Epidemiology of Schistosoma mansoni infection, diagnosis and treatment efficacy of praziquantel after a decade of mass drug administration in northwest Ethiopia
1
Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
2
Biology, Bahir Dar University, Bahir Dar, Ethiopia
3
Mundo Sano Foundation and Institute of Health Carlos III, Madrid, Spain
Popul. Med. 2026;8(Supplement Supplement 1):A498
ABSTRACT
INTRODUCTION:
Despite years of mass drug administration, Schistosoma mansoni remains endemic in Ethiopia. Most prevalence studies rely on the less sensitive Kato Katz (KK) technique, likely underestimating infection rates, and limited data on community knowledge, attitudes, and practices (KAP) hinder control efforts. Although reduced praziquantel (PZQ) efficacy has been reported, comprehensive data are scarce.
METHODS:
A cross-sectional study was conducted in seven districts of northwest Ethiopia from February to June 2023 among 1,192 participants (634 school-aged children (SACs) and 558 adults). Data on KAP were collected via a structured questionnaire. S. mansoni infection was diagnosed using KK and real-time PCR on stool samples, and point–of-care circulating cathodic antigen (POC-CCA) test on urine samples, with diagnostic performance evaluated by latent class analysis (LCA). A cohort of 130 infected SACs received a single 40 mg/kg dose of PZQ and was re-evaluated after three weeks to determine cure and egg reduction rates. Data were analyzed by descriptive statistics and logistic regression in SPSS version 21.
RESULTS:
Of 1192 participants, 782 (65.6%) were infected with S. mansoni, including 452 (71.3%) SACs and 330 (59.1%) adults. KK sensitivity ranged from 54.6% to 88.6% based on endemicity. POC-CCA showed 93.4–100% sensitivity but lower specificity in low (86.0%) and moderate (78.9%) areas. Real-time PCR had 97.2% sensitivity. Awareness about schistosomiasis was 19.2%, with good knowledge 7.9%, positive attitudes 13.1%, and safe practices 43.2%. The KK-based cure rate was 88.2% with 93.5% egg reduction rate; POC-CCA-based cure rate was 70.9%.
CONCLUSIONS:
Schistosoma mansoni prevalence was high, with KK showing low sensitivity, particularly in low-transmission areas, while POC-CCA and real-time PCR performed well. A single 40 mg/kg dose of PZQ was effective and safe. KAP levels were low, highlighting the need for integrated control strategies, and sensitive diagnostics like POC-CCA to support schistosomiasis elimination in Ethiopia.
Despite years of mass drug administration, Schistosoma mansoni remains endemic in Ethiopia. Most prevalence studies rely on the less sensitive Kato Katz (KK) technique, likely underestimating infection rates, and limited data on community knowledge, attitudes, and practices (KAP) hinder control efforts. Although reduced praziquantel (PZQ) efficacy has been reported, comprehensive data are scarce.
METHODS:
A cross-sectional study was conducted in seven districts of northwest Ethiopia from February to June 2023 among 1,192 participants (634 school-aged children (SACs) and 558 adults). Data on KAP were collected via a structured questionnaire. S. mansoni infection was diagnosed using KK and real-time PCR on stool samples, and point–of-care circulating cathodic antigen (POC-CCA) test on urine samples, with diagnostic performance evaluated by latent class analysis (LCA). A cohort of 130 infected SACs received a single 40 mg/kg dose of PZQ and was re-evaluated after three weeks to determine cure and egg reduction rates. Data were analyzed by descriptive statistics and logistic regression in SPSS version 21.
RESULTS:
Of 1192 participants, 782 (65.6%) were infected with S. mansoni, including 452 (71.3%) SACs and 330 (59.1%) adults. KK sensitivity ranged from 54.6% to 88.6% based on endemicity. POC-CCA showed 93.4–100% sensitivity but lower specificity in low (86.0%) and moderate (78.9%) areas. Real-time PCR had 97.2% sensitivity. Awareness about schistosomiasis was 19.2%, with good knowledge 7.9%, positive attitudes 13.1%, and safe practices 43.2%. The KK-based cure rate was 88.2% with 93.5% egg reduction rate; POC-CCA-based cure rate was 70.9%.
CONCLUSIONS:
Schistosoma mansoni prevalence was high, with KK showing low sensitivity, particularly in low-transmission areas, while POC-CCA and real-time PCR performed well. A single 40 mg/kg dose of PZQ was effective and safe. KAP levels were low, highlighting the need for integrated control strategies, and sensitive diagnostics like POC-CCA to support schistosomiasis elimination in Ethiopia.
| eISSN: | 2654-1459 |
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