03586nas a2200301 4500000000100000008004100001260003700042653005700079653002400136100001500160700001300175700001500188700001300203700001100216700001200227700001800239700001200257700001500269700001600284700001500300700001400315245017000329856009900499300001300598490000700611520265200618022001403270 2021 d bPublic Library of Science (PLoS) 10 aPublic Health, Environmental and Occupational Health 10 aInfectious Diseases 1 aWiegand RE 1 aSecor WE 1 aFleming FM 1 aFrench M 1 aKing C 1 aDeol AK 1 aMontgomery SP 1 aEvans D 1 aUtzinger J 1 aVounatsou P 1 ade Vlas SJ 1 aRinaldi G 00 aAssociations between infection intensity categories and morbidity prevalence in school-age children are much stronger for Schistosoma haematobium than for S. mansoni uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009444&type=printable ae0009444 0 v15 3 a
Background
World Health Organization (WHO) guidelines for measuring global progress in schistosomiasis control classify individuals with Schistosoma spp. infections based on the concentration of excreted eggs. We assessed the associations between WHO infection intensity categories and morbidity prevalence for selected S. haematobium and S. mansoni morbidities in school-age children.
Methodology
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 S. haematobium) and irregular hepatic ultrasound image pattern (C-F), enlarged portal vein, laboratory-confirmed diarrhea, and self-reported diarrhea (for S. mansoni) across participants with infection and morbidity data.
Principal findings
S. haematobium 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, S. mansoni infection intensity categories lacked association with prevalence of the morbidity measures assessed.
Conclusions/significance
Current status infection intensity categories for S. haematobium were associated with morbidity levels in school-age children, suggesting urogenital schistosomiasis morbidity can be predicted by an individual’s intensity category. Conversely, S. mansoni infection intensity categories were not consistently indicative of childhood morbidity at baseline or during the first two years of a preventive chemotherapy control program.
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