A systematic review and meta-analysis quantifying schistosomiasis infection burden in pre-school aged children (PreSAC) in sub-Saharan Africa for the period 2000–2020

• Published in: PloS one Vol. 15; no. 12; p. e0244695
• Main Authors: Kalinda, Chester, Mindu, Tafadzwa, Chimbari, Moses John
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 29.12.2020; Public Library of Science (PLoS)
• Subjects: Africa South of the Sahara - epidemiology; Age; Asymmetry; Bias; Biology and Life Sciences; Child; Child, Preschool; Children; Communicable diseases in children; Demographic aspects; Disease; Disease control; Engineering and Technology; Female; Health aspects; Health risks; Health sciences; Heterogeneity; Humans; Infant; Infections; Literature reviews; Male; Marginalized groups; Medicine and Health Sciences; Meta-analysis; Morbidity; Nursing schools; Pediatric research; People and Places; Preschool children; Prevalence; Public health; Schistosoma mansoni; Schistosomiasis; Schistosomiasis - epidemiology; Statistics; Subgroups; Tropical diseases; Urine; Africa South of the Sahara; Sub-Saharan Africa; South Africa; Southern Africa; West Africa; East Africa; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244695

Following the adoption of the World Health Assembly Resolution WHA 65.21 and Neglected Tropical Diseases road map 2021-2030, schistosomiasis control programmes have shifted from morbidity control to disease elimination. However, several gaps continue to be observed in the implementation of control programmes with certain age groups omitted from these campaigns increasing health inequalities and risks of reinfections to previously treated groups. We used the Inverse Variance Heterogeneity (IVhet) model to estimate the prevalence of schistosomiasis infection among preschool-aged children. We did a systematic review of peer-reviewed literature on schistosomiasis in sub-Saharan Africa for the period January 1, 2000 to November 30, 2020. Quantitative data for cases of schistosomiasis infection were extracted, including country and region where the studies were done, year of publication and specific schistosome species observed. The IVhet model was used to estimate the pooled prevalence estimate (PPE), the heterogeneity and publication bias. We screened 2601 articles to obtain 47 eligible studies containing quantitative data on preschool-aged children. Of the selected studies, 44.7% (n = 22) were from East Africa while the least number of studies obtained (2.1%, n = 1) was from Central Africa. 21712 subjects were screened for infection due to Schistosoma spp; 13924 for S. mansoni and 7788 for S. haematobium. The PPE for schistosomiasis among PreSAC was 19% (95% CI: 11-28). Infection due to S. mansoni (IVhet PPE: 22% (95% CI: 9-36) was higher than that due to S. haematobium (15%; 95% CI: 6-25). A Luis Furuya-Kanamori index of 1.83 indicated a lack of publication bias. High level of heterogeneity was observed (I2 > 90%) and this could not be reduced through subgroup analysis. Schistosomiasis infection among pre-school aged children 6 years old and below is high. This indicates the importance of including this age group in treatment programmes to reduce infection prevalence and long-term morbidities associated with prolonged schistosome infection.