Micro-epidemiology of urinary schistosomiasis in Zanzibar: Local risk factors associated with distribution of infections among schoolchildren and relevance for control.

作者: James W Rudge , J Russell Stothard , María-Gloria Basáñez , Ali F Mgeni , I Simba Khamis

DOI: 10.1016/J.ACTATROPICA.2007.09.006

关键词:

摘要: Although it is well recognised that both behavioural and environmental factors play a role in determining small-scale heterogeneities schistosomiasis transmission, empirical evidence of their relative importance often limited. A study was conducted around Chaani, village northern Unguja (Zanzibar) where urinary endemic, order to shed light upon the micro-epidemiology Schistosoma haematobium patterns infection within schoolchildren intermediate host snail Bulinus globosus, may help adjusting recently implemented control programmes. Malacological surveys were identify transmission foci questionnaires devised assess recalled water-contact 150 who had been screened for S. infection, finding an overall prevalence 50.6%. Boys more frequently heavily infected than girls and, accordingly, mean exposure scores significantly higher boys girls. Univariate statistics revealed significant associations between specific activities, including washing/bathing (odds ratio [OR]=3.01, 95% confidence interval [CI]=1.36-6.67) playing (OR=4.03, CI=1.51-10.70) streams/ponds. In multivariate analysis, however, strongest predictor proximity child's home site harbouring haematobium-infected B. globosus (P<0.001), suggesting geography be better proxy self-reported water contact. Surveillance programmes therefore wish prioritise evaluation risk pinpoint at micro-geographical level, although are also recommended as complementary tool rapidly behaviour children most rural communities Zanzibar. Such knowledge prerequisite focusing improving local level.

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