Infants at greater risk of schistosomiasis

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New research has found that children under five living in sub-Saharan Africa are at greater risk than older children of developing a long-term parasitic disease. Infants experience significantly greater exposure to the parasitic worms that cause the chronic disease schistosomiasis, a University of Edinburgh study shows.

Under-fives are vulnerable because they spend time near rivers and lakes in which parasites that cause the disease live. But previous studies have missed pre-schoolers significant exposure to infected water in rivers close to family homes. Researchers found that preschool-age children can suffer parasitic disease for as long as five years before they receive treatment.

Mass administration of anti-parasite medication is currently taking place in 28 African countries but despite infection afflicting as much as 60% of the pre-school population in these countries, the age group is not included in any of the treatment programmes. Researchers claim that current clinical testing of schistosome vaccines is neglecting pre-school children by targeting only primary pupils. They say that this raises the potential of future vaccinations continuing to exclude the younger age group.

Schistosomiasis affects 200m people worldwide and is endemic in 43 African countries, with 90% of cases occurring in sub-Saharan Africa. Researchers who carried out the study, found that infection can occur in babies as young as six months in high transmission areas. Schistosomiasis, commonly known as bilharzia, is second only to malaria as the most significant parasitic disease affecting children in Africa. The disease, transmitted by freshwater snails, affects general health, growth, mental development and future reproductive health.

The Edinburgh study in collaboration with the University of Zimbabwe reaffirms the 2010 World Health Organisation recommendation that preschool-aged children should be included in national schistosome control programmes to redress the current health inequity.

Dr Francisca Mutapi, who led the study, said: “Availability of anti-parasite drugs and improvements in point-of-care infection and disease diagnosis for pre-school children should remove the remaining barriers to delivering a schistosome mass drug administration programme on par with WHO recommendations. We must continue to work toward delivering an integrated, inclusive, sustainable and globally implemented control program for schistosomiasis.”

University of Edinburgh material
Pediatrics abstract

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