Epidemiology and control of intestinal schistosomiasis on the Sesse Islands, Uganda: integrating malacology and parasitology to tailor local treatment recommendations.

Background: Intestinal schistosomiasis is often widespread among the populations living around Lake Victoria and on its islands. The Sesse Island group (containing some 84 islands), however, is typically assumed to be a low prevalence zone, with limited transmission, but has never been surveyed in detail. Here, we present a rapid mapping assessment, bringing together snail and parasite information, at 23 sites for the presence of intermediate host snails and at 61 sites for the prevalence of intestinal schistosomiasis in school-aged children (N = 905).

"Women's bodies are shops": beliefs about transactional sex and implications for understanding gender power and HIV prevention in Tanzania.

Although transactional sex has been linked to undesirable sexual health outcomes, there is a lack of clarity as to the meaning of the practice, which appears to extend beyond behaviors related to women's economic circumstances. This article explored the perspectives of parents and unmarried young people on motivations for, and beliefs about, transactional sex in rural Tanzania using an ethnographic research design. Data collection involved 17 focus groups and 46 in-depth interviews with young people aged 14-24 years and parents/caregivers.

Parent-child communication about sexual and reproductive health in rural Tanzania: Implications for young people's sexual health interventions.

Background: Many programmes on young people and HIV/AIDS prevention have focused on the in-school and channeled sexual and reproductive health messages through schools with limited activities for the young people's families. The assumption has been that parents in African families do not talk about sexual and reproductive health (SRH) with their children. These approach has had limited success because of failure to factor in the young person's family context, and the influence of parents.

Use of Bayesian geostatistical prediction to estimate local variations in Schistosoma haematobium infection in western Africa.

Objective: To predict the subnational spatial variation in the number of people infected with Schistosoma haematobium in Burkina Faso, Mali and the Niger prior to national control programmes.

Methods: We used field survey data sets covering a contiguous area 2750 x 850 km and including 26,790 school-age children (5-14 years old) in 418 schools. The prevalence of high- and low-intensity infection and associated 95% credible intervals (CrIs) were predicted using Bayesian geostatistical models.

Spatial co-distribution of neglected tropical diseases in the east African great lakes region: revisiting the justification for integrated control.

Objective: To determine spatial patterns of co-endemicity of schistosomiasis mansoni and the soil-transmitted helminths (STHs) Ascaris lumbricoides, Trichuris trichiura and hookworm in the Great Lakes region of East Africa, to help plan integrated neglected tropical disease programmes in this region.

Method: Parasitological surveys were conducted in Uganda, Tanzania, Kenya and Burundi in 28 213 children in 404 schools. Bayesian geostatistical models were used to interpolate prevalence of these infections across the study area.

Schistosomiasis in infants and preschool-aged children: Infection in a single Schistosoma haematobium and a mixed S. haematobium-S. mansoni foci of Niger.

The burden of schistosomiasis in infants and preschool-aged children and their mothers is poorly known. We carried out a cross-sectional epidemiological survey in two villages in Niger: Falmado is endemic for Schistosoma haematobium only, whereas a mixed S. haematobium-S.

Mirazid shows insignificant activity against ovine fascioliasis.

In a recent study, the fasciolicidal activity of Mirazid (a myrrh-derived drug) and its effect on the function and histopathology of host liver were investigated in Egyptian sheep, with triclabendazole (TCBZ) used as the positive control. Sheep were infected with metacercariae (150/animal) and treated 3 months later, either with Mirazid (10 mg/kg/day for six consecutive days) or TCBZ (a single dose of 10 mg/kg), or left untreated, as controls. When the animals were killed 4 weeks after the end of treatment, no Fasciola flukes or eggs could be found in the animals given TCBZ but the number of flukes found in the Mirazid-treated animals was only 6% lower than that recorded in the untreated sheep (a statistically insignificant difference).

Impact of iron supplementation on schistosomiasis control in Zambian school children in a highly endemic area.

Aim: To study impact of once weekly iron supplementation on praziquantel cure rate, Schistosoma haematobium reinfection, and haematological parameters in pupils aged between 9 and 15 years of age in Nchelenge district, Zambia.

Methods: Pupils in the intervention group received once weekly dose of ferrous sulphate at 200 mg while those in the control received once weekly vitamin C at 100 mg for up to 9 months. Both study groups received a single dose of praziquantel at baseline.

Polyparasite helminth infections and their association to anaemia and undernutrition in Northern Rwanda.

Background: Intestinal schistosomiasis and soil-transmitted helminth (STH) infections constitute major public health problems in many parts of sub-Saharan Africa. In this study we examined the functional significance of such polyparasite infections in anemia and undernutrition in Rwandan individuals.

Methods: Three polyparasite infection profiles were defined, in addition to a reference profile that consisted of either no infections or low-intensity infection with only one of the focal parasite species.

Control of the Neglected Tropical Diseases in sub-Saharan Africa: the unmet needs.

The neglected tropical diseases (NTDs) are widespread in sub-Saharan Africa with several infecting many millions of individuals. Various integrated control programmes against up to seven NTDs are now being implemented in a few countries in sub-Saharan Africa, but the total coverage is estimated to be only a quarter of the population in need of treatment. We estimate that approximately $200+ million per year is needed to fully implement the proposed integrated NTD control programmes in the rural populations in all the countries in sub-Saharan Africa, and an annual sum for 5-7 years would be needed to reduce morbidity to below public health importance.

Process evaluation of schistosomiasis control in Uganda, 2003 to 2006: perceptions, attitudes and constraints of a national programme.

Schistosomiasis is widespread in Uganda along large lakes and rivers with approximately 4 million people infected. Hookworm infections also prevalent throughout the country, while infections with Ascaris lumbricoides and Trichuris trichiura are mainly found in south-western Uganda. A national programme aimed at controlling morbidity due to these infections was launched in 2003.

Are guidelines for genetic testing of children necessary?

There is now a plethora of guidance on the genetic testing of children. This paper explores the recommendation that childhood testing for adult on-set conditions should be delayed until the child can make up their own mind. It analyses the underpinning arguments used to support this position and asks whether, given some of the problems with these, the guidelines are really necessary.

The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002-2008.

Schistosomiasis remains one of the most prevalent parasitic diseases in developing countries. After malaria, schistosomiasis is the most important tropical disease in terms of human morbidity with significant economic and public health consequences. Although schistosomiasis has recently attracted increased focus and funding for control, it has been estimated that less than 20% of the funding needed to control the disease in Africa is currently available.

Present and future schistosomiasis control activities with support from the Schistosomiasis Control Initiative in West Africa.

Since 2004 the West African countries of Burkina Faso, Mali and Niger have implemented national schistosomiasis and soil-transmitted helminthiasis control programmes with financial and technical support from the Schistosomiasis Control Initiative (SCI). In the first three years of the control programmes, nearly 13.5 million doses of praziquantel and albendazole have been administered against schistosomiasis and soil-transmitted helminthiasis with coverage rates varying between 67.

Evaluation and application of potential schistosome-associated morbidity markers within large-scale mass chemotherapy programmes.

A primary objective of schistosomiasis control programmes is to achieve, and hence also demonstrate, a quantifiable reduction in schistosome-associated morbidity as a consequence of chemotherapeutic intervention. Inherent within such an objective, it is necessary to define and validate direct and indirect indicators of schistosome-related morbidity. However, to define and thereby document such morbidity, and its reduction following treatment, may not be straightforward, particularly for intestinal schistosomiasis-induced morbidity, which is often not apparent in all but the most severe or chronic cases.

A comparative study of the spatial distribution of schistosomiasis in Mali in 1984-1989 and 2004-2006.

Background: We investigated changes in the spatial distribution of schistosomiasis in Mali following a decade of donor-funded control and a further 12 years without control.

Methodology/principal Findings: National pre-intervention cross-sectional schistosomiasis surveys were conducted in Mali in 1984-1989 (in communities) and again in 2004-2006 (in schools). Bayesian geostatistical models were built separately for each time period and on the datasets combined across time periods.

Concise enantioselective synthesis of ent-malbrancheamide B.

A concise enantioselective synthesis of the fungal metabolite ent-malbrancheamide B was accomplished through the union of a C-prenylated proline derivative and a substituted indole pyruvic acid SEM enol ether, followed by a cationic double cyclization as the key step.

Host-parasite relations and implications for control.

This paper considers the various measures available to control several of the neglected tropical diseases (NTDs). To develop the optimum methods for controlling the parasites that cause these NTDs, knowledge of the life cycles of both the parasites and their vectors are essential. Each NTD requires its own strategy for control based on detailed knowledge of the life cycle, and vector control, chemotherapy, better water supplies and better hygiene are all components that may be appropriate.

Two-year impact of single praziquantel treatment on infection in the national control programme on schistosomiasis in Burkina Faso.

Objective: To evaluate the impact on schistosomiasis of biennial treatment with praziquantel (PZQ) among school-age children in Burkina Faso, the first country that achieved full national coverage with treatment of more than 90% of the school-age population.

Methods: A cohort of 1727 schoolchildren (6-14 years old) was monitored at yearly intervals through a longitudinal survey. Additional groups of schoolchildren were monitored in cross-sectional surveys.