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Effectiveness of Four Different Interventions Against Schistosoma haematobium in a Seasonal Transmission Setting of Côte d’Ivoire: A Cluster Randomized Trial

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Názov: Effectiveness of Four Different Interventions Against Schistosoma haematobium in a Seasonal Transmission Setting of Côte d’Ivoire: A Cluster Randomized Trial
Autori: Rufin K. Assaré, Négnorogo Guindo-Coulibaly, Jean T. Coulibaly, Yves-Nathan T. Tian-Bi, Nana R. Diakité, Jan Hattendorf, Fidèle K. Bassa, Cyrille K. Konan, Patrick K. Yao, Mamadou Ouattara, Jürg Utzinger, Naférima Koné, Eliézer K. N’Goran
Zdroj: Clin Infect Dis
Informácie o vydavateľovi: Oxford University Press (OUP), 2021.
Rok vydania: 2021
Predmety: Immunology, Praziquantel, Global Impact of Helminth Infections and Control Strategies, Schistosomiasis haematobia, Ecological Interactions of Parasites in Ecosystems, 03 medical and health sciences, Engineering, 0302 clinical medicine, Sociology, Helminths, Health Sciences, Prevalence, Animals, Humans, Schistosomiasis, Child, Internal medicine, Global Maternal and Child Health Outcomes, Regimen, Demography, Immunology and Microbiology, Ecology, FOS: Clinical medicine, Confidence interval, Life Sciences, Odds ratio, Transmission (telecommunications), FOS: Sociology, 3. Good health, Major Articles and Commentaries, Cote d'Ivoire, Randomized controlled trial, FOS: Biological sciences, Electrical engineering, Environmental Science, Physical Sciences, Pediatrics, Perinatology and Child Health, Schistosoma haematobium, Medicine, Parasitology, Seasons
Popis: Background Annual mass drug administration (MDA) using praziquantel is the cornerstone of schistosomiasis morbidity control but is not sufficient to interrupt transmission. We implemented a cluster-randomized trial to compare the effectiveness of 4 different intervention packages to interrupt transmission of Schistosoma haematobium in a seasonal transmission setting of Côte d’Ivoire. Methods Sixty-four localities with a S. haematobium prevalence in school children aged 13–14 years above 4% were randomly assigned to 1 of 4 intervention arms over a 3-year period: (1) the current standard strategy consisting of annual MDA before peak of transmission, (2) annual MDA after peak of transmission, (3) biannual MDA, and (4) standard MDA combined with snail control. The primary outcome was prevalence and intensity of S. haematobium infection in children aged 9–12 years 1 year after the final intervention, using urine filtration performed by experienced microscopists. Results By study end, we observed the lowest S. haematobium prevalence in the biannual MDA, compared to the standard treatment arm (0.6% vs 7.5%; odds ratio [OR] = 0.07, 95% confidence interval [CI] = .02 to .24). The prevalence in arms 2 and 4 was about 3.5%, which was not statistically significantly different from the standard strategy (both ORs 0.4, 95% CI = .1 to ~1.8). New cases of infection were still observed in all arms at study end. Conclusions Biannual MDA was the only regimen that outperformed the standard treatment. All strategies resulted in decreased prevalence of infection; however, none of them was able to interrupt transmission of S. haematobium within a 3-year period. Clinical Trials Registration ISRCTN10926858.
Druh dokumentu: Article
Other literature type
Popis súboru: application/pdf
Jazyk: English
ISSN: 1537-6591
1058-4838
DOI: 10.1093/cid/ciab787
DOI: 10.60692/0fcs2-4vk90
DOI: 10.60692/rj7p8-3r664
DOI: 10.5451/unibas-ep90733
DOI: 10.5451/unibas-ep90734
Prístupová URL adresa: https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciab787/40861758/ciab787.pdf
https://pubmed.ncbi.nlm.nih.gov/34519344
http://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciab787/40861758/ciab787.pdf
https://www.ncbi.nlm.nih.gov/pubmed/34519344
https://edoc.unibas.ch/90734/
https://edoc.unibas.ch/90733/
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Prístupové číslo: edsair.doi.dedup.....8d24aa107647f739d0bdac5dc1c21de9
Databáza: OpenAIRE
Popis
Abstrakt:Background Annual mass drug administration (MDA) using praziquantel is the cornerstone of schistosomiasis morbidity control but is not sufficient to interrupt transmission. We implemented a cluster-randomized trial to compare the effectiveness of 4 different intervention packages to interrupt transmission of Schistosoma haematobium in a seasonal transmission setting of Côte d’Ivoire. Methods Sixty-four localities with a S. haematobium prevalence in school children aged 13–14 years above 4% were randomly assigned to 1 of 4 intervention arms over a 3-year period: (1) the current standard strategy consisting of annual MDA before peak of transmission, (2) annual MDA after peak of transmission, (3) biannual MDA, and (4) standard MDA combined with snail control. The primary outcome was prevalence and intensity of S. haematobium infection in children aged 9–12 years 1 year after the final intervention, using urine filtration performed by experienced microscopists. Results By study end, we observed the lowest S. haematobium prevalence in the biannual MDA, compared to the standard treatment arm (0.6% vs 7.5%; odds ratio [OR] = 0.07, 95% confidence interval [CI] = .02 to .24). The prevalence in arms 2 and 4 was about 3.5%, which was not statistically significantly different from the standard strategy (both ORs 0.4, 95% CI = .1 to ~1.8). New cases of infection were still observed in all arms at study end. Conclusions Biannual MDA was the only regimen that outperformed the standard treatment. All strategies resulted in decreased prevalence of infection; however, none of them was able to interrupt transmission of S. haematobium within a 3-year period. Clinical Trials Registration ISRCTN10926858.
ISSN:15376591
10584838
DOI:10.1093/cid/ciab787