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AuthorCribb, Danielle M
AuthorClarke, Naomi E
AuthorDoi, Suhail A R
AuthorVaz Nery, Susana
Available date2019-12-15T06:36:39Z
Publication Date2019-10-01
Publication NamePLoS Neglected Tropical Diseasesen_US
Identifierhttp://dx.doi.org/10.1371/journal.pntd.0007808
CitationCribb DM, Clarke NE, Doi SAR, Vaz Nery S (2019) Differential impact of mass and targeted praziquantel delivery on schistosomiasis control in school-aged children: A systematic review and meta-analysis. PLoS Negl Trop Dis 13(10): e0007808. https://doi.org/10.1371/journal.pntd.0007808
ISSN1935-2727
URIhttp://hdl.handle.net/10576/12399
AbstractSchistosomiasis is a widespread public health concern in the poorest regions of the world. The principal control strategy is regular praziquantel administration to school-aged children in endemic areas. With calls for the elimination of schistosomiasis as a public health problem, expanding praziquantel delivery to all community members has been advocated. This systematic review and meta-analysis compares the impact of community-wide and child-targeted praziquantel distribution on schistosomiasis prevalence and intensity in school-aged children. We searched MEDLINE, Embase and Web of Science to identify papers that reported schistosome prevalence before and after praziquantel administration, either to children only or to all community members. Extracted data included Schistosoma species, drug administration strategy, number of treatment rounds, follow-up interval and prevalence and intensity before and after treatment. We used inverse variance weighted generalised linear models to examine the impact of mass versus targeted drug administration on prevalence reduction, and weighted boxplots to examine the impact on infection intensity reduction. This study is registered with PROSPERO, number CRD42018095377. In total, 34 articles were eligible for systematic review and 28 for meta-analysis. Schistosoma mansoni was reported in 20 studies; Schistosoma haematobium in 19 studies, and Schistosoma japonicum in two studies. Results of generalised linear models showed no detectable difference between mass and targeted treatment strategies on prevalence reduction in school-aged children for S. mansoni (odds ratio 0.47, 95%CI 0.13-1.68, p = 0.227) and S. haematobium (0.41, 95%CI 0.06-3.03, p = 0.358). Box plots also showed no apparent differences in intensity reduction between the two treatment strategies. The results of this meta-analysis do not support the hypothesis that community-wide treatment is more effective than targeted treatment at reducing schistosomiasis infections in children. This may be due to the relatively small number of included studies, insufficient treatment coverage, persistent infection hotspots and unmeasured confounders. Further field-based studies comparing mass and targeted treatment are required.
Languageen
PublisherPublic Library of Science
SubjectHelminths
Subjectmass vs targeted
TitleDifferential impact of mass and targeted praziquantel delivery on schistosomiasis control in school-aged children: A systematic review and meta-analysis.
TypeArticle
Issue Number10
Volume Number13
dc.identifier.essn 1935-2735


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