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The Epidemiology and Chemotherapeutic Approaches to the Control of Urinary Schistosomiasis in School-Age Children

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The Epidemiology and Chemotherapeutic Approaches to the Control of Urinary Schistosomiasis in School-Age Children Atalabi and Adubi BMC Infectious Diseases (2019) 19:73 https://doi.org/10.1186/s12879-018-3647-y RESEARCHARTICLE Open Access The epidemiology and chemotherapeutic approaches to the control of urinary schistosomiasis in school-age children (SAC): a systematic review Tolulope Ebenezer Atalabi1* and Taiwo Oluwakemi Adubi2 Abstract Background: Human schistosomiases are acute and chronic infectious diseases of poverty. Currently, epidemiological data of urinary schistosomiasis (US) in school-age children (SAC) and adults are often reported together making it difficult to ascertain the true status of the disease. Based on this premise, we set out to carry out this review. Method: To achieve this aim, we carried out a computer-aided search of PubMed, Web of Science, Science Direct, African Journals OnLine (AJOL) and the database of World Health Organization. However, the information obtained from these sources was supplemented with additional literatures from Mendeley,ARTICLE Research Gate, and Google. Results: The search yielded 183 literatures of which 93 full text research, review and online articles were deemed fit for inclusion. Our key findings showed that: (1) of all World Health Organization (WHO) Regions, Africa is the most endemic zone for US, with Kenya and Senegal recording the highest prevalence and mean intensity respectively; (2) SAC within the range of 5–16 years contribute most significantly to the transmission cycle of US globally; (3) gender is a factor to watch out for, with male often recording the highest prevalence and intensity of infection; (4) contact with open, potentially infested water sources contribute significantly to transmission; (5) parental factors (occupation and education status) predispose SAC to US; (6) economic vis a vis ecological factors play a key role in infection transmission; and (7) in the last decade, a treatment coverage of 45% was never achieved globally for SAC or non-SAC treatment category for urinary schistosomiasis. Conclusion: In view of the WHO strategic plan to eliminate schistosomiasis by 2020 and the findings from this review, it is obvious that this goal, in the face of realities, might not be achieved. It is imperative that annual control programmes be scaled up marginally, particularly in the African region of WHO. While US-based researches should be sponsored at the grass-root level to unveil hidden endemic foci, adequate facilities for Water, Sanitation, and Hygiene (WASH) should be put in place in all schools globally. Keywords: Prevalence, Control, Urinary, Schistosomiasis, School, Children RETRACTED * Correspondence: [email protected] 1Department of Biological Sciences, Federal University, Dutsin-Ma, Km 65, P.M.B. 5001, Dutsin-Ma, Katsina State, Nigeria Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This 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. Atalabi and Adubi BMC Infectious Diseases (2019) 19:73 Page 2 of 12 Background Currently, epidemiological data on prevalence, inten- Human schistosomiases are acute and chronic infectious sity and control of US in SAC and adults are often diseases associated with abject poverty in 78 low and reported together, thus making information peculiar to middle-income countries in the sub-tropical and tropical SAC to be insufficient in the literature. The implication parts of the world where there is negligible access to of this is that it is difficult to ascertain the epidemio- potable water and adequate sanitation. The agents of logical status of the disease in this group to enhance the etiology of these diseases are “blood-thirsty” digenetic success of control programmes targeting this group. trematodes in the genus Schistosoma [1, 2]. Based on this premise, the aim of this review article was Freshwater gastropod snails in the genus Bulinus are to study the epidemiology and chemotherapeutic strat- suitable intermediate hosts to Schistosoma haematobium egies to the control of US in SAC. which causes urinary schistosomiasis. The transmission gap of the disease is bridged when people come into Methods contact with unwholesome water sources [3–5] infested Search strategy with the cercariae (infective larval form) which mechan- We carried out a computer-aided search of PubMed, ically penetrates the skin of their human definitive hosts. Web of Science, Science Direct, African Journals OnLine A transmission cycle is consolidated when infected (AJOL) and the database of World Health Organization humans, due to lack of modern waste disposal facilities, (WHO). However, the information obtained from these indiscriminately pass urine-infested eggs in close prox- sources was supplemented with additional literatures imity to water bodies where they hatch into larval form from Mendeley, Research Gate, and Google. The (called miracidia) which infect Bulinus. In humans, cer- searches were performed independently by the authors cariae undergo series of larval migration before maturing using the key words: “urinary/urinary schistosomiasis” in into adults which migrate to the veins of the urinary combination with “prevalence”, “intensity”, “morbidity”, tract where gravid females lay a large number of eggs “control/praziquantel”, “school” and “children”. which are responsible for the various signs, symptoms ARTICLE and morbidity associated with the disease. The classical Selection criteria sign of urinary schistosomiasis is haematuria, a term Literatures that address prevalence, intensity, morbidity, coined to describe the presence of blood in urine. indicators or risk factors as well as the control of US, Genital schistosomiais causes pathological damage in without restriction to year of publication, were included both sexes, with females being more at risk of contract- in this review article. Besides, such papers addressed ing Human Immuno-Deficiency Virus (HIV) [6, 7]. school children specifically. The implication of this is Nonetheless, a review of the burden of schistosomiasis that articles exclusively addressing intestinal schistosom- has shown that over 200, 000 people die from the com- iasis or other Neglected Tropical Diseases were not plications due to the disease in Sub-Saharan Africa considered eligible for inclusion. (SSA) annually while children suffer anaemia, stunted growth [8, 9], urinary tract damage [10] and reduced Analysis and presentation of data mental ability to cope with academics. In advanced The secondary data presented in this manuscript were cases, hydronephrosis, [11] ureteral and bladder fibrosis/ manually extracted from the articles included in this cancer commonly occur [6]. review paper. Data imported into Microsoft Excel As a follow up to the 2001 World Health Assembly Spreadsheet were used to generate Bar Charts. resolution WHA54.19, many endemic countries in Af- rica launched national control programmes largely based Results on preventive chemotherapeutic intervention with prazi- The search quantel (PZQ) targeting at least 75% of school-age The search yielded 183 literatures. After proper scrutiny children-SAC (5─14 years old) and adults at risk of of the retrieved literatures, 93 full text research, review schistosomiasis [12, 13] by 2010. This resolution aligns and online articles were deemed fit for inclusion. Conse- properly with earlier report that SAC, adolescent and quently, this review is a product of the findings from youngRETRACTED adults usually recorded the highest prevalence these articles. The flow chart in Fig. 1 shows the result and intensities of schistosomiasis [14]. Meanwhile, the of our search. guideline of World Health Organization required that treatment of SAC (enrolled and not enrolled) be Characteristics of the included articles done: once every year for high-risk communities, once Of the 93 literatures included in this review, majority, 46 every two years for moderate-risk communities and (49.46%), were products of researches/reviews carried out twice during their Primary School Age in low-risk in African WHO Region, with Nigeria recording the sec- communities [13, 15]. ond largest number of articles, 19 (20.43%). Switzerland in Atalabi and Adubi BMC Infectious Diseases (2019) 19:73 Page 3 of 12 Fig. 1 Flowchart of the article search and selection process European Region, however, accounted for the largest, 22 tested positive for US, resulting in a prevalence rate of (23.66%), which were all technical reports/review articles 0.31%. (see Table 1). In Cameroon,ARTICLE out of the 1346 school children inter- The sampling years reported by the 61 research arti- viewed and examined as reported by two articles, 446 cles included in this review ranged from 1984 to 2017, were found to be suffering from the menace of US, with the studies executed between 2004 and 2017 being giving a prevalence rate of 33.14%. 11 times more in number than those carried out in each Furthermore, a prevalence of 67.16% was computed of 1984–1993 and 1994–2003. Sixty-Five point from a total sample size of 539 reported by two Fifty-Eight
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