Systems epidemiology of snail-borne diseases: from methodological to social-ecological considerations in the fight towards elimination INAUGURALDISSERTATION Zur Erlangung der Würde eines Doktors der Philosophie vorgelegt der Philosophisch-Naturwissenschaftlichen Fakultät der Universität Basel von Stefanie Jennifer Krauth aus Lörrach (Deutschland) Basel, 2017 Originaldokument gespeichert auf dem Dokumentenserver der Universität Basel edoc.unibas.ch Genehmigt von der Philosophisch-Naturwissenschaftlichen Fakultät auf Antrag von Prof. Dr. Jürg Utzinger; Prof. Dr. Julie Balen Basel, 15.09.2015 Prof. Dr. Jörg Schibler Dekan der Philosophisch- Naturwissenschaftlichen Fakultät Für Dich! i Table of content Table of content Table of content........................................................................................................ ii Index of figures ........................................................................................................ v Index of tables ........................................................................................................ vii Summary ................................................................................................................... 1 1. Introduction ....................................................................................................... 5 1.1 Distribution and disease burden of the snail-borne trematodes schistosomiasis and fascioliasis ................................................................. 5 1.2 Burden of disease through schistosomiasis and fascioliasis ......................... 8 1.3 Biology and life cycles of schistosomiasis and fascioliasis ............................ 9 1.4 Morbidity due to snail-borne trematodes: .................................................... 13 1.5 Diagnostics .................................................................................................. 17 1.6 Treatment and control ................................................................................. 19 1.7 References .................................................................................................. 22 2. Goals and specific objectives ........................................................................ 35 2.1 Specific objectives ....................................................................................... 35 3. Study sites, survey design and sample size ................................................. 36 4. A guide to household sampling in the field: computer-simulated comparison of existing methods and review of the literature ................. 41 4.1 Abstract ....................................................................................................... 42 4.2 Introduction ................................................................................................. 43 4.3 Materials and methods ................................................................................ 45 4.4 Results ........................................................................................................ 47 4.5 Discussion ................................................................................................... 63 4.6 References: ................................................................................................. 71 5. All that is blood is not schistosomiasis: considerations for the use of reagent strip testing for urogenital schistosomiasis with special consideration to very low prevalence settings ............................ 75 5.1 Abstract ....................................................................................................... 76 5.2 Introduction ................................................................................................. 77 ii Table of content 5.3 Materials and methods ................................................................................ 78 5.4 Results ........................................................................................................ 82 5.5 Discussion .................................................................................................. 93 5.6 Conclusion .................................................................................................. 96 5.7 Acknowledgements ..................................................................................... 96 5.8 References ................................................................................................. 97 6. Validation of a point-of-care circulating cathodic antigen urine test for Schistosoma mansoni diagnosis in the Sahel, and potential cross-reaction with pregnancy ................................................................ 101 6.1 Abstract ..................................................................................................... 102 6.2 Introduction ............................................................................................... 103 6.3 Materials and Methods .............................................................................. 104 6.4 Results ...................................................................................................... 105 6.5 Discussion ................................................................................................ 109 6.6 Acknowledgements ................................................................................... 110 6.7 References ............................................................................................... 111 7. Access to, and use of, water by populations living in a schistosomiasis and fascioliasis co-endemic area of northern Côte d’Ivoire ............................................................................................... 115 7.1 Abstract ..................................................................................................... 116 7.2 Introduction ............................................................................................... 117 7.3 Materials and Methods .............................................................................. 118 7.4 Results ...................................................................................................... 121 7.5 Discussion ................................................................................................ 131 7.6 Acknowledgements ................................................................................... 134 7.7 References ............................................................................................... 135 8. Distribution of intermediate host snails of schistosomiasis and fascioliasis in relation to environmental factors during the dry season in the Tchologo region, Côte d’Ivoire ......................................... 139 8.1 Abstract ..................................................................................................... 140 8.2 Introduction ............................................................................................... 141 iii Table of content 8.3 Materials and Methods .............................................................................. 142 8.4 Results ...................................................................................................... 147 8.5 Discussion ................................................................................................. 161 8.6 References ................................................................................................ 165 9. Discussion: .................................................................................................... 171 9.1 From innovation to application .................................................................. 171 9.2 Towards a more holistic systems view of the interrelation between snail-borne trematodiases and the health and wellbeing of populations............................................................................................. 173 9.3 Conclusions ............................................................................................... 185 9.4 Identified research needs .......................................................................... 185 9.5 References ................................................................................................ 188 10. Curriculum Vitae ........................................................................................... 213 iv Index of figures Index of figures FIGURE 1.1 GLOBAL DISTRIBUTION OF HUMAN SCHISTOSOMIASIS ............................................. 6 FIGURE 1.2 GLOBAL DISTRIBUTIYYYYON OF HUMAN FASCIOLIASIS ............................................. 7 FIGURE 1.3 LIFE CYCLE OF SCHISTOSOMA SPP . .....................................................................11 FIGURE 1.4. LIFE CYCLE OF FASCIOLA SPP . ...........................................................................13 FIGURE 3.1 STUDY AREA ......................................................................................................39 FIGURE 4.1 HISTOGRAMS OF HOUSEHOLD INCLUSION FREQUENCY PER SIMULATED METHOD AT 30% CHANCE OF MEETING INCLUSION CRITERIA . .............................................................53 FIGURE 4.2 HISTOGRAMS OF HOUSEHOLD INCLUSION FREQUENCY PER SIMULATED METHOD AT 95% CHANCE OF MEETING INCLUSION CRITERIA . .............................................................54 FIGURE 4.3 FREQUENCY -DISTRIBUTION OF HOUSEHOLD INCLUSION OVER 250 ITERATIONS FROM THE RANDOM SAMPLING . ................................................................................................55