Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Implications for selecting persistent hot spots of schistosomiasis from community- and school-based surveys in Blue Nile, North Kordofan, and Sennar States, Sudan

  • Hassan Ahmed Hassan Ahmed Ismail (Communicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health) ;
  • Seungman Cha (Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University) ;
  • Yan Jin (Department of Microbiology, Dongguk University College of Medicine) ;
  • Sung-Tae Hong (Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine)
  • Received : 2023.02.16
  • Accepted : 2023.04.28
  • Published : 2023.05.31
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Abstract

In several schistosomiasis-endemic countries, the prevalence has remained high in some areas owing to reinfection despite repeated mass drug administration (MDA) interventions; these areas are referred to as persistent hot spots. Identifying hotspots is critical for interrupting transmission. This study aimed to determine an effective means of identifying persistent hot spots. First, we investigated the differences between Schistosoma haematobium and Schistosoma mansoni prevalence among school-aged children (SAC) estimated by a community-based survey, for which local key informants purposively selected communities, and a randomly sampled school-based survey. A total of 6,225 individuals residing in 60 villages in 8 districts of North Kordofan, Blue Nile, or Sennar States, Sudan participated in a community-based survey in March 2018. Additionally, the data of 3,959 students attending 71 schools in the same 8 districts were extracted from a nationwide school-based survey conducted in January 2017. The community-based survey identified 3 districts wherein the prevalence of S. haematobium or S. mansoni infection among SAC was significantly higher than that determined by the randomly sampled school survey (e.g., S. haematobium in the Sennar district: 10.8% vs. 1.1%, P<0.001). At the state level, the prevalence of schistosomiasis among SAC, as determined by the community-based survey, was consistently significantly higher than that determined by the school-based survey. Purposeful selection of villages or schools based on a history of MDA, latrine coverage, open defecation, and the prevalence of bloody urine improved the ability for identifying persistent hot spots.

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Acknowledgement

This project was funded by the Korea International Cooperation Agency (KOICA, P-2015-00145). The funder had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The authors thank the project team members for their efforts and contributions to controlling neglected tropical diseases in Sudan. They extend their appreciation to community members, the Ministries of Heath of 18 states, and the Federal Ministry of Health, Sudan. Special thanks go to Dr. Nahid Abdelgadir, International Health Directorate Project Management Unit, the Federal Ministry of Health, Sudan, and also to Mr. Dae Seong Cho, the field manager of the SUKO project.

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