Experiences with the control of schistosomiasis mansoni in two foci in Central Africa

Experiences with population-based chemotherapy and other methods for the control of schistosomiasis mansoni in two subsaharan foci are described. In the forest area of Maniema (Zaire), intense transmission of Schistosoma mansoni, high prevalences and intensities of infection, and important morbidity...

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Main Authors: B. Gryseels, A. M. Polderman, D. Engels
Format: Article
Language:English
Published: Fundação Oswaldo Cruz (FIOCRUZ) 1992-01-01
Series:Memorias do Instituto Oswaldo Cruz
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02761992000800029
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author B. Gryseels
A. M. Polderman
D. Engels
author_facet B. Gryseels
A. M. Polderman
D. Engels
author_sort B. Gryseels
collection DOAJ
description Experiences with population-based chemotherapy and other methods for the control of schistosomiasis mansoni in two subsaharan foci are described. In the forest area of Maniema (Zaire), intense transmission of Schistosoma mansoni, high prevalences and intensities of infection, and important morbidity have been documental. Taking into account the limited financial means and the poor logistic conditions, the control strategy has been based mainly on targeted chemotherapy of heavily infected people (>600 epg). After ten years of intervention, prevalences and intensities have hardly been affected, but the initial severe hepatosplenic morbidity has almost disappeared. In Burundi, a national research and control programme has been initiated in 1982. Prevalences, intensities and morbidity were moderate, transmission was focal and erratic in time and space. A more structural control strategy was developed, based on screening and selective therapy, health education, sanitation and domestic water supply. Prevalences and intensities have been considerably reduced, though the results show focal and unpredicatable variations. Transmission and reinfection were not signifcantly affected by chemotherapy alone, and eventual outcome of repeated selective treatment appears to be limited by the sensitivity of the screening method. Intestinal morbidity was strongly reduced by community-based selective treatment, but hepatosplenic enlargement was hardly affected; this is possibly due to the confounding impact of increasing malaria morbidity. The experiences show the importance of local structures and conditions for the development of an adapted control strategy. It is further concluded that population-based chemotherapy is a highly valid tool for the rapid control of morbidity, but should in most operational conditions not be considered as a tool for transmission control. Integration of planning, execution and surveillance in regular health services...
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spelling doaj.art-7c51a61c021a496fb58695a270c1c3842023-09-02T22:14:55ZengFundação Oswaldo Cruz (FIOCRUZ)Memorias do Instituto Oswaldo Cruz0074-02761678-80601992-01-018718719410.1590/S0074-02761992000800029Experiences with the control of schistosomiasis mansoni in two foci in Central AfricaB. GryseelsA. M. PoldermanD. EngelsExperiences with population-based chemotherapy and other methods for the control of schistosomiasis mansoni in two subsaharan foci are described. In the forest area of Maniema (Zaire), intense transmission of Schistosoma mansoni, high prevalences and intensities of infection, and important morbidity have been documental. Taking into account the limited financial means and the poor logistic conditions, the control strategy has been based mainly on targeted chemotherapy of heavily infected people (>600 epg). After ten years of intervention, prevalences and intensities have hardly been affected, but the initial severe hepatosplenic morbidity has almost disappeared. In Burundi, a national research and control programme has been initiated in 1982. Prevalences, intensities and morbidity were moderate, transmission was focal and erratic in time and space. A more structural control strategy was developed, based on screening and selective therapy, health education, sanitation and domestic water supply. Prevalences and intensities have been considerably reduced, though the results show focal and unpredicatable variations. Transmission and reinfection were not signifcantly affected by chemotherapy alone, and eventual outcome of repeated selective treatment appears to be limited by the sensitivity of the screening method. Intestinal morbidity was strongly reduced by community-based selective treatment, but hepatosplenic enlargement was hardly affected; this is possibly due to the confounding impact of increasing malaria morbidity. The experiences show the importance of local structures and conditions for the development of an adapted control strategy. It is further concluded that population-based chemotherapy is a highly valid tool for the rapid control of morbidity, but should in most operational conditions not be considered as a tool for transmission control. Integration of planning, execution and surveillance in regular health services...http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02761992000800029Schistosoma mansonicontrolBurundiZaire
spellingShingle B. Gryseels
A. M. Polderman
D. Engels
Experiences with the control of schistosomiasis mansoni in two foci in Central Africa
Memorias do Instituto Oswaldo Cruz
Schistosoma mansoni
control
Burundi
Zaire
title Experiences with the control of schistosomiasis mansoni in two foci in Central Africa
title_full Experiences with the control of schistosomiasis mansoni in two foci in Central Africa
title_fullStr Experiences with the control of schistosomiasis mansoni in two foci in Central Africa
title_full_unstemmed Experiences with the control of schistosomiasis mansoni in two foci in Central Africa
title_short Experiences with the control of schistosomiasis mansoni in two foci in Central Africa
title_sort experiences with the control of schistosomiasis mansoni in two foci in central africa
topic Schistosoma mansoni
control
Burundi
Zaire
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02761992000800029
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