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. 2019 May 2:47:28.
doi: 10.1186/s41182-019-0155-8. eCollection 2019.

Hematobium schistosomiasis control for health management of labor force generation at Nkhotakota and Lilongwe in the Republic of Malawi-assumed to be related to occupational risk

Nobuyuki Mishima  1   2 , Samuel K Jemu  3 , Tomoaki Kuroda  1   2 , Koichiro Tabuchi  1   2 , Andrew W Darcy  1 , Takaki Shimono  1 , Pheophet Lamaningao  1 , Mari Miyake  1 , Seiji Kanda  1 , Susan Ng'ambi  4 , Yoshihiro Komai  5 , Hirofumi Maeba  6 , Hiroyuki Amano  1 , Toshimasa Nishiyama  1   2
Affiliations

Hematobium schistosomiasis control for health management of labor force generation at Nkhotakota and Lilongwe in the Republic of Malawi-assumed to be related to occupational risk

Nobuyuki Mishima et al. Trop Med Health. .

Abstract

Background: In Malawi, hematobium schistosomiasis is highly endemic. According to previous studies, countermeasures have been conducted mainly in school-aged children. In this study, we focused on the age groups, which are assumed to be major labor force generation. Hematobium schistosomiasis is supposed to be related to occupational activities in schistosome-endemic countries because of its infectious route. We chronologically followed the transition of schistosome egg-positive prevalence before and after mass drug administration of praziquantel (MDA) by using a urine filtering examination. We also analyzed the effectiveness of urine reagent strips from the cost perspective.

Results: The egg-positive prevalence was 34.3% (95% CI 28.5-40.5) just before MDA in June 2010 and the highest prevalence was in the age of twenties. The egg-positive prevalence reduced to 12.7% (95% CI 9.2-17.3, p < 0.01) 8 weeks after the first MDA and the prevalence reduced to 6.9% (95% CI 4.6-10.0, p < 0.01) after the second MDA in August 2011. The egg-positive prevalence after MDA in 2013 was reduced from 3.8% (95% CI 2.1-6.9) to 0.9% (95% CI 0.3-3.4) and p value was 0.050. Using urine reagent strips after MDA, the positive predictive value decreased, but the negative predictive value remained high. The cost of one urine reagent strip and one tablet of praziquantel were US$0.06 and US$0.125 in 2013 in Malawi. If the egg-positive prevalence is 40%, screening subjects for MDA using urine reagent strips, the cost reduction can be estimated to be about 24%, showing an overall cost reduction.

Conclusions: MDA of praziquantel can assuredly reduce schistosome egg-positive prevalence. The combination of MDA and urine reagent strips could be both a practical and cost-effective countermeasure for hematobium schistosomiasis. It is key to recognize that hematobium schistosomiasis could be considered a disease that is assumed to have some concern with occupational risk at Nkhotakota and Lilongwe in Malawi. From this point of view, it is very important to manage workers' health; the sound labor force generation is vital for economic growth and development in these areas and countries.

Keywords: Economic growth; Hematobium schistosomiasis; Labor health management; Malawi; Occupational risk; Urine reagent strips.

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Conflict of interest statement

Clearance to undertake the follow-up study was obtained from the District Health Office of the Ministry of Health (MOH) in Malawi and Kansai Medical University Ethical Committee in Japan. In the areas used in the study, permission to proceed with the study was obtained from the District Health Officer (DHO). The approved number of Ethics Review Committee (KAN-I-RIN) is 0758. We distributed instruction on this study written in Chichewa (Malawian domestic language) to all participants and then they received an explanation on this study in Chichewa from the Malawi Ministry of Health staff. After these series of explanation, a signed consent form was obtained from both the new and old participants in this study. The consent form contained the following information: general introduction of the study, usefulness of the study, and purpose of the study. The participants were allowed to withdraw at any point during the project whenever they deemed appropriate.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Process of egg-positive rate among all participants 2010–2011
Fig. 2
Fig. 2
a Process of egg-positive rate by age group 2010–2011. b Process of egg-positive rate by age group 2010–2011
Fig. 3
Fig. 3
Analysis for the results of occult blood by urine strip tests
Fig. 4
Fig. 4
a Process of egg-positive rate by age group 2013. b Process of egg-positive rate by age group 2013
See this image and copyright information in PMC

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