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Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach.
BMC Public Health. 2012 Oct 30; 12:930.BP

Abstract

BACKGROUND

Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. Importantly, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3-5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the outcomes and impact measured in a randomized intervention trial.

METHODS/DESIGN

In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9-12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by standardized questionnaire-interviews with community leaders. Additional issues potentially impacting on study outcomes and all incurring costs will be recordedand monitored longitudinally.

DISCUSSION

Elimination of schistosomiasis has become a priority on the agenda of the Zanzibar government and the international community. Our study will contribute to identifying what, in addition to preventive chemotherapy, needs to be done to prevent, control, and ultimately eliminate schistosomiasis, and to draw lessons for current and future schistosomiasis elimination programmes in Africa and elsewhere.

TRIAL REGISTRATION

ISRCTN48837681.

Authors+Show Affiliations

Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23110494

Citation

Knopp, Stefanie, et al. "Study and Implementation of Urogenital Schistosomiasis Elimination in Zanzibar (Unguja and Pemba Islands) Using an Integrated Multidisciplinary Approach." BMC Public Health, vol. 12, 2012, p. 930.
Knopp S, Mohammed KA, Ali SM, et al. Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach. BMC Public Health. 2012;12:930.
Knopp, S., Mohammed, K. A., Ali, S. M., Khamis, I. S., Ame, S. M., Albonico, M., Gouvras, A., Fenwick, A., Savioli, L., Colley, D. G., Utzinger, J., Person, B., & Rollinson, D. (2012). Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach. BMC Public Health, 12, 930. https://doi.org/10.1186/1471-2458-12-930
Knopp S, et al. Study and Implementation of Urogenital Schistosomiasis Elimination in Zanzibar (Unguja and Pemba Islands) Using an Integrated Multidisciplinary Approach. BMC Public Health. 2012 Oct 30;12:930. PubMed PMID: 23110494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach. AU - Knopp,Stefanie, AU - Mohammed,Khalfan A, AU - Ali,Said M, AU - Khamis,I Simba, AU - Ame,Shaali M, AU - Albonico,Marco, AU - Gouvras,Anouk, AU - Fenwick,Alan, AU - Savioli,Lorenzo, AU - Colley,Daniel G, AU - Utzinger,Jürg, AU - Person,Bobbie, AU - Rollinson,David, Y1 - 2012/10/30/ PY - 2012/08/24/received PY - 2012/10/11/accepted PY - 2012/11/1/entrez PY - 2012/11/1/pubmed PY - 2014/7/6/medline SP - 930 EP - 930 JF - BMC public health JO - BMC Public Health VL - 12 N2 - BACKGROUND: Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. Importantly, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3-5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the outcomes and impact measured in a randomized intervention trial. METHODS/DESIGN: In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9-12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by standardized questionnaire-interviews with community leaders. Additional issues potentially impacting on study outcomes and all incurring costs will be recordedand monitored longitudinally. DISCUSSION: Elimination of schistosomiasis has become a priority on the agenda of the Zanzibar government and the international community. Our study will contribute to identifying what, in addition to preventive chemotherapy, needs to be done to prevent, control, and ultimately eliminate schistosomiasis, and to draw lessons for current and future schistosomiasis elimination programmes in Africa and elsewhere. TRIAL REGISTRATION: ISRCTN48837681. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/23110494/Study_and_implementation_of_urogenital_schistosomiasis_elimination_in_Zanzibar__Unguja_and_Pemba_islands__using_an_integrated_multidisciplinary_approach_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-930 DB - PRIME DP - Unbound Medicine ER -