Intestinal schistosomiasis among preschool and school‐aged children in a rural setting near Alexandria: initiative for elimination

• Published in: Tropical medicine & international health 2021-06, Vol.26 (6), p.632-639
• Main Authors: Allam, Amal Farahat, Salem, Aziza, Elsheredy, Amel, Dewair, Musaad Mohammed, Ibrahim, Heba Said, Farag, Hoda Fahmy, Hagras, Nancy Abd‐elkader, Shehab, Amel Youssef
• Format: Article
• Language: English
• Subjects: Animals; Anthelmintics - therapeutic use; Child; Child, Preschool; Children; Egypt; Egypt - epidemiology; Female; Genetic diversity; Genetic variability; Humans; Infant; Intestine; Kato‐Katz; Luminous intensity; Male; Melt temperature; Praziquantel; Praziquantel - therapeutic use; preschool‐aged children; Prevalence; Real-Time Polymerase Chain Reaction; real‐time PCR; Rural Population; Schistosoma mansoni; Schistosoma mansoni - drug effects; Schistosomiasis; Schistosomiasis mansoni - diagnosis; Schistosomiasis mansoni - drug therapy; Schistosomiasis mansoni - prevention & control; school‐aged children; Treatment Outcome
• ISSN: 1360-2276; 1365-3156; 1365-3156
• DOI: 10.1111/tmi.13562

Objective To assess the status of intestinal schistosomiasis among preschool‐aged (PSAC) and school‐aged children (SAC) and to compare the efficacy of praziquantel (PZQ) in both groups. Methods The study was conducted on 400 children; 103 PSAC and 297 SAC. Diagnosis of Schistosoma mansoni was based on triplicate Kato‐Katz thick smears from a single stool sample. To identify the missed cases by Kato‐Katz, 120 randomly selected negative cases (38 PSAC and 82 SAC) were screened by real‐time PCR. All S. mansoni‐positive cases by Kato‐Katz were treated by crushed PZQ tablets. Four weeks after treatment, the cure rate was assessed by Kato‐Katz smears and real‐time PCR. Results The prevalence of S. mansoni with Kato‐Katz was 7.8% among PSAC and 7.4% among SAC. Most of children (63.3%) had light‐intensity infection. The cure rate was 100% among PSAC by both techniques, and 91%, and 77.2% among SAC by Kato‐Katz and real‐time PCR, respectively. In the 120 stool samples screened by real‐time PCR, S. mansoni prevalence was 25%; 15.8% and 29.3% were among PSAC and SAC respectively. Treated cases showed a lower range of Ct values than untreated cases. Two melting temperature ranges (Tm = 83–87°C and 89–93°C) were recognised among uncured cases which may point to S. mansoni genetic variability. Conclusion Continuous monitoring and inclusion of PSAC in schistosomiasis control programmes are crucial. Real‐time PCR and other molecular tools are recommended for evaluation of the true prevalence, assessment of cure and further studies on genetic diversity.