ABSTRACT
Contexte & objectif : Les adultes fortement exposés par leurs activités professionnelles dans l'eau douce dans les régions d'endémicité de la schistosomiase, entretiennent la transmission de la maladie. Il est donc nécessaire d'investiguer sur leurs fréquences afin de lutter contre la pérennité de la schistosomiase. Méthodes : Il s'agissait d'une étude transversale, réalisée entre septembre et octobre 2019, chez creuseurs le long de la rivière N'djili. Les Schistoma étaient systématiquement recherchés à la fois dans les échantillons de selles et des urines. Résultats : Au total 224 creuseurs de sables ont été examinés. La fréquence de la Schistosomiase était de 28,6 % (IC : 22,8-35). Les S. mansoni (22,8 %), S. intercalatum (3,1 %) et S. haematobium (2,7 %) ont été détectés. Le revenu financier supérieur ou égal au SMIG (ORa= 1,8 ; IC 95% : 1,0 3,4), était associé à la schistosomiase. Conclusion : Les creuseurs s'exposent et entretiennent la schistosomiase. Parmi les espèces qui les affectent, nous comptons également le S. intercalatum à Kinshasa. Il faut donc une étude complémentaire de comparaison avec les autres catégories professionnelles
Context and objective. Adults who are highly exposed to schistosomiasis through their professional activities in freshwater in regions where the disease is endemic, maintain the transmission of the disease. It is therefore necessary to investigate their frequency in order to combat the perpetuation of schistosomiasis. Methods. This was a cross-sectional study, carried out from September to October 2019, among diggers along the N'djili River. Schistosoma were systematically tested both in the stools and urine. Results. A total of 224 sand diggers were included. The prevalence of Schistosomiasis was 28.6 % (95 % CI: 22.8-35). S. mansoni (22.8 %), S. intercalatum (3.1 %) and S. haematobium (2.7 %) were detected. Financial income greater than or equal to SMIG (ORa= 1.8; 95 % CI: 1.0 - 3.4), was associated with schistosomiasis. Conclusion: Diggers are exposed to and maintain schistosomiasis. S. intercalatum is found among the species that affect the diggers in Kinshasa. Therefore, there is need to carry out a further comparative study with other occupational categories.
Subject(s)
Humans , Male , Female , RiversABSTRACT
BACKGROUND: In the Democratic Republic of Congo, artesunate-amodiaquine (ASAQ) is the first-line medication recommended for uncomplicated malaria treatment. We conducted a study in Kinshasa to describe the clinical features of the disease and assess the efficacy of ASAQ and its impact on the multiplicity of infection in children with uncomplicated malaria. METHODS: Children aged 12 to 59 months with uncomplicated P. falciparum malaria were treated with ASAQ and followed up passively for 42 days. To distinguish new infections from recrudescent parasites, samples were genotyped using a stepwise strategy with three molecular markers (GLURP, MSP2 and MSP1). We then assessed PCR-corrected and -uncorrected day-42 cure rates and multiplicity of infection (MOI). RESULTS: In total, 2,796 patients were screened and 865 enrolled in the study. Clinical features were characterized by history of fever (100%), coryza (59.9%) and weakness (59.4%). The crude and PCR-corrected efficacies of ASAQ were 55.3% (95%CI: 51.8-58.8) and 92.8% (95%CI: 91.0-94.6) respectively, as 83.6% (95%CI: 79.1-87.2) of the recurrences were new infections. Compared to monoclonal infections, polyclonal infections were more frequent at enrollment (88.1%) and in recurrences (80.1%; p = 0.005; OR: 1.8, 95%CI: 1.20-2.8). The median MOI at enrollment (MOI = 3.7; IQR: 0.7-6.7) decreased to 3 (IQR: 1-5) in the recurrent samples (p<0.001). Patients infected with a single haplotype on day 0 had no recrudescence; the risk of recrudescence increased by 28% with each additional haplotype (HR: 1.3, 95%CI: 1.24-1.44). CONCLUSION: The PCR-corrected efficacy of ASAQ at day 42 was 92.8%, but crude efficacy was relatively poor due to high reinfection rates. Treatment outcomes were positively correlated with MOI. Continued monitoring of the efficacy of ACTs-ASAQ, in this case-is paramount. TRIAL REGISTRATION: ClinicalTrials.gov NCT01374581.
Subject(s)
Amodiaquine/therapeutic use , Antimalarials/therapeutic use , Artemisinins/therapeutic use , Malaria, Falciparum/drug therapy , Malaria, Falciparum/parasitology , Plasmodium falciparum/drug effects , Child, Preschool , Democratic Republic of the Congo/epidemiology , Drug Combinations , Female , Humans , Infant , Malaria, Falciparum/epidemiology , Male , Plasmodium falciparum/pathogenicity , Treatment OutcomeABSTRACT
School-aged children suffer the most from schistosomiasis infection in sub Saharan Africa due to poverty and limited sanitary conditions. Mapping of disease burden is recommended and there is a need of updating prevalence data which is as old as 20 years in the Democratic Republic of Congo. An epidemiological and parasitological study was carried out in 2011 in the health zone of Kasansa. Six health areas (HA) were included in the study. In each health area, one primary school was selected. School-aged children were screened for S. mansoni infection using parallel Kato-Katz and direct microscopy techniques. A total of 335 school-aged children were screened. The average prevalence was 82.7% and ranged between 59.5-94.9%. Four of the six HAs had a prevalence level over 91%. Of all infected children, about half 112 (43.2%) had light parasite density. These results demonstrate that Schistosoma mansoni infection is a bigger problem than anticipated and there is an urgent need to implement effective control measures.