Moses J. Chimbari

Distribution of Schistosomiasis and Soil Transmitted Helminthiasis in Zimbabwe: Towards a National Plan of Action for Control and Elimination

Background Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009–2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted. Methodology A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques. Main findings Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%–18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened. Conclusion and recommendations This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe.

SUSCEPTIBILITY OF FRESHWATER SNAILS TO THE AMPHISTOME CALICOPHORON MICROBOTHRIUM AND THE INFLUENCE OF THE SPECIES ON SUSCEPTIBILITY OF BULINUS TROPICUS TO SCHISTOSOMA HAEMATOBIUM AND SCHISTOSOMA MATTHEEI INFECTIONS

The susceptibility of Bulinus tropicus, B. globosus, Biomphalaria pfeifferi, Lymnaea natalensis, and Melanoides tuberculata to Calicophoron microbothrium was examined. Bulinus tropicus had the highest prevalence (65.0%), followed by B. pfeifferi (37.5%), B. globosus (6.8%), and M. tuberculata (5.9%). Lymnaea natalensis was refractory to infection. Bulinus tropicus snails infected with C. microbothrium alone or coinfected with either Schistosoma haematobium or S. mattheei 0, 7, 14, and 21 days after exposure to C. microbothrium produced C. microbothrium cercariae only.

Clinical Malaria Transmission Trends and Its Association with Climatic Variables in Tubu Village, Botswana: A Retrospective Analysis

Good knowledge on the interactions between climatic variables and malaria can be very useful for predicting outbreaks and preparedness interventions. We investigated clinical malaria transmission patterns and its temporal relationship with climatic variables in Tubu village, Botswana. A 5-year retrospective time series data analysis was conducted to determine the transmission patterns of clinical malaria cases at Tubu Health Post and its relationship with rainfall, flood discharge, flood extent, mean minimum, maximum and average temperatures. Data was obtained from clinical records and respective institutions for the period July 2005 to June 2010, presented graphically and analysed using the Univariate ANOVA and Pearson cross-correlation coefficient tests. Peak malaria season occurred between October and May with the highest cumulative incidence of clinical malaria cases being recorded in February. Most of the cases were individuals aged >5 years. Associations between the incidence of clinical malaria cases and several factors were strong at lag periods of 1 month; rainfall (r = 0.417), mean minimum temperature (r = 0.537), mean average temperature (r = 0.493); and at lag period of 6 months for flood extent (r = 0.467) and zero month for flood discharge (r = 0.497). The effect of mean maximum temperature was strongest at 2-month lag period (r = 0.328). Although malaria transmission patterns varied from year to year the trends were similar to those observed in sub-Saharan Africa. Age group >5 years experienced the greatest burden of clinical malaria probably due to the effects of the national malaria elimination programme. Rainfall, flood discharge and extent, mean minimum and mean average temperatures showed some correlation with the incidence of clinical malaria cases.

Food selection behaviour of potential biological agents to control intermediate host snails of schistosomiasis: Sargochromis codringtoni and Tilapia rendalli

The food selection behaviour of two fish species indigenous to Zimbabwe (Tilapia rendalli and Sargochromis codringtoni) was studied under laboratory conditions with a view to considering them as biological agents for snail control. Six glass aquaria were set up and divided into two sets each with two aquaria. One S. codringtoni was introduced into each aquarium of the first set while one T. rendalli was introduced into each aquarium of the other set. In one of the aquaria of each set the fish were supplied with snails and trout food. Snails and weeds were provided, but trout food was excluded in the second aquarium of each set while the third aquarium for each set was provided with trout food, snails and weeds. A fourth aquarium with weeds and snails but no fish was set up as a control. Data collected over 9 weeks showed that T. rendalli was primarily herbivorous while S. codringtoni was shown to be malacophagous. Presence of trout food made no difference in the snail-eating habit of S. codringtoni or the weed-eating behaviour of T. rendalli. However, trout food seemed to be a good protein supplement to T. rendalli as the fish with access to trout food gained more weight and length.

Risk factors and micro-geographical heterogeneity of Schistosoma haematobium in Ndumo area, uMkhanyakude district, KwaZulu-Natal, South Africa

Schistosomiasis is a snail-transmitted parasitic disease endemic in most rural areas of sub-Saharan Africa. However, the currently used prediction models fail to capture the focal nature of its transmission due to the macro-geographical levels considered and paucity of data at local levels. This study determined the spatial distribution of Schistosoma haematobium and related risk factors in Ndumo area, uMkhanyakude District, KwaZulu-Natal province in South Africa. A sample of 435 schoolchildren between 10 to 15 years old from 10 primary schools was screened for S. haematobium using the filtration method. Getis-Ord Gi* and Bernoulli model were used to determine the hotspots of S. haematobium infection intensity based on their spatial distribution. Semiparametric-Geographically Weighted Regression (s-GWR) model was used to predict and analyse the spatial distribution of S. haematobium in relation to environmental and socio-economic factors. We confirmed that schistosomiasis transmission is focal in nature as indicated by significant S. haematobium cases and infection intensity clusters (p<0.05) in the study area. The s-GWR model performance was low (R(2)=0.45) and its residuals did not show autocorrelation (Morans I=-0.001; z-score=0.003 and p-value=0.997) indicating that the model was correctly spelled. The s-GWR model also indicated that the coefficients for some of the socio-economic variables such as distances of households from operational piped water collection points, distance from open water sources, religion, toilet use, household head and places of bath and laundry significantly (t-values+/-1.96) varied across the landscape thereby determining the variation of S. haematobium infection intensity. This evidence may be used for control and management of the disease at micro scale. However, there is need for further research into more factors that may improve the performance of the s-GWR models in determining the local variation of S. haematobium infection intensity.

Modelling the spatial and seasonal distribution of suitable habitats of schistosomiasis intermediate host snails using Maxent in Ndumo area, KwaZulu-Natal Province, South Africa

BackgroundSchistosomiasis is a snail-borne disease endemic in sub-Saharan Africa transmitted by freshwater snails. The distribution of schistosomiasis coincides with that of the intermediate hosts as determined by climatic and environmental factors. The aim of this paper was to model the spatial and seasonal distribution of suitable habitats for Bulinus globosus and Biomphalaria pfeifferi snail species (intermediate hosts for Schistosoma haematobium and Schistosoma mansoni, respectively) in the Ndumo area of uMkhanyakude district, South Africa.MethodsMaximum Entropy (Maxent) modelling technique was used to predict the distribution of suitable habitats for B. globosus and B. pfeifferi using presence-only datasets with ≥ 5 and ≤ 12 sampling points in different seasons. Precipitation, maximum and minimum temperatures, Normalised Difference Vegetation Index (NDVI), Normalised Difference Water Index (NDWI), pH, slope and Enhanced Vegetation Index (EVI) were the background variables in the Maxent models. The models were validated using the area under the curve (AUC) and omission rate.ResultsThe predicted suitable habitats for intermediate snail hosts varied with seasons. The AUC for models in all seasons ranged from 0.71 to 1 and the prediction rates were between 0.8 and 0.9. Although B. globosus was found at more localities in the Ndumo area, there was also evidence of cohabiting with B. pfiefferi at some of the locations. NDWI had significant contribution to the models in all seasons.ConclusionThe Maxent model is robust in snail habitat suitability modelling even with small dataset of presence-only sampling sites. Application of the methods and design used in this study may be useful in developing a control and management programme for schistosomiasis in the Ndumo area.

Assessment of Risk Factors Associated with Malaria Transmission in Tubu Village, Northern Botswana

This study investigated potential risk factors associated with malaria transmission in Tubu village, Okavango subdistrict, a malaria endemic area in northern Botswana. Data was derived from a census questionnaire survey, participatory rural appraisal workshop, field observations, and mosquito surveys. History of malaria episodes was associated with several factors: household income (P < 0.05), late outdoor activities (OR = 7.016; CI = 1.786–27.559), time spent outdoors (P = 0.051), travel outside study area (OR = 2.70; CI = 1.004–7.260), nonpossession of insecticide treated nets (OR = 0.892; CI = 0.797–0.998), hut/house structure (OR = 11.781; CI = 3.868–35.885), and homestead location from water bodies (P < 0.05). No associations were established between history of malaria episodes and the following factors: being a farmer (P > 0.05) and number of nets possessed (P > 0.05). Eave size was not associated with mosquito bites (P > 0.05), frequency of mosquito bites (P > 0.05), and time of mosquito bites (P > 0.05). Possession of nets was very high (94.7%). Close proximity of a health facility and low vegetation cover were added advantages. Some of the identified risk factors are important for developing effective control and elimination strategies involving the community, with limited resources.

Implications of Changing Temperatures on the Growth, Fecundity and Survival of Intermediate Host Snails of Schistosomiasis: A Systematic Review

Climate change has been predicted to increase the global mean temperature and to alter the ecological interactions among organisms. These changes may play critical roles in influencing the life history traits of the intermediate hosts (IHs). This review focused on studies and disease models that evaluate the potential effect of temperature rise on the ecology of IH snails and the development of parasites within them. The main focus was on IH snails of schistosome parasites that cause schistosomiasis in humans. A literature search was conducted on Google Scholar, EBSCOhost and PubMed databases using predefined medical subject heading terms, Boolean operators and truncation symbols in combinations with direct key words. The final synthesis included nineteen published articles. The studies reviewed indicated that temperature rise may alter the distribution, optimal conditions for breeding, growth and survival of IH snails which may eventually increase the spread and/or transmission of schistosomiasis. The literature also confirmed that the life history traits of IH snails and their interaction with the schistosome parasites are affected by temperature and hence a change in climate may have profound outcomes on the population size of snails, parasite density and disease epidemiology. We concluded that understanding the impact of temperature on the growth, fecundity and survival of IH snails may broaden the knowledge on the possible effects of climate change and hence inform schistosomiasis control programmes.

The role of snail aestivation in transmission of schistosomiasis in changing climatic conditions

Schistosomiasis vector snails are subjected to extreme seasonal changes, particularly in ephemeral rivers and lentic waterbodies. In the tropics, aestivation is one of the adaptive strategies for survival and is used by snails in times of extremely high temperatures and desiccation. Aestivation therefore plays an important role in maintaining the transmission of schistosomiasis. This review assesses the possible impacts of climate change on the temporal and spatial distribution of schistosomiasis-transmitting snails with special emphasis on aestivation, and discusses the effect of schistosome infection on aestivation ability. The impacts of parasite development on snails, as well as physiological changes, are discussed with reference to schistosomiasis transmission. This review shows that schistosome-infected snails have lower survival rates during aestivation, and that those that survive manage to get rid of the infection. In general, snail aestivation ability is poor and survival chances diminish with time. Longer dry periods result in fewer, as well as uninfected, snails. However, the ability of the surviving snails to repopulate the habitats is high.

Characteristics of Anopheles arabiensis Larval Habitats in Tubu Village, Botswana

ABSTRACT: Documented information on the ecology of larval habitats in Botswana is lacking but is critical for larval control programs. Therefore, this study determined the characteristics of these habitats and the influences of biotic and abiotic factors in Tubu village, Botswana. Eight water bodies were sampled between January and December, 2013. The aquatic vegetation and invertebrate species present were characterized. Water parameters measured were turbidity (NTU), conductivity (µS/cm), oxygen (mg/l), and pH. Larval densities of Anopheles arabiensis mosquitoes and their correlation with abiotic factors were determined. Larval breeding was associated with ‘short’ aquatic vegetation, a variety of habitats fed by both rainfall and flood waters and sites with predators and competitors. The monthly mean (± SEmean) larval density was 8.16±1.33. The monthly mean (±SEmean) pH, conductivity, oxygen, and turbidity were 7.65±0.13, 1152.834±69.171, 5.59±1.33, and 323.421±33.801, respectively. There was a significant negative correlation between larval density and conductivity (r = -0.839; p < 0.01), while a significant positive correlation occurred between turbidity and larval density (r = 0.685; p < 0.05). Oxygen (r = 0.140; p > 0.05) and pH (r = 0.252; p > 0.05) were not correlated with larval density. Floods and diversified breeding sites contributed to prolonged and prolific larval breeding. ‘Short’ aquatic vegetation and predator-infested waters offered suitable environments for larval breeding. Turbidity and conductivity were good indicators for potential breeding places and can be used as early warning indices for predicting larval production levels.