@article{95512,
  keywords = {Public Health, Environmental and Occupational Health, Infectious Diseases},
  author = {Wiegand RE and Secor WE and Fleming FM and French M and King C and Deol AK and Montgomery SP and Evans D and Utzinger J and Vounatsou P and de Vlas SJ},
  editor = {Rinaldi G},
  title = {Associations between infection intensity categories and morbidity prevalence in school-age children are much stronger for Schistosoma haematobium than for S. mansoni},
  abstract = {<jats:sec id="sec001">
<jats:title>Background</jats:title>
<jats:p>World Health Organization (WHO) guidelines for measuring global progress in schistosomiasis control classify individuals with <jats:italic>Schistosoma</jats:italic> spp. infections based on the concentration of excreted eggs. We assessed the associations between WHO infection intensity categories and morbidity prevalence for selected <jats:italic>S</jats:italic>. <jats:italic>haematobium</jats:italic> and <jats:italic>S</jats:italic>. <jats:italic>mansoni</jats:italic> morbidities in school-age children.</jats:p>
</jats:sec>
<jats:sec id="sec002">
<jats:title>Methodology</jats:title>
<jats:p>A total of 22,488 children aged 6–15 years from monitoring and evaluation cohorts in Burkina Faso, Mali, Niger, Uganda, Tanzania, and Zambia from 2003–2008 were analyzed using Bayesian logistic regression. Models were utilized to evaluate associations between intensity categories and the prevalence of any urinary bladder lesion, any upper urinary tract lesion, microhematuria, and pain while urinating (for <jats:italic>S</jats:italic>. <jats:italic>haematobium</jats:italic>) and irregular hepatic ultrasound image pattern (C-F), enlarged portal vein, laboratory-confirmed diarrhea, and self-reported diarrhea (for <jats:italic>S</jats:italic>. <jats:italic>mansoni</jats:italic>) across participants with infection and morbidity data.</jats:p>
</jats:sec>
<jats:sec id="sec003">
<jats:title>Principal findings</jats:title>
<jats:p><jats:italic>S</jats:italic>. <jats:italic>haematobium</jats:italic> infection intensity categories possessed consistent morbidity prevalence across surveys for multiple morbidities and participants with light infections had elevated morbidity levels, compared to negative participants. Conversely, <jats:italic>S</jats:italic>. <jats:italic>mansoni</jats:italic> infection intensity categories lacked association with prevalence of the morbidity measures assessed.</jats:p>
</jats:sec>
<jats:sec id="sec004">
<jats:title>Conclusions/significance</jats:title>
<jats:p>Current status infection intensity categories for <jats:italic>S</jats:italic>. <jats:italic>haematobium</jats:italic> were associated with morbidity levels in school-age children, suggesting urogenital schistosomiasis morbidity can be predicted by an individual’s intensity category. Conversely, <jats:italic>S</jats:italic>. <jats:italic>mansoni</jats:italic> infection intensity categories were not consistently indicative of childhood morbidity at baseline or during the first two years of a preventive chemotherapy control program.</jats:p>
</jats:sec>},
  year = {2021},
  journal = {PLOS Neglected Tropical Diseases},
  volume = {15},
  pages = {e0009444},
  publisher = {Public Library of Science (PLoS)},
  issn = {1935-2735},
  url = {https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009444&type=printable},
  doi = {10.1371/journal.pntd.0009444},
  language = {eng},
}