Protocol and baseline data for a multi-year cohort study of the effects of different mass drug treatment approaches on functional morbidities from schistosomiasis in four African countries

BMC Infectious Diseases

Research Article

Charles H. King¹  Pauline N. M. Mwinzi²  Christopher C. Whalen³  Feng Zhang³  Ye Shen³  Rassul Nalá⁴  Safari Kinung’hi⁵  Susan P. Montgomery⁶  W. Evan Secor⁶  Annette Olsen⁷  Pascal Magnussen⁷  Amadou Garba⁸  Amina Hamidou⁸  Daniel G. Colley⁹  Sue Binder⁹  Carl H. Campbell⁹  Fiona Fleming^1,10  Alan Fenwick^1,10  H. Osvaldo Aurelio^1,10  Anna E. Phillips^1,10  Josefo Ferro^1,11 

[1] Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA;Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases and Department of Microbiology, University of Georgia, Athens, GA, USA;Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA;Instituto Nacional de Saúde, Maputo, Mozambique;National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania;Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA;Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Réseau International Schistosomoses, Environnement, Aménagement et Lutte (RISEAL-Niger), Niamey, Niger;Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases and Department of Microbiology, University of Georgia, Athens, GA, USA;Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College, London, UK;Universidade Católica de Moçambique, Beira, Mozambique;

关键词: Schistosomiasis;    Schistosoma haematobium;    Schistosoma mansoni;    Morbidity;    Drug therapy;    Praziquantel;    Africa;    Cohort study;    Kenya;    Mozambique;    Niger;    Tanzania;   

DOI  :  10.1186/s12879-017-2738-5

 received in 2017-07-20, accepted in 2017-09-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) focus is on randomized trials of different approaches to mass drug administration (MDA) in endemic countries in Africa. Because their studies provided an opportunity to evaluate the effects of mass treatment on Schistosoma-associated morbidity, nested cohort studies were developed within SCORE’s intervention trials to monitor changes in a suite of schistosomiasis disease outcomes. This paper describes the process SCORE used to select markers for prospective monitoring and the baseline prevalence of these morbidities in four parallel cohort studies.MethodsIn July 2009, SCORE hosted a discussion of the potential impact of MDA on morbidities due to Schistosoma infection that might be measured in the context of multi-year control. Candidate markers were reviewed and selected for study implementation. Baseline data were then collected from cohorts of children in four country studies: two in high endemic S. mansoni sites (Kenya and Tanzania), and two in high endemic S. haematobium sites (Niger and Mozambique), these cohorts to be followed prospectively over 5 years.ResultsAt baseline, 62% of children in the S. mansoni sites had detectable eggs in their stool, and 10% had heavy infections (≥ 400 eggs/g feces). Heavy S. mansoni infections were found to be associated with increased baseline risk of anemia, although children with moderate or heavy intensity infections had lower risk of physical wasting. Prevalence of egg-positive infection in the combined S. haematobium cohorts was 27%, with 5% of individuals having heavy infection (≥50 eggs/10 mL urine). At baseline, light intensity S. haematobium infection was associated with anemia and with lower scores in the social domain of health-related quality-of-life (HRQoL) assessed by Pediatric Quality of Life Inventory.ConclusionsOur consensus on practical markers of Schistosoma-associated morbidity indicated that height, weight, hemoglobin, exercise tolerance, HRQoL, and ultrasound abnormalities could be used as reference points for gauging treatment impact. Data collected over five years of program implementation will provide guidance for future evaluation of morbidity control in areas endemic for schistosomiasis.Trial registrationThese cohort studies are registered and performed in conjunction with the International Standard Randomised Controlled Trial Registry trials ISRCTN16755535, ISRCTN14117624, ISRCTN95819193, and ISRCTN32045736.

【 授权许可】

CC BY   
© The Author(s). 2017