title: Bayesian risk mapping and model-based estimation of Schistosoma haematobium-Schistosoma mansoni co-distribution in Côte d'Ivoire.
abstract: BACKGROUND
  Schistosoma haematobium and Schistosoma mansoni are blood flukes that cause urogenital and intestinal schistosomiasis, respectively. In Côte d'Ivoire, both species are endemic and control efforts are being scaled up. Accurate knowledge of the geographical distribution, including delineation of high-risk areas, is a central feature for spatial targeting of interventions. Thus far, model-based predictive risk mapping of schistosomiasis has relied on historical data of separate parasite species.
  
  
  METHODS
  We analyzed data pertaining to Schistosoma infection among school-aged children obtained from a national, cross-sectional survey conducted between November 2011 and February 2012. More than 5,000 children in 92 schools across Côte d'Ivoire participated. Bayesian geostatistical multinomial models were developed to assess infection risk, including S. haematobium-S. mansoni co-infection. The predicted risk of schistosomiasis was utilized to estimate the number of children that need preventive chemotherapy with praziquantel according to World Health Organization guidelines.
  
  
  RESULTS
  We estimated that 8.9% of school-aged children in Côte d'Ivoire are affected by schistosomiasis; 5.3% with S. haematobium and 3.8% with S. mansoni. Approximately 2 million annualized praziquantel treatments would be required for preventive chemotherapy at health districts level. The distinct spatial patterns of S. haematobium and S. mansoni imply that co-infection is of little importance across the country.
  
  
  CONCLUSIONS
  We provide a comprehensive analysis of the spatial distribution of schistosomiasis risk among school-aged children in Côte d'Ivoire and a strong empirical basis for a rational targeting of control interventions.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Chammartin
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche des Sciences de la Nature, Université Nangui Abrogua, Abidjan, Côte d'Ivoire.
authors.forename: Clarisse A
authors.initials: CA
authors.lastname: Houngbedji
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
authors.forename: Eveline
authors.initials: E
authors.lastname: Hürlimann
authors.affiliation: Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Yapi
authors.affiliation: Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
authors.forename: Kigbafori D
authors.initials: KD
authors.lastname: Silué
authors.affiliation: Programme National de Santé Scolaire et Universitaire, Abidjan, Côte d'Ivoire.
authors.forename: Gotianwa
authors.initials: G
authors.lastname: Soro
authors.affiliation: Programme National de Santé Scolaire et Universitaire, Abidjan, Côte d'Ivoire.
authors.forename: Ferdinand N
authors.initials: FN
authors.lastname: Kouamé
authors.affiliation: Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
authors.forename: Eliézer K
authors.initials: EK
authors.lastname: N Goran
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Raso
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Penelope
authors.initials: P
authors.lastname: Vounatsou
mesh_terms: D000293:Adolescent; D001499:Bayes Theorem; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000188:drug therapy / Q000453:epidemiology*; D007560:Cote d'Ivoire / Q000453:epidemiology; D003430:Cross-Sectional Studies; D006801:Humans; D011223:Praziquantel / Q000627:therapeutic use; D012306:Risk; D012553:Schistosomiasis haematobia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D012555:Schistosomiasis mansoni / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology
chemical_list: D011223:Praziquantel