Publications by authors named "Mahamadou Traoré"

17 Publications

  • Page 1 of 1

Factors hindering health care delivery in nomadic communities: a cross-sectional study in Timbuktu, Mali.

BMC Public Health 2021 Feb 28;21(1):421. Epub 2021 Feb 28.

Mali International Center for Excellence in Research (ICER), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali.

Background: In Mali, nomadic populations are spread over one third of the territory. Their lifestyle, characterized by constant mobility, excludes them from, or at best places them at the edge of, health delivery services. This study aimed to describe nomadic populations' characteristics, determine their perception on the current health services, and identify issues associated with community-based health interventions.

Methods: To develop a better health policy and strategic approaches adapted to nomadic populations, we conducted a cross-sectional study in the region of Timbuktu to describe the difficulties in accessing health services. The study consisted in administering questionnaires to community members in the communes of Ber and Gossi, in the Timbuktu region, to understand their perceptions of health services delivery in their settings.

Results: We interviewed 520 individuals, all members of the nomadic communities of the two study communes. Their median age was 38 years old with extremes ranging from 18 to 86 years old. Their main activities were livestock breeding (27%), housekeeping (26.4%), local trading (11%), farming (6%) and artisans (5.5%). The average distance to the local health center was 40.94 km and 23.19 km respectively in Gossi and Ber. In terms of barriers to access to health care, participants complained mainly about the transportation options (79.4%), the quality of provided services (39.2%) and the high cost of available health services (35.7%). Additionally, more than a quarter of our participants stated that they would not allow themselves to be examined by a health care worker of the opposite gender.

Conclusion: This study shows that nomadic populations do not have access to community-based health interventions. A number of factors were revealed to be important barriers per these communities' perception including the quality of services, poverty, lifestyle, gender and current health policy strategies in the region. To be successful, future interventions should take these factors into account by adapting policies and methods.
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http://dx.doi.org/10.1186/s12889-021-10481-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916290PMC
February 2021

Neuropsychiatric and socio-cultural aspects in a Malian family with spinocerebellar ataxia.

Ann Med Psychol (Paris) 2020 Mar 18;178(3):278-282. Epub 2019 Mar 18.

Faculté de Médecine et d'Odontostomatologie, Université des Sciences, des Techniques et des Technologies de Bamako.

Introduction: Spino-cerebellar ataxia or SCA are dominant neurological diseases caused by mutations in several genes. According to social and cultural contexts, especially in populations with low education level, the advent of such diseases might generate other kinds of suffering beside those caused by the physical impairment and disability. The aim of this work was to determine the impact of this disease in patients and their relatives.

Methods: It was a qualitative approach carried out through semi-directive clinical interviews, neuropsychiatric observations and the administration of the Hamilton depression scale.

Results: The study included a polygamous family in which mothers had 10 and 12 maternities. Neurological manifestations concerned four children of the same siblings and the father in a subtle form. The mother of these children was designated as responsible for the transmission of the disease and presented a reaction depression. Irritability, anxiety and depression reactions were observed in two patients and an unaffected brother. The advent of the disease was associated to the hatching of a latent familial conflict related to the father's status that has been established only after four years.

Conclusion: In a social and cultural setting of polygamy, the advent of dominant ataxia with anticipation might revive latent familial conflicts and have psychological and social repercussions on the affected individuals and their relatives.
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http://dx.doi.org/10.1016/j.amp.2018.02.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236554PMC
March 2020

Feasibility and preliminary effectiveness of group antenatal care in Senegalese health posts: a pilot implementation trial.

Health Policy Plan 2020 Jun;35(5):587-599

Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada.

Almost all pregnant women in Senegal receive some antenatal care (ANC), yet only around half receive four or more visits and provision of education and counselling during ANC is often inadequate and, in some cases, non-existent. This results in missed opportunities to provide support and to counsel women regarding appropriate care-seeking practices and health behaviours during pregnancy and across the continuum of care. This pilot effectiveness-implementation randomized controlled trial explored whether group ANC (G-ANC), a model that integrates standard individual pregnancy care with facilitated participatory group education activities and peer support, could potentially address some of these challenges. The G-ANC model adapted for Senegal builds on local healthcare delivery systems and aligns with World Health Organization recommendations for a shift towards women-centred models of maternity services. It was implemented at the health post level, and a total of 330 pregnant women participated in the study, of whom 85% were followed up at 6-10 weeks post-delivery. We assessed implementation outcomes (e.g. acceptability, cost) to establish the feasibility of the model in Senegal and explored effectiveness outcomes related to maternal and infant health for the planning of a large-scale trial. Results indicate that women and ANC providers were overwhelmingly enthusiastic about the G-ANC model, and exploratory analyses suggested improvements in exclusive breastfeeding, intention to use family planning, birth preparations and knowledge around maternal and newborn danger signs. This article provides timely and relevant evidence on the feasibility of G-ANC as an alternative model of care during pregnancy and a solid basis for recommending the conduct of a large-scale implementation study of G-ANC in Senegal.
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http://dx.doi.org/10.1093/heapol/czz178DOI Listing
June 2020

Schistosomiasis - Assessing Progress toward the 2020 and 2025 Global Goals.

N Engl J Med 2019 12;381(26):2519-2528

From the Schistosomiasis Control Initiative (A.K.D., F.M.F., B.C.-U.), the London Centre for Neglected Tropical Disease Research (A.K.D., F.M.F., M.W., M.-G.B., J.P.W.), the Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Imperial College London (A.K.D., F.M.F., M.W., M.-G.B., J.P.W.), and the Royal Veterinary College, the Department of Pathobiology and Population Sciences, University of London (M.W., J.P.W.) - all in London; the Ministry of Health Burundi, Bujumbura (V.B.); the Ministry of Health Niger, Niamey (I.G.); the Ministry of Health Uganda, Vector Control Division, Kampala (E.M.T.); the Ministry of Health Malawi, Lilongwe (S.J.); the Ministry of Health Tanzania and the National Institute for Medical Research, Dar es Salaam (U.J.M.); the Ministry of Health Yemen, Sana'a (A.A.); the Ministry of Public Health and Hygiene Mali, Bamako (M.T.); the Neglected Tropical Diseases Unit, Malaria and Other Parasitic Diseases Division, Institute of HIV-AIDS, Disease Prevention, and Control, Rwanda Biomedical Center, Ministry of Health, Kigali (E.R.); the National Schistosomiasis Program, Ministry of Health, Ouagadougou, Burkina Faso (S.T.); and RTI International, Washington, DC (M.D.F.).

Background: With the vision of "a world free of schistosomiasis," the World Health Organization (WHO) set ambitious goals of control of this debilitating disease and its elimination as a public health problem by 2020 and 2025, respectively. As these milestones become imminent, and if programs are to succeed, it is important to evaluate the WHO programmatic guidelines empirically.

Methods: We collated and analyzed multiyear cross-sectional data from nine national schistosomiasis control programs (in eight countries in sub-Saharan Africa and in Yemen). Data were analyzed according to schistosome species ( or ), number of treatment rounds, overall prevalence, and prevalence of heavy-intensity infection. Disease control was defined as a prevalence of heavy-intensity infection of less than 5% aggregated across sentinel sites, and the elimination target was defined as a prevalence of heavy-intensity infection of less than 1% in all sentinel sites. Heavy-intensity infection was defined as at least 400 eggs per gram of feces for infection or as more than 50 eggs per 10 ml of urine for infection.

Results: All but one country program (Niger) reached the disease-control target by two treatment rounds or less, which is earlier than projected by current WHO guidelines (5 to 10 years). Programs in areas with low endemicity levels at baseline were more likely to reach both the control and elimination targets than were programs in areas with moderate and high endemicity levels at baseline, although the elimination target was reached only for infection (in Burkina Faso, Burundi, and Rwanda within three treatment rounds). Intracountry variation was evident in the relationships between overall prevalence and heavy-intensity infection (stratified according to treatment rounds), a finding that highlights the challenges of using one metric to define control or elimination across all epidemiologic settings.

Conclusions: These data suggest the need to reevaluate progress and treatment strategies in national schistosomiasis control programs more frequently, with local epidemiologic data taken into consideration, in order to determine the treatment effect and appropriate resource allocations and move closer to achieving the global goals. (Funded by the Children's Investment Fund Foundation and others.).
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http://dx.doi.org/10.1056/NEJMoa1812165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785807PMC
December 2019

Gender and neglected tropical disease front-line workers: Data from 16 countries.

PLoS One 2019 19;14(12):e0224925. Epub 2019 Dec 19.

RTI International, Washington, DC, United States of America.

Background: Delivery of preventive chemotherapy (PC) through mass drug administration (MDA) is used to control or eliminate five of the most common neglected tropical diseases (NTDs). The success of an MDA campaign relies on the ability of drug distributors and their supervisors-the NTD front-line workers-to reach populations at risk of NTDs. In the past, our understanding of the demographics of these workers has been limited, but with increased access to sex-disaggregated data, we begin to explore the implications of gender and sex for the success of NTD front-line workers.

Methodology/principal Findings: We reviewed data collected by USAID-supported NTD projects from national NTD programs from fiscal years (FY) 2012-2017 to assess availability of sex-disaggregated data on the workforce. What we found was sex-disaggregated data on 2,984,908 trainees trained with financial support from the project. We then analyzed the percentage of males and females trained by job category, country, and fiscal year. During FY12, 59% of these data were disaggregated by sex, which increased to nearly 100% by FY15 and was sustained through FY17. In FY17, 43% of trainees were female, with just four countries reporting more females than males trained as drug distributors and three countries reporting more females than males trained as trainers/supervisors. Except for two countries, there were no clear trends over time in changes to the percent of females trained.

Conclusions/significance: There has been a rapid increase in availability of sex-disaggregated data, but little increase in recruitment of female workers in countries included in this study. Women continue to be under-represented in the NTD workforce, and while there are often valid reasons for this distribution, we need to test this norm and better understand gender dynamics within NTD programs to increase equity.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224925PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6922366PMC
March 2020

[Factors associated to the cessation of exclusive breastfeeding in rural and urban areas in Mali]

Sante Publique 2019 May June;Vol. 31(3):451-458

Introduction: The study had for object to identify factors associated to the cessation of the exclusive breast-feeding at the mothers of children from 0 to 6 months in the urban and rural circles in Mali.

Method: The study was longitudinal forward-looking, realized in Bamako (urban area) and in Dialakoroba (rural area) from April till November, 2016. in total, 218 mothers were enlisted (114 by area) in a voluntary way in health centers. A monthly follow-up of six months was realized in the place of residence. The SPSS 20 software was used for the seizure and the data analysis. The expected event was to give to the child another food than maternal milk. Test statistics such as Chi2 of Log Rank and Hazard Ratio (HR) were used with threshold of meaning p ≤ 0,05.

Results: In urban zones and rural respectively 68,5 % and 71,5% of the mothers had stopped the Exclusive Breast-feeding (EBF) before six months. Factors associated to this cessation of the EBF were: the use of the feeding-bottle (HR=2,61; IC 95%: [1,46-4,48]), the care of the child during less than three months as main occupation (HR=3,18; IC 95%: [1,95-5,20]), the support for the mother during less than three months (HR=3,79; IC 95%: [2,31-6,22]), the advice(council) on the EBF (HR=0,64; IC 95%: [0,46-0,98]) and the experience (experiment) of breastfeeding (HR=0,34; IC 95%: [0,15-0,84]).

Conclusion: The consideration of the identified factors(mailmen) will allow to improve the practice of the EBF in six months in the sites of the study.
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http://dx.doi.org/10.3917/spub.193.0451DOI Listing
October 2019

Genetics and genomic medicine in Mali: challenges and future perspectives.

Mol Genet Genomic Med 2016 Mar 17;4(2):126-34. Epub 2016 Mar 17.

Neurogenetics Branch National Institute of Neurological Disorders and Stroke (NINDS) National Institutes of Health (NIH) Bethesda Maryland.

Genetics and genomic medicine in Mali: challenges and future perspectives.
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http://dx.doi.org/10.1002/mgg3.212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799869PMC
March 2016

Epidemiology of malaria in the Taabo health and demographic surveillance system, south-central Côte d'Ivoire.

Malar J 2016 Jan 6;15. Epub 2016 Jan 6.

Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.

Background: A deep understanding of the local epidemiology of malaria is essential for the design and implementation of setting-specific control and elimination efforts. In Côte d'Ivoire, new initiatives are underway to reduce the burden of malaria, which requires high-quality longitudinal data. The epidemiology of malaria was studied in the Taabo health and demographic surveillance system (HDSS) in south-central Côte d'Ivoire and implications for control are discussed.

Methods: Two cross-sectional surveys were carried out in the rainy season of June/July in 2010 and 2011. Inhabitants of approximately 7% of randomly selected households in the Taabo HDSS were invited to participate. People were clinically examined, ear temperature was measured and spleen size determined. Finger-prick blood samples were collected and subjected to a rapid diagnostic test (RDT). Additionally, thick and thin blood films were prepared on microscope slides and diagnosed under a microscope for Plasmodium infection and parasitaemia. Haemoglobin (Hb) level was determined using a HemoCue device.

Results: A total of 1187 and 1264 people in 2010 and 2011, respectively, had complete data records. The prevalence of Plasmodium infection was 46.0% in 2010 and 56.6% in 2011, owing to a statistically significant difference (p < 0.05). Males showed a higher Plasmodium infection prevalence than females (49.6 and 62.8% versus 42.6 and 51.2%; respectively, in 2010 and 2011; both p < 0.05). The highest malaria prevalence was observed among infants and young children (aged ≤9 years). The risk of Plasmodium infection was significantly higher in villages compared to small hamlets and urban settings (p < 0.05). Fever, Hb level and splenomegaly were associated with parasitaemia.

Conclusion: Malaria is highly endemic in the Taabo HDSS in south-central Côte d'Ivoire with considerable spatial heterogeneity of Plasmodium infection. There is a pressing need to scale-up control interventions against malaria.
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http://dx.doi.org/10.1186/s12936-015-1076-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4704401PMC
January 2016

Epilepsy genetics in Africa: challenges and future perspectives.

North Afr Middle East Epilepsy J 2014 Sep-Oct;3(5):5-7

Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, (USA).

Despite the diversity of the African population, genetic studies, of epilepsy in particular, have been limited, especially in sub-Saharan Africa. In recent years, with the regression of infectious diseases in developing countries, the focus has shifted more towards non communicable disorders. The prevalence of epilepsy in Africa is higher compared to other continents. Although this has been attributed to the high rate of infectious diseases, genetic contributions should not be ignored. Research in genetic epilepsy in Africa could well benefit from the decreasing cost of genetic analysis, and could contribute to further our knowledge on the spectrum of these diseases in Africa. The growing collaboration between African research institutions and those of developed countries offers a unique opportunity to boost research in Africa and improve our global understanding of human disease, thus leading to the development of better therapeutic approaches.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4580280PMC
September 2015

[Factors associated with exclusive breastfeeding among mothers of children 24 months in Bamako].

Sante Publique 2014 Mar-Apr;26(2):259-65

Objective: The aim of our study was to examine the factors associated with exclusive breastfeeding in the city of Bamako.

Methods: It was a cross sectional and quantitative study. It was held from March 03 to April 14, 2013 in Bamako. Mothers of children 24 months not having reached their third birthday constituted the study population. Two-stage random sampling was used to interview them using a questionnaire. The data analysis using logistic regression was performed with Epi 2000 version 3.5.1.

Results: The study interviewed 362 mothers. The average age of mothers and of the duration of breastfeeding were 26.86 +/- 6.44 years and 19.22 +/- 3.28 months, respectively. Approximately 92% of mothers were married, 30.7% had practiced exclusive breastfeeding, 22.9% breastfed in the 30 minutes following birth and 29% of mothers breastfed to at least 24 months. However, we observed an association between exclusive breastfeeding and the practice of breastfeeding in the 30 minutes following birth, and education.

Conclusion: We have identified modifiable factors for improving the practice of exclusive breastfeeding in Bamako.
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September 2014

Genetics of low spinal muscular atrophy carrier frequency in sub-Saharan Africa.

Ann Neurol 2014 Apr 2;75(4):525-32. Epub 2014 Apr 2.

Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Institute of Biomedical Sciences, George Washington University, Washington, DC.

Objective: Spinal muscular atrophy (SMA) is one of the most common severe hereditary diseases of infancy and early childhood in North America, Europe, and Asia. SMA is usually caused by deletions of the survival motor neuron 1 (SMN1) gene. A closely related gene, SMN2, modifies the disease severity. SMA carriers have only 1 copy of SMN1 and are relatively common (1 in 30-50) in populations of European and Asian descent. SMN copy numbers and SMA carrier frequencies have not been reliably estimated in Malians and other sub-Saharan Africans.

Methods: We used a quantitative polymerase chain reaction assay to determine SMN1 and SMN2 copy numbers in 628 Malians, 120 Nigerians, and 120 Kenyans. We also explored possible mechanisms for SMN1 and SMN2 copy number differences in Malians, and investigated their effects on SMN mRNA and protein levels.

Results: The SMA carrier frequency in Malians is 1 in 209, lower than in Eurasians. Malians and other sub-Saharan Africans are more likely to have ≥3 copies of SMN1 than Eurasians, and more likely to lack SMN2 than Europeans. There was no evidence of gene conversion, gene locus duplication, or natural selection from malaria resistance to account for the higher SMN1 copy numbers in Malians. High SMN1 copy numbers were not associated with increased SMN mRNA or protein levels in human cell lines.

Interpretation: SMA carrier frequencies are much lower in sub-Saharan Africans than in Eurasians. This finding is important to consider in SMA genetic counseling in individuals with black African ancestry.
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http://dx.doi.org/10.1002/ana.24114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112719PMC
April 2014

An in-depth analysis of a piece of shit: distribution of Schistosoma mansoni and hookworm eggs in human stool.

PLoS Negl Trop Dis 2012 20;6(12):e1969. Epub 2012 Dec 20.

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.

Background: An accurate diagnosis of helminth infection is important to improve patient management. However, there is considerable intra- and inter-specimen variation of helminth egg counts in human feces. Homogenization of stool samples has been suggested to improve diagnostic accuracy, but there are no detailed investigations. Rapid disintegration of hookworm eggs constitutes another problem in epidemiological surveys. We studied the spatial distribution of Schistosoma mansoni and hookworm eggs in stool samples, the effect of homogenization, and determined egg counts over time in stool samples stored under different conditions.

Methodology: Whole-stool samples were collected from 222 individuals in a rural part of south Côte d'Ivoire. Samples were cut into four pieces and helminth egg locations from the front to the back and from the center to the surface were analyzed. Some samples were homogenized and fecal egg counts (FECs) compared before and after homogenization. The effect of stool storing methods on FECs was investigated over time, comparing stool storage on ice, covering stool samples with a water-soaked tissue, or keeping stool samples in the shade.

Principal Findings: We found no clear spatial pattern of S. mansoni and hookworm eggs in fecal samples. Homogenization decreased S. mansoni FECs (p = 0.026), while no effect was observed for hookworm and other soil-transmitted helminths. Hookworm FECs decreased over time. Storing stool samples on ice or covered with a moist tissue slowed down hookworm egg decay (p<0.005).

Conclusions/significance: Our findings have important implications for helminth diagnosis at the individual patient level and for epidemiological surveys, anthelmintic drug efficacy studies and monitoring of control programs. Specifically, homogenization of fecal samples is recommended for an accurate detection of S. mansoni eggs, while keeping collected stool samples cool and moist delayed the disintegration of hookworm eggs.
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http://dx.doi.org/10.1371/journal.pntd.0001969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527364PMC
May 2013

[Management of sickle cells disease by households in Bamako].

Mali Med 2009 ;24(3):53-6

Centre de Recherche d’Etude et de Documentation pour la Survie de l’Enfant (CREDOS), Service d’Hématologie Oncologie Médicale et Faculté de Médecine, de Pharmacie et d’Odontostomatologie, Direction Nationale de la Santé (DNS), BP E5675 Bamako, Mali.

The sickle cell disease constitutes a major problem of public health. We find 5% to 20% of carriers of this disease in West Africa and 40% among some populations in central Africa (Congo, Zaire) and Nigeria (Beguè). In Mali prevalence is estimated to 12% with 3% for the homozygote form. It is a known disease and well documented on the scientific plan and its management is better and better codified nowadays, which contributes to the improvement of life quality. For this reason, Centre for Research and Documentation on Child Survival (CREDOS) lead this study. The aim was to assess the knowledge of the mothers for a best management of sickle cell disease in the households. We conducted a cross-sectional study with single passage realized in the households in 6 communes of Bamako district. We inquired 360 parents of children less than 5 years, according to the method of cluster sampling. The study found that 95.8% of mothers know the sickle cell disease. In addition 63.9% of the mothers didn't know the complications of the sickle cell disease and 58% the causes. In the event of discovered sickle cell disease, 58.3% of the mothers stated to want to resort to a medical structure in first intention, 18.3% with self medication and 13.9% with the traditional practitioner. In front of a sickle cell disease crisis, 56% stated to have recourse to modern medicine against 15.2% with the traditional practitioner. Household's implication in the management of the child sickle cell disease suffers a low knowledge of cause, clinical signs, and complications of this disease by the parents. For a better knowledge of this pathology by the families, information and education of the populations through messages BCC are necessary.
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May 2011

Sequential analysis of helminth egg output in human stool samples following albendazole and praziquantel administration.

Acta Trop 2009 Mar 25;109(3):226-31. Epub 2008 Nov 25.

Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland.

Large-scale administration of anthelminthic drugs currently is the most widely used intervention for controlling morbidity due to schistosomiasis and soil-transmitted helminthiasis. An important issue is drug efficacy monitoring. However, the optimal time points post-treatment for assessing the efficacy of praziquantel against Schistosoma mansoni and albendazole against hookworm infections are not known. Forty-nine schoolchildren infected with S. mansoni and 52 infected with hookworm were treated with a single oral dose of praziquantel (40 mg/kg) and albendazole (400 mg), respectively. Stool samples were collected on 19 occasions over a 44-day post-treatment follow-up period, and two Kato-Katz thick smears per sample were examined at each time point. Both the mean egg counts and observed cure rates varied depending on the time point post-treatment. The highest reduction in the geometric mean egg counts (>97%) and the highest observed cure rate (>97%) of S. mansoni infections were found 15-20 days after praziquantel administration. Among the hookworm-infected children, egg counts decreased rapidly within the first week after albendazole administration (>95%), whereas infection rates showed high and heterogeneous (45.0-71.2%) levels at later time points. Both praziquantel and albendazole were highly efficacious in reducing the overall egg burden of S. mansoni and hookworm, respectively. We suggest that 15-20 days post-treatment is the most appropriate time point for efficacy evaluation of praziquantel against S. mansoni. Although no clear conclusion can be drawn for the optimal timing of efficacy evaluation of albendazole against hookworm, a 2-3-week time frame seems a reasonable compromise. This is justified on logistical grounds (i.e. collection of stool samples only once) and growing emphasis on integrating the control of schistosomiasis and soil-transmitted helminthiasis, including drug efficacy monitoring.
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http://dx.doi.org/10.1016/j.actatropica.2008.11.015DOI Listing
March 2009

Risk factors for Schistosoma mansoni and hookworm in urban farming communities in western Côte d'Ivoire.

Trop Med Int Health 2007 Jun;12(6):709-23

Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland.

Objectives: To identify risk factors for Schistosoma mansoni and hookworm infections in urban farming communities, and to investigate small-scale spatial patterns of infection prevalence.

Methods: A cross-sectional survey was carried out in 113 farming households (586 individuals) and 21 non-farming households (130 individuals) from six agricultural zones in the town of Man, western Côte d'Ivoire. Heads of households were interviewed on common agricultural activities, land and water use, education attainment, socioeconomic status and sanitation facilities. Household members provided stool specimens that were processed by the Kato-Katz technique and a formol-ether concentration method and diagnosed for S. mansoni, hookworms and other soil-transmitted helminths and intestinal protozoa. Bayesian statistics were employed for spatial analyses.

Results: The prevalences of S. mansoni and hookworm in farming households were 51.4% and 24.7%, respectively. Risk factors for a S. mansoni infection comprised living in close proximity to the Kô River, water contact with irrigation wells and ponds and low education attainment. Living in zones of smallholder irrigated rice plots or large rice perimeters, using water from domestic wells, and low socioeconomic status were risk factors for a hookworm infection. We found significant spatial heterogeneity between agricultural zones, with the highest infection prevalences of S. mansoni and hookworm in the zone where there was a large rice perimeter.

Conclusions: In this urban setting, both S. mansoni and hookworm infections were related to specific agricultural activities. Health education and active participation of urban farmers for the control of schistosomiasis and soil-transmitted helminthiasis is recommended.
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http://dx.doi.org/10.1111/j.1365-3156.2007.01841.xDOI Listing
June 2007

Polyparasitism with Schistosoma mansoni, geohelminths, and intestinal protozoa in rural Côte d'Ivoire.

J Parasitol 2002 Jun;88(3):461-6

Office of Population Research, Princeton University, New Jersey 08544, USA.

Single species infections with schistosomes, geohelminths, and intestinal protozoans are common over large parts of sub-Saharan Africa, and it is expected that polyparasitism affects a considerable proportion of the population, hence posing a great toll on public health. However, few investigations have been carried out to quantify the extent of polyparasitism. Here, a detailed assessment is reported for the epidemiology of Schistosoma mansoni, geohelminths, and intestinal protozoan infections, with particular emphasis on polyparasitism among 260 community members in rural Cĵte d'Ivoire. Schistosoma mansoni, Entamoeba coli, and hookworm were the predominant species with prevalences of 71.5, 64.6, and 51.9%, respectively. Only 8 individuals displayed no infection, whereas two-thirds of the population harbored 3 or more parasites concurrently. There were a series of significant pairwise parasite co-occurrences, e.g., between S. mansoni and hookworms and between S. mansoni and E. coli. It is concluded that polyparasitism in the population studied here was very common, which is probably the case also in other areas of rural Cĵte d'Ivoire and elsewhere in sub-Saharan Africa. These findings call for integrated approaches to effectively control multiple parasitic and protozoan infections.
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http://dx.doi.org/10.1645/0022-3395(2002)088[0461:PWSMGA]2.0.CO;2DOI Listing
June 2002