title: Gastro-intestinal symptoms associated with intense Schistosoma mansoni infection affect class-attentiveness of schoolchildren in Ethiopia.
abstract: OBJECTIVE
  To assess effect of subtle morbidities related to Schistosomiasis mansoni on class-attentiveness of schoolchildren.
  
  
  METHODS
  A cross-sectional study was undertaken involving 568 schoolchildren (mean age 13.4 years; 333 from Schistosoma mansoni endemic villages (Sille and Worke-Mado) and 235 from the non-endemic town Sheno. A questionnaire on signs and symptoms of ill-health was administered to all study subjects. In addition, parasitological and nutritional anthropometric data were collected. All study subjects from S. mansoni endemic areas were treated with praziquantel and albendazol while children from the non-endemic town were only treated with albendazol.FindingsPrevalence of S. mansoni infection was 95% in Sille and 90.6% in Worke-Mado. Overall, among schoolchildren from S. mansoni endemic areas, 36.3% were under-nourished; 66.4% reported easy fatigue/listlessness; 61.3% had abdominal cramps with bloody-mucoid stools, and 17.7% reported to have severe and frequent abdominal cramps which distracted their class-attentiveness. The latter two symptoms were significantly associated with intensity of S. mansoni infection. Among schoolchildren from the non-endemic town Sheno, only 8.9% were under-nourished, 20% reported infrequent abdominal cramps and none had symptoms that were severe enough to affect class-attentiveness.
  
  
  CONCLUSIONS
  Symptoms associated with intense S. mansoni infection may negatively affect class-attentiveness of schoolchildren which may have important implications on their overall educational achievements. Further detailed intervention-based prospective studies are recommended to validate these findings which, if confirmed, could further justify school-age targeted praziquantel-based control of schistosomiasis.
authors.affiliation: Department of Infectious Diseases, Centre for Imported and Tropical Diseases, Ullevål University Hospital, 0407 Oslo, Norway. nega_berhe@yahoo.com
authors.forename: Nega
authors.initials: N
authors.lastname: Berhe
authors.forename: Bjørn
authors.initials: B
authors.lastname: Myrvang
authors.forename: Svein Gunnar
authors.initials: SG
authors.lastname: Gundersen
mesh_terms: D015746:Abdominal Pain / Q000150:complications*; D000293:Adolescent; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D001288:Attention; D002648:Child; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D006801:Humans; D008297:Male; D011223:Praziquantel / Q000627:therapeutic use; D012424:Rural Population; D012550:Schistosoma mansoni / Q000302:isolation & purification*; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D000871:Anthelmintics; D011223:Praziquantel; D015766:Albendazole