title: Schistosoma mansoni morbidity among school-aged children: a SCORE project in Kenya.
abstract: Schistosomiasis control programs aim to reduce morbidity but are evaluated by infection prevalence and intensity reduction. We present baseline cross-sectional data from a nested cohort study comparing indicators of morbidity for measuring program impact. Eight hundred twenty-two schoolchildren 7-8 years of age from Nyanza Province, Kenya, contributed stool for diagnosis of Schistosoma mansoni and soil-transmitted helminths (STH) and blood smears for malaria, and were evaluated for anemia, quality of life, exercise tolerance, anthropometry, and ultrasound abnormalities. Schistosoma mansoni, STH, and malaria infection prevalence were 69%, 25%, and 8%, respectively. Only anemia and S. mansoni infection (adjusted odds ratio [aOR] = 1.70; confidence interval [CI] = 1.03-2.80), and hepatomegaly and heavy S. mansoni infection (aOR = 2.21; CI = 1.19-4.11) were associated. Though anemia and hepatomegaly appeared most useful at baseline, additional morbidity indicators may be sensitive longitudinal measures to evaluate schistosomiasis program health impact.
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA. iyp2@cdc.gov
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Samuels
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Matey
authors.forename: Pauline N M
authors.initials: PN
authors.lastname: Mwinzi
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Wiegand
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Muchiri
authors.forename: Edmund
authors.initials: E
authors.lastname: Ireri
authors.forename: Molly
authors.initials: M
authors.lastname: Hyde
authors.forename: Susan P
authors.initials: SP
authors.lastname: Montgomery
authors.forename: Diana M S
authors.initials: DM
authors.lastname: Karanja
authors.forename: W Evan
authors.initials: WE
authors.lastname: Secor
mesh_terms: D000818:Animals; D002648:Child; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D010270:Parasite Egg Count; D011788:Quality of Life; D012550:Schistosoma mansoni / Q000302:isolation & purification*; D012552:Schistosomiasis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000469:parasitology / Q000503:physiopathology; D014463:Ultrasonography