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      Schistosoma haematobium infection morbidity, praziquantel effectiveness and reinfection rate among children and young adults in Gabon

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          Abstract

          Background

          Sub-Saharan Africa carries most of the global burden of schistosomiasis. To optimize disease control and reduce morbidity, precise data are needed for control measures adapted to the local epidemiological situation. The objective of this study is to provide baseline information on schistosomiasis dynamics, including praziquantel (PZQ) treatment outcome in children and young adults living in the vicinity of Lambaréné, Gabon.

          Methods

          Eligible volunteers were included into a prospective longitudinal study. Urine filtration technique was used to detect eggs in urine for schistosomiasis diagnosis. Subjects were treated with 60 mg of PZQ once per month for three consecutive months, and the outcome was assessed by cure rate (CR) and egg reduction rate (ERR).

          Results

          A total of 328 volunteers were enrolled in the study with a mean (± SD) age of 12.2 ± 4.7 years-old. The female-to-male ratio was 0.99. Out of 258 participants in total, 45% had schistosomiasis during the survey and 43% presented with heavy infections. The incidences of haematuria and schistosomiasis were 0.11 and 0.17 person-years, respectively. After the first and third dose of PZQ, overall ERR of 93% and 95% were found, respectively; while the CR were 78% and 88%, respectively. Both ERR (100 vs 88%) and CR (90 vs 68%) were higher among females than males after the first dose. The CR increased for both groups after the third dose to 95% and 80%, respectively. After the first PZQ dose, ERR was higher for heavy compared to light infections (94 vs 89%), while the CR was higher for light than for heavy infections (87 vs 59%). After the third PZQ dose, ERR increased only for light infections to 99%, while CR increased to 98% and 75% for light and for heavy infections, respectively. The reinfection rate assessed at a mean of 44.6 weeks post-treatment was 25%.

          Conclusions

          The prevalence of schistosomiasis is moderate in communities living in the vicinity of Lambaréné, where a subpopulation with a high risk of reinfection bears most of the burden of the disease. To improve schistosomiasis control in this scenario, we suggest education of these high-risk groups to seek themselves a one-year PZQ treatment.

          Trial registration clinicaltrials.gov Identifier NCT 02769103. Registered 11 May 2016, retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02769013

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          Most cited references25

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          How to Calculate Sample Size for Different Study Designs in Medical Research?

          Calculation of exact sample size is an important part of research design. It is very important to understand that different study design need different method of sample size calculation and one formula cannot be used in all designs. In this short review we tried to educate researcher regarding various method of sample size calculation available for different study designs. In this review sample size calculation for most frequently used study designs are mentioned. For genetic and microbiological studies readers are requested to read other sources.
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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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              Schistosomiasis.

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                Author and article information

                Contributors
                jcagobe@gmail.com
                jronaldedoa@gmail.com
                hyjosy@gmail.com
                zinaff@gmail.com
                aromakobs@gmail.com
                mngwese@gmail.com
                ancemangaboula@gmail.com
                bertrand.lell@gmail.com
                m.p.grobusch@amsterdamumc.nl
                benjamin.murdmueller@uni-tuebingen.de
                aadegnika@gmail.com
                Journal
                Parasit Vectors
                Parasit Vectors
                Parasites & Vectors
                BioMed Central (London )
                1756-3305
                10 December 2019
                10 December 2019
                2019
                : 12
                : 577
                Affiliations
                [1 ]GRID grid.452268.f, Centre de Recherches Médicales de Lambaréné, ; Lambaréné, Gabon
                [2 ]ISNI 0000000084992262, GRID grid.7177.6, Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, , University of Amsterdam, ; Amsterdam, The Netherlands
                [3 ]ISNI 0000000089452978, GRID grid.10419.3d, Department of Parasitology, , Leiden University Medical Center, ; Leiden, The Netherlands
                [4 ]ISNI 0000 0000 9259 8492, GRID grid.22937.3d, Division of Infectious Diseases and Tropical Medicine, Department of Medicine 1, , Medical University of Vienna, ; Vienna, Austria
                [5 ]ISNI 0000 0001 2190 1447, GRID grid.10392.39, Institut für Tropenmedizin, , Eberhard Karls Universität Tübingen, ; Partner Site, Tübingen, Germany
                [6 ]GRID grid.452463.2, German Center for Infection Research, ; Tübingen, Germany
                Author information
                http://orcid.org/0000-0003-3816-998X
                Article
                3836
                10.1186/s13071-019-3836-6
                6905022
                31823806
                a3774e45-29e0-4cc2-b2ca-caf84f0ab627
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 May 2019
                : 3 December 2019
                Funding
                Funded by: Deutsche ForschungsGemeinschaft
                Award ID: GZ:MO 1071/12-1 AOBJ: 620617
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Parasitology
                schistosoma spp.,morbidity,praziquantel,egg rate reduction,cure rate,efficacy,effectiveness,reinfection,incidence,prevalence

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