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Nosocomial infections, a prevalent issue in intensive care units due to antibiotic overuse, could potentially be addressed by metal oxide nanoparticles (NPs). However, there is still no comprehensive understanding of the impact of NPs' size on their antibacterial efficacy. Therefore, this study provides a novel investigation into the impact of ZnO NPs' size on bacterial growth kinetics. NPs were synthesized using a sol-gel process with monoethanolamine (MEA) and water. X-ray diffraction (XRD), transmission electron microscopy (TEM), and Raman spectroscopy confirmed their crystallization and size variations. ZnO NPs of 22, 35, and 66 nm were tested against the most common nosocomial bacteria: Escherichia coli, Pseudomonas aeruginosa (Gram-negative), and Staphylococcus aureus (Gram-positive). Evaluation of minimum inhibitory and bactericidal concentrations (MIC and MBC) revealed superior antibacterial activity in small NPs. Bacterial growth kinetics were monitored using optical absorbance, showing a reduced specific growth rate, a prolonged latency period, and an increased inhibition percentage with small NPs, indicating a slowdown in bacterial growth. Pseudomonas aeruginosa showed the lowest sensitivity to ZnO NPs, attributed to its resistance to environmental stress. Moreover, the antibacterial efficacy of paint containing 1 wt% of 22 nm ZnO NPs was evaluated, and showed activity against E. coli and S. aureus.
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A mixed metal oxide W-TiO2 nanopowder photocatalyst was prepared by using the sol-gel method with a broad range of elemental compositions x = CW/(CW + CTi), including TiO2 and WO3. The material was structurally characterized and evaluated in adsorption and photocatalytic processes by testing its removal capacity of a representative pollutant methylene blue (MB) in aqueous solutions and under UV-A and sunlight illuminations. The nanopowders appeared to be more effective adsorbents than pure TiO2 and WO3 materials, showing a maximum at 15 mol% W, which was set as the tungsten solubility limit in anatase titania. At the same time, the photocatalytic decomposition of MB peaked at 2 mol% W. The examination of different compositions showed that the most effective MB removal took place at 15 mol% W, which was attributed to the combined action of adsorption and heterogeneous photocatalysis. Moreover, MB decomposition under sunlight was stronger than under UV-A, suggesting photocatalyst activation by visible light. The pollutant removal efficiency of the material with 15 mol% W was enhanced by a factor of ~10 compared to pure TiO2 at the beginning of the process, which shows its high potential for use in depollution processes in emergency cases of a great pollutant leak. As a result, a Wx=0.15-TiO2 catalyst could be of high interest for wastewater purification in industrial plants.
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INTRODUCTION: To improve and maintain quality and safety in anesthesia, standards have been proposed regarding human resources, facilities and equipment, medications and intravenous fluids, monitoring, and the conduct of anesthesia. Compliance with these standards remains a challenge in French-speaking sub-Saharan Africa (SSA) and results in high morbidity and mortality particularly in children. This aim of this study was to assess the progress made in improving the pediatric anesthesia infrastructures, human resources, education, medications, and equipment in French-speaking SSA over the past 10 years (2013-2022). METHODS: This is a descriptive, multicenter, cross-sectional study with retrospective data collection, conducted from September 1 to November 5, 2023. Comparative data from 2012 to 2022 were collected through an online survey. Descriptive statistics were used to summarize data. RESULTS: Data were obtained from 12 countries out of 14. The number of hospitals providing pediatric surgery and anesthesia rose from 94 in 2012 to 142 in 2022 (+51%). The total number of physician anesthesiologists rose from 293 (0.1 physician anesthesiologists/100 000 inhabitants) in 2012 to 597 (0.2 physician anesthesiologists/100 000 inhabitants) in 2022 (+103.7%). Five (0.006 physician anesthesiologists/100 000 children) had completed a fellowship in pediatric anesthesia and intensive care in 2012, and 15 (0.01 physician anesthesiologists/100 000 children) in 2022 (+200%). Five physician anesthesiologists had an exclusive pediatric anesthesia practice in 2012, whereas they were 32 in 2022 (+540%). There is no specialized training in pediatric anesthesia and intensive care in any of these countries. Halothane was always available in 81.5% of the hospitals in 2012, and in 50.4% of the hospitals in 2022. Sevoflurane was always available in 5% of the hospitals in 2012, and in 36.2% in 2022. Morphine was always available in 32.2% in 2012, whereas it was available in 52.9% of them in 2022. Pediatric pulse oximeter sensors were available in 36% of the hospitals in 2012, and in 63.4% in 2022. Capnography was available in 5.3% of the hospitals in 2012, and in 48% in 2022. CONCLUSION: Progress have been made over the last 10 years in French-speaking SSA to improve infrastructures, human resources, education, medications, and equipment for pediatric anesthesia in French-speaking SSA. However, major efforts must be continued. Standards adapted to the local context should be formulated.
Subject(s)
Anesthesia , Pediatrics , Humans , Cross-Sectional Studies , Africa South of the Sahara , Child , Retrospective Studies , Anesthesiology , Anesthesiologists/statistics & numerical data , Pediatric AnesthesiaABSTRACT
Introduction: Spermatic cord torsion (SCT) is a rare urological emergency that can jeopardize the fertility of the patient. Our study aimed to investigate the epidemiological, diagnostic and therapeutic aspects of SCT in Souro Sanou University Teaching Hospital. Materials and Methods: This was a descriptive cross-sectional study with retrospective data collection from January 1, 2017, to December 31, 2021, in the emergency surgical and urology division of Souro Sanou University Hospital. Results: The annual frequency of SCT was 4.4 patients/year. The mean age of the patients was 17.82 ± 6.74 years. Painful swelling of the hemi-scrotum was the main presenting symptom. The torsion involved the left spermatic cord in 50% of cases and both spermatic cords in 5% of cases. The mean time of symptoms before presentation was 78.8 hours ± 153 hours. Only 27.3% of patients presented before the 6th hour after the onset of pain. The average time from presentation to surgical intervention was 5.6 hours ± 5 hours. Orchiectomy was performed in 11 patients (47.8%). The average hospital stay was 3.1 ± 1.4 days. Conclusion: SCT is a rare urological emergency. The prognosis depends on the duration and degree of torsion. A high orchidectomy rate can be observed with a delay in presentation.
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The spread of SARS-CoV-2 cannot be well monitored and understood in areas without capacity for effective disease surveillance. Countries with a young population will have disproportionately large numbers of asymptomatic or pauci-symptomatic infections, further hindering detection of infection in the population. Sero-surveillance on a country-wide scale by trained medical professionals may be limited in scope in resource limited setting such as Mali. Novel ways of broadly sampling the human population in a non-invasive method would allow for large-scale surveillance at a reduced cost. Here we evaluate the collection of naturally bloodfed mosquitoes to test for human anti-SARS-CoV-2 antibodies in the laboratory and at five field locations in Mali. Immunoglobulin-G antibodies were found to be readily detectable within the mosquito bloodmeals by a bead-based immunoassay at least through 10 hours post-feeding with high sensitivity (0.900 ± 0.059) and specificity (0.924 ± 0.080), respectively, indicating that most blood-fed mosquitoes collected indoors during early morning hours (and thus, have likely fed the previous night) are viable samples for analysis. We find that reactivity to four SARS-CoV-2 antigens rose during the pandemic from pre-pandemic levels. Consistent with other sero-surveillance studies in Mali, crude seropositivity of blood sampled via mosquitoes was 6.3% in October/November 2020 over all sites, and increased to 25.1% overall, with the town closest to Bamako reaching 46.7% in February of 2021. Mosquito bloodmeals a viable target for conventional immunoassays, and therefore country-wide sero-surveillance of human diseases (both vector-borne and non-vector-borne) is attainable in areas where human-biting mosquitoes are common, and is an informative, cost-effective, non-invasive sampling option.
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Background: The spread of SARS-CoV-2 cannot be well monitored and understood in areas without capacity for effective disease surveillance. Countries with a young population will have disproportionately large numbers of asymptomatic or pauci-symptomatic infections, further hindering detection of infection. Sero-surveillance on a country-wide scale by trained medical professionals may be limited in a resource-limited setting such as Mali. Novel ways of broadly sampling the human population in a non-invasive method would allow for large-scale surveillance at a reduced cost. Approach: Here we evaluate the collection of naturally blood-fed mosquitoes to test for human anti-SARS-CoV-2 antibodies in the laboratory and at five field locations in Mali. Results: Immunoglobulin-G antibodies to multiple SARS-CoV-2 antigens were readily detected in mosquito bloodmeals by bead-based immunoassay through at least 10â h after feeding [mean sensitivity of 0.92 (95% CI 0.78-1) and mean specificity of 0.98 (95% CI 0.88-1)], indicating that most blood-fed mosquitoes collected indoors during early morning hours (and likely to have fed the previous night) are viable samples for analysis. We found that reactivity to four SARS-CoV-2 antigens rose during the pandemic from pre-pandemic levels. The crude seropositivity of blood sampled via mosquitoes was 6.3% in October and November 2020 across all sites, and increased to 25.1% overall by February 2021, with the most urban site reaching 46.7%, consistent with independent venous blood-based sero-surveillance estimates. Conclusions: We have demonstrated that using mosquito bloodmeals, country-wide sero-surveillance of human diseases (both vector-borne and non-vector-borne) is possible in areas where human-biting mosquitoes are common, offering an informative, cost-effective, and non-invasive sampling option.
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BACKGROUND: In 2015, the Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated Community Case Management (iCCM). This paper aims to analyze the impact of including community health workers (CHWs) as treatment providers outside the Health Facilities (HFs) on the coverage of SAM treatment when scaling up the intervention in the three largest districts of the Kayes Region in Mali. METHODS: A baseline coverage assessment was conducted in August 2017 in the three districts before the CHWs started treating SAM. The end-line assessment was conducted one year later, in August 2018. Coverage was assessed by the standardized methodology called Semi-Quantitative Evaluation of Access and Coverage (SQUEAC). The primary outcome was treatment coverage and other variables evaluated were the geographical distribution of the HFs, CHW's sites and overlapping between both health providers, the estimation of children with geographical access to health care and the estimation of children screened for acute malnutrition in their communities. RESULTS: Treatment coverage increased in Kayes (28.7-57.1%) and Bafoulabé (20.4-61.1%) but did not in Kita (28.4-28.5%). The decentralization of treatment has not had the same impact on coverage in all districts, with significant differences. The geospatial analyses showed that Kita had a high proportion of overlap between HFs and/or CHWs 48.7% (39.2-58.2), a high proportion of children without geographical access to health care 70.4% (70.1-70.6), and a high proportion of children not screened for SAM in their communities 52.2% (51.9-52.5). CONCLUSIONS: Working with CHWs in SAM increases treatment coverage, but other critical aspects need to be considered by policymakers if this intervention model is intended to be scaled up at the country level. To improve families' access to nutritional health care, before establishing decentralized treatment in a whole region it must be considered the geographical location of CHWs. This previous assessment will avoid overlap among health providers and ensure the coverage of all unserved areas according to their population densities need. TRIAL REGISTRATION: ISRCTN registry with ID 1990746. https://doi.org/10.1186/ISRCTN14990746.
Subject(s)
Community Health Workers , Severe Acute Malnutrition , Child , Humans , Mali , Severe Acute Malnutrition/therapy , Rural Population , Health FacilitiesABSTRACT
This chapter introduces unique methodology of antibacterial activity evaluation of nanoparticles in both solution and thin films. Nanoparticles of ZnO, TiO2, and CuO are synthesized via the sol-gel method. Antibacterial tests are carried out against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli bacteria using disk diffusion and bioluminescence. To perform antibacterial tests on thin films and to overcome bacterial strains recuperation on the supports, a new method of bacterial detaching from the slides is developed based on French standard NF EN 14561.
Subject(s)
Nanoparticles , Zinc Oxide , Anti-Bacterial Agents/pharmacology , Copper , Escherichia coli , Gram-Negative Bacteria , Microbial Sensitivity Tests , Titanium , Zinc Oxide/pharmacologyABSTRACT
Schistosomiasis is a helminthiasis infecting approximately 250 million people worldwide. In 2001, the World Health Assembly (WHA) 54.19 resolution defined a new global strategy for control of schistosomiasis through preventive chemotherapy programmes. This resolution culminated in the 2006 WHO guidelines that recommended empirical treatment by mass drug administration with praziquantel, predominately to school-aged children in endemic settings at regular intervals. Since then, school-based and community-based preventive chemotherapy programmes have been scaled-up, reducing schistosomiasis-associated morbidity. Over the past 15 years, new scientific evidence-combined with a more ambitious goal of eliminating schistosomiasis and an increase in the global donated supply of praziquantel-has highlighted the need to update public health guidance worldwide. In February, 2022, WHO published new guidelines with six recommendations to update the global public health strategy against schistosomiasis, including expansion of preventive chemotherapy eligibility from the predominant group of school-aged children to all age groups (2 years and older), lowering the prevalence threshold for annual preventive chemotherapy, and increasing the frequency of treatment. This Review, written by the 2018-2022 Schistosomiasis Guidelines Development Group and its international partners, presents a summary of the new WHO guideline recommendations for schistosomiasis along with their historical context, supporting evidence, implications for public health implementation, and future research needs.
Subject(s)
Anthelmintics , Helminthiasis , Schistosomiasis , Child , Humans , Child, Preschool , Praziquantel/therapeutic use , Schistosomiasis/drug therapy , Schistosomiasis/epidemiology , Schistosomiasis/prevention & control , Helminthiasis/drug therapy , Mass Drug Administration , Prevalence , World Health Organization , Anthelmintics/therapeutic useABSTRACT
BACKGROUND: Spatial repellents have been widely used for the prevention of mosquito bites but their efficacy in reducing mosquito-borne diseases has never been evaluated in Africa. Additionally, spatial repellents have the potential of being critical tools in the prevention of mosquito-borne diseases in contexts where typical vectors control efforts such as insecticide-treated nets (ITNs) and indoor residual spray (IRS) are inaccessible or underutilized such as among displaced populations or in emergency relief settings. To address this knowledge gap, Kolondieba District, Sikasso Region, Mali was selected as a site to estimate the impact of the Mosquito Shield™, a spatial repellent that incorporates transfluthrin on a plastic sheet, on malaria-related outcomes. Over the past decade, the Region of Sikasso, Health districts of Kadiolo, Yorosso, and Kolondieba have remained among the most afflicted, characterized by an annual parasite incidence of more than 116 cases per 1000 population [1] and a Plasmodium falciparum prevalence rate of 29.7% [2]. METHODS: Cluster-randomized, placebo-controlled, double-blinded clinical trial, whereby children ≥ 6 months to < 10 years old will be enrolled and followed to determine the time to malaria infection with monthly blood samples for microscopic diagnosis. A total of 1920 subjects (HHs) will be enrolled in 60 clusters (30 spatial repellent, 30 placebo). Malaria incidence will be estimated and compared to demonstrate and quantify the protective efficacy (PE) of a spatial repellent, in reducing malaria infection. Monthly mosquito collections using CDC light traps will be conducted to determine if there are entomological correlates of spatial repellent efficacy that may be useful for the evaluation of new spatial repellents. Quarterly human landing catches (HLC) will assess the behavioral effects of the intervention. DISCUSSION: Findings will serve as an efficacy trial of spatial repellent products for sub-Saharan Africa. Findings will be submitted to the World Health Organization Vector Control Advisory Group (WHO VCAG) for assessment of whether spatial repellents have "public health value." Entomological outcomes will also be measured as proxies of malaria transmission to help develop guidelines for the evaluation of future spatial repellent products. TRIAL REGISTRATION: ClinicalTrials.gov NCT04795648 . Registered on March 12, 2021.
Subject(s)
Insect Repellents , Insecticide-Treated Bednets , Insecticides , Malaria , Animals , Child , Humans , Incidence , Infant , Insecticides/pharmacology , Malaria/epidemiology , Malaria/prevention & control , Mali/epidemiology , Mosquito Control/methods , Randomized Controlled Trials as TopicABSTRACT
In this study, ultraporous aluminas (UPA) were synthesized as new effective adsorbents for Remazol Brilliant Blue R (RBBR) removal from aqueous solutions. The UPA monoliths were grown via facile oxidation process, followed by isochronous annealing treatment in air at different temperatures, through which γ, θ, and α phase polycrystalline fibrous grains of UPA can be accordingly obtained. The experimental factors that affect the material adsorption performances including initial pH, contact time, and temperature were comprehensively studied by batch experiments. The RBBR adsorption isotherms of UPA(γ) and UPA(θ) powders were found almost identical, while UPA(α) powders showed low effectiveness. To obtain the desirable mechanical stability of the UPA monolith with considerable RBBR adsorption capacity, UPA(θ) powders were further studied. The UPA(θ) powders exhibited maximum RBBR adsorption at pH 2 due to the positively charged surface under acidic conditions. Compared with the Lagergren pseudo-first-order model, the pseudo-second-order model was found to explain the adsorption kinetics better. Despite the film diffusion dominating the adsorption process, the contributions of the intraparticle diffusion and chemical reactions were also found significant. The adsorption equilibrium data at different temperatures were fitted by the Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich (D-R) isotherm models. The Langmuir model was found the most effective in the description of equilibrium data, and the maximum RBBR adsorption capacity retained by UPA(θ) powders was 122.55 mg·g-1 at 295 K. Thermodynamic parameters (ΔG0, ΔH0, and ΔS0) indicated the adsorption process was spontaneous and exothermic in nature.
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(1) Background: The Ministry of Health in Mali included the treatment of severe acute malnutrition (SAM) into the package of activities of the integrated community case management (iCCM). This paper evaluates the most effective model of supervision for treating SAM using community health workers (CHWs). Methods (2): This study was a prospective non-randomized community intervention trial with two intervention groups and one control group with different levels of supervision. It was conducted in three districts in rural areas of the Kayes Region. In the high supervision group, CHWs received supportive supervision for the iCCM package and nutrition-specific supervision. In the light supervision group, CHWs received supportive supervision based on the iCCM package. The control group had no specific supervision. (3) Results: A total of 6112 children aged 6-59 months with SAM without medical complications were included in the study. The proportion of cured children was 81.4% in those treated by CHWs in the high supervision group, 86.2% in the light supervision group, and 66.9% in the control group. Children treated by the CHWs who received some supervision had better outcomes than those treated by unsupervised CHWs (p < 0.001). There was no difference between areas with light and high supervision, although those with high supervision performed better in most of the tasks analyzed. (4) Conclusions: Public policies in low-income countries should be adapted, and their model of supervision of CHWs for SAM treatment in the community should be evaluated.
Subject(s)
Child Nutrition Disorders/therapy , Community Health Workers , Severe Acute Malnutrition/therapy , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Mali , Prospective Studies , Socioeconomic Factors , Surveys and Questionnaires , Treatment OutcomeABSTRACT
We report on an elaboration of new composite photocatalysts (TiO2-P25@ n-TiO2@HAP) based on grafted size-selected 5-nm titanium-oxo-alkoxo nanoparticles on P25-TiO2 nanoparticles and HAP obtained by co-precipitation of salts. The 5-nm oxo-TiO2 particles were prepared in a sol-gel reactor with rapid reagents micromixing. The photocatalytic test of ethylene degradation, in a continuous-flow fixed-bed reactor, showed an increase of the photocatalytic yield for the composite photocatalysts with an addition of HAP. This result was interpreted by a synergy between adsorption and photo-oxidation.
Subject(s)
Nanoparticles , Titanium , Adsorption , CatalysisABSTRACT
In Mali, qualified laboratories for testing of dangerous pathogens are centralized in Bamako. Creating a specimen transport system respecting timeline, specimen quality, biosafety, and biosecurity standards is a challenge. The current ad hoc system that relies on untrained public transport companies carries risks of spoilage, accidental release of pathogens, and delays, which compromise specimen quality. This pilot study aimed to evaluate the effectiveness (ie, timeline, quality of specimen, and cost) of using the trained postal service for sample transportation from district to central level, compared with the current system. The postal service intervention ran from mid-2016 to mid-2017 and covered 3 districts. Data were collected in the same districts during the same period of the preceding year for comparison. In all, 41 specimens were shipped using public transportation and 51 were shipped using the postal service. These included suspected meningitis, measles, yellow fever, and polio samples. Only 46% of samples sent by public transportation were received in Bamako within 72 hours of collection, compared to 71% of samples shipped via the postal service (p < .05). Further, 93% of samples shipped by public transportation arrived in good condition at the receiving laboratory, compared to 98% by postal service. Although cost comparisons were difficult (flat fee vs per-specimen fare), the average cost per specimen was 8 times higher with the postal service. Shipment of specimens from districts to central level using the postal service was feasible and appeared to be faster than public transportation, thus allowing specimen quality to be preserved. Further analysis regarding the most efficient costing mechanism is needed.
Subject(s)
Specimen Handling/methods , Transportation/methods , Communicable Diseases , Humans , Mali , Pilot Projects , Postal Service/economics , Specimen Handling/standards , Time Factors , Transportation/economicsABSTRACT
The high frequency and incidence of foodborne outbreaks related to fresh vegetables consumption is a major public health concern and an economic burden worldwide. This study evaluated the effect of individual and combined application of ultrasound (40 kHz, 100 W) and ozone on the inactivation of foodborne Escherichia coli and Salmonella, as well as their impact on cabbage color and vitamin C content. Plate count, scanning electron microscopy (SEM), and flow cytometry (FCM) following single or double staining with carboxyfluorescein diacetate and (or) propidium iodide were used to determine bacterial inactivation parameters, such as cell culturability, membrane integrity, intracellular enzyme activity, and injured and dead cells. The results of FCM and SEM showed that ultrasound treatment affected bacteria mainly by acting on the cell membrane and inactivating intracellular esterase, which resulted in bacterial death. Furthermore, when combined with ozone at 1.5 mg/L, the maximum reduction of bacterial populations was observed at 8 min with no damage on the surface of treated leaves. Therefore, fresh products sanitization using a combination of ultrasound and ozone has the potential to be an alternative for maintaining the color and vitamin C content of green cabbage.
Subject(s)
Anti-Infective Agents/pharmacology , Brassica/microbiology , Escherichia coli/drug effects , Food Microbiology , Ozone/pharmacology , Salmonella/drug effects , Ascorbic Acid/analysis , Bacterial Proteins/drug effects , Bacterial Proteins/metabolism , Brassica/chemistry , Color , Escherichia coli/growth & development , Esterases/drug effects , Esterases/metabolism , Fluoresceins , Food Contamination/prevention & control , Plant Leaves/chemistry , Plant Leaves/microbiology , Propidium , Salmonella/growth & development , Ultrasonic WavesABSTRACT
This is a report on the antibacterial activity of ZnO and CuO nanoparticles synthesized via sol-gel method. The studies were performed on Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli and Pseudomonas aeruginosa bacteria using disc and well diffusion methods, bioluminescence and optical density analysis. The results show a strong decline of bacterial strains after a short contact with nanoparticles. The modelling allowed clarifying the bacterial sensitivity of toxic agents at different stages of their population evolution kinetics. It was concluded that the bacterial suppression is most effective at the exponential growth phase while it is of a lower effectiveness at the lag and stationary phases. The CuO and ZnO nanoparticles showed comparable effectiveness at the exponential growth phase. In the same time, ZnO was almost inactive at the lag phase and of lower effectiveness at the stationary phase, at which CuO conserved a significant activity.
Subject(s)
Anti-Bacterial Agents/pharmacology , Copper/pharmacology , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Metal Nanoparticles/chemistry , Zinc Oxide/pharmacology , Microbial Sensitivity Tests/methods , Particle SizeABSTRACT
BACKGROUND: Schistosomiasis is one of the neglected tropical diseases endemic to Mali. There has been insufficient investigation of the morbidity burden in highly endemic irrigated rice areas with the ongoing mass drug administration with praziquantel. In February 2005, a year after an initial mass drug administration in 2004, we performed the first cross-sectional survey of schistosomiasis in the Kokry-Bozo village in the Office du Niger rice irrigation region. In the fourteen years since this survey, there has been almost no research into schistosomiasis morbidity in Mali due to lack of funding. Therefore, the 2005 survey supplies near-baseline data for any future research into the treatment impacts in the area. METHODS: One hundred and ninety-four children aged 6-14â¯years from two schools were assessed for bladder pathology by ultrasound, and for anaemia and micro-haematuria by laboratory tests. Schistosoma eggs were examined microscopically in fresh stool and urine samples. Multivariate logistic regression analysis quantified the association of Schistosoma infections with anaemia, bladder pathology and micro-haematuria. Akaike's information criterion was used to test the assumption of linear effects of infection intensity classes and used to compare across models. RESULTS: The overall prevalence of schistosomiasis in 189 school children was 97%; 17% (33/189) had a single infection (S. mansoni,13%, or S. haematobium, 4%) and 80% (156/189) were co-infected with S. mansoni and S. haematobium. The overall prevalence of S. mansoni with light infection was 27% (53/194), moderate infection was 24% (47/194) and heavy infection was 42% (81/194). Of the 194 of children investigated for S. haematobium 59% (114/194) had light infection and 26% (50/194) had heavy infection. No hookworm eggs were detected. The level of abnormal bladder pathology was 18% (35/189) with the highest found in 10-14â¯year old children. The prevalence of anaemia was 91% (172/189) and was twice as likely to be associated (OR 2.0, 95% CI 1.1-3.9) with S. mansoni infections than in children without infection. As infection intensity with S. mansoni increased the risk of anaemia (OR 2.0, 95% CI 1.1-3.9) also increased. As infection intensity with S. haematobium increased bladder pathology (OR 2.4, 95%CI 1.3-4.5), haematuria (OR 6.7, 95%CI 3.3-13.6) and micro-haematuria increased (OR 2.4, 95%CI 1.3-4.5). CONCLUSION: Our research contributes an important micro-geographical assessment of the heavy burden of schistosomiasis and associated morbidity in children who live in the rice irrigation regions. Our literature review found that there has been very limited research conducted on the impact of the treatment to control morbidity in the ON. Therefore, there is a need to do a comparable, but more extensive, study to identify any changes in morbidity and to indicate current requirements for the control programme. Our results from 2005 called for routine integration of iron supplementation, food fortification and diet diversification into the deworming program.