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      Urinary schistosomiasis in Nigeria: a 50 year review of prevalence, distribution and disease burden Translated title: La schistosomiase urinaire au Nigeria : un bilan de 50 ans sur la prévalence, la distribution et le fardeau de la maladie

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          We reviewed survey data deposited in the Global Neglected Tropical Diseases database and many other articles on the prevalence and distribution of Schistosoma haematobium in Nigeria. Schistosoma haematobium surveys conducted over the period of 50 years under review using different diagnostic tools revealed that Ogun State has the highest prevalence, followed by Ekiti state, while the lowest prevalence was recorded in Adamawa. No incidence of Schistosoma haematobium was recorded for states such as Akwa Ibom, Bayelsa, Nasarawa, Jigawa and Gombe. In terms of endemicity, this review has shown that Nigeria is divided into four zones: hyperendemic, moderately endemic, low endemic, and no endemic zones. A survey of 47 (15%) of the 323 dams in Nigeria revealed that 45 out of the 47 dams are located in the hyperendemic zone, while the remaining two are located in the moderately endemic zone. Twenty (43%) of the total surveyed dams harboured Bulinus globosus and/or Biomphalaria pfeifferi, the local intermediate hosts of schistosomes, and 18 of these are located in the hyperendemic zone, while the other two are in the moderately endemic zone. We conclude that there is an urgent need to carry out a nationwide survey to help in planning, coordinating, and evaluating schistosomiasis control activities.

          Translated abstract

          Nous avons examiné les données recueillies dans la base de données mondiale sur les maladies tropicales négligées et de nombreux autres articles sur la prévalence et la répartition de Schistosoma haematobium au Nigéria. Les enquêtes sur S. haematobium menées au cours des 50 dernières années à l’aide de différents outils de diagnostic ont révélé que l’État d’Ogun avait la prévalence la plus élevée, suivi de l’état d’Ekiti, la plus faible prévalence ayant été enregistrée à Adamawa. Aucune incidence de S. haematobium n’a été enregistrée dans des États comme Akwa Ibom, Bayelsa, Nasarawa, Jigawa et Gombe. En termes d’endémicité, cette revue a montré que le Nigéria est divisé en quatre zones: hyper endémique, modérée, basse et sans endémie. L’enquête menée auprès de 47 (15 %) des 323 barrages au Nigeria a révélé que 45 des 47 barrages sont situés dans la zone d’hyperendémie, tandis que les 2 restants sont situés dans une zone d’endémie modérée. Parmi les barrages étudiés, 20 (43 %) hébergeaient Bulinus globosus et/ou Biomphalaria pfeifferi, les hôtes intermédiaires locaux des schistosomes, et 18 d’entre eux sont situés dans la zone d’hyperendémie tandis que les 2 autres se trouvent dans la zone d’endémie modérée. Nous concluons qu’il est urgent de mener une enquête à l’échelle nationale pour faciliter la planification, la coordination et l’évaluation des activités de lutte contre la schistosomiase.

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          Most cited references 18

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          Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at risk.

          An estimated 779 million people are at risk of schistosomiasis, of whom 106 million (13.6%) live in irrigation schemes or in close proximity to large dam reservoirs. We identified 58 studies that examined the relation between water resources development projects and schistosomiasis, primarily in African settings. We present a systematic literature review and meta-analysis with the following objectives: (1) to update at-risk populations of schistosomiasis and number of people infected in endemic countries, and (2) to quantify the risk of water resources development and management on schistosomiasis. Using 35 datasets from 24 African studies, our meta-analysis showed pooled random risk ratios of 2.4 and 2.6 for urinary and intestinal schistosomiasis, respectively, among people living adjacent to dam reservoirs. The risk ratio estimate for studies evaluating the effect of irrigation on urinary schistosomiasis was in the range 0.02-7.3 (summary estimate 1.1) and that on intestinal schistosomiasis in the range 0.49-23.0 (summary estimate 4.7). Geographic stratification showed important spatial differences, idiosyncratic to the type of water resources development. We conclude that the development and management of water resources is an important risk factor for schistosomiasis, and hence strategies to mitigate negative effects should become integral parts in the planning, implementation, and operation of future water projects.
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            The global status of schistosomiasis and its control.

            Schistosomiasis is being successfully controlled in many countries but remains a major public health problem, with an estimated 200 million people infected, mostly in Africa. Few countries in this region have undertaken successful and sustainable control programmes. The construction of water schemes to meet the power and agricultural requirements for development have lead to increasing transmission, especially of Schistosoma mansoni. Increasing population and movement have contributed to increased transmission and introduction of schistosomiasis to new areas. Most endemic countries are among the least developed whose health systems face difficulties to provide basic care at the primary health level. Constraints to control include, the lack of political commitment and infrastructure for public health interventions. Another constraint is that available anti-schistosomal drugs are expensive and the cost of individual treatment is a high proportion of the per capita drug budgets. There is need for increased support for schistosomiasis control in the most severely affected countries.
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              Association between genital schistosomiasis and HIV in rural Zimbabwean women.

              To determine the association between female genital Schistosoma haematobium infection and HIV. A cross-sectional study with a 1-year follow-up. Gynecological and laboratory investigations were performed for S. haematobium and HIV. Sexually transmitted infections, demographic and urogenital history were analysed as confounders. The participants were 527 sexually active, non-pregnant, non-menopausal women between the ages of 20 and 49 years. The setting was a rural Zimbabwean community where S. haematobium related lesions were found in 46% of the women, HIV in 29% and herpes simplex type- 2 (HSV-2) in 65%. In permanent residents (>3 years residency), HIV was found in 41% (29/70) of women with laboratory proven genital schistosomiasis as opposed to 26% HIV positive (96/375) in the schistosomal ova negative group [odds ratio (OR), 2.1; 95% confidence interval (CI), 1.2-3.5; P = 0.008. In multivariate analysis S. haematobium infection of the genital mucosa was significantly associated with HIV seropositivity (adjusted OR, 2.9; 95% CI, 1.11-7.5; P = 0.030). All seven women who became HIV positive during the study period (seroincidence 3.1%) had signs of S. haematobium at baseline. In accordance with other studies HIV was significantly associated with HSV-2 (OR, 3.0; 95% CI, 1.7-5.3; P < 0.001), syphilis and human papillomavirus. The highest HIV prevalence (45%) was found in the 25-29 years age group. Women with genital schistosomiasis had an almost three-fold risk of having HIV in this rural Zimbabwean community. Prospective studies are needed to confirm the association.

                Author and article information

                EDP Sciences
                03 April 2019
                : 26
                : ( publisher-idID: parasite/2019/01 )
                [1 ] Department of Medical Biochemistry, Faculty of Medical Sciences, University of Nigeria, Enugu Campus Enugu State Nigeria
                [2 ] National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention Shanghai PR China
                [3 ] College of Life Science, Fudan University Shanghai PR China
                [4 ] Nigerian Institute of Medical Research Lagos Nigeria
                Author notes
                parasite180129 10.1051/parasite/2019020
                © C.O. Ezeh et al., published by EDP Sciences, 2019

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 30, Pages: 10
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