Micro-geographical heterogeneity in and infection and morbidity in a co-endemic community in Northern Senegal

L. Meurs, M. Mbow, N. Boon, F. Van den Broeck, Kim Vereecken, T.N. Dieye, E. Abatih, T. Huyse, S. Mboup, K. Polman

Research output: Contribution to journalA1: Web of Science-article

13 Downloads (Pure)

Abstract

BACKGROUND: Schistosoma mansoni and S. haematobium are co-endemic in many areas in Africa. Yet, little is known about the micro-geographical distribution of these two infections or associated disease within such foci. Such knowledge could give important insights into the drivers of infection and disease and as such better tailor schistosomiasis control and elimination efforts. METHODOLOGY: In a co-endemic farming community in northern Senegal (346 children (0-19 y) and 253 adults (20-85 y); n = 599 in total), we studied the spatial distribution of S. mansoni and S. haematobium single and mixed infections (by microscopy), S. mansoni-specific hepatic fibrosis, S. haematobium-specific urinary tract morbidity (by ultrasound) and water contact behavior (by questionnaire). The Kulldorff's scan statistic was used to detect spatial clusters of infection and morbidity, adjusted for the spatial distribution of gender and age. PRINCIPAL FINDINGS: Schistosoma mansoni and S. haematobium infection densities clustered in different sections of the community (p = 0.002 and p = 0.023, respectively), possibly related to heterogeneities in the use of different water contact sites. While the distribution of urinary tract morbidity was homogeneous, a strong geospatial cluster was found for severe hepatic fibrosis (p = 0.001). Particularly those people living adjacent to the most frequently used water contact site were more at risk for more advanced morbidity (RR = 6.3; p = 0.043). CONCLUSIONS/SIGNIFICANCE: Schistosoma infection and associated disease showed important micro-geographical heterogeneities with divergent patterns for S. mansoni and S. haematobium in this Senegalese community. Further in depth investigations are needed to confirm and explain our observations. The present study indicates that local geospatial patterns should be taken into account in both research and control of schistosomiasis. The observed extreme focality of schistosomiasis even at community level, suggests that current strategies may not suffice to move from morbidity control to elimination of schistosomiasis, and calls for less uniform measures at a finer scale.
Original languageEnglish
JournalPLoS Neglected Tropical Diseases
Volume7
Issue number12
Pages (from-to)e2608
ISSN1935-2727
DOIs
Publication statusPublished - 2013

Keywords

  • Helminthic diseases
  • Schistosomiasis
  • Schistosoma mansoni
  • Schistosoma haematobium
  • Infection
  • Distribution
  • Spatial analysis
  • Farms
  • Mixed infections
  • Morbidity
  • Hepatic
  • Fibrosis
  • Risk factors
  • Distance
  • Water contact
  • Contact tracing
  • Foci
  • Senegal
  • Africa-West

Fingerprint

Dive into the research topics of 'Micro-geographical heterogeneity in and infection and morbidity in a co-endemic community in Northern Senegal'. Together they form a unique fingerprint.

Cite this