03163nas a2200289 4500000000100000008004100001260003400042653002400076653002700100100001500127700001300142700001600155700001700171700001600188700001100204700001500215700001300230700001500243700001200258700002300270700001500293700001700308245016500325856009800490520226000588022002502848 2021 d bOxford University Press (OUP) 10 aInfectious Diseases 10 aMicrobiology (medical) 1 aOuattara M 1 aBassa FK 1 aDiakité NR 1 aHattendorf J 1 aCoulibaly J 1 aYao PK 1 aTian-Bi YT 1 aKonan CK 1 aAssaré RK 1 aKoné N 1 aGuindo-Coulibaly N 1 aUtzinger J 1 aN’Goran EK 00 aEffectiveness of Four Different Interventions against Schistosoma haematobium in a Seasonal Transmission Setting of Côte d’Ivoire: A Cluster Randomized Trial uhttps://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciab787/40364286/ciab787.pdf 3 aAbstract
Background
Annual mass drug administration (MDA) using praziquantel is the cornerstone of schistosomiasis morbidity control, but is not sufficient to interrupt transmission. We implemented a cluster-randomized trial to compare the effectiveness of four different intervention packages to interrupt transmission of Schistosoma haematobium in a seasonal transmission setting of Côte d’Ivoire.
Methods
Sixty-four localities with a S. haematobium prevalence in school children aged 13-14 years above 4% were randomly assigned to one of four intervention arms over a 3-year period: (1) the current standard strategy consisting of annual MDA before peak of transmission; (2) annual MDA after peak of transmission; (3) biannual MDA; and (4) standard MDA combined with snail control. The primary outcome was prevalence and intensity of S. haematobium infection in children aged 9-12 years 1 year after the final intervention, using urine filtration performed by experienced microscopists.
Results
By study end, we observed the lowest S. haematobium prevalence in the biannual MDA, compared to the standard treatment arm (0.6% vs. 7.5%; odds ratio [OR] = 0.07, 95% confidence interval [CI] = 0.02 to 0.24). The prevalence in arms 2 and 4 was about 3.5%, which was not statistically significantly different from the standard strategy (both ORs 0.4, 95% CI = 0.1 to ~1.8). New cases of infection were still observed in all arms at study end.
Conclusions
Biannual MDA was the only regimen that outperformed the standard treatment. All strategies resulted in decreased prevalence of infection, however none of them was able to interrupt transmission of S. haematobium within a 3-year period.
a1058-4838, 1537-6591