clove and Schistosomiasis-mansoni

The goal to eliminate the parasitic disease of poverty schistosomiasis as a public health problem is aligned with the 2030 United Nations agenda for sustainable development goals, including universal health coverage (UHC). Current control strategies focus on school-aged children, systematically neglecting adults. We aimed at providing evidence for the need of shifting the paradigm of schistosomiasis control programs from targeted to generalized approaches as key element for both the elimination of schistosomiasis as a public health problem and the promotion of UHC.. In a cross-sectional study performed between March 2020 and January 2021 at three primary health care centers in Andina, Tsiroanomandidy and Ankazomborona in Madagascar, we determined prevalence and risk factors for schistosomiasis by a semi-quantitative PCR assay from specimens collected from 1482 adult participants. Univariable and multivariable logistic regression were performed to evaluate odd ratios.. The highest prevalence of S. mansoni, S. haematobium and co-infection of both species was 59.5%, 61.3% and 3.3%, in Andina and Ankazomborona respectively. Higher prevalence was observed among males (52.4%) and main contributors to the family income (68.1%). Not working as a farmer and higher age were found to be protective factors for infection.. Our findings provide evidence that adults are a high-risk group for schistosomiasis. Our data suggests that, for ensuring basic health as a human right, current public health strategies for schistosomiasis prevention and control need to be re-addressed towards more context specific, holistic and integrated approaches.

Topics: Adult; Agriculture; Animals; Coinfection; Cross-Sectional Studies; Humans; Madagascar; Male; Middle Aged; Prevalence; Risk Factors; Schistosoma haematobium; Schistosoma mansoni; Schistosomiasis haematobia; Schistosomiasis mansoni; Sex Factors; Young Adult

Schistosomiasis is a major public health problem in Madagascar. The WHO recommends preventive chemotherapy by mass drug administration (MDA) with praziquantel as the primary approach to control Schistosoma mansoni-related morbidity in endemic populations, alongside complementary interventions such as health education. The impact of annual MDA and health education programs was assessed in the hard-to-reach Marolambo district of eastern Madagascar, an area endemic for S. mansoni. Repeated cross-sectional studies undertaken 2015-2019 examined between 300 and 381 school-aged children (aged 5-14 years) annually. The prevalence and infection intensity of S. mansoni were assessed by urine-circulating cathodic antigen (CCA) dipsticks and coproscopy using Kato-Katz (KK) methodologies. After four rounds of annual MDA, a reduction in S. mansoni prevalence was seen in CCA (93.9% in year 1-87.7% in year 5; P = 0.007) and KK (73.9% in year 1-59.4% in year 5; P < 0.0001). The prevalence of heavy-intensity infections roughly halved from 23.7% to 10.1% (P < 0.0001), and the mean intensity of infection fell by 55.0% (480.2-216.3 eggs per gram of feces). A malacological survey found Biomphalaria pfeifferi snail intermediate hosts in multiple water contact sites including rice paddies, streams, and Nosivolo River. Despite reductions in infection prevalence and intensity, schistosomiasis still poses a significant public health challenge in Marolambo district. Twice yearly MDA cycles and/or community-wide MDA are suggested to better reduce infections. Expanding health education, improving standards of water, sanitation and hygiene, and attention on snail-related control will also be important, especially in rice paddy irrigated areas.

Topics: Adolescent; Animals; Anthelmintics; Child; Child, Preschool; Chronic Disease; Female; Humans; Madagascar; Male; Mass Drug Administration; Praziquantel; Prevalence; Schistosoma mansoni; Schistosomiasis mansoni

School-aged children (SAC) have a considerable burden of intestinal schistosomiasis in Madagascar yet its burden in pre-school aged children (PSAC) is currently overlooked. To assess the at-risk status of PSAC, we undertook a pilot epidemiological survey in June 2019 examining children (n = 89), aged 2-4-years of balanced gender, in six remote villages in Marolambo District, Madagascar. Diagnosis included use of urine-circulating cathodic antigen (CCA) dipsticks and coproscopy of stool with duplicate Kato-Katz (K-K) thick smears. Prevalence of intestinal schistosomiasis by urine-CCA was 67.4% (95% confidence interval [CI]: 56.5-77.2%) and 35.0% (95% CI: 24.7-46.5%) by K-K. The relationship between faecal eggs per gram (epg) and urine-CCA G-scores (G1 to G10) was assessed by linear regression modelling, finding for every increment in G-score, epg increased by 20.4 (6.50-34.4, P = 0.006). Observed proportions of faecal epg intensities were light (78.6%), moderate (17.9%) and heavy (3.6%). Soil-transmitted helminthiasis was noted, prevalence of ascariasis was 18.8% and trichuriasis was 33.8% (hookworm was not reported). Co-infection of intestinal schistosomiasis and soil-transmitted helminthiasis occurred in 36.3% of PSAC. These results provide solid evidence highlighting the overlooked burden of intestinal schistosomiasis in PSAC, and they also offer technical  guidance for better surveillance data for the Madagascan national control programme.

Topics: Animals; Child; Child, Preschool; Cross-Sectional Studies; Feces; Helminthiasis; Humans; Madagascar; Prevalence; Schistosoma mansoni; Schistosomiasis mansoni

Female Genital Schistosomiasis (FGS) is a neglected disease affecting millions, however challenging to diagnose. This explorative descriptive study compares Schistosoma real-time PCR analysis of cervico-vaginal lavages (CVL) with corresponding urine and stool samples of 933 women from five different previously described study populations. Sampling included 310 women from an S. mansoni endemic region in Mwanza, Tanzania and 112 women from a nearby S. haematobium endemic region. Findings were compared with samples collected from S. haematobium endemic regions in South Africa from 394 women and from 117 women from Madagascar of which 79 were urine pre-selected microscopy positive cases from highly-endemic communities and 38 were urine microscopy negatives from a low-endemic community. As anticipated, urine and stool microscopy and gynecological investigations varied substantially between study populations; however, the same Schistosoma real-time PCR was performed in one reference laboratory. Schistosoma DNA was detected in 13% (120/933) of the CVL, ranging from 3% in the S. mansoni Tanzanian endemic region to 61% in the pre-selected Malagasy urine microscopy positive cases. Detectable Schistosoma DNA in CVL was associated with Schistosoma DNA in urine but not with microscopic detection of eggs in urine or by cytological examination. This study confirmed real-time PCR for the detection of Schistosoma DNA in gynecological samples to be a valuable diagnostic tool to study the distribution of FGS within schistosomiasis endemic areas.

Topics: Adolescent; Animals; Child; Diagnostic Tests, Routine; DNA, Helminth; Female; Genitalia; Humans; Madagascar; Real-Time Polymerase Chain Reaction; Schistosoma haematobium; Schistosoma mansoni; Schistosomiasis haematobia; Schistosomiasis mansoni; South Africa; Tanzania; Urinalysis; Young Adult

A cross-sectional survey was performed to estimate the prevalence of periportal fibrosis in children based on ultrasound examination in the Marolambo district of the Atsinanana region of Madagascar. This is a remote area known to have a high prevalence of intestinal schistosomiasis.. School-aged children (5-14 y) were selected from six villages for parasitological and sonographic examination. Circulating cathodic antigen (CCA) tests and Kato Katz (KK) stool microscopy were performed. Video-clips of liver views were recorded with a SonoSite iViz and interpreted in the UK by comparison with standardised images (WHO protocol).. The prevalence of schistosomiasis according to CCA testing was 97.8% (269/275) and 73.8% (203/275) by KK. Sonographic evidence of periportal fibrosis was observed in 11.3% (31/275). The youngest children with fibrosis were aged 6 y. Fibrosis was more common in older children (p=0.03) but was not associated with either infection intensity category (p=0.07) or gender (p=0.67).. Findings of periportal fibrosis among children in these hard-to-reach villages suggests chronic Schistosoma mansoni infection from a very young age. This may reflect other similarly remote schistosomiasis-endemic areas and reinforces the need to investigate morbidity in neglected communities to understand the true extent of disease burden in endemic countries.

Topics: Animals; Antigens, Helminth; Child; Cross-Sectional Studies; Feces; Humans; Liver Cirrhosis; Madagascar; Prevalence; Schistosoma mansoni; Schistosomiasis mansoni; Schools

Schistosomiasis is a chronic debilitating parasitic disease that causes hepatic damage and is known to be endemic in developing countries. Recent control strategies for schistosomiasis depend exclusively on chemotherapeutic agents, specifically praziquantel. Unfortunately, praziquantel has low efficacy in the early phase of infection, and resistance to treatment is increasingly reported. The aim of this work was to find an alternative treatment by assessing the in vivo activity of aqueous extract of Callistemon citrinus against Schistosoma mansoni in both prepatent and patent phases in experimentally infected mice. The study was conducted on 80 male BALB/c albino mice divided into eight groups. Callistemon was administered at a dose of 200 mg/kg on days 14 and 45 post infection as a single therapy and in combination with praziquantel. Porto-mesenteric worm burden, hepatic and intestinal egg counts, hepatic granuloma number and diameter, and oogram pattern were assessed to evaluate the anti-schistosomal properties of C. citrinus. Liver enzymes and total bilirubin were tested to assess hepatoprotective effects. Results revealed that the use of C. citrinus was associated with a significant decrease in worm burden and tissue egg load together with an increased percentage of dead eggs. In addition, there was a significant reduction in granuloma formation. Callistemon also led to a significant improvement in liver function. The best results were obtained when C. citrinus was given in the prepatent phase of infection and when combined with praziquantel. Although the effects of C. citrinus are considered to be promising, further studies using different extracts, active ingredients and doses are needed.

Topics: Animals; Drug Therapy, Combination; Granuloma; Intestines; Liver; Male; Mice; Mice, Inbred BALB C; Myrtaceae; Parasite Egg Count; Plant Extracts; Plant Leaves; Praziquantel; Schistosoma mansoni; Schistosomiasis mansoni

A school-based survey was undertaken to assess prevalence and infection intensity of schistosomiasis in school-aged children in the Marolambo District of Madagascar.. School-aged children from six purposively selected schools were tested for Schistosoma haematobium by urine filtration and Schistosoma mansoni using circulating cathodic antigen (CCA) and Kato-Katz stool analysis. The investigators did not address soil-transmitted helminths (STH) in this study.. Of 399 school-aged children screened, 93.7% were infected with S. mansoni based on CCA analysis. Kato-Katz analysis of stool revealed S. mansoni infection in 73.6% (215/ 292). Heavy infections (> 400 eggs per gram) were common (32.1%; 69/ 215), with a mean of 482 eggs per gram of stool. Moderate infection intensities were detected in 31.2% (67/ 215) and light infection intensities in 36.7% (79/ 215) of infected participants. No infection with S. haematobium was detected by urine filtration.. Intestinal schistosomiasis appears a considerable public health issue in this remote area of Madagascar where there is a pressing need for mass drug administration.

Topics: Adolescent; Age Distribution; Animals; Child; Child, Preschool; Cohort Studies; Cross-Sectional Studies; Feces; Female; Humans; Madagascar; Male; Multivariate Analysis; Parasite Egg Count; Prevalence; Schistosoma mansoni; Schistosomiasis mansoni; Sex Distribution

Madagascar is an endemic area for schistosomiasis, but recent prevalence data are scarce. We investigated stool samples of 410 children aged 4-18 years from a combined primary and secondary school in a Madagascan highland village near Ambositra in order to assess the prevalence of Schistosoma mansoni using microscopy and real-time polymerase chain reaction (PCR). A high prevalence of S. mansoni of 77.1% was detected by PCR, while only 15.2% of microscopic examinations of sedimentation-enriched stools were positive. We estimated the sensitivity and specificity of stool sedimentation microscopy (19.7% and 98.8%) and of PCR (98.9% and 89.3%) using a Bayesian approach for two dependant tests in one population without a reference standard. Our Bayesian posterior estimate of the prevalence is 80.2%. Simple sedimentation technique misses about 4/5 of all PCR-confirmed infections and is insufficient to determine the prevalence of S. mansoni. A survey comparing PCR with a classical standard technique (KatoKatz) is desirable.

Topics: Adolescent; Animals; Child; Cross-Sectional Studies; Diagnostic Tests, Routine; Female; Humans; Madagascar; Male; Microscopy; Parasitology; Polymerase Chain Reaction; Prevalence; Schistosoma mansoni; Schistosomiasis mansoni; Schools; Students

Ultrasound (US) is a quite economical and noninvasive technique for morbidity assessment in intestinal schistosomiasis and it is widely used in order to detect organ-specific schistosomiasis-associated changes even if it may be invalidated by low reproducibility of measurements and high interobserver variance. Reports on histological assessment in patients with intestinal schistosomiasis mansoni are unusual because liver biopsy is not commonly feasible in endemic areas and it is not warranted for ethical reasons. This short report is a retrospective analysis of sonographic and histologic findings in patients with early liver pathology, in view of the pathogenesis and morbidity assessment of intestinal schistosomiasis, in a European hospital setting.. Seven immigrants from Madagascar with chronic diarrhea or Schistosoma mansoni egg detection in feces were admitted to our department. All of them were subjected to clinical, biochemical and ultrasound examination following current World Health Organization (WHO) guidelines. Each patient underwent percutaneous liver biopsy.. Abdominal ultrasonography showed schistosomiasis image patterns or US signs of liver involvement only in one out of seven patients while histological findings showed dense discrete fibrous tissue formation in five out of seven patients. In three out of seven patients liver biopsy also showed inflammatory infiltration of eosinophils and macrophages with periportal granulomas with S. mansoni eggs. Considering the mean egg intensity of three stool specimens as the gold standard, US showed a sensitivity of 16% with a negative predictive value (NPV) of 16% and a specificity of 100% with a positive predictive value (PPV) of 100%. Liver biopsy showed a sensitivity of 83% with a NPV of 50% and a specificity of 100% with a PPV of 100%.. In our small study, US seemed to underestimate hidden liver fibrosis in intestinal schistosomiasis. In some European clinical settings, histological evaluation by liver biopsy may be a useful tool to detect early liver pathology in schistosomiasis mansoni. These findings could provide additional information for studies from endemic areas where US is commonly used for morbidity assessment.

Topics: Adult; Animals; Emigrants and Immigrants; Female; Humans; Italy; Liver; Liver Cirrhosis; Liver Diseases, Parasitic; Madagascar; Parasite Egg Count; Schistosoma mansoni; Schistosomiasis mansoni; Ultrasonography; Young Adult

Portopulmonary hypertension is characterized by a chronic liver disease associated with a mean pulmonary artery pressure >25 mmHg at rest, an increased pulmonary vascular resistance and a capillary pulmonary pressure <15 mmHg with portal hypertension. Schistosomiasis may be an aetiology of this syndrome, however, few cases have been reported. We describe the first cases of portopulmonary hypertension with schistosomiasis in Malagasy patients. There were 2 men aged of 18 and 20 from hyperendemic area of schistosomiasis in Madagascar Both had a history of repeated water contact. They presented a dyspnea associated with ascites and oedema. Clinical examination showed portal and pulmonary hypertension with right ventricular heart failure. Cardiac examination revealed a systolic murmur and splint of the second heart pulmonary Pulmonary hypertension was confirmed by cardiac ultrasonogaphy Serology of bilharzias was positive. Parasitological examination showed eggs of S. mansoni. The treatment based on salt-free diet, spironolactone and praziquantel led to a better evolution of symptoms (case 1). Symptoms of right heart failure remained for the second patient even though improvement was noted. In tropical countries, schistosomiasis may be one of the cause of portopulmonary hypertension and may appear in early age. Its treatment remains difficult as the drugs recommended are not affordable.

Topics: Adolescent; Adult; Anthelmintics; Ascites; Combined Modality Therapy; Diet, Sodium-Restricted; Dyspnea; Endemic Diseases; Heart Failure; Humans; Hypertension, Portal; Hypertension, Pulmonary; Madagascar; Male; Mineralocorticoid Receptor Antagonists; Praziquantel; Schistosomiasis mansoni; Spironolactone

Topics: Adult; Hospitals, University; Humans; Lung Diseases, Parasitic; Madagascar; Male; Schistosomiasis mansoni

In a study in three neighbouring villages of southern Madagascar, where Schistosoma mansoni is hyperendemic, ultrasound examination using the Niamey protocol showed marked differences in the burden of disease from one village to another. Hepatosplenic schistosomiasis was more frequent in the village with the highest geometric mean egg counts and the earliest onset of infections, demonstrating that the morbidity induced by S. mansoni may vary greatly within a given area. True representativeness of study populations, a keystone of epidemiological studies, is mandatory to obtain a clear picture of a wide area. Ultrasound examinations in a small number of villages, or even a single one, may be a questionable approach. Using logistic regression analysis, the explanatory variables found to be significantly associated with a risk of severe hepatosplenic disease in our study were sex, age, village of residence and S. mansoni egg counts. On the other hand, a concurrent infection with an intestinal helminth seems to reduce the risk of severe hepatosplenic disease. Further studies should assess the role and possible impact of intestinal helminths on S. mansoni associated-morbidity.

Topics: Adolescent; Adult; Age Distribution; Analysis of Variance; Child; Child, Preschool; Female; Helminthiasis; Humans; Hypertension, Portal; Infant; Infant, Newborn; Likelihood Functions; Liver Diseases, Parasitic; Logistic Models; Madagascar; Male; Parasite Egg Count; Prevalence; Residence Characteristics; Risk Factors; Schistosomiasis mansoni; Splenic Diseases

Topics: Biopsy; Child; Humans; Madagascar; Rectal Diseases; Rectum; Schistosomiasis mansoni

Schistosoma mansoni and S. haematobium affect respectively 2 million and 500,000 persons in Madagascar. Over the past decade, S. mansoni has spread in the central Highlands of Madagascar, essentially throughout the mid-west and Antananarivo plain. To understand this recent change in the epidemiology of S. mansoni, we examined the relationship between its spatial distribution and several host factors, including labour migration, urbanization and water development projects. In the Highlands, the disease in distribution could be superimposed on the potential expansion areas of snail distribution defined in 1958. However, the distribution is not homogeneous, as for example the road between Betafo and Mandoto (South West of Antananarivo). This focal pattern described in other African countries is unique to the central Highlands of Madagascar. Rice cultivation is the main economic activity and is associated with intense water contact. The focal distribution may be related to an environmental adaptation of host-parasite interaction depending on behavioural patterns, water and soil chemistry and incompatibility between Biomphalaria pfeifferi and S. mansoni. It is also possible that these focal patterns precede homogeneous endemicity, as along the road Itasy-Tsiroanomandidy (west Antananarivo). Major water development carried out in this migration area led to a rapid endemization of the disease. In Befato-Mandoto, where soil management is more restricted, schistosomiasis due to S. mansoni seems to have been established in some foci where epidemiologic conditions are favourable (for example, traditional irrigation canals). In contrast, the spread of S. mansoni in the Antananarivo plain closely follows the settlement of an infected rural population. Epidemiologic surveys conducted on school children in the Antananarivo suburbs, where sanitary conditions are poor, showed a prevalence of 25%. Human migration linked to development projects and urbanization seems to be the principal factor associated with the spread of schistosomiasis in the mid-west area and Antananarivo plain. In the Highlands, the preferential exposure of adult labour migrants has contributed to the widening of the endemic area.

Topics: Adult; Animals; Biomphalaria; Child; Climate; Humans; Madagascar; Rural Population; Schistosomiasis mansoni; Soil; Urban Population; Water

Before the sonographic era, clinics or parasitology even autopsy have been the only sources of basic principles on the morbidity due to Schistosoma mansoni. The exploration of inner organs and their pathologies became easier. The organ's size as well as their echogenicity permit grading. Up till now, any classification is not appropriate. Attempts of standardization haven't yet succeeded, thus any comparison among different endemic regions is not possible. A simple method based on qualitative observation of the periportal fibrosis is proposed to help sonographist for the diagnosis of presumption in front of evocative image and to be a guideline for later investigation.

Topics: Adult; Cohort Studies; Endemic Diseases; Female; Forecasting; Humans; Liver Cirrhosis; Madagascar; Male; Practice Guidelines as Topic; Rural Health; Schistosomiasis mansoni; Sensitivity and Specificity; Severity of Illness Index; Ultrasonography

A ultrasonographical survey of morbidity in schistosomiasis mansoni was carried out in two villages of an endemic area of Madagascar. Using the Managil-Hannover classification, the overall prevalence of morbidity in the first village was of 49.4% and of 39.4% in the second one, while modified Cairo/WHO classification found 9.1% and 1.9% respectively. Thus, results given by the two classifications for a same individual are often discordant. This discrepancy is essentially observed in the lower stage of morbidity while advanced cases are generally well-staged by either of these two methods. These differences in the sonographical assessment of morbidity related to hepatosplenic schistosomiasis make it necessary to continue investigations in order to establish a classification that will have the agreement of everybody.

Topics: Adolescent; Adult; Age Distribution; Bias; Child; Child, Preschool; Endemic Diseases; Female; Humans; Madagascar; Male; Morbidity; Parasite Egg Count; Population Surveillance; Practice Guidelines as Topic; Prevalence; Rural Health; Schistosomiasis mansoni; Severity of Illness Index; Ultrasonography; World Health Organization

Using an ELISA method, we quantitated the level of glutathion S-transferase 28 kDa (Sm28GST), specific of Schistosoma mansoni, in the urine of 13 malagasy patients. The presence of Sm28GST antigen has been demonstrated for the first time, in 8 patients (69%). No significant correlation could be found between antigen level and the parasitological burden in the feces. The use of an immunocapture ELISA technic on a larger number of samples will be necessary to assess if this test could be quantitative and reliable enough for the diagnosis or the follow up of patients infected with Schistosoma mansoni.

Topics: Adolescent; Adult; Animals; Antigens, Helminth; Case-Control Studies; Child; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Female; Glutathione Transferase; Humans; Madagascar; Male; Parasite Egg Count; Schistosoma mansoni; Schistosomiasis mansoni; Sensitivity and Specificity; Severity of Illness Index

The examination of 544 inhabitants (93.2% of the whole population) of a village in the middle west of Madagascar, where Schistosoma mansoni is hyperendemic and where no previous antischistosomal treatment had been delivered at a community level, showed a prevalence rate of 61.8%. The highest prevalences and the most intense infections were observed in the 10-24 age group. The egg count decreases dramatically from the age of 25. A highly significant relationship was found between recent histories of bloody diarrhoea and S. mansoni eggs excretion. Clinical examination showed a high frequency of splenomegalies (62.2% > or = stade 2 Hackett), with two modes: one in the 10-14 age group and the other in the 35-39 age group. The respective liability of S. mansoni and malaria remain to be clarified. Side effects after treatment of the entire population with praziquantel were observed in 27.2% of treated individuals. Side effects occurred mainly in infected people. A highly significant relationship was found between intensity of infection and frequency of these side effects which are essentially mild and disappear in the 24 hours.

Topics: Adolescent; Adult; Age Distribution; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Madagascar; Male; Middle Aged; Morbidity; Population Surveillance; Praziquantel; Prevalence; Schistosomiasis mansoni; Sex Distribution

During a morbidity survey in two endemic foci of hepatosplenic schistosomiasis in the malagasy Hauts Plateaux (Tetikanana, 80 km East of Ambositra and Lohanosy, in the vicinity of Antananarivo), the objectives of a comparative pathology WHO project are presented. The survey in Madagascar was concurrently organized by the Ministry of Health (Bilharziasis central laboratory, DLMT), the Parasitology Unit of the local Pasteur Institute and the Medical Parasitology Institute of Bonn University, in Germany. This was the fourth part of this investigation of the morbidity variation due to Schistosoma mansoni infection in six african countries, a project sponsored by the WHO within its TDR programme. This comparison was based on the standardized description of morbidity as visualized by echography, following the "Cairo-1990" and the "Hannover-Managil-1989" classifications, and on coprology. One of the main objectives of this study was to demonstrate a morbidity variation at the scale of the African region (due to different S. mansoni strains or to a variable genetic background within the studied human populations), while participating to an international standardization effort for field echography. The project was conducted since July 1991 by a constant medical staff from Bonn and Hannover german universities. Eight foci in four african countries (Senegal, Mali, Uganda and Madagascar) are still analyzed and we are presenting here the first results. The data of an independent ultrasonographic investigation, organized by the Blair Institute and the Danish Bilharziasis Laboratory in Zimbabwe, was kindly proposed for this comparison. This project will end with the study of two supplementary foci in Tanzania and Burundi.

Topics: Africa; Humans; Madagascar; Morbidity; Population Surveillance; Prevalence; Schistosomiasis mansoni; Ultrasonography; World Health Organization

In 1976, 1983, 1986 to 1989 and 1993, the population of Ampefy, on the shores of lake Itasy, was invited to participate in an active detection programme of Schistosoma mansoni infection. An increase in the global prevalence was observed from 1976 (17.0%) to 1983 (40.0%). This prevalence level was then stabilized during the four years annual selective treatment (1986 to 1989) and the mean intensity of infection for positive patients fell from 393 eggs/g to 271 eggs/g and the proportion of severe infections, with a high risk of developing "hepatosplenic disease", fell from 8% to 4.2%. Selective treatment was interrupted from 1989 to 1993, during which time the global prevalence rose to 70.6% and mean intensity of infection to 594 eggs/g, with 22% of those examined classified as severely infested. This local control programme, associating active detection with annual treatment, seems effective in stabilizing prevalence and intensity of infection in spite of a regular arrival of infested, and never treated, immigrants. However, its impact throughout time is limited.

Topics: Adolescent; Adult; Child; Child, Preschool; Emigration and Immigration; Female; Humans; Infant; Infant, Newborn; Madagascar; Male; Middle Aged; Population Surveillance; Prevalence; Schistosomiasis mansoni

"Schistosoma mansoni morbidity in a Southern region of Madagascar: preliminary data". The prospective study of the schistosomiasis mansoni morbidity among the practice of a medical and surgical hospital located at Sakalalina, a village of the southern foot-hills of the malagasy Highlands, allowed to record a prevalence rate of 5.45%.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Child; Child, Preschool; Female; Hospitalization; Humans; Madagascar; Male; Middle Aged; Morbidity; Population Surveillance; Prevalence; Prospective Studies; Referral and Consultation; Rural Population; Schistosomiasis mansoni

Topics: Adolescent; Antibodies, Helminth; Child; Feces; Female; Humans; Madagascar; Male; Parasite Egg Count; Prevalence; Schistosomiasis mansoni; Urban Population

Topics: Adolescent; Child; Child, Preschool; Feces; Helminthiasis; Humans; Madagascar; Parasite Egg Count; Population Surveillance; Rural Population; Schistosomiasis mansoni

Topics: Adolescent; Age Factors; Antibodies; Child; Child, Preschool; Feces; Female; Fluorescent Antibody Technique; Humans; Madagascar; Male; Parasite Egg Count; Praziquantel; Schistosoma mansoni; Schistosomiasis mansoni; Sex Factors

Topics: Adolescent; Child; Enzyme-Linked Immunosorbent Assay; Feces; Female; Humans; Madagascar; Male; Praziquantel; Schistosoma mansoni; Schistosomiasis mansoni; Sex Factors

Topics: Asian People; Black People; Humans; Madagascar; Schistosomiasis; Schistosomiasis mansoni