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Scope and Limits of an Anamnestic Questionnaire in a Control-Induced Low-Endemicity Helminthiasis Setting in South-Central Côte d’Ivoire

Identifieur interne : 002A32 ( Pmc/Curation ); précédent : 002A31; suivant : 002A33

Scope and Limits of an Anamnestic Questionnaire in a Control-Induced Low-Endemicity Helminthiasis Setting in South-Central Côte d’Ivoire

Auteurs : Thomas Fürst [Suisse] ; Mamadou Ouattara ; Kigbafori D. Silué ; Dje N. N Oran ; Lukas G. Adiossan ; Isaac I. Bogoch [Canada] ; Yao N Uessan ; Siaka Koné ; Jürg Utzinger [Suisse] ; Eliézer K. N Oran

Source :

RBID : PMC:3670890

Abstract

Background

Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available.

Methodology

Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d’Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals’ helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i) to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii) to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings.

Principal Findings

Our study sample consisted of 195 adults (101 males, 94 females). We found prevalences of hookworm, Trichuris trichiura, Schistosoma haematobium, and Schistosoma mansoni of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No Ascaris lumbricoides infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05) associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties.

Conclusions/Significance

The generally low prevalence and intensity of helminth infection in this part of south-central Côte d’Ivoire indicates that recent control efforts have turned our study area into a low endemicity setting. Our anamnestic questionnaire had low sensitivity and specificity to identify infected individuals or treatment groups.


Url:
DOI: 10.1371/journal.pone.0064380
PubMed: 23755120
PubMed Central: 3670890

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PMC:3670890

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Mamadou Ouattara
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Kigbafori D. Silué
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Kigbafori D. Silué
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Dje N. N Oran
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Lukas G. Adiossan
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Yao N Uessan
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Siaka Koné
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Eliézer K. N Oran
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Eliézer K. N Oran
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<sec>
<title>Background</title>
<p>Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available.</p>
</sec>
<sec>
<title>Methodology</title>
<p>Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d’Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals’ helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i) to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii) to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings.</p>
</sec>
<sec>
<title>Principal Findings</title>
<p>Our study sample consisted of 195 adults (101 males, 94 females). We found prevalences of hookworm,
<italic>Trichuris trichiura</italic>
,
<italic>Schistosoma haematobium</italic>
, and
<italic>Schistosoma mansoni</italic>
of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No
<italic>Ascaris lumbricoides</italic>
infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05) associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties.</p>
</sec>
<sec>
<title>Conclusions/Significance</title>
<p>The generally low prevalence and intensity of helminth infection in this part of south-central Côte d’Ivoire indicates that recent control efforts have turned our study area into a low endemicity setting. Our anamnestic questionnaire had low sensitivity and specificity to identify infected individuals or treatment groups.</p>
</sec>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group>
<journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher>
<publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">23755120</article-id>
<article-id pub-id-type="pmc">3670890</article-id>
<article-id pub-id-type="publisher-id">PONE-D-12-40414</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0064380</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Medicine</subject>
<subj-group>
<subject>Diagnostic Medicine</subject>
</subj-group>
<subj-group>
<subject>Epidemiology</subject>
<subj-group>
<subject>Clinical Epidemiology</subject>
<subject>Epidemiological Methods</subject>
<subject>Infectious Disease Epidemiology</subject>
<subject>Social Epidemiology</subject>
<subject>Survey Methods</subject>
</subj-group>
</subj-group>
<subj-group>
<subject>Infectious Diseases</subject>
<subj-group>
<subject>Neglected Tropical Diseases</subject>
<subj-group>
<subject>Schistosomiasis</subject>
<subject>Soil-Transmitted Helminths</subject>
</subj-group>
</subj-group>
<subj-group>
<subject>Infectious Disease Control</subject>
</subj-group>
</subj-group>
<subj-group>
<subject>Public Health</subject>
<subj-group>
<subject>Behavioral and Social Aspects of Health</subject>
<subject>Disease Ecology</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Scope and Limits of an Anamnestic Questionnaire in a Control-Induced Low-Endemicity Helminthiasis Setting in South-Central Côte d’Ivoire</article-title>
<alt-title alt-title-type="running-head">Anamnestic Questionnaires for Helminth Control</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Fürst</surname>
<given-names>Thomas</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ouattara</surname>
<given-names>Mamadou</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Silué</surname>
<given-names>Kigbafori D.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>N’Goran</surname>
<given-names>Dje N.</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Adiossan</surname>
<given-names>Lukas G.</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bogoch</surname>
<given-names>Isaac I.</given-names>
</name>
<xref ref-type="aff" rid="aff7">
<sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>N’Guessan</surname>
<given-names>Yao</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Koné</surname>
<given-names>Siaka</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Utzinger</surname>
<given-names>Jürg</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>N’Goran</surname>
<given-names>Eliézer K.</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1">
<label>1</label>
<addr-line>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line>
</aff>
<aff id="aff2">
<label>2</label>
<addr-line>University of Basel, Basel, Switzerland</addr-line>
</aff>
<aff id="aff3">
<label>3</label>
<addr-line>Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire</addr-line>
</aff>
<aff id="aff4">
<label>4</label>
<addr-line>Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire</addr-line>
</aff>
<aff id="aff5">
<label>5</label>
<addr-line>Programme National de Lutte contre la Schistosomiase, les Géohelminthiases et la Filariose Lymphatique, Abidjan, Côte d’Ivoire</addr-line>
</aff>
<aff id="aff6">
<label>6</label>
<addr-line>Hôpital Général de Taabo, Taabo Cité, Côte d’Ivoire</addr-line>
</aff>
<aff id="aff7">
<label>7</label>
<addr-line>Divisions of Internal Medicine and Infectious Diseases, Toronto General Hospital, Toronto, Canada</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Diemert</surname>
<given-names>David Joseph</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>The George Washington University Medical Center, United States of America</addr-line>
</aff>
<author-notes>
<corresp id="cor1">* E-mail:
<email>juerg.utzinger@unibas.ch</email>
</corresp>
<fn fn-type="conflict">
<p>
<bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con">
<p>Conceived and designed the experiments: TF MO KDS SK JU EKN. Performed the experiments: TF MO KDS DNN LA YN EKN. Analyzed the data: TF IIB. Contributed reagents/materials/analysis tools: TF MO KDS DNN LA YN SK JU EKN. Wrote the paper: TF MO KDS IIB JU EKN.</p>
</fn>
</author-notes>
<pub-date pub-type="collection">
<year>2013</year>
</pub-date>
<pub-date pub-type="epub">
<day>3</day>
<month>6</month>
<year>2013</year>
</pub-date>
<volume>8</volume>
<issue>6</issue>
<elocation-id>e64380</elocation-id>
<history>
<date date-type="received">
<day>18</day>
<month>12</month>
<year>2012</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>4</month>
<year>2013</year>
</date>
</history>
<permissions>
<copyright-year>2013</copyright-year>
<copyright-holder>Fürst et al</copyright-holder>
<license>
<license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available.</p>
</sec>
<sec>
<title>Methodology</title>
<p>Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d’Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals’ helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i) to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii) to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings.</p>
</sec>
<sec>
<title>Principal Findings</title>
<p>Our study sample consisted of 195 adults (101 males, 94 females). We found prevalences of hookworm,
<italic>Trichuris trichiura</italic>
,
<italic>Schistosoma haematobium</italic>
, and
<italic>Schistosoma mansoni</italic>
of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No
<italic>Ascaris lumbricoides</italic>
infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05) associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties.</p>
</sec>
<sec>
<title>Conclusions/Significance</title>
<p>The generally low prevalence and intensity of helminth infection in this part of south-central Côte d’Ivoire indicates that recent control efforts have turned our study area into a low endemicity setting. Our anamnestic questionnaire had low sensitivity and specificity to identify infected individuals or treatment groups.</p>
</sec>
</abstract>
<funding-group>
<funding-statement>The authors thank Fairmed for sustained funding that allowed us to establish and run the Taabo health demographic surveillance system in south-central Côte d’Ivoire, and the accompanying health interventions with the aim to reduce the mortality and morbidity due to malaria and neglected tropical diseases. TF is associated to the National Centre of Competence in Research North-South and received financial support through a Pro*Doc Research Module from the Swiss National Science Foundation (SNSF; project no. PDFMP3-123185). Furthermore, he is thankful for a personal stipend from the Freiwillige Akademische Gesellschaft Basel. JU and EKN are grateful to the SNSF (project no. IZ70Z-123900). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts>
<page-count count="10"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>

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