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. 2024 Mar 6;17(1):113.
doi: 10.1186/s13071-024-06156-1.

Progress in controlling the transmission of schistosome parasites in Southern Ethiopia: the Geshiyaro Project in the Wolaita Zone

Birhan Mengistu  1 , Ewnetu Firdawek Liyew  2 , Melkie Chernet  2 , Geremew Tasew  2 , Santiago Rayment Gomez  3 , Rosie Maddren  3 , Benjamin Collyer  3 , Ufaysa Anjulo  4 , Adugna Tamiru  4 , Kathryn Forbes  3 , Zelalem Mehari  5 , Kebede Deribe  5 , Teshale Yadeta  5 , Mihretab Salasibew  5 , Getachew Tollera  2 , Roy Anderson  3
Affiliations

Progress in controlling the transmission of schistosome parasites in Southern Ethiopia: the Geshiyaro Project in the Wolaita Zone

Birhan Mengistu et al. Parasit Vectors. .

Erratum in

Abstract

Background: This paper describes changes in the prevalence and intensity of schistosome parasite infections in a project integrating mass drug administration (MDA), water, sanitation, and hygiene (WaSH), and behavioral change interventions.

Methods: The Geshiyaro Project comprises three intervention arms. Arm 1 is subdivided into "Arm 1 pilot" (one district) and Arm 1 (four other districts), both receiving integrated community-wide MDA with intensive WaSH interventions. Arm 2 involves 17 districts with community-wide MDA interventions, while Arm 3 serves as a control with school-based MDA interventions in three districts. A total of 150 individuals, stratified by age group, were randomly selected from each of the 45 sentinel sites. Arm sizes were 584 (Arm 1 pilot), 1636 (Arm 1), 2203 (Arm 2), and 2238 (Arm 3). Statistical tests were employed to compare infection prevalence and intensity across the different arms.

Results: The prevalence of schistosome parasite infection ranged from 0% to 2.6% and from 1.7% to 25.7% across districts, employing the Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) diagnostics, respectively. The mean infection intensity level showed no marked difference between baseline and follow-up surveys when measured by KK, except in Arm 2 (t = 6.89, P < 0.0001). Infection prevalence decreased significantly in Arm 1 (t = 8.62, P < 0.0001), Arm 2 (t = 6.94, P < 0.0001), and Arm 3 (t = 8.83, P < 0.0001), but not in Arm 1 pilot (t = 1.69, P = 0.09) by POC-CCA, when trace was considered positive. The decrease was significant only in Arm 1 (t = 3.28, P = 0.0001) and Arm 2 (t = 7.62, P < 0.0001) when the trace was considered negative in POC-CCA. Arm 2 demonstrated a significant difference in difference (DID) compared to the control group, Arm 3, regardless of whether trace in POC-CCA was considered positive (DID = 3.9%, df = 8780, P = 0.025) or negative (DID = -5.2, df = 8780, P = 0.0004).

Conclusions: The prevalence of schistosomiasis was low when employing the KK diagnostic but moderate in some locations by the POC-CCA diagnostic. The infection level had decreased across all arms of the Geshiyaro study at mid-term of the 7-year project, but further efforts are needed to reduce the rate of parasite transmission based on the POC-CCA diagnostic scores.

Keywords: Kato-Katz (KK); Mass drug administration (MDA); Point-of-care circulating cathodic antigen (POC-CCA); Schistosomiasis (SCH).

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Trends in S. mansoni infection, with confidence intervals, in different arms by KK and CCA (when trace was considered positive or negative). A Trend in S. mansoni infection in Arm 1 pilot; B trend in S. mansoni infection in Arm 1; C trend in S. mansoni infection in Arm 2; D trend in S. mansoni infection in Arm 3
Fig. 2
Fig. 2
Trends in the prevalence of schistosome infection (S. mansoni) at the district level over the various cohort surveys. A and B Prevalence of SCH in Arm 1 pilot by KK and POC-CCA(+) at BL (2018) and FU3 (2022); C and D prevalence of SCH in Arm 1 by KK and POC-CCA(+) at BL (2019) and FU2 (2021); E and F prevalence of SCH in Arm 2 by KK and POC-CCA(+) at BL (2029) and FU2 (2021); G and H prevalence of SCH in Arm 3 by KK and POC-CCA(+) at BL (2021) and FU1 (2022). BL baseline
Fig. 2
Fig. 2
Trends in the prevalence of schistosome infection (S. mansoni) at the district level over the various cohort surveys. A and B Prevalence of SCH in Arm 1 pilot by KK and POC-CCA(+) at BL (2018) and FU3 (2022); C and D prevalence of SCH in Arm 1 by KK and POC-CCA(+) at BL (2019) and FU2 (2021); E and F prevalence of SCH in Arm 2 by KK and POC-CCA(+) at BL (2029) and FU2 (2021); G and H prevalence of SCH in Arm 3 by KK and POC-CCA(+) at BL (2021) and FU1 (2022). BL baseline
None
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