Schistosoma haematobium in Guinea-Bissau: unacknowledged morbidity due to a particularly neglected parasite in a particularly neglected country
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Schistosomiasis is the major neglected tropical helminthic disease worldwide. Current knowledge on the epidemiology of schistosomiasis in Guinea-Bissau is scarce and regarding to the absence of Schistosoma haematobium (S.h.). Therefore, a pilot study was undertaken to assess the prevalence and morbidity due to S.h. infection in randomly selected 90 children and adolescents aged 6 to 15 years. Prevalence of S.h. infection was 20.00 % (18/90). Microhematuria was observed in 61.11 % (11/18) of S.h.-egg-excreting vs. 37.50 % (27/72) of non-S.h.-egg-excreting children p ≤ 0.01. Body mass index (BMI) was less than 15 kg/m2 in 52/90 (57.78 %) of all children and adolescents, but this proportion increased to 66.67 % (12/18) in S.h.-infected children who were more frequently stunted and wasted than in non-infected children. The mean weight-for-age Z score (WAZ) was reduced in S.h. infected as compared to non-infected children (−1.48 ± 1.08 SD vs. −0.80 ± 1.11 SD; p ≤ 0.01). To our knowledge, this is the first epidemiologic report on S. haematobium infection in Guinea-Bissau since 22 years. Even in this relatively small study sample, it appears that S. haematobium, besides the well-known symptoms such as hematuria, leads to significant, albeit commonly unacknowledged morbidity such as stunting and wasting. These observations underscore the notion that this vulnerable but neglected population urgently needs to be targeted for implementation of measures for treatment and control.
KeywordsSchistosomiasis Schistosoma haematobium Guinea-Bissau Hematuria Stunting wasting Nutrition status Unacknowledged morbidity
We would like to show our deepest appreciation to the children who participated in this study and their parents.
We would like to express our gratitude to Prof. Maria Elena Bottazzi for critically reading the paper.
MCB and HA thank Fundação Professor Ernesto Morais for funding.
The fieldwork was partially funded by AAB personal funds and by a grant to AAB from the Portuguese Fundação para a Ciência e Tecnologia Agency [PTDC/AAC-CLI/1035392008]. The agency had no involvement in the study design. The NGO Aida provided ground transportation in Guinea-Bissau and its local Director Mr. Adulai Embalo was instrumental in providing contacts with local authorities.
Compliance with ethical standards
This research was carried out in compliance with the Helsinki Declaration and with the approval of the Executive Board of the Institute of Biomedical Sciences Abel Salazar of Porto University.
Conflict of interests
The authors declare that there is no conflict of interests regarding the publication of this article.
Having in mind the organization of the country society, the peculiarities relative to ethnic groups of each area and the difficulties of communication in local languages (Portuguese, the official language is not universally spoken, neither the Guinea-Bissau Creole), the field research team (AAB, AM, AC) cooperated with local communities, and community and/or local religious leaders who explained the purposes of the study to the children’s parents, and obtained their informed consent. This research was carried out in compliance with the Helsinki Declaration and with the approval of the Executive Board of the Institute of Biomedical Sciences Abel Salazar of Porto University.
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