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Evaluation and application of potential schistosome-associated morbidity markers within large-scale mass chemotherapy programmes

Published online by Cambridge University Press:  15 June 2009

J. P. WEBSTER ,
A. KOUKOUNARI ,
P. H. L. LAMBERTON ,
J. R. STOTHARD  and
A. FENWICK
J. P. WEBSTER*
Affiliation:
Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College (St Mary's Campus), Norfolk Place, London, W2 1PG, UK
A. KOUKOUNARI
Affiliation:
Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College (St Mary's Campus), Norfolk Place, London, W2 1PG, UK
P. H. L. LAMBERTON
Affiliation:
Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College (St Mary's Campus), Norfolk Place, London, W2 1PG, UK
J. R. STOTHARD
Affiliation:
Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK
A. FENWICK
Affiliation:
Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College (St Mary's Campus), Norfolk Place, London, W2 1PG, UK
*
*Corresponding author: Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College (St Mary's Campus), Norfolk Place, London, W2 1PG, UK. Tel: +44 (0) 20 75943636; Fax: +44 (0) 20 74023927. E-mail: joanne.webster@imperial.ac.uk
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Summary

A primary objective of schistosomiasis control programmes is to achieve, and hence also demonstrate, a quantifiable reduction in schistosome-associated morbidity as a consequence of chemotherapeutic intervention. Inherent within such an objective, it is necessary to define and validate direct and indirect indicators of schistosome-related morbidity. However, to define and thereby document such morbidity, and its reduction following treatment, may not be straightforward, particularly for intestinal schistosomiasis-induced morbidity, which is often not apparent in all but the most severe or chronic cases. Within all ‘Schistosomiasis Control Initiative’ activities, across selected sub-Saharan African countries since 2002, a range of standard and novel potential morbidity markers have been monitored and evaluated. Parasitological intensity measures, combined with haemoglobin/anaemia counts and ultrasonography, proved valuable schistosomiasis-related morbidity indicators, being both logistically practical and informative. Additional measures tested, such as albumin excretion profiles, were promising, and are subject to ongoing research, whilst some measures, such as distended stomach/umbilical circumference, anthropometrics and health questionnaires proved less reliable. These results serve to both illustrate the success of current control activities in reducing schistosome-induced morbidity, and to highlight key tools and techniques for continued application within ongoing and future mass drug administration programmes.

Keywords

SchistosomiasismorbiditydiagnosiscontrolAfrica
Type
SECTION 4 MONITORING AND EVALUATION OF INTERVENTIONS
Information
Parasitology , Volume 136 , Special Issue 13: Control of schistosomiasis in sub-Saharan Africa , November 2009 , pp. 1789 - 1799
Copyright
Copyright © Cambridge University Press 2009

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