schools to the nearest HWCS were considerably 
      shorter in hot-spot shehias (n = 229 m vs n = 722 m). CONCLUSION: The number of 
      HWCSs, their infestation with B. globosus and their distance to schools seem to 
      play a major role for a persistently high S. haematobium prevalence in children. 
      In addition to treatment, increasing access to reliably working taps, targeted 
      snail control at HWCSs near schools and enhanced behaviour change measures are 
      needed to reduce prevalences in hot-spot areas and to finally reach elimination. 
      TRIAL REGISTRATION: ISRCTN48837681 .
FAU - Pennance, Tom
AU  - Pennance T
AD  - Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural 
      History Museum, Cromwell Road, London, SW7 5BD, UK.
AD  - Department of Pathology and Pathogen Biology, Centre for Emerging, Endemic and 
      Exotic Diseases, Royal Veterinary College, University of London, Hawkshead Lane, 
      Hatfield, Hertfordshire, AL9 7TA, UK.
FAU - Person, Bobbie
AU  - Person B
AD  - Independent Consultant, Schistosomiasis Consortium for Operational Research and 
      Evaluation, University of Georgia, Athens, GA, USA.
FAU - Muhsin, Mtumweni Ali
AU  - Muhsin MA
AD  - Zanzibar Neglected Tropical Diseases Programme, Ministry of Health, P.O. Box 236, 
      Zanzibar Town, Unguja, United Republic of Tanzania.
FAU - Khamis, Alipo Naim
AU  - Khamis AN
AD  - Zanzibar Neglected Tropical Diseases Programme, Ministry of Health, P.O. Box 236, 
      Zanzibar Town, Unguja, United Republic of Tanzania.
FAU - Muhsin, Juma
AU  - Muhsin J
AD  - Zanzibar Neglected Tropical Diseases Programme, Ministry of Health, P.O. Box 236, 
      Zanzibar Town, Unguja, United Republic of Tanzania.
FAU - Khamis, Iddi Simba
AU  - Khamis IS
AD  - Zanzibar Neglected Tropical Diseases Programme, Ministry of Health, P.O. Box 236, 
      Zanzibar Town, Unguja, United Republic of Tanzania.
FAU - Mohammed, Khalfan Abdallah
AU  - Mohammed KA
AD  - Zanzibar Neglected Tropical Diseases Programme, Ministry of Health, P.O. Box 236, 
      Zanzibar Town, Unguja, United Republic of Tanzania.
FAU - Kabole, Fatma
AU  - Kabole F
AD  - Zanzibar Neglected Tropical Diseases Programme, Ministry of Health, P.O. Box 236, 
      Zanzibar Town, Unguja, United Republic of Tanzania.
FAU - Rollinson, David
AU  - Rollinson D
AD  - Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural 
      History Museum, Cromwell Road, London, SW7 5BD, UK.
FAU - Knopp, Stefanie
AU  - Knopp S
AD  - Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural 
      History Museum, Cromwell Road, London, SW7 5BD, UK. s.knopp@unibas.ch.
AD  - Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, 
      Basel, Switzerland. s.knopp@unibas.ch.
AD  - University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland. 
      s.knopp@unibas.ch.
LA  - eng
SI  - ISRCTN/ISRCTN48837681
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20161216
PL  - England
TA  - Parasit Vectors
JT  - Parasites & vectors
JID - 101462774
RN  - 0 (Anthelmintics)
RN  - 0 (Drinking Water)
RN  - 6490C9U457 (Praziquantel)
SB  - IM
MH  - Animals
MH  - Anthelmintics/therapeutic use
MH  - Child
MH  - Disease Eradication/methods
MH  - Drinking Water/parasitology
MH  - Female
MH  - Humans
MH  - Infection Control/methods
MH  - Male
MH  - Praziquantel/therapeutic use
MH  - *Prevalence
MH  - Schistosoma haematobium/*isolation & purification
MH  - Schistosomiasis haematobia/*epidemiology/parasitology/*transmission
MH  - Schools
MH  - Snails/*parasitology
MH  - Surveys and Questionnaires
MH  - Tanzania/epidemiology
MH  - Urine/parasitology
PMC - PMC5162088
OTO - NOTNLM
OT  - Bulinus globosus
OT  - Cercariae
OT  - Control
OT  - Elimination
OT  - Hot-spot
OT  - Safe water
OT  - Schistosoma haematobium
OT  - Snail
OT  - Urogenital schistosomiasis
OT  - Zanzibar
EDAT- 2016/12/18 06:00
MHDA- 2017/10/20 06:00
PMCR- 2016/12/16
CRDT- 2016/12/18 06:00
PHST- 2016/08/15 00:00 [received]
PHST- 2016/10/12 00:00 [accepted]
PHST- 2016/12/18 06:00 [entrez]
PHST- 2016/12/18 06:00 [pubmed]
PHST- 2017/10/20 06:00 [medline]
PHST- 2016/12/16 00:00 [pmc-release]
AID - 10.1186/s13071-016-1847-0 [pii]
AID - 1847 [pii]
AID - 10.1186/s13071-016-1847-0 [doi]
PST - epublish
SO  - Parasit Vectors. 2016 Dec 16;9(1):646. doi: 10.1186/s13071-016-1847-0.