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Providing the Evidence Base and Tools for Prioritising and Implementing Paediatric Schistosomiasis Control to Enhance Early Childhood Development

Principal Investigator: Professor Francisca Mutapi, University of Edinburgh

Over 2 billion people, most of whom are children, are infected with parasitic worms with currently over 4 billion at risk of infection. Schistosomes (commonly known as blood flukes) are responsible for the greatest helminth-related morbidity and pathology in Africa. Urogenital schistosomiasis caused by Schistosoma haematobium is a chronic disease acquired primarily in childhood by exposure to freshwater contaminated with the parasites released from freshwater snails. Infection with the parasites causes haematuria, dysuria, nutritional deficiencies, anaemia, growth retardation, decreased physical performance and impaired memory and cognition. If left untreated, the disease can progress to bladder wall pathology, hydronephrosis and hepatosplenomegaly. In adulthood, chronic schistosomiasis can also affect reproductive health, with manifestations including lesions of the cervix and vagina, vaginal bleeding, nodules in the vulva in women while in males symptoms include pathology of the seminal vesicles, prostate and other genital organs. Schistosomiasis is controlled by treatment of infected people with the drug praziquantel, which is cheap, efficacious and safe. Our studies and those of others indicate that these irreversible disease symptoms can be prevented by treating infection early in childhood, when pathology is still reversible. The World Health Organisation treatment guidelines exclude preschool children (PSAC) (< 5 years old) from schistosomiasis treatment programmes despite the growing body of studies reporting high schistosome infection levels and significant morbidity in these children. An estimated 50M African PSAC need treatment, but remain excluded from national schistosome control programs. We will quantify the impact of PSAC schistosomiasis and its treatment on child health and development, evaluate diagnostic tools for PSAC schistosomiasis, and identify community engagement strategies for accessing PSAC for treatment. Our results will provide the evidence base and tools for prioritising and implementing paediatric schistosomiasis control to enhance early childhood development. 

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Update Friday 6th April 2018

Initial meeting held in Harare with the team from South Africa.

Figure 1: Participants at the ECD meeting in Harare

The objectives of the meeting were;

  1. to introduce the ECD project to all team members,
  2. to discuss progress on country activities,
  3. to identify country specific activities,
  4. to develop country plans,
  5. to develop a harmonized project implementation plan.

Prof Chimbari made a presentation that provided background to the ECD grant and zeroed in on the Zimbabwe – UoE – UKZN funded project emphasizing on the objectives and expected outcomes of the project; what was expected from the co-PIs (Prof Chimbari and Prof Chibanda). A discussion ensued during which participants sought clarifications based on the presentation.

Following the presentation made by Prof Chimbari the following presentations were made by key project members:

  • Nutritional Aspects for under 5 years children by Prof Nnyepi (Nutritionist)
  • Schistosomiasis cognitive aspects: an animal model design by Dr Qulu (Nueroscientist)
  • Schistosomiasis and soil-transmitted helminthiasis treatment coverage and efficacy of praziquantel among preschool children aged (1-5 years) in rural KwaZulu-Natal by Ms Sacolo (PhD student)
  • Introduction to the BASIC II and other possible tools for assessing child cognition by Dr Chikara
  • An overview of the Parasitology/Immunology aspects related to schistosomiasis with emphasis on ECD by Prof Mduluza
  • Presentation on SOPs by Prof Mduluza

The above listed presentations brought all participants to the same level of understanding the project. When this was achieved, Prof Chimbari introduced the planning concept and split teams into groups by country. Each group developed a plan of activities and at plenary the plans were merged. The following were the group participants.

Zimbabwean Team UKZN Team

1. Dr Dixon Chibanda
2. Prof. Taka Mduluza
3. Miss Maritha Kasambala
4. Dr Chikara
5. Ms Emilia Choto
6. Mr Arthur Vengesai

1. Prof Moses Chimbari
2. Prof Nnyepi
3. Dr Qulu
4. Ms Mathonsi
5. Ms Sacolo
6. Mr Janury
7. Mr Chavhunduka
8. Mrs Ntombela

The last day of the session was dedicated to a presentation by the KoboCollect expert (Mr Chavhunduka) and that was followed by a hands on training on use of the tool. The KoboCollect is an online tool for collecting data using android phones. It removes errors of data entry and speeds up the process from data collection to analysis ensuring all the necessary quality checks.

Workshop outcomes
The following outcomes were achieved:

  1. All team members became familiar with the mother project
  2. Country specific progress was made clear to all team members
  3. Consensus on country specific activities was reached
  4. Country implementation plans were developed
  5. A Consolidated project plan was developed

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