RESUMEN
OBJECTIVE: To compare the extent of intestinal schistosomiasis among school children attending school in an irrigation and non-irrigation area of Central Kenya. DESIGN: A cross sectional study. SETTING: Three separate parasitological surveys involving four primary schools in Mwea irrigation scheme, Kirinyaga District and two from a non-irrigation area in Machakos District. SUBJECTS: One thousand two hundred and twenty two children aged between five and nineteen years were examined for Schistostoma mansoni infection by Kato thick smear technique. RESULTS: High prevelances ranging from 73% to 94% were noted among children in all the participating schools. Overall 41% of the infected children had heavy infection (>400 eggs per gram), 27% had moderate infection (101-400 epg) and 32% had light infection (10-100epg). When data from the two areas were analysed seperately, peak eggs output were found in 5-9 year olds among children in Kirinyaga while this situation shifted to the 10-14 year olds in Machakos children. In Kirinyaga District, boys in the 10-14 years age group had a significantly higher output than girls (P<0.01), but this situation was reversed in the older children (P<0.05). Girls in Machakos District had consistently but non-significantly higher output than boys. CONCLUSION: Intestinal schistomiasis is more prevalent and with a higher intensity in the irrigated than in non-irrigated areas. There were also pronounced age and gender related differences in the pattern of infection between the two study areas.
Asunto(s)
Esquistosomiasis/epidemiología , Abastecimiento de Agua , Adolescente , Distribución por Edad , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Kenia/epidemiología , Masculino , Prevalencia , Características de la Residencia , Distribución por SexoRESUMEN
OBJECTIVE: To determine the relative susceptibility of Schistosoma mansoni infections to treatment with the oxamniquine (OXA) and praziquantel (PZQ). DESIGN AND SETTING: Three separate cross sectional studies were performed in six primary schools located in two Schistosoma mansoni endemic areas in Eastern Kenya: Kangundo (low morbidity) and Kibwezi (high morbidity). SUBJECTS: One thousand two hundred and fourteen infected children aged 6-20 years were involved. INTERVENTION: Each child received either 15-mg OXA/kg body weight twice within an interval of six hours or a single dose of 40 or 60 mg PZQ/kg body weight. Three duplicate Kato stool examinations were done before and four or five weeks after treatment to assess treatment efficacy. RESULTS: The cure rates in different schools with OXA were 71.7-79.7% in Kangundo and 56.7-61.9% in Kibwezi. In children treated with PZQ, the 40-mg/kg-dose regimen achieved cure rates of 77.6-87.2% in Kangundo and 67.1-81.1% in Kibwezi, whereas the 60-mg/kg dose regimen attained cure rates of 93.2% in Kangundo and 76.3% in Kibwezi. Both OXA and PZQ efficacy declined significantly with age in Kangundo, whereas the age effect was not seen in Kibwezi. CONCLUSION: The poorer cure rates in Kibwezi than in the Kangundo children were not due to known previous drug exposure to either OXA or PZQ. The varying efficacy may be attributed to innate low drug susceptibility, possibly related to schistosome strain differences between the two areas.
Asunto(s)
Enfermedades Endémicas , Oxamniquina/uso terapéutico , Praziquantel/uso terapéutico , Esquistosomiasis mansoni/tratamiento farmacológico , Esquistosomicidas/uso terapéutico , Adolescente , Animales , Niño , Preescolar , Estudios Transversales , Humanos , Modelos Logísticos , Oxamniquina/administración & dosificación , Praziquantel/administración & dosificación , Schistosoma mansoni/efectos de los fármacos , Esquistosomiasis mansoni/epidemiología , Esquistosomicidas/administración & dosificación , Instituciones Académicas , Resultado del TratamientoRESUMEN
A clinical trial to compare the effectiveness of 4- and 6-mo repeated treatment with albendazole 600 mg (Zentel, SmithKline Beecham) or mebendazole 600 mg (Vermox, Janssen) on geohelminth infections was carried out on children in 6 primary schools; the study included 1,186 children, ages 4 to 19 yr. Kato-Katz examination was performed on stool samples before and after treatment. Overall, albendazole produced better cure rates and egg reduction rates for geohelminths. The cure rates for albendazole were 92.4% for hookworm infection, 83.5% for Ascaris lumbricoides, and 67.8% for Trichuris trichiura. Mebendazole given either 2 or 3 times in a year had cure rates of 50 and 55.0% (respectively) for hookworm, 79.6 and 97.5% for A. lumbricoides, and 60.6 and 68.3% for T. trichiura infection. The geometric mean intensity of hookworm eggs per gram (epg) of stool decreased by 96.7% after albendazole treatment compared with 66.3 and 85.1%, respectively, for 2 or 3 doses of mebendazole (P < 0.05) over the same period. Reductions in epg for A. lumbricoides and T. trichiura were comparable for both drugs. Our results indicate that treatment with albendazole at a 6-mo interval was more effective than mebendazole regimens and may be the best choice for use in the control of the 3 geohelminths.
Asunto(s)
Albendazol/uso terapéutico , Antihelmínticos/uso terapéutico , Helmintiasis/tratamiento farmacológico , Parasitosis Intestinales/tratamiento farmacológico , Mebendazol/uso terapéutico , Adolescente , Adulto , Albendazol/administración & dosificación , Antihelmínticos/administración & dosificación , Niño , Preescolar , Esquema de Medicación , Femenino , Helmintiasis/epidemiología , Humanos , Parasitosis Intestinales/epidemiología , Kenia , Masculino , Mebendazol/administración & dosificación , Prevalencia , Estaciones del AñoRESUMEN
OBJECTIVE: To determine the extent of intestinal schistosomiasis, ascariasis, trichuriasis and hookworm infections among school children of Usigu and Bondo divisions of Bondo District. DESIGN: A cross sectional study. SETTING: Fifty out of 130 primary schools in Usigu and Bondo divisions, Bondo District. SUBJECTS: Randomly selected school children (n= 3158) aged five to 20 years, were examined for intestinal helminths and schistosomiasis using Kato thick smear technique. RESULTS: The overall prevalence and geometric mean egg counts per gram/faeces for Schistosoma mansoni were 31.6% and 3.1; hookworm 36.8% and 4.1; Trichuris trichiura 21.8% and 1.5, and Ascaris lumbricoides 16.5% and 2.5. More girls (34.9%) than boys (28.6%) were infected with S. mansoni whereas more boys (39.0%) than girls (34.5%) were infected with hookworm. The prevalence of S. mansoni and hookworm infections increased with age but Ascaris and Trichuris infections decreased with age without any sex differences. Children under ten years of age tended to be more heavily infected with ascariasis, trichuriasis and hookworm than the older ones, while the intensity of S. mansoni increased gradually with age. There were positive relationships between different infections except for a significant negative correlation between Schistosoma mansoni and hookworm infections. Only four cases out of 789 had S. haematobium infection. CONCLUSION. Schistosoma mansoni and geohelminths were endemic in Bondo District, where two thirds of the school children suffered from these parasites. Polyparasitism was also common. There was a little overlap in the distribution of Schistosoma mansoni and hookworm, whereas ascariasis and trichuriasis were fairly distributed in the district.