Korean J Parasitol.  2020 Aug;58(4):421-430. 10.3347/kjp.2020.58.4.421.

Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

Affiliations
  • 1Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang 37554, Korea
  • 2Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, Seoul 03080, Korea
  • 3Korea Association of Health Promotion, Seoul 07653, Korea
  • 4Clinical Trial Center, Chungnam National University Hospital, Daejeon 35015, Korea
  • 5Ministry of Health, White Nile State, Kosti, Sudan
  • 6Communicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum, Sudan
  • 7Research and Grants Unit, Ahfad University for Women, Omdurman, Khartoum, Sudan
  • 8Department of Infection Biology and Department of Medical Science, Chungnam National University College of Medicine, Daejeon 35015, Korea

Abstract

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

Keyword

; prevalence; infection intensity; mass drug administration; Sudan
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