title: Countrywide Reassessment ofSchistosoma mansoniInfection in Burundi Using a Urine-Circulating Cathodic Antigen Rapid Test: Informing the National Control Program.
abstract: Following implementation of the national control program, a reassessment ofSchistosoma mansoniprevalence was conducted in Burundi to determine the feasibility of moving toward elimination. A countrywide cluster-randomized cross-sectional study was performed in May 2014. At least 25 schools were sampled from each of five eco-epidemiological risk zones for schistosomiasis. Fifty randomly selected children 13-14 years of age per school were included for a single urine-circulating cathodic antigen (CCA) rapid test and, in a subset of schools, for duplicate Kato-Katz slide preparation from a single stool sample. A total of 17,331 children from 347 schools were tested using CCA. The overall prevalence ofS. mansoniinfection, when CCA trace results were considered negative, was 13.5% (zone range [zr] = 4.6-17.8%), and when CCA trace results were considered positive, it was 42.8% (zr = 34.3-49.9%). In 170 schools, prevalence of this infection determined using Kato-Katz method was 1.5% (zr = 0-2.7%). The overall mean intensity ofS. mansoniinfection determined using Kato-Katz was 0.85 eggs per gram (standard deviation = 10.86). A majority of schools (84%) were classified as non-endemic (prevalence = 0) using Kato-Katz; however, a similar proportion of schools were classified as endemic when CCA trace results were considered negative (85%) and nearly all (98%) were endemic when CCA trace results were considered positive. The findings of this nationwide reassessment using a CCA rapid test indicate thatSchistosomainfection is still widespread in Burundi, although its average intensity is probably low. Further evidence is now needed to determine the association between CCA rapid test positivity and low-intensity disease transmission.
authors.affiliation: Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Ortu
authors.affiliation: Programme National Intégré de lutte contre les Maladies Tropicales Négligées et la Cécité (PNIMTNC), Ministère de la Santé Publique et de la Lutte contre le SIDA, Bujumbura, Burundi.
authors.forename: Onésime
authors.initials: O
authors.lastname: Ndayishimiye
authors.affiliation: Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
authors.forename: Michelle
authors.initials: M
authors.lastname: Clements
authors.affiliation: Programme National Intégré de lutte contre les Maladies Tropicales Négligées et la Cécité (PNIMTNC), Ministère de la Santé Publique et de la Lutte contre le SIDA, Bujumbura, Burundi.
authors.forename: Donatien
authors.initials: D
authors.lastname: Kayugi
authors.affiliation: Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Department of Microbiology, Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, Athens, Georgia.
authors.forename: Carl H
authors.initials: CH
authors.lastname: Campbell
authors.affiliation: World Health Organization (WHO), Libreville, Gabon.
authors.forename: Mariama Sani
authors.initials: MS
authors.lastname: Lamine
authors.affiliation: Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
authors.forename: Antonio
authors.initials: A
authors.lastname: Zivieri
authors.affiliation: Children's Health Research Centre, The University of Queensland, South Brisbane, Australia.|School of Veterinary Science, The University of Queensland, Gatton Campus, Gatton, Australia.
authors.forename: Ricardo Soares
authors.initials: RS
authors.lastname: Magalhaes
authors.affiliation: Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Department of Microbiology, Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, Athens, Georgia.
authors.forename: Sue
authors.initials: S
authors.lastname: Binder
authors.affiliation: Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio.|Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Department of Microbiology, Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, Athens, Georgia.
authors.forename: Charles H
authors.initials: CH
authors.lastname: King
authors.affiliation: Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Fenwick
authors.affiliation: Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Department of Microbiology, Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, Athens, Georgia.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Colley
authors.affiliation: Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
authors.forename: Peter Mark
authors.initials: PM
authors.lastname: Jourdan
mesh_terms: D000293:Adolescent; D000818:Animals; D000947:Antigens, Helminth / Q000652:urine*; D002063:Burundi / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012550:Schistosoma mansoni / Q000302:isolation & purification; D012555:Schistosomiasis mansoni / Q000175:diagnosis* / Q000453:epidemiology* / Q000652:urine; D012680:Sensitivity and Specificity
chemical_list: D000947:Antigens, Helminth