title: Scope and Limits of an anamnestic questionnaire in a control-induced low-endemicity helminthiasis setting in south-central Côte d'Ivoire.
abstract: BACKGROUND
  Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available.
  
  
  METHODS
  Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d'Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals' helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i) to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii) to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings.
  
  
  RESULTS
  Our study sample consisted of 195 adults (101 males, 94 females). We found prevalences of hookworm, Trichuris trichiura, Schistosoma haematobium, and Schistosoma mansoni of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No Ascaris lumbricoides infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05) associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties.
  
  
  CONCLUSIONS
  The generally low prevalence and intensity of helminth infection in this part of south-central Côte d'Ivoire indicates that recent control efforts have turned our study area into a low endemicity setting. Our anamnestic questionnaire had low sensitivity and specificity to identify infected individuals or treatment groups.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fürst
authors.forename: Mamadou
authors.initials: M
authors.lastname: Ouattara
authors.forename: Kigbafori D
authors.initials: KD
authors.lastname: Silué
authors.forename: Dje N
authors.initials: DN
authors.lastname: N'Goran
authors.forename: Lukas G
authors.initials: LG
authors.lastname: Adiossan
authors.forename: Isaac I
authors.initials: II
authors.lastname: Bogoch
authors.forename: Yao
authors.initials: Y
authors.lastname: N'Guessan
authors.forename: Siaka
authors.initials: S
authors.lastname: Koné
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: Eliézer K
authors.initials: EK
authors.lastname: N'Goran
mesh_terms: D000328:Adult; D015331:Cohort Studies; D007560:Cote d'Ivoire / Q000453:epidemiology; D003710:Demography; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005260:Female; D006373:Helminthiasis / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D006801:Humans; D008297:Male; D011939:Mental Recall; D015999:Multivariate Analysis; D010349:Patient Compliance; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires