Praziquantel coverage in schools and communities targeted for the elimination of urogenital schistosomiasis in Zanzibar: a cross-sectional survey

© 2015 Knopp et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The attached file is the published version of the article

Development of novel multiplex microsatellite polymerase chain reactions to enable high-throughput population genetic studies of Schistosoma haematobium

© 2015 Webster et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The attached file is the published version of the article

Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach

ABSTRACT: BACKGROUND: Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. However, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3--5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the impact measured in a randomized intervention trial. METHODS: In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9--12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by standardized questionnaire-interviews with community leaders. Additional issues potentially impacting on study outcomes and all incurring costs will be monitored and recorded. DISCUSSION: Elimination of schistosomiasis has become a priority on the agenda of the Zanzibar government and the international community. Our study will contribute to identifying what, in addition to preventive chemotherapy, needs to be done to prevent, control, and ultimately eliminate schistosomiasis, and to draw lessons for current and future schistosomiasis elimination programmes in Africa and elsewhere.Trial registrationISRCTN4883768

Sensitivity and Specificity of Multiple Kato-Katz Thick Smears and a Circulating Cathodic Antigen Test for Schistosoma mansoni Diagnosis Pre- and Post-repeated-Praziquantel Treatment

Two Kato-Katz thick smears (Kato-Katzs) from a single stool are currently recommended for diagnosing Schistosoma mansoni infections to map areas for intervention. This ‘gold standard’ has low sensitivity at low infection intensities. The urine point-of-care circulating cathodic antigen test (POC-CCA) is potentially more sensitive but how accurately they detect S. mansoni after repeated praziquantel treatments, their suitability for measuring drug efficacy and their correlation with egg counts remain to be fully understood. We compared the accuracies of one to six Kato-Katzs and one POC-CCA for the diagnosis of S. mansoni in primary-school children who have received zero to ten praziquantel treatments. We determined the impact each diagnostic approach may have on monitoring and evaluation (M&E) and drug-efficacy findings

Renormalization of Multiple qq-Zeta Values

In this paper we shall define the renormalization of the multiple $q$-zeta values (M$q$ZV) which are special values of multiple $q$-zeta functions $\zeta_q(s_1,...,s_d)$ when the arguments are all positive integers or all non-positive integers. This generalizes the work of Guo and Zhang (math.NT/0606076v3) on the renormalization of Euler-Zagier multiple zeta values. We show that our renormalization process produces the same values if the M$q$ZVs are well-defined originally and that these renormalizations of M$q$ZV satisfy the $q$-stuffle relations if we use shifted-renormalizations for all divergent $\zeta_q(s_1,...,s_d)$ (i.e., $s_1\le 1$). Moreover, when \qup our renormalizations agree with those of Guo and Zhang.Comment: 22 pages. This is a substantial revision of the first version. I provide a new and complete proof of the fact that our renormalizations satisfy the q-stuffle relations using the shifting principle of MqZV

Elimination of Schistosomiasis Transmission in Zanzibar: Baseline Findings before the Onset of a Randomized Intervention Trial.

Gaining and sustaining control of schistosomiasis and, whenever feasible, achieving local elimination are the year 2020 targets set by the World Health Organization. In Zanzibar, various institutions and stakeholders have joined forces to eliminate urogenital schistosomiasis within 5 years. We report baseline findings before the onset of a randomized intervention trial designed to assess the differential impact of community-based praziquantel administration, snail control, and behavior change interventions. In early 2012, a baseline parasitological survey was conducted in ∼20,000 people from 90 communities in Unguja and Pemba. Risk factors for schistosomiasis were assessed by administering a questionnaire to adults. In selected communities, local knowledge about schistosomiasis transmission and prevention was determined in focus group discussions and in-depths interviews. Intermediate host snails were collected and examined for shedding of cercariae. The baseline Schistosoma haematobium prevalence in school children and adults was 4.3% (range: 0-19.7%) and 2.7% (range: 0-26.5%) in Unguja, and 8.9% (range: 0-31.8%) and 5.5% (range: 0-23.4%) in Pemba, respectively. Heavy infections were detected in 15.1% and 35.6% of the positive school children in Unguja and Pemba, respectively. Males were at higher risk than females (odds ratio (OR): 1.45; 95% confidence interval (CI): 1.03-2.03). Decreasing adult age (OR: 1.04; CI: 1.02-1.06), being born in Pemba (OR: 1.48; CI: 1.02-2.13) or Tanzania (OR: 2.36; CI: 1.16-4.78), and use of freshwater (OR: 2.15; CI: 1.53-3.03) showed higher odds of infection. Community knowledge about schistosomiasis was low. Only few infected Bulinus snails were found. The relatively low S. haematobium prevalence in Zanzibar is a promising starting point for elimination. However, there is a need to improve community knowledge about disease transmission and prevention. Control measures tailored to the local context, placing particular attention to hot-spot areas, high-risk groups, and individuals, will be necessary if elimination is to be achieved

Discontinuous Molecular Dynamics for Semi-Flexible and Rigid Bodies

A general framework for performing event-driven simulations of systems with semi-flexible or rigid bodies interacting under impulsive torques and forces is outlined. Two different approaches are presented. In the first, the dynamics and interaction rules are derived from Lagrangian mechanics in the presence of constraints. This approach is most suitable when the body is composed of relatively few point masses or is semi-flexible. In the second method, the equations of rigid bodies are used to derive explicit analytical expressions for the free evolution of arbitrary rigid molecules and to construct a simple scheme for computing interaction rules. Efficient algorithms for the search for the times of interaction events are designed in this context, and the handling of missed interaction events is discussed.Comment: 16 pages, double column revte

The Hilbert-Schmidt Theorem Formulation of the R-Matrix Theory

Using the Hilbert-Schmidt theorem, we reformulate the R-matrix theory in terms of a uniformly and absolutely convergent expansion. Term by term differentiation is possible with this expansion in the neighborhood of the surface. Methods for improving the convergence are discussed when the R-function series is truncated for practical applications.Comment: 16 pages, Late

On Kedlaya type inequalities for weighted means

In 2016 we proved that for every symmetric, repetition invariant and Jensen concave mean $\mathscr{M}$ the Kedlaya-type inequality $$\mathscr{A}\big(x_1,\mathscr{M}(x_1,x_2),\ldots,\mathscr{M}(x_1,\ldots,x_n)\big)\le \mathscr{M} \big(x_1, \mathscr{A}(x_1,x_2),\ldots,\mathscr{A}(x_1,\ldots,x_n)\big)$$ holds for an arbitrary $(x_n)$ ($\mathscr{A}$ stands for the arithmetic mean). We are going to prove the weighted counterpart of this inequality. More precisely, if $(x_n)$ is a vector with corresponding (non-normalized) weights $(\lambda_n)$ and $\mathscr{M}_{i=1}^n(x_i,\lambda_i)$ denotes the weighted mean then, under analogous conditions on $\mathscr{M}$, the inequality $$\mathscr{A}_{i=1}^n \big(\mathscr{M}_{j=1}^i (x_j,\lambda_j),\:\lambda_i\big) \le \mathscr{M}_{i=1}^n \big(\mathscr{A}_{j=1}^i (x_j,\lambda_j),\:\lambda_i\big)$$ holds for every $(x_n)$ and $(\lambda_n)$ such that the sequence $(\frac{\lambda_k}{\lambda_1+\cdots+\lambda_k})$ is decreasing.Comment: J. Inequal. Appl. (2018