Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections: A 33 months follow up study

Nicholas Midzi, Sekesai Mtapuri-Zinyowera, Davison Sangweme, Noah H. Paul, Godfrey Makware, Munyaradzi P. Mapingure, Kimberly C. Brouwer, James Mudzori, Gibson Hlerema, Vivian Chadukura, Francisca Mutapi, Nirbhay Kumar, Takafira Mduluza

Research output: Contribution to journalArticle

Abstract

Background: The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. Methods. A cohort of primary schoolchildren (5-17 years) received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Results: Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5%, 70.8%, 67.3% and 58.8% respectively (p <0.001, p <0.001, p <0.001, p <0.001 respectively). More importantly, the prevalence of STH + schistosomes, P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0%, 84.2%, and 90.7%, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3% at 12 months follow up survey to 10.7%, slightly more than the baseline level (10.3%) while other co-infection combinations remained significantly low. The overall prevalence of heavy S. haematobium, S. mansoni and hookworms infection intensities were significantly reduced from: 17.9-22.4% to 2.6-5.1%, 1.6-3.3% to 0.0% and 0.0-0.7% to 0.0% respectively. Conclusion: Biannual Integrated school based antihelminthic and sustained prompt malaria treatment has a potential to reduce the burden of helminths-plasmodium co-infections in primary school children. In areas of stable malaria transmission, active case finding is recommended to track and treat asymptomatic malaria cases as these may sustain transmission in the community.

Original languageEnglish (US)
Article number9
JournalBMC International Health and Human Rights
Volume11
Issue number1
DOIs
StatePublished - 2011

Fingerprint

losigame
Helminths
Plasmodium falciparum
Coinfection
Malaria
Therapeutics
Praziquantel
Albendazole
Plasmodium
Hookworm Infections
Ancylostomatoidea
Zimbabwe
School Health Services
Africa South of the Sahara
Schistosomiasis
Infection

Keywords

  • co-infection
  • deworming
  • malaria
  • schistosomiasis
  • STHs

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections : A 33 months follow up study. / Midzi, Nicholas; Mtapuri-Zinyowera, Sekesai; Sangweme, Davison; Paul, Noah H.; Makware, Godfrey; Mapingure, Munyaradzi P.; Brouwer, Kimberly C.; Mudzori, James; Hlerema, Gibson; Chadukura, Vivian; Mutapi, Francisca; Kumar, Nirbhay; Mduluza, Takafira.

In: BMC International Health and Human Rights, Vol. 11, No. 1, 9, 2011.

Research output: Contribution to journalArticle

Midzi, N, Mtapuri-Zinyowera, S, Sangweme, D, Paul, NH, Makware, G, Mapingure, MP, Brouwer, KC, Mudzori, J, Hlerema, G, Chadukura, V, Mutapi, F, Kumar, N & Mduluza, T 2011, 'Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections: A 33 months follow up study', BMC International Health and Human Rights, vol. 11, no. 1, 9. https://doi.org/10.1186/1472-698X-11-9
Midzi, Nicholas ; Mtapuri-Zinyowera, Sekesai ; Sangweme, Davison ; Paul, Noah H. ; Makware, Godfrey ; Mapingure, Munyaradzi P. ; Brouwer, Kimberly C. ; Mudzori, James ; Hlerema, Gibson ; Chadukura, Vivian ; Mutapi, Francisca ; Kumar, Nirbhay ; Mduluza, Takafira. / Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections : A 33 months follow up study. In: BMC International Health and Human Rights. 2011 ; Vol. 11, No. 1.
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abstract = "Background: The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. Methods. A cohort of primary schoolchildren (5-17 years) received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Results: Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5{\%}, 70.8{\%}, 67.3{\%} and 58.8{\%} respectively (p <0.001, p <0.001, p <0.001, p <0.001 respectively). More importantly, the prevalence of STH + schistosomes, P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0{\%}, 84.2{\%}, and 90.7{\%}, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3{\%} at 12 months follow up survey to 10.7{\%}, slightly more than the baseline level (10.3{\%}) while other co-infection combinations remained significantly low. The overall prevalence of heavy S. haematobium, S. mansoni and hookworms infection intensities were significantly reduced from: 17.9-22.4{\%} to 2.6-5.1{\%}, 1.6-3.3{\%} to 0.0{\%} and 0.0-0.7{\%} to 0.0{\%} respectively. Conclusion: Biannual Integrated school based antihelminthic and sustained prompt malaria treatment has a potential to reduce the burden of helminths-plasmodium co-infections in primary school children. In areas of stable malaria transmission, active case finding is recommended to track and treat asymptomatic malaria cases as these may sustain transmission in the community.",
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author = "Nicholas Midzi and Sekesai Mtapuri-Zinyowera and Davison Sangweme and Paul, {Noah H.} and Godfrey Makware and Mapingure, {Munyaradzi P.} and Brouwer, {Kimberly C.} and James Mudzori and Gibson Hlerema and Vivian Chadukura and Francisca Mutapi and Nirbhay Kumar and Takafira Mduluza",
year = "2011",
doi = "10.1186/1472-698X-11-9",
language = "English (US)",
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TY - JOUR

T1 - Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections

T2 - A 33 months follow up study

AU - Midzi, Nicholas

AU - Mtapuri-Zinyowera, Sekesai

AU - Sangweme, Davison

AU - Paul, Noah H.

AU - Makware, Godfrey

AU - Mapingure, Munyaradzi P.

AU - Brouwer, Kimberly C.

AU - Mudzori, James

AU - Hlerema, Gibson

AU - Chadukura, Vivian

AU - Mutapi, Francisca

AU - Kumar, Nirbhay

AU - Mduluza, Takafira

PY - 2011

Y1 - 2011

N2 - Background: The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. Methods. A cohort of primary schoolchildren (5-17 years) received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Results: Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5%, 70.8%, 67.3% and 58.8% respectively (p <0.001, p <0.001, p <0.001, p <0.001 respectively). More importantly, the prevalence of STH + schistosomes, P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0%, 84.2%, and 90.7%, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3% at 12 months follow up survey to 10.7%, slightly more than the baseline level (10.3%) while other co-infection combinations remained significantly low. The overall prevalence of heavy S. haematobium, S. mansoni and hookworms infection intensities were significantly reduced from: 17.9-22.4% to 2.6-5.1%, 1.6-3.3% to 0.0% and 0.0-0.7% to 0.0% respectively. Conclusion: Biannual Integrated school based antihelminthic and sustained prompt malaria treatment has a potential to reduce the burden of helminths-plasmodium co-infections in primary school children. In areas of stable malaria transmission, active case finding is recommended to track and treat asymptomatic malaria cases as these may sustain transmission in the community.

AB - Background: The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. Methods. A cohort of primary schoolchildren (5-17 years) received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Results: Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5%, 70.8%, 67.3% and 58.8% respectively (p <0.001, p <0.001, p <0.001, p <0.001 respectively). More importantly, the prevalence of STH + schistosomes, P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0%, 84.2%, and 90.7%, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3% at 12 months follow up survey to 10.7%, slightly more than the baseline level (10.3%) while other co-infection combinations remained significantly low. The overall prevalence of heavy S. haematobium, S. mansoni and hookworms infection intensities were significantly reduced from: 17.9-22.4% to 2.6-5.1%, 1.6-3.3% to 0.0% and 0.0-0.7% to 0.0% respectively. Conclusion: Biannual Integrated school based antihelminthic and sustained prompt malaria treatment has a potential to reduce the burden of helminths-plasmodium co-infections in primary school children. In areas of stable malaria transmission, active case finding is recommended to track and treat asymptomatic malaria cases as these may sustain transmission in the community.

KW - co-infection

KW - deworming

KW - malaria

KW - schistosomiasis

KW - STHs

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