Can direct smear results that are routinely collected at health centre level be used for monitoring the impact of mass drug administration with praziquantel on schistosomiasis in Burundi? A preliminary assessment
Open Access
- 21 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Parasites & Vectors
- Vol. 13 (1), 1-7
- https://doi.org/10.1186/s13071-020-04076-4
Abstract
Background Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel has been rolled out in 11 endemic districts. The national programme relies on school-based surveys with kato-katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used. MethodsFrom the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts during 2011-2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n = 11) were compared with those without (n = 34). In addition, prevalence data on intestinal schistosomiasis based on kato-katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts. ResultsIn the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (beta(2014) = -0.826, P = 0.010) and 2015 (beta(2015) = -1.294, P < 0.001) and for the five-year period (beta = -0.286, P < 0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (beta = -0.087, P = 0.219). In most of the 45 sanitary districts, the low prevalence based on kato-katz in school children was confirmed by low incidence rates based on direct smears in the health centres. Conclusions National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the point-of-care circulating cathodic antigen assay are desirable.Other Versions
Funding Information
- Schistosomiasis Control Initiative
- VLIR-UOS
This publication has 20 references indexed in Scilit:
- Sensitivity and Specificity of Multiple Kato-Katz Thick Smears and a Circulating Cathodic Antigen Test for Schistosoma mansoni Diagnosis Pre- and Post-repeated-Praziquantel TreatmentPLoS Neglected Tropical Diseases, 2014
- Evaluation of circulating cathodic antigen (CCA) urine-cassette assay as a survey tool for Schistosoma mansoni in different transmission settings within Bugiri District, UgandaActa Tropica, 2014
- Control of Neglected Tropical Diseases in Burundi: Partnerships, Achievements, Challenges, and Lessons Learned after Four Years of Programme ImplementationPLoS Neglected Tropical Diseases, 2014
- Time to set the agenda for schistosomiasis eliminationActa Tropica, 2013
- The Urine Circulating Cathodic Antigen (CCA) Dipstick: A Valid Substitute for Microscopy for Mapping and Point-Of-Care Diagnosis of Intestinal SchistosomiasisPLoS Neglected Tropical Diseases, 2013
- Bayesian spatial analysis of a national urinary schistosomiasis questionnaire to assist geographic targeting of schistosomiasis control in Tanzania, East AfricaInternational Journal for Parasitology, 2008
- A Bayesian approach to estimate the age-specific prevalence of Schistosoma mansoni and implications for schistosomiasis controlInternational Journal for Parasitology, 2007
- Human schistosomiasisThe Lancet, 2006
- Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at riskThe Lancet Infectious Diseases, 2006
- Regression analyses of counts and rates: Poisson, overdispersed Poisson, and negative binomial models.Psychological Bulletin, 1995