title: Initiating NTD programs targeting schistosomiasis and soil-transmitted helminthiasis in two provinces of the Democratic Republic of the Congo: Establishment of baseline prevalence for mass drug administration.
abstract: BACKGROUND
  Schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) are widely distributed in the Democratic Republic of the Congo (DRC) and constitute a serious public health problem. As recommended by the World Health Organization (WHO), before launching mass chemotherapy to control these diseases, parasitological surveys were conducted in sentinel sites in six health zones (HZs) in Bandundu and Maniema provinces. Baseline prevalence and intensity of infection for SCH and STH were determined to establish the appropriate treatment plan using Praziquantel (PZQ) and Albendazole (ALB).
  
  
  METHODS
  Parasitological surveys were conducted from April to May 2015 in twenty-six selected sampling units (schools) for baseline mapping in six HZs: Fifty school children (25 females and 25 males) aged 9-15 years were randomly selected per sampling unit. A total of 1300 samples (urine and stool) were examined using haematuria dipsticks, parasite-egg filtration and the point-of-care Circulating Cathodic Antigen (POC-CCA) assay for urine samples and the Kato-Katz technique for stool specimens.
  
  
  RESULTS
  Three species of schistosomes (S. mansoni, S. haematobium and S. intercalatum) and three groups of STH (hookworm, Ascaris and Trichuris) were detected at variable prevalence and intensity among the schools, the HZs and the provinces. In Bandundu, no SCH was detected by either Kato-Katz or the POC-CCA technique, despite a high prevalence of STH with 68% and 80% at Kiri and Pendjua HZs, respectively. In Maniema, intestinal schistosomiasis was detected by both Kato-Katz and POC-CCA with an average prevalence by Kato-Katz of 32.8% and by POC-CCA of 42.1%. Comparative studies confirmed the greater sensitivity (and operational feasibility) of the POC-CCA test on urine compared to Kato-Katz examination of stool for diagnosing intestinal schistosomiasis even in areas of comparatively light infections. STH was widely distributed and present in all HZs with a mean prevalence (95% CI) of 59.62% (46.00-65.00%). The prevalence of hookworm, roundworm and whipworm were 51.62% (32.40%-71.50%), 15.77% (0.50%-39.60%) and 13.46 (0.50%-33.20%), respectively.
  
  
  CONCLUSIONS
  This study provided the evidence base for implementing programs targeting SCH and STH in these Health Zones. Observations also reinforce the operational value and feasibility of the POC-CCA test to detect S. mansoni and, for the first time, S. intercalatum infections in a routine NTD program setting.
authors.affiliation: RTI International, District of Columbia, 3040 Cornwallis Road, Research Triangle Park, NC 27709, WA, United States. Electronic address: akabore@rti.org.
authors.forename: Achille
authors.initials: A
authors.lastname: Kabore
authors.affiliation: Département de Zoologie, Faculté des Sciences et Techniques, Université d'Abomey-Calavi 01BP526, Cotonou, Benin. Electronic address: mibikounle2001@yahoo.fr.
authors.forename: Moudachirou
authors.initials: M
authors.lastname: Ibikounle
authors.affiliation: RTI International, District of Columbia, 3040 Cornwallis Road, Research Triangle Park, NC 27709, WA, United States. Electronic address: jtougoue@rti.org.
authors.forename: Jean Jacques
authors.initials: JJ
authors.lastname: Tougoue
authors.affiliation: Coordination nationale des maladies tropicales négligées, programme national de lutte contre la bilharziose, Gombe, Kinshasa, Democratic Republic of the Congo. Electronic address: smupoyi@yahoo.fr.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Mupoyi
authors.affiliation: RTI International, ENVISION Program, DRC-Office, 4630, Avenue de la Science, Gombe Kinshasa, Democratic Republic of the Congo. Electronic address: mndombe@rti.org.
authors.forename: Martin
authors.initials: M
authors.lastname: Ndombe
authors.affiliation: IMA World Health, DRC-Office, 14 Av Sergent Moke, Ngaliema Kinshasa, Democratic Republic of the Congo. Electronic address: scottshannon@imaworldhealth.org.
authors.forename: Scott
authors.initials: S
authors.lastname: Shannon
authors.affiliation: RTI International, District of Columbia, 3040 Cornwallis Road, Research Triangle Park, NC 27709, WA, United States. Electronic address: eottesen.Contractor@rti.org.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Ottesen
authors.affiliation: Coordination nationale des maladies tropicales négligées, programme national de lutte contre la bilharziose, Gombe, Kinshasa, Democratic Republic of the Congo. Electronic address: mukundafaustin@yahoo.fr.
authors.forename: Faustin
authors.initials: F
authors.lastname: Mukunda
authors.affiliation: Coordination nationale des maladies tropicales négligées, programme national de lutte contre l'onchocercose, Gombe, Kinshasa, Democratic Republic of the Congo. Electronic address: naopitchouna@gmail.com.
authors.forename: Naomi
authors.initials: N
authors.lastname: Awaca
mesh_terms: D000293:Adolescent; D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D002648:Child; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005243:Feces / Q000469:parasitology; D005260:Female; D006306:Health Surveys; D006373:Helminthiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006376:Helminths / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D058069:Neglected Diseases / Q000175:diagnosis / Q000453:epidemiology*; D019095:Point-of-Care Systems; D015995:Prevalence; D012547:Schistosoma / Q000302:isolation & purification*; D012552:Schistosomiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012574:Schools; D012680:Sensitivity and Specificity; D012987:Soil / Q000469:parasitology*
chemical_list: D000981:Antiprotozoal Agents; D012987:Soil
keywords: Democratic Republic of the Congo; Kato-Katz test; POC-CCA test; Schistosomiasis; Soil transmitted helminthiasis