M Adriko1, B Tinkitina2, E M Tukahebw2, C J Standley3, J R Stothard4, N B Kabatereine5. 1. Vector Control Division, Ministry of Health, P.O. Box 1661, Plot 15 Bombo Road, Kampala, Uganda; Uganda Institute of Allied Health & Management Science (UIAHMS), School of Medical Entomology and Parasitology, P.O. Box 1661, Kampala, Uganda. Electronic address: adrikomoses@gmail.com. 2. Vector Control Division, Ministry of Health, P.O. Box 1661, Plot 15 Bombo Road, Kampala, Uganda. 3. Ecology & Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA. 4. Parasitology Department, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK. 5. Uganda Institute of Allied Health & Management Science (UIAHMS), School of Medical Entomology and Parasitology, P.O. Box 1661, Kampala, Uganda; Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
Abstract
INTRODUCTION: Lango region is the only known endemic region for urinary and intestinal schistosomiasis in Uganda. Although there has been no significant improvement in sanitation and safe water supply in the region over years, the endemicity and prevalence of Schistosoma haematobium, in particular, have declined, perhaps due to yearly mass treatment campaigns implemented since 2003. METHODS: We report the epidemiology of Urinary and Intestinal schistosomiasis in Lango since 1951-2011 determined through Microscopic examinations for S. mansoni and S. haematobium respectively. A retrospective data review from 195 to 2011 was done to establish the prevalence over the years in the region. We performed Poisson regression analysis to observe trends in epidemiology before and after control was initiated in 2002. In addition, malacological surveys were undertaken in 2007 to assess local transmission potential. FINDINGS: Contrary to earlier records, S. haematobium was low and confined to a few putative foci, with declined in infections from 28.2% in 1951 to 2.48% by 2011. Although this decline can be attributed to control, this was already much lower in 1967 than 1951, long before control interventions began suggesting that environmental changes may have made the habitat less suitable for the transmission of S. haematobium. Compared to the historical records S. mansoni prevalence first increased up immediately before control interventions in 2003, significantly declined (p=<0.001) until 2007. However, in 2007 and 2011 declined insignificant, (p = 0.656). No snail has ever been isolated shedding S. haematobium cercariae but many Bulinus snail spp. were found shedding S. bovis cercariae. CONCLUSION: This suggests that a combination of environmental and mass treatment has had a significant impact on transmission in Lango region.
INTRODUCTION: Lango region is the only known endemic region for urinary and intestinal schistosomiasis in Uganda. Although there has been no significant improvement in sanitation and safe water supply in the region over years, the endemicity and prevalence of Schistosoma haematobium, in particular, have declined, perhaps due to yearly mass treatment campaigns implemented since 2003. METHODS: We report the epidemiology of Urinary and Intestinal schistosomiasis in Lango since 1951-2011 determined through Microscopic examinations for S. mansoni and S. haematobium respectively. A retrospective data review from 195 to 2011 was done to establish the prevalence over the years in the region. We performed Poisson regression analysis to observe trends in epidemiology before and after control was initiated in 2002. In addition, malacological surveys were undertaken in 2007 to assess local transmission potential. FINDINGS: Contrary to earlier records, S. haematobium was low and confined to a few putative foci, with declined in infections from 28.2% in 1951 to 2.48% by 2011. Although this decline can be attributed to control, this was already much lower in 1967 than 1951, long before control interventions began suggesting that environmental changes may have made the habitat less suitable for the transmission of S. haematobium. Compared to the historical records S. mansoni prevalence first increased up immediately before control interventions in 2003, significantly declined (p=<0.001) until 2007. However, in 2007 and 2011 declined insignificant, (p = 0.656). No snail has ever been isolated shedding S. haematobium cercariae but many Bulinus snail spp. were found shedding S. bovis cercariae. CONCLUSION: This suggests that a combination of environmental and mass treatment has had a significant impact on transmission in Lango region.
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