Hybridization in urogenital schistosomiasis (HUGS)
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Date
2021-10-18
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Kamuzu University of Health Sciences
Abstract
Type of study: Cohort study, with cross-sectional snail surveys
Problem to be studied: Schistosomiasis is a Neglected Tropical Disease
(NTD) caused by infection with parasitic flatworms
of the Schistosoma genus. With our discovery of
novel Schistosoma haematobium hybrids
commonly co-infecting Malawian school children,
critical knowledge gaps in the biology and control of
schistosomiasis in Central Africa have emerged.
These amplify formal concerns of the WHO’s
preventive chemotherapy (PC) strategy and
underpinning targets within their 2021-2030
Roadmap. Our HUGS (hybridisation in urogenital
schistosomiasis) investigation aims to address
these critical knowledge gaps in the transmission
biology, applied epidemiology and clinical
importance of S. haematobium hybrids.
Objectives: The objectives of the study are:
i. To test if the proportion of hybrid coinfection is
uniform across two representative communities
in Mangochi and Nsanje districts where S.
haematobium-mattheei or S. haematobiumbovis
occur, inclusive of household GPS
mapping and identification of associated risk
factors by questionnaire.
ii. To verifyassess any changes in the proportions
and spatial patterns of hybrid coinfection with
annual praziquantel treatment, in a 2-year
longitudinal population follow-up studystudy, if
the above proportions and spatial patterns of hybrid coinfection hold, or alter, with annual
praziquantel treatment.
iii. To ascertain if there is any altered host
morbidity (e.g. urogenital inflammation) in
hybrid coinfection(s) as measured by portable
ultrasonography and point-of-contact assays.
iv. To reveal describe the hybrid environmental
transmission dynamics of the hybrid
coinfection(s) upon malacological, livestock
tracking and abattoir surveys, dissecting
schistosome material by advanced genetic
profiling.
Methodology: This multi-study will comprise of environmental
snail surveys, animal-abattoir surveys and human
cohort studies. Twelve quarterly spaced
environmental snail surveys will commence before,
during and complete after, examinations for hybrids
in livestock and people to give best chance of
revealing environmental transmission. Three
inspections of slaughtered livestock at abattoir,
each precede human sampling to better alert novel
hybrids/animal schistosomes before three annual
examinations of the human cohort, baseline and
two follow-up surveys. Data will be obtained from a
questionnaire and participants will also provide
urine and stool samples on the same day which will
be tested for Schistosoma-hybrids.
Expected findings and dissemination: We will describe the prevalence of Schistosomahybrids.
We will therefore share our findings with
the Kamuzu University of Health Sciences,
(COMREC), Mangochi District Health Office,District Health Management Team, Communities in
Mangochi, the District Commissioner and District
Executive Committee. We will also present findings
at local and international conferences and in peer
reviewed publications.
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Research Subject Categories::MEDICINE