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Background: In areas of low disease endemicity, highly sensitive diagnostic tools to identify, diagnose, and monitor intestinal schistosomiasis transmission are needed to reliably measure the burden and risk of infection. Here, we used highly sensitive molecular diagnostic methods to investigate Schistosoma mansoni prevalence and transmission along the southern shoreline of Lake Malawi, five years post-disease outbreak. Methodology and principal findings: Faecal and urine samples were provided by school-aged children situated along the southern shoreline of Lake Malawi. Kato-Katz faecal-egg microscopy and point-of-care circulating cathodic antigen (POC-CCA) rapid diagnostic tests were then performed to diagnose infection with S. mansoni. Urine-egg microscopy was also used to diagnose infection with Schistosoma haematobium. In addition, Schistosoma miracidia were isolated from faecal material using a standard miracidium hatching technique. A two-step real-time PCR approach was then used to diagnose infection with S. mansoni using DNA isolated from faecal samples. Furthermore, isolated miracidia were genotyped to species level through PCR and Sanger sequencing. Phylogenetic analyses were then carried out to identify which previously defined S. mansoni cox1 lineage group S. mansoni miracidia were most closely related to. The measured prevalence of S. mansoni infection varied considerably depending on which diagnostic assay was used. When compared to real-time PCR, faecal-egg microscopy had a sensitivity of 9% and a specificity of 100%. When POC-CCA 'trace' results were considered positive, POC-CCA had a sensitivity of 73% and a specificity of 81% when compared to real-time PCR. However, when considered negative, POC-CCA sensitivity was reduced to 56%, whereas specificity was increased to 90%. In addition, a high degree of S. haematobium DNA was detected in DNA isolated from faecal samples and motile S. haematobium miracidia were recovered from faecal samples. Schistosoma mansoni miracidia were closely related to two independent cox1 lineage groups, suggesting multiple recent introduction and colonisation events originating from surrounding east African countries. Conclusions and significance: Intestinal schistosomiasis is now highly prevalent along the southern shoreline of Lake Malawi just five years post-disease outbreak. In addition, a high prevalence of urogenital schistosomiasis persists. The revision of ongoing schistosomiasis control programmes in this area is therefore recommended. Our study also highlights the need for reliable diagnostic assays capable of distinguishing between Schistosoma species in multispecies co-endemic areas. Author summary: Highly sensitive diagnostic approaches to identify, diagnose, and monitor intestinal schistosomiasis transmission are needed to reliably measure the burden and risk of infection in endemic areas. Here, we used a range of diagnostic approaches, including highly sensitive molecular diagnostic methods, to investigate Schistosoma mansoni prevalence and transmission along the southern shoreline of Lake Malawi, Mangochi District, Malawi, five years post-disease outbreak. The measured prevalence of S. mansoni infection varied considerably depending on which diagnostic assay was used. Additionally, a high degree of Schistosoma haematobium DNA was detected in DNA isolated from faecal samples and motile S. haematobium miracidia were recovered from faecal samples. Through phylogenetic analyses, it was also suggested that multiple introduction and colonisation events of S. mansoni originating from surrounding east African countries into Mangochi District may have recently taken place. As such, the revision of ongoing schistosomiasis control programmes in this area is recommended. Our study also highlights the need for reliable diagnostic assays capable of distinguishing between Schistosoma species in multispecies co-endemic areas. [ABSTRACT FROM AUTHOR]

Introduction: Immunoinformatic tools can be used to predict schistosome-specific B-cell epitopes with little sequence identity to human proteins and antigens other than the target. This study reports an approach for identifying schistosome peptides mimicking linear B-cell epitopes using in-silico tools and peptide microarray immunoassay validation. Method: Firstly, a comprehensive literature search was conducted to obtain published schistosome-specific peptides and recombinant proteins with the best overall diagnostic performances. For novel peptides, linear B-cell epitopes were predicted from target recombinant proteins using ABCpred, Bcepred and BepiPred 2.0 in-silico tools. Together with the published peptides, predicted peptides with the highest probability of being B-cell epitopes and the lowest sequence identity with proteins from human and other pathogens were selected. Antibodies against the peptides were measured in sera, using peptide microarray immunoassays. Area under the ROC curve was calculated to assess the overall diagnostic performances of the peptides. Results: Peptide AA81008-19-30 had excellent and acceptable diagnostic performances for discriminating S. mansoni and S. haematobium positives from healthy controls, with AUC values of 0.8043 and 0.7326 respectively for IgG. Peptides MS3_10186-123-131, MS3_10385-339-354, SmSPI-177-193, SmSPI-379-388, MS3-10186-40-49 and SmS-197-214 had acceptable diagnostic performances for discriminating S. mansoni positives from healthy controls with AUC values ranging from 0.7098 to 0.7763 for IgG. Peptides SmSPI-359-372, Smp126160-438-452 and MS3 10186-25-41 had acceptable diagnostic performances for discriminating S. mansoni positives from S. mansoni negatives with AUC values of 0.7124, 0.7156 and 0.7115 respectively for IgG. Peptide MS3-10186-40-49 had an acceptable diagnostic performance for discriminating S. mansoni positives from healthy controls, with an AUC value of 0.7413 for IgM. Conclusion: One peptide with a good diagnostic performance and nine peptides with acceptable diagnostic performances were identified using the immunoinformatic approach and peptide microarray validation. There is need for evaluation of the peptides with true negatives and a good standard positive reference. Author summary: Schistosomiasis, commonly known as bilharzia, is the third most significant tropical disease after malaria and soil-transmitted helminthiases. Like other neglected tropical diseases common in Zimbabwe, schistosomiasis remains mostly undiagnosed or undetected. This is partly due to the fact that reliable identification of parasites requires expertise for specimen preparation, and microscopic examination. Unfortunately, this level of expertise is unavailable in most rural clinics. This limitation is further compounded by the fact that the recommended microscopy-based methods for schistosomiasis diagnosis lack sensitivity, especially in infections of low intensity. To overcome some of the problems associated with microscopy-based methods, highly sensitive serological tests have been utilized. Unfortunately, currently available serological tests have low specificity and show cross-reactivity with other helminthic infections. One way to mitigate cross-reactivity and increase the specificity, is to use immunoinformatic tools and immunoassays to identify schistosomiasis species-specific immunogenic peptides mimicking B-cell epitopes (short amino acid sequences of the antigen that reacts with antibodies). Utilizing immunoinformatic tools coupled with peptide microarray immunoassay validation approach several peptides that can be used to develop diagnostic tools for showing exposure to infection for people living in non-endemic or low-transmission areas were identified in the current study. [ABSTRACT FROM AUTHOR]

Background: Tsetse flies (Glossina sp.) are vectors of Trypanosoma brucei subspecies that cause human African trypanosomiasis (HAT). Capturing and screening tsetse is critical for HAT surveillance. Classically, tsetse have been microscopically analysed to identify trypanosomes, but this is increasingly replaced with molecular xenomonitoring. Nonetheless, sensitive T. brucei-detection assays, such as TBR-PCR, are vulnerable to DNA cross-contamination. This may occur at capture, when often multiple live tsetse are retained temporarily in the cage of a trap. This study set out to determine whether infected tsetse can contaminate naïve tsetse with T. brucei DNA via faeces when co-housed. Methodology/Principle findings: Insectary-reared teneral G. morsitans morsitans were fed an infectious T. b. brucei-spiked bloodmeal. At 19 days post-infection, infected and naïve tsetse were caged together in the following ratios: (T1) 9:3, (T2) 6:6 (T3) 1:11 and a control (C0) 0:12 in triplicate. Following 24-hour incubation, DNA was extracted from each fly and screened for parasite DNA presence using PCR and qPCR. All insectary-reared infected flies were positive for T. brucei DNA using TBR-qPCR. However, naïve tsetse also tested positive. Even at a ratio of 1 infected to 11 naïve flies, 91% of naïve tsetse gave positive TBR-qPCR results. Furthermore, the quantity of T. brucei DNA detected in naïve tsetse was significantly correlated with cage infection ratio. With evidence of cross-contamination, field-caught tsetse from Tanzania were then assessed using the same screening protocol. End-point TBR-PCR predicted a sample population prevalence of 24.8%. Using qPCR and Cq cut-offs optimised on insectary-reared flies, we estimated that prevalence was 0.5% (95% confidence interval [0.36, 0.73]). Conclusions/Significance: Our results show that infected tsetse can contaminate naïve flies with T. brucei DNA when co-caged, and that the level of contamination can be extensive. Whilst simple PCR may overestimate infection prevalence, quantitative PCR offers a means of eliminating false positives. Author summary: Tsetse flies (Glossina sp.) are vectors of Trypanosoma brucei parasites that cause human African trypanosomiasis, also known as sleeping sickness. As part of disease surveillance, tsetse can be captured in traps and checked for parasite presence. The molecular screening of disease vectors (such as mosquitoes, ticks and blackflies) for the presence of pathogen DNA has gained popularity in recent years. However, DNA contamination may occur at capture when live vectors are retained for a limited period in a trap cage. To explore this, we conducted experiments, initially with laboratory-reared tsetse and then field-caught tsetse from Tanzania. Our results show that infected tsetse can contaminate uninfected tsetse with T. brucei DNA when retained together in a trap cage, and that the level of contamination can be extensive. Infected tsetse consistently shed T. brucei DNA in their faeces, which in turn contaminates other tsetse. This can produce false-positive results, leading to inaccurate reporting of infection prevalence. These findings impact not only trypanosomiasis surveillance, but may also have ramifications for the xenomonitoring of other vector-borne neglected diseases. Future work should explore whether pathogen DNA contamination routes exist in other vector species and, if so, the methods to mitigate DNA contamination in entomological traps. [ABSTRACT FROM AUTHOR]

Background: After decades of praziquantel mass drug administration (MDA), several countries approach schistosomiasis elimination. Continuing MDA in largely uninfected populations no longer seems justified. Alternative interventions to maintain the gains or accelerate interruption of transmission are needed. We report results, strengths, and shortcomings of novel test-treat-track-test-treat (5T) interventions in low Schistosoma haematobium prevalence areas on Pemba, Tanzania. Methods: School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area. Results: The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive. Conclusions: The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination. Trial registration: ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the prevalence of gastrointestinal parasites (GIP) in the rural community of West Ismailia and its associated risk factors. Human infection by GIP is natural and expected. There are few records concerning parasitic infection in the rural areas of the Ismailia Governorate. Methods: From 520 individuals, sociodemographic and risk factors information were retrieved. Fecal samples were collected, concentrated, and tested for GIP infection using a microscopic examination. Results: The West Ismailia study population had a 40.4% prevalence of GIP infection, including single and concomitant parasite infections. The most common cause of GIP infection was protists (38%). Entamoeba sp., Blastocystis sp., and G. duodenalis were the most common parasites. Poly-parasitism was prevalent within the West Ismailia region. Age, abdominal symptoms, perianal itching, ownership of numerous animal species, exposure to turbid water, previous parasitic infection (PPI), and non-treatment reception of PPI were all considered significant factors associated with GIP infection. Specific individuals from the same family have been observed to have identical GIP. Conclusion: GIP infection remains underestimated in rural areas. Periodic screening and treatment for GIP infection in children and public education on GIP hazards and prevention, focusing on personal hygiene, are recommended. Family members of affected individuals should be screened and treated for GIP. [ABSTRACT FROM AUTHOR]

Schistosomiasis is an old parasitic disease in Egypt primarily caused by Schistosoma mansoni, transmitted through infected water canals, and disproportionately affects rural areas. Despite substantial reductions in the disease prevalence over the years, it still affects more than 5% of the population in some governorates, highlighting the need for sustained control efforts. Among the recent control measures: (a) mass drug administration with large-scale, biannual administration of praziquantel, which remains the cornerstone of the control program targeting the interruption of vector transmission cycles. (b) Improving disease diagnostics, including point-of-care tests, which facilitate early detection and case management, particularly in remote areas. (c) Snail control using targeted mollusciciding aims to reduce parasite transmission by controlling intermediate snail hosts. And (d) behavioral change communication focusing on raising awareness regarding hygiene practices and safe water access. Even if control attempts have shown positive results, several challenges still exist, including (a) drug resistance, especially to praziquantel, the most commonly used drug, which calls for ongoing observation and monitoring. (b) Sustainability of funding to avoid program disruptions and setbacks. And (c) social and environmental factors like poverty, poor sanitation, and access to clean water. The transition from disease control to elimination requires meticulous planning and vigilance. Robust surveillance systems, enhanced case management, and continued community engagement are vital for such elimination. Strengthening research on drug resistance, snail control methods, and innovative diagnostics would further support elimination efforts. This report aims to address the most recent data regarding the prevalence and control measures for schistosomiasis in Egypt and provide the information required to lead the transition from disease control to elimination. [ABSTRACT FROM AUTHOR]

Background: The life cycle and geographic range of mosquitoes are profoundly influenced by weather conditions. In Faiyum Governorate, Egypt, researchers looked at over 42 different mosquito breeding areas in the wild. Culex pipiens, Culex antennatus, Culex perexiguus, Culex theileri, Anopheles multicolor, Anopheles sergentii, Ochlerotatus caspius, Culiseta longiareolata, and Uranotaenia unguiculata, were all represented among the collected mosquito larvae. Using Maxent, we identified the most important bioclimatic factors affecting habitat appropriateness for each species. In order to determine the link between a species' habitat appropriateness and bioclimatic factors, the computer builds response curves for each bioclimatic factor. All species risk maps, species richness maps, and individual species maps were generated with a Software that build interactive web maps (ArcGIS 10.3). Results: Each mosquito species' range was impacted by four bioclimatic factors. The most influential factors were those linked to temperature and precipitation. Culex antennatus, Culex perexiguus, Culex pipiens, and Ochlerotatus caspius responded best to temperature-related factors. Precipitation of wettest month (bio 13) was effective in four species (Anopheles multicolor, Culex antennatus, Culex perexiguus, and Culex pipiens). Conclusion: Areas in the north and west of El-Fayoum district (Zawyat El-Karadsah, Beni-Saleh, and Monshat Abd-Allah), in Tamiya in Kafr Mahfouz, in the south of Abshway, especially in Tobhar, in the north of Atssa, in the south and center of Sinnuris have been identified as high-risk areas and more susceptible to mosquito-borne diseases. [ABSTRACT FROM AUTHOR]

Introduction: Schistosomiasis is a parasitic infection highly prevalent in sub-Saharan Africa (SSA) with Madagascar being among the countries with highest burden of the disease worldwide. Despite WHO recommendations, suggesting treatment of pregnant women after the first trimester, this group is still excluded from Mass Drug Administration programs. Our study, had the objective to measure the prevalence of schistosome infection among pregnant women in Madagascar in order to inform public health policies for treatment in this vulnerable population. Methods: Women were recruited for this cross-sectional study between April 2019 and February 2020 when attending Antenatal Care Services (ANCs) at one of 42 included Primary Health Care Centers. The urine-based upconverting reporter particle, lateral flow (UCP-LF) test detecting circulating anodic antigen was used for the detection of schistosome infections. To identify factors associated with the prevalence of schistosome infection crude and adjusted prevalence ratios and 95% CIs were estimated using mixed-effect Poisson regression. Results: Among 4,448 participating women aged between 16 and 47 years, the majority (70.4%, 38 n = 3,133) resided in rural settings. Overall, the prevalence of schistosome infection was 55.9% (n = 2486, CI 95%: 53.3–58.5). A statistically significant association was found with age group (increased prevalence in 31–47 years old, compared to 16–20 years old (aPR = 1.15, CI 95%: 1.02–1.29) and with uptake of antimalaria preventive treatment (decreased prevalence, aPR = 0.85, CI 95%: 0.77–0.95). No other associations of any personal characteristics or contextual factors with schistosome infection were found in our multivariate regression analysis. Discussion and conclusion: The high prevalence of schistosome infection in pregnant women supports the consideration of preventive schistosomiasis treatment in ANCs of the Malagasy highlands. We strongly advocate for adapting schistosomiasis programs in highly endemic contexts. This, would contribute to both the WHO and SDGs agendas overall to improving the well-being of women and consequently breaking the vicious cycle of poverty perpetuated by schistosomiasis. Author summary: Schistosomiasis is a parasitic infection highly prevalent in sub-Saharan Africa and in Madagascar, where pregnant women are systematically excluded from prevention and control strategies. Our study shows the urgency for adapting public health strategies. We report a high prevalence of schistosome infection among pregnant women in Madagascar. The lack of systematic treatment for this vulnerable group can have a direct impact on the well-being of women and their offspring contributing to the vicious cycle of poverty perpetuated by schistosomiasis. [ABSTRACT FROM AUTHOR]

Malaria is a serious Anopheles mosquito-borne disease. It is not endemic in Egypt but continues to be imported by travelers returning from endemic areas. The transmission of malaria in non-endemic areas is an extremely unusual event, but it is possible under certain conditions. Herein, we report a case of prolonged fever in a patient living in the countryside of Egypt with no reported travel history following accidental blood exposure to a malaria patient. The purpose is to shed light on this rare mode of malaria transmission and also to alert physicians and infectious disease specialists to consider malaria in the differential diagnosis in case of contact history to the blood of a malaria patient. [ABSTRACT FROM AUTHOR]

Background: This paper describes changes in the prevalence and intensity of schistosome parasite infections in a project integrating mass drug administration (MDA), water, sanitation, and hygiene (WaSH), and behavioral change interventions. Methods: The Geshiyaro Project comprises three intervention arms. Arm 1 is subdivided into "Arm 1 pilot" (one district) and Arm 1 (four other districts), both receiving integrated community-wide MDA with intensive WaSH interventions. Arm 2 involves 17 districts with community-wide MDA interventions, while Arm 3 serves as a control with school-based MDA interventions in three districts. A total of 150 individuals, stratified by age group, were randomly selected from each of the 45 sentinel sites. Arm sizes were 584 (Arm 1 pilot), 1636 (Arm 1), 2203 (Arm 2), and 2238 (Arm 3). Statistical tests were employed to compare infection prevalence and intensity across the different arms. Results: The prevalence of schistosome parasite infection ranged from 0% to 2.6% and from 1.7% to 25.7% across districts, employing the Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) diagnostics, respectively. The mean infection intensity level showed no marked difference between baseline and follow-up surveys when measured by KK, except in Arm 2 (t = 6.89, P < 0.0001). Infection prevalence decreased significantly in Arm 1 (t = 8.62, P < 0.0001), Arm 2 (t = 6.94, P < 0.0001), and Arm 3 (t = 8.83, P < 0.0001), but not in Arm 1 pilot (t = 1.69, P = 0.09) by POC-CCA, when trace was considered positive. The decrease was significant only in Arm 1 (t = 3.28, P = 0.0001) and Arm 2 (t = 7.62, P < 0.0001) when the trace was considered negative in POC-CCA. Arm 2 demonstrated a significant difference in difference (DID) compared to the control group, Arm 3, regardless of whether trace in POC-CCA was considered positive (DID = 3.9%, df = 8780, P = 0.025) or negative (DID = −5.2, df = 8780, P = 0.0004). Conclusions: The prevalence of schistosomiasis was low when employing the KK diagnostic but moderate in some locations by the POC-CCA diagnostic. The infection level had decreased across all arms of the Geshiyaro study at mid-term of the 7-year project, but further efforts are needed to reduce the rate of parasite transmission based on the POC-CCA diagnostic scores. [ABSTRACT FROM AUTHOR]

Background: This paper describes changes in the prevalence and intensity of schistosome parasite infections in a project integrating mass drug administration (MDA), water, sanitation, and hygiene (WaSH), and behavioral change interventions. Methods: The Geshiyaro Project comprises three intervention arms. Arm 1 is subdivided into "Arm 1 pilot" (one district) and Arm 1 (four other districts), both receiving integrated community-wide MDA with intensive WaSH interventions. Arm 2 involves 17 districts with community-wide MDA interventions, while Arm 3 serves as a control with school-based MDA interventions in three districts. A total of 150 individuals, stratified by age group, were randomly selected from each of the 45 sentinel sites. Arm sizes were 584 (Arm 1 pilot), 1636 (Arm 1), 2203 (Arm 2), and 2238 (Arm 3). Statistical tests were employed to compare infection prevalence and intensity across the different arms. Results: The prevalence of schistosome parasite infection ranged from 0% to 2.6% and from 1.7% to 25.7% across districts, employing the Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) diagnostics, respectively. The mean infection intensity level showed no marked difference between baseline and follow-up surveys when measured by KK, except in Arm 2 (t = 6.89, P < 0.0001). Infection prevalence decreased significantly in Arm 1 (t = 8.62, P < 0.0001), Arm 2 (t = 6.94, P < 0.0001), and Arm 3 (t = 8.83, P < 0.0001), but not in Arm 1 pilot (t = 1.69, P = 0.09) by POC-CCA, when trace was considered positive. The decrease was significant only in Arm 1 (t = 3.28, P = 0.0001) and Arm 2 (t = 7.62, P < 0.0001) when the trace was considered negative in POC-CCA. Arm 2 demonstrated a significant difference in difference (DID) compared to the control group, Arm 3, regardless of whether trace in POC-CCA was considered positive (DID = 3.9%, df = 8780, P = 0.025) or negative (DID = −5.2, df = 8780, P = 0.0004). Conclusions: The prevalence of schistosomiasis was low when employing the KK diagnostic but moderate in some locations by the POC-CCA diagnostic. The infection level had decreased across all arms of the Geshiyaro study at mid-term of the 7-year project, but further efforts are needed to reduce the rate of parasite transmission based on the POC-CCA diagnostic scores. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization recommends the use of Schisto point-of-care circulating cathodic antigens (Schisto POC-CCA) for screening of Schistosoma mansoni as it offers better sensitivity than microscopy. However, there are limitation facing the use of this method including timely availability of the test cassettes. The aim of this study was to determine the reliability of dried urine spot (DUS) method for collection of urine and detection of S. mansoni using Schisto POC-CCA cassettes in a resource-limited settings. Methods: A cross-sectional study was conducted between October and November 2022 among 250 primary school children in Sengerema District, northwestern Tanzania. S. mansoni CCA was detected in filter paper-based DUS, liquid urine using DUS Schisto POC-CCA (index), and direct urine Schisto POC-CCA (comparator) methods respectively. S. mansoni eggs in stool were detected using duplicate Kato-Katz (KK) method. The measures of accuracy were computed and compared between the index and comparator methods. The strength of agreement between inter-raters precisions was tested using Cohen’s kappa (k). Results: This study revealed S. mansoni prevalence rates of 28.8%, 54.0% and 50.8% by duplicate KK, direct urine Schisto POC-CCA and DUS Schisto POC-CCA methods respectively. The mean intensity of infection among infected participants was 86.3 eggs per gram of stool (EPG) ranging from 12.0 EPG to 824.0 EPG. The sensitivity of DUS Schisto POC-CCA and direct urine Schisto POC-CCA was 94.44% (95% CI: 89.15–99.74%) and 97.22% (95% CI: 93.43–100.00%) respectively. The DUS Schisto POC-CCA method had slightly higher specificity (66.85%) than direct urine Schisto POC-CCA method (63.48%). The accuracy of the DUS Schisto POC-CCA was found to be slightly high (74.80%, 95% CI: 68.94–79.06%) compared to that of direct urine Schisto POC-CCA (73.20%, 95% CI: 67.25–78.59%). There was good agreement between two laboratory technologists who performed the DUS Schisto POC-CCA method on similar samples (k = 0.80, 95% CI: 0.59–0.95). Conclusions: The DUS Schisto POC-CCA method had comparable S. mansoni detection accuracy to direct urine Schisto POC-CCA. This suggests that the method could be a potential alternative to direct urine Schisto POC-CCA for screening S. mansoni in resource-limited situations. [ABSTRACT FROM AUTHOR]

Background: Filarial worms are important vector-borne pathogens of a large range of animal hosts, including humans, and are responsible for numerous debilitating neglected tropical diseases such as, lymphatic filariasis caused by Wuchereria bancrofti and Brugia spp., as well as loiasis caused by Loa loa. Moreover, some emerging or difficult-to-eliminate filarioid pathogens are zoonotic using animals like canines as reservoir hosts, for example Dirofilaria sp. 'hongkongensis'. Diagnosis of filariasis through commonly available methods, like microscopy, can be challenging as microfilaremia may wane below the limit of detection. In contrast, conventional PCR methods are more sensitive and specific but may show limited ability to detect coinfections as well as emerging and/or novel pathogens. Use of deep-sequencing technologies obviate these challenges, providing sensitive detection of entire parasite communities, whilst also being better suited for the characterisation of rare or novel pathogens. Therefore, we developed a novel long-read metabarcoding assay for deep-sequencing the filarial nematode cytochrome c oxidase subunit I gene on Oxford Nanopore Technologies' (ONT) MinION™ sequencer. We assessed the overall performance of our assay using kappa statistics to compare it to commonly used diagnostic methods for filarial worm detection, such as conventional PCR (cPCR) with Sanger sequencing and the microscopy-based modified Knott's test (MKT). Results: We confirmed our metabarcoding assay can characterise filarial parasites from a diverse range of genera, including, Breinlia, Brugia, Cercopithifilaria, Dipetalonema, Dirofilaria, Onchocerca, Setaria, Stephanofilaria and Wuchereria. We demonstrated proof-of-concept for this assay by using blood samples from Sri Lankan dogs, whereby we identified infections with the filarioids Acanthocheilonema reconditum, Brugia sp. Sri Lanka genotype and zoonotic Dirofilaria sp. 'hongkongensis'. When compared to traditionally used diagnostics, such as the MKT and cPCR with Sanger sequencing, we identified an additional filarioid species and over 15% more mono- and coinfections. Conclusions: Our developed metabarcoding assay may show broad applicability for the metabarcoding and diagnosis of the full spectrum of filarioids from a wide range of animal hosts, including mammals and vectors, whilst the utilisation of ONT' small and portable MinION™ means that such methods could be deployed for field use. [ABSTRACT FROM AUTHOR]

Objective To determine if the prevalence of schistosomiasis in children aged 9- 12 years is associated with the prevalence in 5-8-year-olds and adults after preventive chemotherapy in schools or the community. Methods We combined data from four community-randomized, preventive chemotherapy trials in treatment-naive populations in Cote d'Ivoire, Kenya and the United Republic of Tanzania during 2010-2016 according to the number of praziquantel treatments and the delivery method. Schistosoma mansoni infection was sought on two slides prepared from each participant's first stool using the Kato-Katz technique. We assessed associations between S. mansoni prevalence in 9-12-year-olds and 5- 8-year-olds and adults in the community before and after treatment using Bayesian regression models. Findings Stool samples from 47 985 5-8-year-olds, 81 077 9-12-year-olds and 20 492 adults were analysed. We found associations between the prevalence in 9-12-year-olds and that in 5-8-year-olds and adults after preventive treatment, even when only school-age children were treated. When the prevalence in 9-12-year-olds was under 10%, the prevalence in 5-8-year-olds was consistently under 10%. When the prevalence in 9-12-year-olds was under 50%, the prevalence in adults after two or four rounds of preventive chemotherapy was 10%-15% lower than before chemotherapy. Post-chemotherapy age-group associations were consistent with pre-chemotherapy associations in this analysis and previous studies. Conclusion The prevalence of S. mansoni infection in 9-12-year-olds was associated with the prevalence in other age groups and could be used to guide community treatment decisions. Abstracts in [phrase omitted], Francais, [phrase omitted] and Espanol at the end of each article. [phrase omitted] Objectif Determiner si la prevalence de la schistosomiase chez les enfants de 9 a 12 ans est associee a celle observee chez les 5-8 ans et les adultes apres une chimiotherapie preventive au sein des ecoles ou de la communaute. Methodes Nous avons regroupe les donnees provenant de quatre essais randomises de chimiotherapie preventive menes en milieu communautaire aupres de populations n'ayant jamais ete traitees en Cote d'Ivoire, au Kenya et en Republique-Unie de Tanzanie entre 2010 et 2016, en fonction du nombre de traitements au praziquantel et du mode d'administration. Une infection a Schistosoma mansoni a ete recherchee sur deux lames preparees a partir des premieres selles de chaque participant, a l'aide de la technique de Kato-Katz. Nous avons employe des modeles de regression bayesienne qui nous ont permis d'identifier un rapport entre la prevalence de S. mansoni au sein de la communaute chez les 9-12 ans d'une part, et chez les 5-8 ans et les adultes de l'autre, avant et apres traitement. Resultats Les echantillons de selles de 47 985 enfants ages de 5 a 8 ans, 81 077 enfants de 9 a 12 ans et 20 492 adultes ont ete analyses. Nous avons constate qu'apres un traitement preventif, la prevalence chez les 9-12 ans ainsi que chez les 5-8 ans et les adultes etait liee, meme quand seuls les enfants d'age scolaire etaient traites. Lorsque la prevalence chez les 9-12 ans etait inferieure a 10%, celle chez les 5-8 ans etait systematiquement sous les 10%. Lorsque la prevalence chez les 9-12 ans etait inferieure a 50%, celle chez les adultes apres deux ou quatre traitements par chimiotherapie preventive etait 10 a 15% plus faible qu'avant toute chimiotherapie. Les liens par categorie d'age en post-chimiotherapie etaient coherents avec ceux en pre-chimiotherapie, tant dans la presente analyse que dans de precedentes etudes. Conclusion La prevalence de l'infection a S. mansoni chez les 9-12 ans etait associee a la prevalence dans d'autres categories d'age, ce qui pourrait servir a orienter les decisions de prise en charge au sein de la communaute. [phrase omitted] Objetivo Determinar si la prevalencia de la esquistosomiasis en ninos de 9 a 12 anos esta asociada con la prevalencia en ninos de 5 a 8 anos y adultos tras la quimioterapia preventiva en escuelas o en la comunidad. Metodos Se combinaron datos de cuatro ensayos aleatorizados a nivel comunitario de quimioterapia preventiva en poblaciones sin tratamiento en Costa de Marfil, Kenia y la Republica Unida de Tanzania entre 2010 y 2016 segun el numero de tratamientos con praziquantel y el metodo de administracion. La infeccion por Schistosoma mansoni se busco en dos laminillas preparadas a partir de las primeras heces de cada participante mediante la tecnica de Kato-Katz. Se evaluaron las asociaciones entre la prevalencia de S. mansoni en ninos de 9 a 12 anos y de 5 a 8 anos y adultos en la comunidad antes y despues del tratamiento mediante modelos de regresion bayesiana. Resultados Se analizaron muestras de heces de 47 985 ninos de 5 a 8 anos, 81 077 ninos de 9 a 12 anos y 20 492 adultos. Se encontraron asociaciones entre la prevalencia en ninos de 9 a 12 anos y la de ninos de 5 a 8 anos y adultos tras el tratamiento preventivo, incluso cuando solo se trato a ninos en edad escolar. Cuando la prevalencia en ninos de 9 a 12 anos era inferior al 10%, la prevalencia en ninos de 5 a 8 anos era siempre inferior al 10%. Cuando la prevalencia en ninos de 9 a 12 anos era inferior al 50%, la prevalencia en adultos despues de dos o cuatro ciclos de quimioterapia preventiva era entre un 10% y un 15% inferior que antes de la quimioterapia. Las asociaciones entre grupos de edad tras la quimioterapia fueron coherentes con las asociaciones previas a la quimioterapia en este analisis y en estudios anteriores. Conclusion La prevalencia de la infeccion por S. mansoni en ninos de 9 a 12 anos se asocio con la prevalencia en otros grupos de edad. Ademas, podria utilizarse para orientar las decisiones de tratamiento en la comunidad., Introduction Control programmes for schistosomiasis, the human disease caused by worms of the genus Schistosoma, focus on collecting and evaluating data from school-age children. (1) The use of school-age children [...]