title: Schistosomiasis in pre-school-age children and their mothers in Chikhwawa district, Malawi with notes on characterization of schistosomes and snails.
abstract: BACKGROUND
  To complement ongoing schistosomiasis control within national control programmes (NCPs) that administer praziquantel to school-age children, assessing the risk and extent of schistosomiasis in pre-school-age children (PSAC) is important.
  
  
  METHODS
  In June 2012, schistosomiasis in Chikhwawa district, Malawi was assessed across 12 villages examining pre-school-age children (PSAC) and their mothers by serological and parasitological diagnosis, as supplemented with urine-antigen and questionnaire-interview methods. Urinary tract morbidity was inferred by haematuria and albuminuria assays.
  
  
  RESULTS
  In total, 49.5% (CI₉₅ 42.6-56.4) of 208 PSAC and 94.5% (CI₉₅ 90.9-98.1) of 165 mothers were seropositive for schistosomiasis, in 2 villages seroprevalence exceeded 75% in PSAC. Egg-patent urogenital and intestinal schistosomiasis was observed; 17.7% (CI₉₅ 12.4-23.2) of PSAC and 45.1% (CI₉₅ 37.4-52.8) of mothers having active schistosomiasis by parasitological and urine-antigen testing combined. PSAC often had extensive daily water contact and many (~25%) had haematuria and albuminuria. As eggs with an atypical morphology of Schistosoma haematobium were observed, a general selection of schistosome eggs was characterized by DNA barcoding, finding Group I S. haematobium and Group IV and V S. mansoni. Malacological surveys encountered several populations of Bulinus globosus but failed to find Biomphalaria.
  
  
  CONCLUSIONS
  Both PSAC and their mothers appear to be at significant risk of schistosomiasis and should be considered for treatment within the NCP of Malawi.
authors.forename: Helen
authors.initials: H
authors.lastname: Poole
authors.forename: Dianne J
authors.initials: DJ
authors.lastname: Terlouw
authors.forename: Andrew
authors.initials: A
authors.lastname: Naunje
authors.forename: Kondwani
authors.initials: K
authors.lastname: Mzembe
authors.forename: Michelle
authors.initials: M
authors.lastname: Stanton
authors.forename: Martha
authors.initials: M
authors.lastname: Betson
authors.forename: David G
authors.initials: DG
authors.lastname: Lalloo
authors.affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. r.stothard@liv.ac.uk.
authors.forename: J Russell
authors.initials: JR
authors.lastname: Stothard
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011223:Praziquantel / Q000008:administration & dosage / Q000627:therapeutic use; D015995:Prevalence; D012547:Schistosoma / Q000145:classification / Q000235:genetics*; D012552:Schistosomiasis / Q000188:drug therapy / Q000453:epidemiology*; D012908:Snails / Q000145:classification* / Q000469:parasitology / Q000502:physiology
chemical_list: D000871:Anthelmintics; D011223:Praziquantel