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. 2021 Jan 8;6(1):7.
doi: 10.3390/tropicalmed6010007.

Baseline and Impact of First-Year Intervention on Schistosoma haematobium Infection in Seasonal Transmission Foci in the Northern and Central Parts of Côte d'Ivoire

Nana R Diakité  1   2 , Mamadou Ouattara  1   2 , Fidèle K Bassa  1   2 , Jean T Coulibaly  1   2   3   4 , Yves-Nathan T Tian-Bi  1 , Aboulaye Meïté  5 , Jan Hattendorf  3   4 , Jürg Utzinger  3   4 , Eliézer K N'Goran  1   2
Affiliations

Baseline and Impact of First-Year Intervention on Schistosoma haematobium Infection in Seasonal Transmission Foci in the Northern and Central Parts of Côte d'Ivoire

Nana R Diakité et al. Trop Med Infect Dis. .

Abstract

In order to assess the impact of different control strategies against Schistosoma haematobium in seasonal transmission foci in Côte d'Ivoire, a three-year cluster randomized trial was implemented. The decrease in S. haematobium prevalence among children aged 9-12 years was the primary outcome. In the first step, an eligibility survey was conducted, subjecting 50 children aged 13-14 years to a single urine filtration. Sixty-four villages with a prevalence of S. haematobium of ≥4% were selected and randomly assigned to four intervention arms consisting of annual mass drug administration (MDA) before (arm 1) and after (arm 2) the peak transmission, biannual treatment with praziquantel before and after the peak transmission season (arm 3), and annual MDA before the peak transmission season, coupled with focal chemical snail control using molluscicides (arm 4). At baseline, we observed a prevalence of 24.8%, 10.1%, 13.9%, and 15.9% in study arms 1, 2, 3, and 4, respectively. One year after the first intervention, the prevalence decreased in all study arms by about two-thirds or more. The prevalence in arm 2 was lower than in arm 1 (3.5% vs. 8.1%), but the difference was not statistically significant (odds ratio (OR) = 0.42, 95% confidence interval (CI) = 0.10-1.80). After adjusting for baseline prevalence, arms 1 and 2 performed roughly similarly (adjusted odds ratio (aOR) = 1.03, 95% CI = 0.34-3.07). The prevalence in arms 3 and 4 (1.9% and 2.2%) were significantly lower compared to arm 1 in the unadjusted and the adjusted models (arm 3 vs. arm 1, OR = 0.22, 95% CI = 0.05-0.95, aOR = 0.19, 95% CI = 0.08-0.48; arm 4 vs. arm 1, OR = 0.26, 95% CI = 0.08-0.85, aOR = 0.23, 95% CI = 0.06-0.87). The initial intervention showed a significant impact on the prevalence of S. haematobium. It will be interesting to monitor the comparative impact of the different intervention arms and to determine whether the interruption of seasonal transmission of S. haematobium can be achieved in this epidemiological setting within three years.

Keywords: Côte d’Ivoire; Schistosoma haematobium; control strategies; intensity; prevalence; seasonal transmission.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Map of the study area showing villages by arm in the northern and central parts of Côte d’Ivoire (n = 64).
Figure 3
Figure 3
Village-level prevalence and intensity of S. haematobium, stratified by age group and intervention arm in 64 villages at baseline. The color code shows the mean infection intensity at the village level with low (yellow) and heavy (red). 1 = arm 1; 2 = arm 2; 3 = arm 3; 4 = arm 4. (A) Schoolchildren aged 9−12-years; (B) first-grade children aged 5−8 years; (C) adults aged 20−55 years.
Figure 4
Figure 4
Change in S. haematobium prevalence in 64 villages (16 by arm) from baseline (BL) to the first year follow-up (FU), stratified by age group and by study arm (arms 1, 2, 3, and 4). Each line indicates the evolution of one village from baseline to year one, and the boxplots show the distribution by study arm.
Figure 2
Figure 2
Study flow chart.
See this image and copyright information in PMC

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