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Summary Background Over the past 20 years, schistosomiasis control has been scaled up. Preventive chemotherapy with praziquantel is the main intervention. We aimed to assess the effect of preventive chemotherapy on schistosomiasis prevalence in sub-Saharan Africa, comparing 2000–10 with 2011–14 and 2015–19. Methods In this spatiotemporal modelling study, we analysed survey data from school-aged children (aged 5–14 years) in 44 countries across sub-Saharan Africa. The data were extracted from the Global Neglected Tropical Diseases database and augmented by 2018 and 2019 survey data obtained from disease control programmes. Bayesian geostatistical models were fitted to Schistosoma haematobium and Schistosoma mansoni survey data. The models included data on climatic predictors obtained from satellites and other open-source environmental databases and socioeconomic predictors obtained from various household surveys. Temporal changes in Schistosoma species prevalence were estimated by a categorical variable with values corresponding to the three time periods (2000–10, 2011–14, and 2015–19) during which preventive chemotherapy interventions were scaled up. Findings We identified 781 references with relevant geolocated schistosomiasis survey data for 2000–19. There were 19 166 unique survey locations for S haematobium and 23 861 for S mansoni, of which 77% (14 757 locations for S haematobium and 18 372 locations for S mansoni) corresponded to 2011–19. Schistosomiasis prevalence among school-aged children in sub-Saharan Africa decreased from 23·0% (95% Bayesian credible interval 22·1–24·1) in 2000–10 to 9·6% (9·1–10·2) in 2015–19, an overall reduction of 58·3%. The reduction of S haematobium was 67·9% (64·6–71·1) and that of S mansoni 53·6% (45·2–58·3) when comparing 2000–10 with 2015–19. Interpretation Our model-based estimates suggest that schistosomiasis prevalence in sub-Saharan Africa has decreased considerably, most likely explained by the scale-up of preventive chemotherapy. There is a need to consolidate gains in the control of schistosomiasis by means of preventive chemotherapy, coupled with other interventions to interrupt disease transmission. Funding European Research Council and WHO.

Background Onchocerciasis is endemic in most local government areas (LGAs) in Enugu and Ogun states. Most meso- and hyper-endemic LGAs have received many rounds of ivermectin mass drug administration (MDA). This study aimed to determine the current prevalence of onchocerciasis in villages in Enugu and Ogun states that were formerly highly endemic and to assess progress toward elimination of the infection in areas believed to be at high risk for persistence. Methods Cross-sectional community surveys were conducted 8 to 12 months after the last round of MDA in 16 villages (6 in Enugu state and 10 in Ogun state) in individuals aged ≥ 18 years. Study participants were examined for the presence of palpable subcutaneous nodules. Skin snips from the posterior iliac crests were used to assess microfiladermia (Mf) prevalence and density. Results 643 subjects were palpated for nodules and 627 individuals (225 in Enugu state; 402 in Ogun state) provided skin snips. Nodule prevalence in the study villages ranged from 42 to 66.7% in Enugu state and from 0 to 25.0% in Ogun state. Mf prevalence in the Enugu and Ogun study villages ranged from 32 to 51.1% and 0 to 28.6%, respectively. Geometric mean skin Mf density in surveyed Enugu state villages ranged between 1 and 3.1 Mf/mg; these values were Conclusion Results from this study show that onchocerciasis persists in adults in many villages in Enugu and Ogun states despite many prior rounds of ivermectin MDA. Prevalence was higher in villages surveyed in Enugu than in Ogun. Low Mf densities suggest the MDA program is working well to reduce disease, but more time will be required to reach the elimination goal.

Background Poor environmental conditions and hygiene practices at the time of childbirth is linked to life-threatening infections and death in mothers and babies. Improvements in water, sanitation, and hygiene (WASH) have been identified as a means through which the lives of mothers and babies could be saved. This study was carried out to explore WASH conditions and infection prevention and control (IPC) practices in traditional birth homes/centers in Abeokuta, Southwest Nigeria. A total of 50 traditional birth centers and attendants (TBAs) were enrolled in the study. Sociodemographic characteristics of the TBAs and features of the birth centers were obtained using a semi-structured questionnaire. Assessment of WASH conditions and IPC practices was based on established protocols. Results Findings revealed that majority of the centers operated under poor WASH conditions and IPC practices; none met with the WHO minimum standards for environmental health. Conclusions Adequate WASH facilities and IPC practices remain a critical component of maternal and child health even in non-facility birth. As the transition to facility births continues in many countries, the large number of non-facility births demands their inclusion in WASH-related strategies, if global goals of reducing deaths of newborns and women deaths will be achieved.

Schistosomiasis and soil-transmitted helminthiasis (STH) are public health problems in communities which lack basic social amenities with poor hygienic conditions. Studies were carried out to determine the prevalence and effect of schistosomes and soil-transmitted helminths infection on labour input on rice production in 9 rice-growing communities of Ogun State. Parasitological examinations of urine and faecal samples, and structured questionnaires were conducted on 243 consented individuals from May 2009 to March 2010. The results showed an overall prevalence of 17% for Ascaris lumbricoides, 12% for hookworms, 2% for Trichuris trichiura, 1% for Schistosoma haematobium and 1% for Schistosoma mansoni. A. lumbricoides and hookworms were more prevalent in Agbajege (25%), and varied in the other 8 communities. T. trichiura was prevalent in three communities, Agbajege (5%), Akodu (4.2%), and Moloko-Asipa (4.8 %); S. haematobium was prevalent only in Ayedere (2.6%) and Lufoko (8%), while S. mansoni was prevalent only in Moloko-Asipa (9.5%). Infections among the gender were varied as 26.3 % of males and 33.8 % of females had an overall prevalence of: A. lumbricoides (16.8%), hookworms (11.8%), T. trichiura (1.6%), S. haematobium (1.1%) and S. mansoni (1.1%). On frequency of infection to incapacitation per year, 45% of respondents were incapacitated 1-2 times, 27% 3-4 times and 19% were incapacitated more than 4 times. Understanding the effect of these two diseases will not only improve the health status of residents but also increase their productivity and ensure food security.

An epidemiological study was conducted in four communities of Yewa-South Local Government Area of Ogun State to determine the prevalence of lymphatic filariasis. Also investigated was the intensity among the study participants. Three hundred and sixty-two participants of both sexes and age ranging from 5 to 85 years were examined. Blood samples for parasitological examination were obtained from consenting participants between 21.00 and 02.00 a.m. The samples were prepared using thick blood smear technique. The data obtained were collected and analyzed using descriptive statistics and chi-square. The result showed that, from the 362 blood samples examined, 186 were positive with an overall of 51.4%. Microfilaraemic prevalence was not significantly related (p>0.05) by sex category with male having 78 (21.5%) and female 108 (29.3%). However, there was significant (p0.05). The high prevalence observed in these communities could be due to bushy vegetation. There is the important need for increased and consistent treatment with Albendazole and health education in all affected communitiesto reduce prevalence and possible elimination of the parasite. Keywords: Intensity, Lymphatic filariasis, prevalence, Ogun State, Nigeria

Polyparasitism is widespread in many communities in Sub-Saharan Africa. However, there is paucity of data on polyparasitism in infants and preschool-aged children (IPSAC), to inform policy developments. Therefore, a survey of 1110 consented IPSAC was undertaken in Egbedore Local Government Area (LGA), Osun State, Nigeria, to determine the prevalence of polyparasitism in IPSAC in ten randomly selected rural communities. Fresh stool and blood samples were collected and processed for intestinal parasites and malaria infection. Mothers/caregivers were interviewed using a structured questionnaire to obtain demographic data of their IPSAC and to document knowledge, attitude, and practice (KAP) on parasitic infections. Data obtained through the questionnaire were analyzed using EpiData version 3.1, while parasitological data were analyzed using Statistical Package for Social Sciences (version 20.0). Descriptive statistics were computed for demographic data and association which were tested using bivariate analysis at a 95% confidence level while significance was set at p<0.05. The results showed that 349 (46.29%) were infected with a single parasite. Infants and preschool-aged children infected with double, triple, and quadruple parasites are 268 (35.54%), 122 (16.18%), and 15 (1.99%), respectively. The prevalence of polyparasitism is 405 (53.71%). Although females (54.07%) were more infected than males (45.93%), there was no significant difference (p>0.05) observed. Significantly (p<0.05) more preschool children (65.93%) harbour more infections than the infants do (34.07%). Ara community (14.81%) had the highest cases of polyparasitized IPSAC, but no significant difference (p>0.05) was observed across the communities. Double parasitic infection of Plasmodium falciparum and Ascaris lumbricoides (30.12%) and triple parasitic infection of P. falciparum, A. lumbricoides, and T. trichiura (14.81%) were the most common forms of polyparasitism encountered in the study. This study showed that polyparasitism is a burden in IPSAC and needs further investigation.

Background Soil transmitted helminthiasis (STH) are among the most common human infections worldwide with over 1 billion people affected. This study produced predictive risk maps of STH and estimated the number of people infected, and the amount of drug required for preventive chemotherapy in Ogun state, Nigeria. Methods Georeferenced STH infection data obtained from community cross-sectional survey, at 33 locations between July 2016-November 2018, together with remotely sensed environmental and socio-economic data were analyzed using Bayesian geostatistical models. Result An overall prevalence of 17.2% (95 % CI: 14.9, 19.5) was recorded for STH infection. Ascaris lumbricoides infections was the most predominant, 13.6% (95% CI: 11.5, 15.7), while Hookworm and Trichuris trichiura had 4.6 % (95% CI: 3.3, 5.9) and 1.7% (95 % CI: 0.9, 2.4), respectively. The predictive maps reveal a spatial pattern of high risk in the central, western and on the border connecting Republic of Benin. The model identified soil pH, soil moisture and elevation as important predictors of the STH infection. Approximately 1.1 million persons (preschoolers, school-aged children (SAC) and adults) are infected and requires 7.8 million doses. Also, 375,374 SAC were estimated to be infected, requiring 2.7 million doses for annual PC. Conclusion Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, by identifying priority areas for delivery of interventions in Ogun State, Nigeria.

Background Integrated transmission assessment surveys (iTAS) have been recommended for evaluation of the transmission of both lymphatic filariasis (LF) and onchocerciasis as the prevalence of both diseases moves toward their respective elimination targets in Nigeria. Therefore, we conducted an iTAS between May and December 2017 in five local government areas (LGAs), also known as implementation units (IUs), in states of Cross River, Taraba and Yobe in Nigeria. Methods The TAS comprised two phases: the Pre-iTAS and the iTAS itself. Three states (Cross River, Taraba and Yobe), comprising five LGAs and 20 communities that have completed five rounds of combined treatment with ivermectin and albendazole for LF and 12 total rounds of ivermectin, were selected for inclusion in the study. All participants were tested with the Filariasis Test Strip (FTS; Alere Inc.) and the Biplex rapid Diagnostic Test (RDT; identifying filaria antigens Ov16/Wb123; Abbott diagnosctics Korea Inc.). Pre iTAS included 100 children ages 5-9 in each 4 communities and 300 individuals ages 10 and older in a subset of two communities. For the iTAS, only LGAs where antigenemia prevalence in all sampled communities during the Pre-iTAS was < 2% for LF were selected. Results Of the five LGAs included in the study, four met the cutoff of the Pre-iTAS and were included in the iTAS; the Ikom LGA was excluded from the iTAS due to antigenemia prevalence. A total of 11,531 school-aged children from 148 schools were tested for LF and onchocerciasis across these four LGAs, including 2873 children in Bade, 2622 children in Bekwara, 3026 children in Gashaka and 3010 children in Karim Lamido. Using the FTS, all samples from Bade and Karim Lamido were negative, whereas 0.2% of the samples from Bekwara and Gashaka were positive. Using the Biplex RDT, LF prevalence in Bade, Bekwara, Gashaka and Karim Lamido was Conclusion This study has provided additional information on the current burden of onchocerciasis and LF in the four IUs sampled where mass drug administration (MDA) for both infections has been ongoing for years. The study identifies that LF-MDA can be safely stopped in all four of the IUs studied, but that MDA for onchocerciasis needs to continue, even though this may pose a challenge for LF surveillance. Based on the preliminary results from all four sites, this study has fulfilled the primary objective of determining the programmatic feasibility of an iTAS as a tool to simultaneously assess onchocerciasis and LF prevalence in areas co-endemic for the two infections that have completed the recommended treatment for one or both infections, and to make decisions on how to proceed. Graphical Abstract

Background: Soil transmitted helminth (STH) infections are among the most common human infections worldwide with over 1 billion people affected. Many estimates of STH infection are often based on school-aged children (SAC). This study produced predictive risk-maps of STH on a more finite scale, estimated the number of people infected, and the amount of drug required for preventive chemotherapy (PC) in Ogun state, Nigeria. Methods: Georeferenced STH infection data obtained from a cross-sectional survey at 33 locations between July 2016 and November 2018, together with remotely-sensed environmental and socio-economic data were analyzed using Bayesian geostatistical modelling. Stepwise variable selection procedure was employed to select a parsimonious set of predictors to predict risk and spatial distribution of STH infections. The number of persons (preschoolers, SAC and adults) infected with STH were estimated, with the amount of tablets needed for preventive chemotherapy.Results: An overall prevalence of 17.2% (95 % CI: 14.9, 19.5) was recorded for any STH infection. Ascaris lumbricoides infections was the most predominant, with an overall prevalence of 13.6% (95% CI: 11.5, 15.7), while Hookworm and Trichuris trichiura had overall prevalence of 4.6 % (95% CI: 3.3, 5.9) and 1.7% (95 % CI: 0.9, 2.4), respectively. The model-based prevalence predictions ranged from 5.0 % to 23.8 % for Ascaris lumbricoides, from 2.0 % to 14.5 % for hookworms, and from 0.1 % to 5.7 % for Trichuris trichiura across the implementation units. The predictive maps revealed a spatial pattern of high risk in the central, western and on the border of Republic of Benin. The model identified soil pH, soil moisture and elevation as the main predictors of infection for A. lumbricoides, Hookworms and T. trichiura respectively. About 50% (10/20) of the implementation units require biannual rounds of mass drug administration (MDA). Approximately, a total of 1.1 million persons were infected and require 7.8 million doses. However, a sub-total of 375,374 SAC were estimated to be infected, requiring 2.7 million doses. Conclusion: Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, either for resource acquisition or identifying priority areas for delivery of interventions in Ogun State, Nigeria.

Background The impact of single-dose mass drug administration (MDA) of ivermectin for onchocerciasis on mosquito populations was investigated in Ogun State, Nigeria. Methods Indoor and outdoor collection of mosquitoes was carried out in two intervention (IC) and two control communities (CC) at three different periods: pre-MDA (baseline), 2–3 days after MDA and 13–14 days after MDA. The density and parity rate of female Anopheles and Culex mosquitoes were determined and compared. Environmental and climatic data of study locations were obtained to perform generalized linear model analysis. Results A total of 1399 female mosquitoes were collected, including 1227 Anopheles and 172 Culex mosquitoes. There was a similar magnitude of reduction in the indoor density of Anopheles by 29% in the IC and CC 2–3 days post-MDA but the reduction in indoor parity rate was significantly higher (p = 0.021) in the IC, reducing by more than 50%. In the IC, observation of a significant reduction at 2–3 days post-MDA was consistent for both the indoor density (1.43 to 1.02) and indoor parity rate (95.35% to 44.26%) of Anopheles mosquitoes. The indoor parity rate of Anopheles remained significantly reduced (75.86%) 13–14 post-MDA. On the other hand, the indoor density of Culex increased from 0.07 to 0.10 at 2–3 days post-MDA while the indoor parity rate of Culex did not change. The outdoor density of Anopheles in the IC increased (p = 0.394) from 0.58 to 0.90 at 2–3 days post-MDA; a similar observation was consistent for the outdoor density (2.83 to 3.90) and outdoor parity rate (70.59% to 97.44%) of Culex, while the outdoor parity rate of Anopheles reduced from 85.71 to 66.67% at 2–3 days post-MDA. A generalized linear model showed that ivermectin MDA significantly caused a reduction in both the indoor density (p p = 0.003) of Anopheles in the IC. Conclusion Ivermectin MDA resulted in the reduction of both the survival and density of Anopheles mosquitoes. This has strong implications for malaria transmission, which depends strongly on vector survival. Graphical abstract

Objectives: Review meetings are critical activities aiding successful implementation of mass administration of medicines (MAM) for Neglected Tropical Diseases (NTD) control. The objective of this study was to assess the changes in practices amid COVID-19 pandemic during the review and planning meeting for 2020 MAM.Results: A total of 42 NTD implementers participated in this study [59.5% females and 40.5% males]. Majority of the participants were Local Government NTD (LNTD) coordinators (40.48%), State NTD officers (26.19%), LGA NTD data managers (23.81%) and NGDO partners (4.76%). Majority of the participants expressed their level of satisfaction on these modes of invitation (97.5%), admission (92.5%) and coordination (97.5%) during the meeting. Our findings have shown the importance of online platforms such as WhatsApp groups and email as communication channels between programmers involved in NTD control. Furthermore, compliance level to WHO guidelines were optimal for venue spacing (100%), usage of facemasks (85%) and physical distancing (72.5%), but sub-optimal for hand-washing (67.5%) and respiratory etiquette (52.5%). There were gaps in the provision of adequate handwashing facilities for the attendees. There is a need for more refined guidelines to steer investments in the provision of adequate hand-washing points in consideration of the population during subsequent meetings or mass gatherings.

Background The need to control Neglected Tropical Diseases (NTDs) and sustain progress towards elimination through mass administration of medicines requires substantial communal participation. This study, therefore, assessed the knowledge and perception of attendees’ regarding NTDs and its control activities during the inaugural World NTD day event in Ekiti State, Nigeria. Methodology A cross-sectional study involving the administration of pretested semi-structured questionnaires to consenting attendees at the Inaugural World NTD day event was conducted on the 30th January, 2020. The questionnaire collected data on attendee’s demography, knowledge and awareness about NTDs and its control in Nigeria. Quantitative data were analysed using descriptive statistics in SPSS. 20.0 software and expressed as frequencies and percentages. However, qualitative data to support quantitative analysis were obtained using open-ended questionnaires and analysed thematically. Principal findings/conclusion A total of 309 attendees comprising 167 (54.0%) females, and 142 (46.0%) males participated in this study. By age groupings, majority 206 (66.7%) were within 15–25 years. 167 (54.8%) of the attendees have not heard about NTDs before, whereas 77(35.0%) have heard about NTDs through the advertisement of the event. 181(63.3%) were aware of ongoing NTD control programs in schools and communities. Also, 246 (83.4%) of them have not taken or do not know anyone that has taken drugs donated in schools or communities. The number of attendees 41(13.3%) who incorrectly classified malaria as NTDs is higher than those who recognized onchocerciasis 36 (11.7%) and worm infections 34(11.0%) as NTDs (p>0.05). This study has shown that awareness and knowledge about NTDs control activities in Ekiti State is low, thus justifying the event as an awareness day for addressing NTDs. Public enlightment and regular promotional activities such as media engagement will raise the public appreciation and participation in NTDs control activities., Author summary Neglected Tropical Diseases has remained a public health menace in most developing countries including Nigeria. Efforts targeted at controlling the diseases requires substantial community acceptance and participation in drug donation campaigns. This study, therefore, provides information on public knowledge and awareness about NTDs and its control activities. We surveyed 309 attendees during the inaugural 2020 World NTD Day event in Ekiti, Nigeria. Our results show that attendees’ knowledge and awareness about NTD control programme and promotional activities is low. There is thus a need for NTD control program managers to engage in regular promotional activities such as media engagements to ensure improved awareness and community involvement.

Background We redesigned the Schisto and Ladders health educational board game and evaluated its potential to encourage compliance to school-based mass drug administration with praziquantel. Methods Two hundred and seventy-five children from six schools who rejected praziquantel treatment were divided into intervention and control groups. Before the intervention, preassessment interviews were conducted on their knowledge about praziquantel treatment and schistosomiasis. The Schisto and Ladders version 2 game as an intervention, and the Snakes and Ladders game as a control, were played for 6 mo. Postassessment interviews, including focus group discussions, were conducted. Results At preassessment, 0/98 (0.0%) children in the intervention group had heard of praziquantel compared with 2/177 (1.1%) in the control group. Similarly, 0/98 (0.0%) children in the intervention group did not know that praziquantel does not kill compared with 4/177 (2.3%) in the control group. The postassessment showed that 53/78 (67.9%) in the intervention group were aware of praziquantel compared with 2/177 (1.1%) in the control group (p=0.000). Similarly, 53 (69.7%) in the intervention group knew about the safety of praziquantel compared with 0/177 (0.0%) in the control group (p=0.000). Sixty-four children (65.3%) from the intervention group sought praziquantel treatment after the trial. Conclusions Schisto and Ladders version 2 is a useful sensitisation tool with which to encourage compliance to praziquantel treatment in schools.

Provision of water, sanitation and hygiene (WASH) resources has been advocated as necessary add-on strategy for sustainable control of soil-transmitted helminthiasis (STH) alongside annual mass drug administration (MDA) of albendazole to endemic communities. This study investigated the burden of STH and status of WASH resources in eight rural communities in Aiyedaade LGA, Osun State, Nigeria. Four of the communities were supported with improved water and hygiene resources (Category A), and another four supported only with improved water resources (Category B). Two hundred and sixteen (216) fresh stool samples were collected from consenting community members and screened for Ascaris lumbricoides, Hookworm and Trichuris trichiura infections using ether concentration method. The status and condition of WASH resources were determined using questionnaire and physical observation. An overall prevalence of 35.2% was observed for any STH infection. Species’ prevalence of Ascaris lumbricoides, Hookworm and Trichuris trichiura prevalence was 33.8%, 22.7%, and 0.5% respectively. Intensity of STH infection was significantly higher in Category A communities than in Category B communities. The prevalence of STH in Category A communities was higher (42.0%) than that in Category B communities (30.1%). There were significant differences (p = 0.000) in STH infections between the two categories. The status of improved water supply was not significantly different (p = 0.3153) in the two categories. Knowledge, attitude, and practices about STH, its transmission and control were low in both categories of communities. These results imply that current implementation of WASH which tends to focus on resource distribution, equity, and coverage, is unlikely to impact on STH transmission and control. Therefore, it is necessary for WASH providers to consider STH transmission control in their planning and implementation of WASH intervention for STH endemic communities.

In most endemic sub-Saharan African countries, repeated infections with soil-transmitted helminth (STH) occur as early as six weeks after the end of mass drug administration (MDA) with albendazole. In this study, we designed a new health educational board game Worms and Ladders and evaluated its potential to complement MDA with albendazole and reduce reinfection rates through the promotion of good hygiene practices among school-aged children. The evaluation employed a randomized control trial (RCT) design. Baseline knowledge, attitude and practices (KAP) relating to STH were obtained using a questionnaire from 372 pupils across six schools in Abeokuta, Nigeria. Schools were randomly assigned into intervention and control group, with the former and latter receiving Worms and Ladders and the common Snake and Ladder board game respectively. Fresh stool samples were also collected at baseline for STH diagnosis before administering 400mg single dose albendazole. Follow-up assessments of STH burden and KAP were conducted three and six months' post-intervention. Data generated from the study were analyzed using SPSS 20.0 software, with confidence interval set at 95%. Prevalence of STH dropped from 25.0% to 10.4% in the intervention group and 49.4% to 33.3% in the control group at three months' post-intervention. The prevalence further dropped to 5.6% in the intervention group at six months’ post-intervention. However, it increased to 37.2% in the control group at six months' post-intervention. There was a significant difference (p, Author summary School-aged children are the most affected group of people in terms of burden due to soil-transmitted helminth infections. Unfortunately, the available treatment programme with albendazole cannot prevent reinfection. Health and hygiene education has been recommended to be effective at reducing the rate of STH infections through increased knowledge about transmission and improved hygiene attitude and practices. We, therefore, developed a health educational board game Worms and Ladders and evaluated its potential to complement treatment and reduce reinfection rates. Our findings show that the worm burden dropped significantly among children who played the newly developed game, compared to other children who played another game. The knowledge, attitude and practices of the children as regards STH also improved significantly. The Worms and Ladders board game, therefore, has the potential to promote good hygiene behavior, which in turn translated to a reduced rate of infections. These findings present the newly developed game as a reliable tool to complement mass drug administration campaigns for STH control.

BackgroundAscariasis, Trichuriasis and Hookworm infections poses a considerable public health burden in Sub-Saharan Africa, and a sound understanding of their spatial distribution facilitates to better target control interventions. This study, therefore, assessed the prevalence of the trio, and mapped their spatial distribution in the 20 administrative regions of Ogun State, Nigeria.MethodsParasitological surveys were carried out in 1,499 households across 33 spatially selected communities. Fresh stool samples were collected from 1,027 consenting participants and processed using ether concentration method. The locations of the communities were georeferenced using a GPS device while demographic data were obtained using a standardized form. Data were analysed using SPSS software and visualizations and plotting maps were made in ArcGIS software.ResultsFindings showed that 19 of the 20 regions were endemic for one or more kind of the three infections, with an aggregated prevalence of 17.2%. Ascariasis was the most frequently observed parasitic infection in 28 communities with a prevalence of 13.6%, followed by hookworm infections with a prevalence of 4.6% while Trichuriasis was the least encountered with a prevalence of 1.7%. The spatial distribution of infections ranges between 5.3-49.2% across the regions. The highest and lowest distribution of overall helminth infections was recorded in Egbado South and Egbado North respectively. Nine regions had infection status between 20.0%-49.2%, while 10 regions had infection status between 5.3%-15.8%.ConclusionThis study provides epidemiological data on the prevalence and spatial distribution of ascariasis, trichuriasis and hookworm infections which will add to the baseline data and guide the public health officers in providing appropriate control strategies in the endemic communities.

Educational programmes have for long been used in biodiversity conservation; however introduction of board games in these efforts is a new concept, which is believed, will result in greater achievements. This study developed and used a new educational board game, biodiversity loss and conservation game (BLACOG) and a test-questionnaire to appraise the knowledge, attitude and perception of biodiversity (KAPOB) among secondary school students in Abeokuta, Nigeria. Students (n=283) were selected randomly from three schools, two of the schools serving as Experimental Groups while the third served as the control-group. The test-questionnaire, rated on a Likert scale, was administered to both the control and experimental groups prior to and after five exposures to the game, though the control-group did not have any exposure to the game. Data obtained were tested for significant differences in the mean scores of the respondents in the tests prior to and after the game. T-test comparison of the mean scores of the pre- and post-tests of the Control Group was not significantly different (p=0.207). The mean scores in the post-test were significantly higher than the pre-test scores in both of the experimental schools. The results also showed that, though the mean scores of the pre-tests of the control and experimental groups were not significantly different, the mean score in the post-test of the Experimental Group was significantly higher than in the control group. This study showed that the use of BLACOG had significantly positive effects on the KAPOB of the experimental group and that the game could become a veritable educational tool for teaching biodiversity conservation in schools.Keywords: Conservation education; biodiversity conservation; biodiversity loss; biodiversity education game.

Schistosoma japonicum, differs from the African species including S. mansoni and S. haematobium, is a zoonotic parasite as it infects both human and animals including domestic ruminant animals such as cattle and animals from the wild. Considering China's success story in the elimination of schistosomiasis, the China-Africa collaboration on schistosomaisis elimination in Africa is an important cooperative health development initiative. This review examines the importance of China-Africa collaboration on schistosomiasis elimination using effective surveillance-response intervention strategy as the platform to effectively drive the elimination of schistosomiasis in Africa. Three conclusions were made after reviewing the similarity and differences in schistososmiasis control programmes between China and African continent as follows: (i) Politically, China's lessons is that leveraging on the integrated control strategies and the recognition that schistosomiasis is a public health problem which prompted the interest of government in China. It is necessary for African leaders and governments to recognize schistosomiasis as a public health challenge that must be given serious attention in terms of funding and setting up frameworks to complement control efforts. (ii) Technically, efficient monitoring and surveillance system mechanism will facilitate contextual and effective management of schistosomiasis elimination across different environment, and African programme managers should embrace the use of appropriate diagnostic tools to guide treatment strategies at different thresholds of schistosomiasis control. (iii) Strategically, effective control of snail intermediate hosts and precision mapping of snail distribution should be prioritized for successful schistosomiasis elimination in Africa.

Background Snail intermediate hosts play active roles in the transmission of snail-borne trematode infections in Africa. A good knowledge of snail-borne diseases epidemiology particularly snail intermediate host populations would provide the necessary impetus to complementing existing control strategy. Main body This review highlights the importance of molecular approaches in differentiating snail hosts population structure and the need to provide adequate information on snail host populations by updating snail hosts genome database for Africa, in order to equip different stakeholders with adequate information on the ecology of snail intermediate hosts and their roles in the transmission of different diseases. Also, we identify the gaps and areas where there is need for urgent intervention to facilitate effective integrated control of schistosomiasis and other snail-borne trematode infections. Conclusions Prioritizing snail studies, especially snail differentiation using molecular tools will boost disease surveillance and also enhance efficient schistosomaisis control programme in Africa. Electronic supplementary material The online version of this article (10.1186/s40249-018-0401-z) contains supplementary material, which is available to authorized users.

A cross-sectional survey was carried out in primary schools to determine prevalence, intensity and spatial co-distribution of Schistosomiasis and soil transmitted helminths (STH) infections in Ogun State, Nigeria. A total of 2148 pupils from 42 schools were examined forSchistosomaand STH infections from urine and fresh fecal samples respectively. Ethyl ether concentration method prepared in sodium acetate – acetic acid – formalin ether was used to concentrate parasites’ ova before microscopic examination. The overall prevalence of schistosomiasis and STH infections were 4.0% (95% CI = 3.21–4.92) and 34.64% (95% CI = 32.62–36.69) respectively.Schistosoma haematobiumandAscaris lumbricoideswere the most prevalent across the study area among theSchistosomaand STH species respectively. Overall, intensity of infection was higher in males than in females for allSchistosomaand STH infections, but with no significant difference (P > 0.05), except forTrichuris trichiura(χ2 = 6.490,P χ2 = 12.953,P Schistosomaand STH infections occurred in 15 (35.7%) out of 42 schools, and only 30 children (1.4%) had co-infection ofSchistosomaand STH. This study provides information on the prevalence and spatial risk of schistosomiasis and STH in Ogun State. This will serve as decision-support tool for Ogun State programme managers to help facilitate integration of schistosomiasis and STH control.

Objective Schistosomiasis and intestinal helminthiasis are major public health problems with school-aged children considered the most at-risk group. Pre-school aged children (PSAC) are excluded from existing control programs because of limited evidence of infections burden among the group. We assessed the prevalence of infections and effect on nutritional status of preschool aged children in Abeokuta, Southwestern Nigeria. Results A community-based cross-sectional study involving 241 children aged 0–71 months was conducted in 4 sub-urban communities of Abeokuta. Urine and faecal samples were collected for laboratory diagnosis for parasites ova. Nutritional status determined using age and anthropometric parameters was computed based on World Health Organization 2006 growth standards. Data were subjected to descriptive statistics analysis, Chi square, t-test and ANOVA. Of 167 children with complete data, 8 (4.8%) were infected with Schistosoma haematobium; Schistosoma mansoni 6 (3.6%); Taenia species 84 (50.3%); Ascaris lumbricoides 81 (48.5%) and hookworm 63 (37.7%). Overall, 46.7% of the children were malnourished, 39.5% stunted, 22.8% underweight and 11.4% exhibiting wasting/thinness. Mean values of anthropometric indices were generally lower in children with co-infection than those with single infection. We observed low level of schistosomiasis but high prevalence of intestinal helminthiasis and poor nutritional status that calls for inclusion of PSAC in control programs. Electronic supplementary material The online version of this article (10.1186/s13104-017-2973-2) contains supplementary material, which is available to authorized users.

Background Schistosomiasis remains a public health problem in many regions of the world, including Nigeria. Current control strategy involves mass drug administration with praziquantel to the endemic population. To complement and sustain on-going preventive chemotherapy, we developed a health educational game named Schisto and Ladders™ and tested its potential for the control of schistosomiasis among schoolchildren living in Imala-Odo, a highly endemic community near Abeokuta, Nigeria. Methods One hundred school children were randomly selected and divided into intervention and control groups through balloting. Their knowledge, attitudes and practices (KAP) concerning schistosomiasis transmission, control and prevention were assessed using structured questionnaires. Schisto and Ladders™ game were given to the intervention group and the popular Snake and Ladders™ game to the control group. Both games were played for 2 months under the supervision of their class teachers. A post-KAP assessment was carried out in both groups, including focus group discussions (FGDs) to investigate knowledge and the impact of the games. Results Knowledge about urinary schistosomiasis and its transmission significantly improved (P = 0.000) in the intervention group (68.0%) compared to the control group (8.0%). FGDs showed that the frequency of visits to dam water also significantly reduced (P = 0.048) in the intervention group (18.0%) compared to the control group (40.0%). There was a significant increase in knowledge regarding risk behaviours, prevention and control of schistosomiasis among the intervention group, but no new knowledge gained in the control group. Conclusions This study demonstrates the potential of the health education game Schisto and Ladders™ for teaching basic health education and promoting behavioural changes among schoolchildren in endemic communities.

This cross-sectional study was undertaken to assess the status of school-based water, sanitation and hygiene (WASH) resources and soil-transmitted helminthiasis (STH) in Odeda, Ogun State, Nigeria. The status and condition of WASH resources were determined in eight selected schools (three with WASH support and five without). Stool samples were also collected from 428 pupils from both school categories and screened for STH infections. Findings showed that water and sanitation conditions of WASH resource programming schools were better than those in schools without WASH support. However, pupils’ knowledge about STH infections and basic hygiene were not significantly different between both categories of school (P > 0·05). The prevalence of Hookworm, Ascariasis and Trichuriasis cases recorded were 26·2, 18·2 and 1·6% respectively, with an overall prevalence of 33·4%. By school categories, Ascariasis (14·9 vs 20·6), Hookworm (17·7 vs 32·0), Trichuriasis (1·7 vs 1·6) and, any STH prevalence (27·4 vs 37·5) were recorded for schools with WASH resource programming and those without respectively. A greater portion of the infected children 95 (66·4%) were from schools without WASH support. Our findings imply that WASH resource may have very positive impact on the control of STH among school children. However, there is need for improvement on coverage, adequacy and maintenance of WASH facilities in school.

SUMMARY The Nigerian national control programme (NCP) for schistosomiasis does not have a specific action plan for female genital schistosomiasis (FGS), mainly due to gaps in epidemiological and clinical surveillance. To address this, we conducted a pilot investigation for FGS in girls (>5 and ≤15 years) and adult women (≥16 years) in four rural communities near Abeokuta, Ogun State. Urine samples were collected from 317 participants [children (n = 187), adults (n = 130)] and examined for ova of S chistosoma haematobium by microscopy. A total of 149 participants (47·0%) had egg-patent urogenital schistosomiasis [children (64·7%), adults (21·6%)], reported blood in urine was common (44·5%) as well as sign-post symptoms of FGS. To verify FGS directly, 20 adult women each underwent a gynaecological investigation by colposcopy with observed lesions classified according to the WHO FGS pocket atlas. Fourteen (70·0%) women presented with FGS as grainy-sandy patches (n = 10), homogenous yellow sandy patches (n = 6), nabothian cysts and rubbery papules (n = 1). Our study confirms FGS in Ogun State and calls for further appraisals of this disease in other areas where urogenital schistosomiasis is endemic. The Nigerian NCP should be encouraged to develop an appropriate response to FGS not only to detect it, but also to prevent it.

Urinary schistosomiasis is a serious disease in Cross River State, Nigeria. Dearth of information on its distribution has hampered the implementation of focused control of the disease. The availability of a rapid method for mapping the disease necessitated this research to provide data for control of Urinary schistosomiasis in Cross River State, Nigeria. The study used a rapid validated school-based questionnaire method in mapping schistosomiasis. Geographical information system (GIS) software tools were used to produce a spatial map for prevalence of infection and areas at risk for urinary schistosomiasis in Cross River State. Data analysis with SPSS package revealed that 9,993 (10.2%) female and 10,328 (10.0%) male pupils in 218 schools passed blood in urine in one month out of 199,794 pupils interviewed. There was no statistically significant difference in the prevalence between male and female pupils with infection (p < 0.005). The prevalence of urinary schistosomiasis using questionnaire method correlated positively with the filtration method used in determining the egg output (r = 0.71, p < 0.001). Endemic schools were distributed in thirteen Local Government Areas of Cross River State, Nigeria. Yala and Yakurr LGAs had the highest number of schools that reported schistosomiasis with 39 (59%) and 13 (59%), respectively. Odukpani LGA had the lowest prevalence of 1 (0.2%). The overall results showed a mean urinary schistosomiasis prevalence of 10.2% for Cross River State, Nigeria. The findings of this study would guide Government and other relevant agencies in the implementation of control strategies for the treatment of urinary schistosomiasis in Cross River State, Nigeria.

There is a hypothesis that Mass drug administration (MDA) of ivermectin and albendazole for the treatment of onchocerciasis and lymphatic filariasis could have an impact on the burden of soil-transmitted helminthiasis (STH) in MDA communities. We, therefore, assessed the burden of STH ( Ascaris lumbricoides , Trichuris trichiura , and hookworm) infections in nine communities from 3 LGAs (two MDA local government areas (LGAs) and one control LGA) in Kebbi State, Nigeria after 5-years (2010–2015) of MDA for onchocerciasis and/or lymphatic filariasis. We also administered questionnaire to obtain demographic information and history of MDA in the past five years. The three LGAs are Bagudo (Ivermectin MDA); Zuru (Ivermectin/Albendazole MDA) and Dandi (No MDA). The study was a cross sectional survey. The total number of people that complied with provision of stool samples and questionnaire were 1357 persons; stool samples collected were examined for STH infections in the three LGAs. Zuru LGA had the highest prevalence of STH (41.89, 95% CI: 37.08–46.81) followed by Dandi LGA (24.66, 95% CI: 20.69–28.97) and Bagudo LGA (3.36, 95% CI: 1.97–5.32). Prevalence of STH infection was not significantly different among age group and sex. Geometric mean intensity per gram of infection for both A. lumbricoides and Hookworm were highest in Zuru LGA with (1.16 GMI, 95% CI: 0.97–1.36) and (1.49 GMI, 95% CI: 1.29–1.70) respectively. Treatment coverage was less than 65% from 2010 to 2013 in the intervention LGAs. The study shows that STH is still a public health problem in Zuru LGA (IVM + ALB) and requires MDA of albendazole for STH control to continue, while Dandi LGA (No MDA history) requires MDA with albendazole to scale up treatment for STH control.

SUMMARYUntil recently, the epidemiology and control of schistosomiasis in sub-Saharan Africa have focused primarily on infections in school-aged children and to a lesser extent on adults. Now there is growing evidence and reports of infection in infants and pre-school-aged children (⩽6 years old) in Ghana, Kenya, Mali, Niger, Nigeria and Uganda, with reported prevalence from 14% to 86%. In this review, we provide available information on the epidemiology, transmission and control of schistosomiasis in this age group, generally not considered or included in national schistosomiasis control programmes that are being implemented in several sub-Saharan African countries. Contrary to previous assumptions, we show that schistosomiasis infection starts from early childhood in many endemic communities and factors associated with exposure of infants and pre-school-aged children to infection are yet to be determined. The development of morbidity early in childhood may contribute to long-term clinical impact and severity of schistosomiasis before they receive treatment. Consistently, these issues are overlooked in most schistosomiasis control programmes. It is, therefore, necessary to review current policy of schistosomiasis control programmes in sub-Saharan Africa to consider the treatment of infant and pre-school-aged children and the health education to mothers.

Recurrent cycles of fevers and chills are obvious symptoms for malaria disease usually necessitating treatment. However, some Plasmodium infections could be without symptoms, leading to late diagnosis and delayed treatment- seeking behaviours. The objective of this study was to determine the prevalence of asymptomatic malaria infections, and document associated prevention and treatment-seeking behaviours among literates in Abeokuta. A cross-sectional study design involving 309 attendees at the 2016 World Malaria Day Celebration event held at the Federal University of Agriculture, Abeokuta was conducted. Finger-prick blood samples were collected for Plasmodium parasite detection by malaria rapid diagnostic test (mRDT) and anthropometric indices such as weight, height and age were also collected to estimate Body-Mass-Index. An already pre-tested questionnaire was also used to collect information on malaria prevention and treatment-seeking behaviours. Data were analysed in SPSS 20.0 software. Results revealed that the prevalence of asymptomatic malaria was 7.4% (23/309), with no significant association between sex, febrile illness and Body Mass Index ( p >0.05). Participants aged 15-25 years were more infected with malaria than other age groups. Only 58.3% of the participants have heard of Long Lasting Insecticidal Nets (LLINs) and about 78% do not have mosquito bed-net. Self-diagnosis for the disease was more common (60.8%) among the participants, compared to other measures; seeking laboratory test (26.5%) and clinical diagnosis (9.1%). A good proportion of the participants (73.1%) rely on Artemisinin-based Combination Therapy (ACT) drugs for treating malaria, although few others still rely on non-ACT drugs (17.8%), chloroquine (1.9%) and herbs (1.6%). Findings show existence of asymptomatic malaria. Also, access to and utilization of malaria prevention and control commodities is poor among the literates. There is thus a need to intensify efforts in addressing these concerns as we move towards eliminating the disease. Keywords: Asymptomatic malaria; World Malaria Day; prevalence; Abeokuta; Nigeria

Background: Trichomoniasis is the most prevalent treatable sexually transmitted disease in the world. This study investigated the prevalence of trichomoniasis and associated risk factors among pregnant women attending ante-natal sessions in a tertiary health care facility in Abeokuta.Materials and Methods: High Vaginal Swabs (HVS) were collected and analyzed microscopically from 300 randomly selected ante-natal attendees. Questionnaires were concurrently administered to investigate associated risk factors about infection. Descriptive analysis was employed using SPSS (IBM, Amonk, NY, USA) version 20.0 and associations were ascertained using Pearson chi square. Significance level was set at p≤ 0.05Results: An overall prevalence of 10.3% was recorded. Age group 40-44(14.8%) had the highest infection, while lowest infection was recorded among age group 25-29(9%). Majority of the infected patients were married 26(11%) and in their second trimester stage of pregnancy 11(11.1%). Type of toilet used and shared usage of toiletries show significant relationship with infections among patients with (P=0.024) and (P=0.000)respectively. Occupational related prevalence showed that traders were the most infected 12(18.5%).Conclusion: Our findings present higher prevalence of Trichomonas vaginalis among older women of reproductive age. Poor hygiene practices and knowledge about infection are major risk factors predisposing patients to infection. However, measures geared towards promoting prevention mechanism/s through safe hygiene practices should be emphasized through public enlightenment programs. Inclusion of Trichomonas vaginalis clinical testing during antenatal care services will also assist prompt diagnosis, anagement and control of infection.Key-words: Abeokuta, Ante-natal care, Clinical testing, Pregnant women, Trichomoniasis, Nigeria

Praziquantel (PZQ) remains the drug of choice for treatment of schistosomiasis in infected persons. This study assessed the efficacy and safety of PZQ in school-aged children in four communities’ endemic for schistosomiasis. Urine samples (10 ml) were collected from 300 primary school children aged 5-16 years in Ibaro Oyan, Imala Odo, Apojola and Abule Titun communities located in parts of Ogun State, Nigeria. The urine was examined for the presence of haematuria and ova of S. haematobium . All pupils were also treated with a single dose of PZQ at 40 mg/kg. Urine samples were collected from positive pupils 21 days later to determine the Cure Rate (CR) and Egg Reduction Rate (ERR). Survey forms were also used to collect information on safety of the drug, documenting observed adverse reaction. Results showed that prevalence by haematuria was 147 (69%). Assessing haematuria with ova of S. haematobium revealed that 132 (44%) were positive for haematuria using dip-stick and eggs of S. haematobium simultaneously. Two hundred and nine pupils (69.7%) were infected with S. haematobium with mean egg count of 16.23 eggs/10 ml of urine. Males (73%) were more infected than females (66.7%). The highest prevalence (72.8%) was observed among the age-group 9-12 years and the least prevalence among age-group 5-8 years. The presence of S. haematobium was neither age nor sex dependent ( p >0.05). On location and intensity, school children located in Imala Odo Community had the highest prevalence of 89.2%, but pupils in Ibaro had the highest Geometric Mean (GM) of 18.31 eggs/10 ml. At 21 days post-treatment the cure-rate (CR) was 96.1%. The anthelminthic drug Praziquantel efficacy was satisfactory with an Egg Reduction Rate (ERR) of 98.5%. Most of the adverse effects occurred within 4-24 hours after PZQ administration but abdominal pains were the most common adverse visible micro effects complained by the school-children. Keywords: Efficacy, praziquantel; Schistosoma haematobium ; school-aged children; Ogun State; Nigeria

A cross-sectional study to determine malaria parasitemia amongst 300 randomly selected pregnant women attending government and private healthcare facilities in Rivers State was carried out. Blood samples were obtained through venous procedure and the presence or absence of Plasmodium was determined microscopically through thin and thick blood films. Socio-demographic information was obtained from questionnaires administered to the pregnant women enrolled. A total of 81 (27.0%) pregnant women were infected with P. falciparum. In private healthcare centres, 39 (26.0%) pregnant women were infected, while 42 (28.0%) were found infected in government hospital (x2= 0.101, df= 1, p>0.05). In the private healthcare centres, malaria prevalence among pregnant women in their first, second and third trimesters varied between 24.0-30.0% while in the government healthcare centre, malaria prevalence varied between 22.0%-30.0% (x2= 0.502, df= 2, p>0.05). In the private healthcare centres, malaria prevalence among primigravidae, secundigravidae and multigravidae varied between 22.0-28.0% while in the government healthcare centres, malaria prevalence varied between 23.0-32.0% (x2 = 0.084, df= 2, p>0.05). In the private healthcare centres, malaria prevalence among age groups 11-20, 21-30 and 31-40 varied between 17.0-29.0% while in the government healthcare centre, malaria prevalence varied between 26.0-29.0% (x2= 1.408, df= 2, p>0.05). There was no overall significant difference in malaria prevalence between the government and private healthcare facilities. Malaria is a public health burden especially amongst pregnant women, therefore adequate health education and proper control measures against malaria should be encouraged.Keywords: Prevalence; pregnancy; plasmodium; gestation; parity; age.

Background: There is growing interest in predictive risk mapping of neglected tropical diseases (NTDs) particularly in the context of scaling up preventive chemotherapy surveillance and elimination efforts. Although soil transmitted helminths (Ascaris lumbricoides hookworm and Trichuris trichiura) are the most widespread infections among the NTDs attempts for district national or regional geostatistical analyses are scarce. The purpose of this study was to predict the spatial and temporal distribution of soil transmitted helminth infections including the number of infected people and treatment needs across sub Saharan Africa. Methods: We systematically searched PubMed Web of Knowledge and African Journal Online from inception to 31 December 2013 with no language restrictions to identify georeferenced surveys pertaining to soil transmitted helminth infections in 43 countries of sub Saharan Africa. We compiled data from readily available household surveys to extract information on sanitation drinking water sources and education of adult females. Bayesian geostatistical models were used to align the data in space and to obtain soil transmitted helminth infection risk estimates over a grid of around one million pixels at a spatial resolution of 5 × 5 km. Findings: We identified 459 sources reporting surveys on soil transmitted helminth infections. We georeferenced 6040 unique locations and entered them into the open access Global Neglected Tropical Diseases database. We estimate that the prevalence of hookworm A. lumbricoides and T. trichiura among school aged children from 2000 onwards was 16.5 6.7 and 4.4 respectively. Compared to surveys conducted before 2000 those estimates are between 52 and 74 lower. Interestingly in the latter time period prevalence levels among school aged children. are similar to those in entire communities. Following World Health Organization guidelines treatment requirements are estimated at 126 million doses per year. Interpretation: Patterns of soil transmitted helminth infection in sub Saharan Africa have changed and the prevalence of infection has declined considerably in the new millennium most likely due to socioeconomic development and large scale deworming. Because prevalence levels in school aged children and entire communities are now similar the global control strategy should be reassessed with greater emphasis placed on adults to consolidate morbidity control and move towards local elimination.

Summary Background Schistosomiasis affects more than 200 million individuals, mostly in sub-Saharan Africa, but empirical estimates of the disease burden in this region are unavailable. We used geostatistical modelling to produce high-resolution risk estimates of infection with Schistosoma spp and of the number of doses of praziquantel treatment needed to prevent morbidity at different administrative levels in 44 countries. Methods We did a systematic review to identify surveys including schistosomiasis prevalence data in sub-Saharan Africa via PubMed, ISI Web of Science, and African Journals Online, from inception to May 2, 2014, with no restriction of language, survey date, or study design. We used Bayesian geostatistical meta-analysis and rigorous variable selection to predict infection risk over a grid of 1 155 818 pixels at 5 × 5 km, on the basis of environmental and socioeconomic predictors and to calculate the number of doses of praziquantel needed for prevention of morbidity. Findings The literature search identified Schistosoma haematobium and Schistosoma mansoni surveys done in, respectively, 9318 and 9140 unique locations. Infection risk decreased from 2000 onwards, yet estimates suggest that 163 million (95% Bayesian credible interval [CrI] 155 million to 172 million; 18·5%, 17·6–19·5) of the sub-Saharan African population was infected in 2012. Mozambique had the highest prevalence of schistosomiasis in school-aged children (52·8%, 95% CrI 48·7–57·8). Low-risk countries (prevalence among school-aged children lower than 10%) included Burundi, Equatorial Guinea, Eritrea, and Rwanda. The numbers of doses of praziquantel needed per year were estimated to be 123 million (95% CrI 121 million to 125 million) for school-aged children and 247 million (239 million to 256 million) for the entire population. Interpretation Our results will inform policy makers about the number of treatments needed at different levels and will guide the spatial targeting of schistosomiasis control interventions. Funding European Research Council, China Scholarship Council, UBS Optimus Foundation, and Swiss National Science Foundation.

Lymphatic filariasis (LF) is one of the neglected tropical diseases endemic in Nigeria. Epidemiological studies were conducted to determine the prevalence, distribution and clinical signs of the disease in three communities of Ose LGA, Ondo State from October 2014 to January 2015. One thousand and ninety consented participants enrolled for the study. 100 μ l of blood from finger-prick, were tested using the Binax Now ® Immunochromatographic Test (ICT) which detects Wuchereria bancrofti antigens. Physical observations were conducted for clinical signs of LF in addition to demographic parameters. Chi -square test was used to establish statistical significance of relationship between variables ( p 0.05). Infection among age-groups was higher in the 36-45 age-group (36%) and varied among the other age-groups but with no significant difference ( p >0.05). Infection was significantly ( p

There is an urgent need for information on schistosomiasis in preschool children, who are often excluded in mass treatment programmes. The prevalence and intensity of Schistosoma haematobium infection were determined in preschool children aged ≤ 6 years in two rural communities in Ijebu East, south-western Nigeria. Two urine samples each were collected from 83 preschool children from the two communities, tested for microhaematuria using reagent strips and then processed and examined with a microscope for S. haematobium eggs. Focus group discussions on perceptions of the disease and water contact practices were held in the communities with their guardians, caregivers and preschool children, using an interview guide. The prevalence of S. haematobium in the two communities was 14 (16.9%), with no significant differences (P = 0.661) in infection rate between boys (18.4%) and girls (14.7%). Both prevalence and intensity of infection did not increase significantly with age in both Korede and Obada community. However, there were significant differences in prevalence of infection between the two communities (P = 0.035). There was no association (P = 0.750) between intensity in boys (0.176 eggs/10 ml urine) and girls (0.110 eggs/10 ml urine). Focal group discussions with guardians and caregivers revealed that preschool children acquired infection early in their lives through exposure to infected stream water by their mothers, while the older children visit the stream for playing, bathing and swimming. It has therefore become imperative for preschool children to be included in the planning of schistosomiasis intervention programmes as a means of reducing transmission.