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Conventional microscopy is the standard procedure for the diagnosis of schistosomiasis, despite its limited sensitivity, reliance on skilled personnel, and the fact that it is error prone. Here, we report the performance of the innovative (semi-)automated Schistoscope 5.0 for optical digital detection and quantification of Schistosoma haematobium eggs in urine, using conventional microscopy as the reference standard. At baseline, 487 participants in a rural setting in Nigeria were assessed, of which 166 (34.1%) tested S. haematobium positive by conventional microscopy. Captured images from the Schistoscope 5.0 were analyzed manually (semiautomation) and by an artificial intelligence (AI) algorithm (full automation). Semi- and fully automated digital microscopy showed comparable sensitivities of 80.1% (95% confidence interval [CI]: 73.2–86.0) and 87.3% (95% CI: 81.3–92.0), but a significant difference in specificity of 95.3% (95% CI: 92.4–97.4) and 48.9% (95% CI: 43.3–55.0), respectively. Overall, estimated egg counts of semi- and fully automated digital microscopy correlated significantly with the egg counts of conventional microscopy (r = 0.90 and r = 0.80, respectively, P < 0.001), although the fully automated procedure generally underestimated the higher egg counts. In 38 egg positive cases, an additional urine sample was examined 10 days after praziquantel treatment, showing a similar cure rate and egg reduction rate when comparing conventional microscopy with semiautomated digital microscopy. In this first extensive field evaluation, we found the semiautomated Schistoscope 5.0 to be a promising tool for the detection and monitoring of S. haematobium infection, although further improvement of the AI algorithm for full automation is required.

Schistosoma haematobium is the most prevalent of the human-infecting schistosome species, causing significant morbidity in endemically exposed populations. Despite this, it has been relatively understudied compared to its fellow species, S. mansoni. Here we provide the first comprehensive characterization of the S. haematobium Tegument Allergen-Like protein family, a key protein family directly linked to protective immunity in S. mansoni infection. Comparable with observations for S. mansoni, parasite phylogenetic analysis and relative gene expression combined with host serological analysis support a cross-reactive relationship between S. haematobium TAL proteins, exposed to the host immune system as adult worms die, and closely related proteins, exposed during penetration by the infecting cercarial and early schistosomulae stages. Specifically, our results strengthen the evidence for host immunity driven by cross-reactivity between family members TAL3 and TAL5, establishing it for the first time for S. haematobium infection. Furthermore, we build upon this relationship to include the involvement of an additional member of the TAL protein family, TAL11 for both schistosome species. Finally, we show a close association between experience of infection and intensity of transmission and the development of protective IgE responses to these antigens, thus improving our knowledge of the mechanisms by which protective host immune responses develop. This knowledge will be critical in understanding how control efforts such as mass drug administration campaigns influence the development of host immunity and subsequent patterns of infection and disease within endemic populations.

Schistosoma haematobium continues to pose a significant public health burden despite ongoing global control efforts. One of several barriers to sustained control (and ultimately elimination) is the lack of access to highly sensitive diagnostic or screening tools that are inexpensive, rapid, and can be utilized at the point of sample collection. Here, we report an automated point-of-care diagnostic based on mobile phone microscopy that rapidly images and identifies S. haematobium eggs in urine samples. Parasite eggs are filtered from urine within a specialized, inexpensive cartridge that is then automatically imaged by the mobile phone microscope (the “SchistoScope”). Parasite eggs are captured at a constriction point in the tapered cartridge for easy imaging, and the automated quantification of eggs is obtained upon analysis of the images by an algorithm. We demonstrate S. haematobium egg detection with greater than 90% sensitivity and specificity using this device compared to the field gold standard of conventional filtration and microscopy. With simple sample preparation and image analysis on a mobile phone, the SchistoScope combines the diagnostic performance of conventional microscopy with the analytic performance of an expert technician. This portable device has the potential to provide rapid and quantitative diagnosis of S. haematobium to advance ongoing control efforts.

Schistosomiasis is one of the most important parasitic diseases in tropical and subtropical areas. Its prevalence is associated with the distribution of freshwater snails, which are their intermediate hosts. Thus, control of freshwater snails is the solution to reduce the transmission of this disease. This will be achieved by understanding the relationship between the snails and their habitats including natural enemies and associated aquatic plants as well as the factors affecting their distribution. In this study, Maximum Entropy model (MaxEnt) was used for mapping and predicting the possible geographic distribution of Bulinus truncatus snail (the intermediate host of Schistosoma haematobium), Odonata nymph (predatory aquatic insect), and Ceratophyllum demersum (the associated aquatic plant) in Egypt based on topographic and climatic factors. The models of the investigated species were evaluated using the area under receiver operating characteristic curve. The results showed that the potential risk areas were along the banks of the Nile River and its irrigation canals. In addition, the MaxEnt models revealed some similarities in the distribution pattern of the vector, the predator, and the aquatic plant. It is obvious that the predictive distribution range of B. truncatus was affected by altitude, precipitation seasonality, isothermality, and mean temperature of warmest quarter. The presence of B. truncatus decreases with the increase of altitude and precipitation seasonality values. It could be concluded that the MaxEnt model could help introducing a predictive risk map for Schistosoma haematobium prevalence and performing better management strategies for schistosomiasis.

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: Acute appendicitis is sudden inflammation of the appendix, usually initiated by obstruction of the lumen. This results in invasion of the appendix wall by gut flora, and it becomes inflamed and infected. Aim: To investigate retrospectivelythe prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. Materials and Methods: This is retrospective assessment of hospital records of 150 patients who were diagnosed as acute appendicitis and underwent appendicectomy during March 2018 to February 2020 at Government Medical College, Bhagya Nagar, Ongole, Andhra Pradesh .Data of the patients were assessed based on age, sex, histopathological diagnosis, coexisting pathologies and uncommon findings on histology. Results: According to histopathology report, negative for acute appendicitis were noted in 82 cases (55%), whereas positive for acute appendicitis in 68 cases (45.3%) . Rare findings were foundin 38 (55.8%) cases out of 68 cases. Parasites were found in 7 (18.4%) (Enterobius Vermicularis, Balantidum Coli, Schistosoma Haematobium), Mucocele in 12 (32%), carcinoid tumour in 8(21%), B cell malignant lymphoma in 2 (5%), leiomyoma in 2 (5%), Primary appendiceal adenocarcinoma in 3 (8%), Acute appendicitis with dysplastic changes in 2 (5%) and inflammatory bowel polyp was reported in remaining two cases(5%). Conclusion : Even though unusualpathologies can be seen rarely during appendectomy, this should be kept in mind for further evaluation of each cases. Keywords: Acute appendicitis, Appendicectomy, Histopathology

Urinary schistosomiasis is considered a major public health parasitic disease in African communities. Prior to this study, Nsugbe community was not considered endemic for the disease and as such was not involved in Praziquantel-Preventive Chemotherapy (PC). Longitudinal study of 281 consented pupils aged 5-16 years was carried out with aim of determining the status of urinary schistosomiasis. Urinalysis laboratory test strip, urine filtration technique and syndromic diagnosis were used for the confirmation of the presence of haematuria in urine samples, identification of Schistosoma haematobium ova and the confirmation of female genital schistosomiasis (FGS), respectively. Risk factors for urinary schistosomiasis infection were determined using pre-tested structured questionnaire. Data were analyzed using Minitab 17 software and intensity of infection categorized following World Health Organization (WHO) recommendations. Of the 281 pupils, 117 (42%) were males and 164 (58%) were females with mean age of 9 years. At baseline, an overall prevalence of 0.4% (1/281) which was of light intensity was established. At follow-up, an overall prevalence of 2.1% (6/281) which was of both light (16.7%) and heavy infection (83.3%) was established. The result of the clinical examination showed eggs of S. haematobium in and around the vaginal area indicating FGS of a female pupil aged 12 years. This was treated. Identified risk factors for S. haematobium infection in the community include water-contact activities, ignorance, source of water supply among others. The study revealed the need for an all inclusive mass administration of Praziquantel-PC in the study community for effective control and possible elimination.

Background The identification and mapping of at-risk populations at a lower administrative level than the district are prerequisites for the planning, resource allocation and design of impactful control intervention measures. Thus, the objective of the current study was to conduct sub-district precision mapping of soil-transmitted helminthiasis (STH) and schistosomiasis in 29 districts of north-western Tanzania using the current recommended World Health Organization criteria. Methods A cross-sectional survey was conducted in 145 schools between March and May 2021. A urine filtration technique was used for the quantification of Schistosoma haematobium eggs, whereas quantification of Schistosoma mansoni and STH eggs was done using the Kato–Katz technique. Microhaematuria was examined using a urine dipstick. Results The overall prevalences of any STH and schistosome infections were 9.3% [95% confidence interval (95%CI) 8.6–9.9] and 14.6% (95%CI 13.9–15.4), respectively. The overall prevalence of S. mansoni was 8.7% (95%CI 8.1–9.3), and 36.4%, 41.6%, and 21.9% of the children had low, moderate, and heavy infections, respectively. The overall prevalence of S. haematobium was 6.1% (95%CI 5.5–6.5), and 71.7% and 28.3% of the infected children had light and heavy intensity infections, respectively. The prevalence of microhaematuria was 7.3% (95%CI 6.7–7.8), with males having the highest prevalence (8.4%, P Trichuris trichiura, Ascaris lumbricoides and hookworm were, respectively, 1.3% (95%CI 0.1–1.5), 2.9% (95%CI 2.5–3.3) and 6.2% (95%CI 5.7–6.7). Most of the children infected with STH had light to moderate intensities of infection. The overall prevalence of co-infection with STH and schistosomiasis was 19.1%. The prevalence of schistosomiasis (P P Schistosoma mansoni and S. haematobium were observed in 60 and 71 schools, respectively, whereas any STH was observed in 49 schools. In schools where schistosomiasis was observed, prevalence was Conclusions The data reported here show that schistosomiasis and STH are widely distributed around Lake Victoria. In most of the schools where schistosomiasis and STH occurred the transmission thresholds were low. These data are important and need to be taken into consideration when decisions are made on the implementation of the next round of mass chemotherapies for schistosomiasis and STH in Tanzania. Graphical Abstract

Background Female genital schistosomiasis (FGS) occurs when Schistosoma haematobium eggs are deposited in reproductive tissue. Female genital schistosomiasis in the cervical mucosa is associated with increased vascularity. If FGS is associated with the presence of hemoglobin in cervicovaginal lavage (CVL), the use of urinary reagent strips to detect hemoglobin in CVL could supplement FGS diagnosis. Methods Nonmenstruating, nonpregnant, sexually active women aged 18–31 participating in the HPTN 071 (PopART) Population-Cohort were invited in 2 Zambian communities. Genital self-swabs and a urine specimen were collected at a home visit, and CVL and hand-held colposcopy were performed at a midwife led clinic visit. Urinary reagent strips were used to identify hemoglobin in CVL. Eggs and circulating anodic antigen (CAA) were detected from urine. Visual-FGS was defined as the presence of sandy patches, rubbery papules, or abnormal blood vessels. Polymerase chain reaction (PCR)-FGS was defined as Schistosoma deoxyribonucleic acid detected by real-time PCR on CVL or cervical or vaginal swab. Results Of 209 women with home genital swabs and companion CVL specimens, 66% (138 of 209) had detectable CVL hemoglobin, 13.4% (28 of 209) had PCR-defined FGS, and 17.2% (36 of 209) had visual-FGS. Active Schistosoma infection, diagnosed by CAA or urine microscopy, was present in 21.0% (44 of 209) participants. Active Schistosoma infection (P = .4), PCR-FGS (P = 0.7), and visual-FGS (P = 0.3) were not associated with CVL hemoglobin presence. Results did not differ in subgroups with high infection burden (cycle threshold < 35 or 2–3 positive genital PCR). Conclusions Polymerase chain reaction-FGS, visual-FGS, and active Schistosoma infection were not associated with the presence of CVL hemoglobin. Further research is needed to establish accessible community-based FGS diagnostics.

Schistosomiasis is a chronic and debilitating disease especially in developing countries. S. haematobiumof the urinogenital system is a major human health problem across Africa. Geneticvariability recommended studying variation in disease burden and pathology, and epidemiologicalaspects. The present study investigated genetic diversity and polymorphism human S. S.haematobium isolated by using RAPD-PCR technique on 50/100 urine samples from differentareas in Sohag Governorate.Extracted DNA was used for molecular analysis using RAPD-PCR primers (A01, A02, A12,A13, & Y20). 27 S. haematobium DNA isolates (54%) were amplified by using specific primers.The isolates showed distinct variation in size and number of amplified fragments, indicatinghigh genetic variation among them.

Schistosomiasis is a serious and neglected global tropical disease, affecting upwards of 230 million people, with more than 95% of infections concentrated in Africa. For many years, the main schistosomiasis control strategy in Africa focused on mass drug administration (MDA). The aim of this study was to compare the difference between MDA alone and alongside another intervention, namely snail control, by exploring effective measures for eliminating schistosomiasis. Retrospective data of human prevalence on Schistosoma haematobium and major control measures were collected from the China-Zanzibar-WHO Cooperation Project for Schistosomiasis Elimination (CZW) and the Zanzibar Elimination of Schistosomiasis Transmission (ZEST) project since 2012. The optimal order polynomial regression fitting model and joinpoint regression model (JRM) were used to analyze trends in schistosomiasis prevalence and the consistency of change points with strengthening of the control measures. In Unguja Island, the main control measure was MDA, and prevalence decreased to a nadir in 2019, and then rebounded. The R2 value of the optimal fitting model was 0.6641. There was a single JRM changepoint in 2019, the annual percent change (APC) was −19.3% (p < 0.05) from 2012 to 2019, and the APC was 59.7% (p > 0.05) from 2019 to 2021. In Pemba Island, the main control measures until 2016 was MDA, while integrated measures of MDA and snail control were implemented from 2017, the prevalence continuously decreased, and the R2 value was 0.8673. There was also a single JRM changepoint in 2017, the APC was −22.2% (p < 0.05) from 2012 to 2017, and was maintained at −8.6% (p > 0.05) from 2017 to 2021. Our data indicate that, while it is challenging to eliminate schistosomiasis by MDA alone, integrated measures, including both MDA and snail control, can prevent reinfection and help to eliminate the diseases in Africa.

Despite a human schistosomiasis control programme through praziquantel mass drug administration (MDA) between 2011 and 2015,there was still persistent transmission among primary schoolchildren (PSC) in Mkuranga district, Tanzania. Our cross-sectional study was conducted among 396 PSC who provided urine for diagnosis of

This study investigated the co-infection of Plasmodium falciparum and Schistosoma haematobium among women in Igedeland of Benue State, Nigeria using parasitological and molecular approaches. Urine and blood samples were collected from women and processed parasitologically for S. haematobium and P. falciparum respectively. Well-structured questionnaires were used to obtain socio-demographic data from the women. Representative samples were afterward processed molecularly using PCR technology. Data obtained were entered into SPSS and analyzed using the chi-square test to test the relationship between variables and co-infection rates. Results obtained revealed an overall co-infection rate of 1.25% with P. falciparum and S. haematobium recording individual rates of 17.45% and 6.07% respectively. A higher co-infection rate was recorded for women within the age range of 20-30years (1.92%) as well as those who were farmers (2.80%). Those with secondary education recorded (2.29%) while those separated had (13.04%). There was a significant difference in the co-infection rates of women in Igedeland with respect to age, education, and location (P0.05). Also, molecular characterization of the parasites revealed the presence of plasmodium (Pf 18S) and S. haematobium (Sh73) DNA markers in women of Igedeland. It was concluded that the co-infection rate is relatively low when compared to reports in times past. Nevertheless, the occurrence of single parasite infection is high with P. falciparum being the most dominant parasite.

Background Gastropod snails remain strongly understudied, despite their important role in transmitting parasitic diseases. Knowledge of their distribution and population dynamics increases our understanding of the processes driving disease transmission. We report the first study to use high-throughput sequencing (HTS) to elucidate the population genetic structure of the hermaphroditic snail Bulinus truncatus (Gastropoda, Heterobranchia) on a regional (17–150 km) and inter-regional (1000–5400 km) scale. This snail species acts as an intermediate host of Schistosoma haematobium and Schistosoma bovis, which cause human and animal schistosomiasis respectively. Methods Bulinus truncatus snails were collected in Senegal, Cameroon, Egypt and France and identified through DNA barcoding. A single-end genotyping-by-sequencing (GBS) library, comprising 87 snail specimens from the respective countries, was built and sequenced on an Illumina HiSeq 2000 platform. Reads were mapped against S. bovis and S. haematobium reference genomes to identify schistosome infections, and single nucleotide polymorphisms (SNPs) were scored using the Stacks pipeline. These SNPs were used to estimate genetic diversity, assess population structure and construct phylogenetic trees of B. truncatus. Results A total of 10,750 SNPs were scored and used in downstream analyses. The phylogenetic analysis identified five clades, each consisting of snails from a single country but with two distinct clades within Senegal. Genetic diversity was low in all populations, reflecting high selfing rates, but varied between locations due to habitat variability. Significant genetic differentiation and isolation by distance patterns were observed at both spatial scales, indicating that gene flow is not strong enough to counteract the effects of population bottlenecks, high selfing rates and genetic drift. Remarkably, the population genetic differentiation on a regional scale (i.e. within Senegal) was as large as that between populations on an inter-regional scale. The blind GBS technique was able to pick up parasite DNA in snail tissue, demonstrating the potential of HTS techniques to further elucidate the role of snail species in parasite transmission. Conclusions HTS techniques offer a valuable toolbox to further investigate the population genetic patterns of intermediate schistosome host snails and the role of snail species in parasite transmission. Graphical Abstract

Background Imported schistosomiasis is an emerging issue in European countries as a result of growing global migration from schistosomiasis-endemic countries, mainly in sub-Saharan Africa. Undetected infection may lead to serious long-term complications with an associated high cost for public healthcare systems especially among long-term migrants. Objective To evaluate from a health economics perspective the introduction of schistosomiasis screening programs in non-endemic countries with high prevalence of long-term migrants. Methodology We calculated the costs associated with three approaches—presumptive treatment, test-and-treat and watchful waiting—under different scenarios of prevalence, treatment efficacy and the cost of care resulting from long-term morbidity. Costs were estimated for our study area, in which there are reported to reside 74,000 individuals who have been exposed to the infection. Additionally, we methodically reviewed the potential factors that could affect the cost/benefit ratio of a schistosomiasis screening program and need therefore to be ascertained. Results Assuming a 24% prevalence of schistosomiasis in the exposed population and 100% treatment efficacy, the estimated associated cost per infected person of a watchful waiting strategy would be €2,424, that of a presumptive treatment strategy would be €970 and that of a test-and-treat strategy would be €360. The difference in averted costs between test-and-treat and watchful waiting strategies ranges from nearly €60 million in scenarios of high prevalence and treatment efficacy, to a neutral costs ratio when these parameters are halved. However, there are important gaps in our understanding of issues such as the efficacy of treatment in infected long-term residents, the natural history of schistosomiasis in long-term migrants and the feasibility of screening programs. Conclusion Our results support the roll-out of a schistosomiasis screening program based on a test-and-treat strategy from a health economics perspective under the most likely projected scenarios, but important knowledge gaps should be addressed for a more accurate estimations among long-term migrants.

Objectives: Schistosomiasis is a chronic, progressive and granulomatous disease which is not immediately fatal but constitutes enormous medical and public health implications. This study was carried out to determine the prevalence, intensity, Knowledge, Attitude and Practice of urinary schistosomiasis among primary school pupils (aged 4-16 years) in Owena town, Ondo State, Nigeria.Methods: Urine specimens were collected and examined, using a 325 Wire Mesh filter and microscopy. The conclusive diagnosis was based on the presence of the characteristic eggs of Schistosoma haematobium, while the intensity of infection was described as the number of eggs per 10 ml of urine (eggs/10ml). 464 school children, comprising 268 (57.8%) boys and 196 (42.2%) girls, were examined.Results: Altogether, 175 (37.7%) of the pupils examined had the characteristic egg of S. haematobium in their urine. Boys, (42.3%), were significantly more infected than girls, (31.6%) (p

According to the Kenya National School-Based Deworming program launched in 2012 and implemented for the first 5 years (2012–2017), the prevalence of soil-transmitted helminths (STH) and schistosomiasis substantially reduced over the mentioned period among the surveyed schools. However, this reduction is heterogeneous. In this study, we aimed to determine the factors associated with the 5-year school-level infection prevalence and relative reduction (RR) in prevalence in Kenya following the implementation of the program. Multiple variables related to treatment, water, sanitation, and hygiene (WASH) and environmental factors were assembled and included in mixed-effects linear regression models to identify key determinants of the school location STH and schistosomiasis prevalence and RR. Reduced prevalence of Ascaris lumbricoides was associated with low (< 1%) baseline prevalence, seven rounds of treatment, high (50–75%) self-reported coverage of household handwashing facility equipped with water and soap, high (20–25°C) land surface temperature, and community population density of 5–10 people per 100 m2. Reduced hookworm prevalence was associated with low (< 1%) baseline prevalence and the presence of a school feeding program. Reduced Trichuris trichiura prevalence was associated with low (< 1%) baseline prevalence. Reduced Schistosoma mansoni prevalence was associated with low (< 1%) baseline prevalence, three treatment rounds, and high (> 75%) reported coverage of a household improved water source. Reduced Schistosoma haematobium was associated with high aridity index. Analysis indicated that a combination of factors, including the number of treatment rounds, multiple related program interventions, community- and school-level WASH, and several environmental factors had a major influence on the school-level infection transmission and reduction.

This study was carried out to evaluate the effect of drug treatments and enzymes level on the worm burden in an experimental Schistosoma haematobium infected guinea pig. Eggs of S. haematobium were collected from the urine of infected persons and hatched into miracidia. Fresh water Snail species Bulinus truncatus were exposed to miracidia and allowed for five weeks to establish infection and develop to cercaria. Guinea pigs were exposed to S. haematobium cercaraie by subcutaneous injection. The infected guinea pigs were divided into four groups, designated as 7, 28, 90 days post infection and controls. The guinea pigs were treated singly and in combination with different doses of Praziquantel (PZQ), Artemether (ART) and Artequine (ARQ). The efficacy of the different drugs on worm burden were assessed. Blood samples were collected from the guinea pigs before and after treatment for determination of Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST). Result showed that treatment with higher doses of PZQ/ART (100/200mg/kg) and PZQ/ARQ (100/200mg/kg) resulted in total worm reduction rate of 58 and a percentage efficacy of 98.3%. ARQ (300 mg/kg) had the highest percentage efficacy of 89.8% amongst the single drugs used with respect to higher doses. There were observed alteration in the levels of the enzymes after S. haematobium infection. The serum level of ALP, AST and ALT after infection generally decreased. There were various activities in the level of ALPAST and ALT after treatment with different drug regimen at different stages of S. haematobium infection. ARQ alone and in combination with PZQ had anti schistosomal effect and could be promising in controlling schistosomiasis. Keywords: S. haematobium, Guinea Pigs, Liver functioning enzymes, Worm burden

Background: Schistosomiasis is endemic in Nigeria and three species; Schistosoma haematobium, Schistosoma mansoni, and Schistosoma intercalatum have been reported in Niger Delta, Nigeria. This study aimed to determine the prevalence of schistosomiasis in rural communities of Bayelsa State, Nigeria.Methodology: Four rural homogeneous communities; Otuegala, Immiringi, Otuesega, and Ibelebiri in Ogbia Local Government Area of Bayelsa State, Nigeria, were randomly selected for the study. A structured questionnaire was administered to each participant in their native language and used to collect participant’s biodata and swimming history. Stool samples collected from all participants were examined qualitatively by wet preparation and after formolethol concentration. Data were analyzed using SPSS version 20.0 software and results presented in proportion and tables.Results: A total of 829 participants (age range 1 - 80 years) were recruited for the study. Helminth ova were identified in the stool samples of 218 (26.3%) participants. Among 380 males examined, 82 (21.6%) were infected, while out of 449 females examined, 138 (30.3%) were infected. The ova of seven helminths identified and their frequency of occurrence were; S. intercalatum 86 (10.4%), Ascaris lumbricoides 53 (6.4%), S. mansoni 35 (4.2%), Trichuris trichiura 22 (2.6%), hookworm 20 (2.4%) and Taenia spp 2 (0.2%). Schistosoma haematobium was identified in non-urine contaminated stool sample of an eight-year old boy. A total of 11 (1.3%) participants had double infections, affecting 7 (63.6%) females and 4 (36.4%) males, with the commonest combination being S. intercalatum and A.lumbricoides 6 (0.7%), followed by S. intercalatum and hookworm 4 (0.5%), and S. mansoni and hookworm 1(0.1%).Conclusion: S. intercalatum was the most prevalent intestinal helminthic infection in this study, which is a rare finding in most epidemiological investigations. The affinity of Schistosoma species to establish double infections with hookworm and other intestinal helminths should be taken into account during chemoprophylaxis. Keywords: Schistosomiasis, Chemoprophylaxis, Prevalence, Rural Population

Background Heat shock proteins (HSPs) are evolutionarily conserved proteins, produced by cells in response to hostile environmental conditions, that are vital to organism homeostasis. Here, we undertook the first detailed molecular bioinformatic analysis of these important proteins and mapped their tissue expression in the human parasitic blood fluke, Schistosoma mansoni, one of the causative agents of the neglected tropical disease human schistosomiasis. Methods Using bioinformatic tools we classified and phylogenetically analysed HSP family members in schistosomes, and performed transcriptomic, phosphoproteomic, and interactomic analysis of the S. mansoni HSPs. In addition, S. mansoni HSP protein expression was mapped in intact parasites using immunofluorescence. Results Fifty-five HSPs were identified in S. mansoni across five HSP families; high conservation of HSP sequences were apparent across S. mansoni, Schistosoma haematobium and Schistosoma japonicum, with S. haematobium HSPs showing greater similarity to S. mansoni than those of S. japonicum. For S. mansoni, differential HSP gene expression was evident across the various parasite life stages, supporting varying roles for the HSPs in the different stages, and suggesting that they might confer some degree of protection during life stage transitions. Protein expression patterns of HSPs were visualised in intact S. mansoni cercariae, 3 h and 24 h somules, and adult male and female worms, revealing HSPs in the tegument, cephalic ganglia, tubercles, testes, ovaries as well as other important organs. Analysis of putative HSP protein-protein associations highlighted proteins that are involved in transcription, modification, stability, and ubiquitination; functional enrichment analysis revealed functions for HSP networks in S. mansoni including protein export for HSP 40/70, and FOXO/mTOR signalling for HSP90 networks. Finally, a total of 76 phosphorylation sites were discovered within 17 of the 55 HSPs, with 30 phosphorylation sites being conserved with those of human HSPs, highlighting their likely core functional significance. Conclusions This analysis highlights the fascinating biology of S. mansoni HSPs and their likely importance to schistosome function, offering a valuable and novel framework for future physiological investigations into the roles of HSPs in schistosomes, particularly in the context of survival in the host and with the aim of developing novel anti-schistosome therapeutics.

Schistosomiasis elimination has gained renewed priority in the WHO guidance documents published in 2020 and 2022. The SchistoBreak project, implemented in Pemba, Tanzania between 2020 and 2024, aims to assess new tools and strategies for shifting from elimination as a public health problem towards interruption of transmission. Here we report our baseline findings and discuss implications for future interventions.In 2020, human water contact sites (HWCSs) in the study area were geolocated and snail surveys were conducted. A parasitological and questionnaire cross-sectional baseline survey was implemented in 20 communities and their 16 primary schools between November 2020 and February 2021. Urine samples were collected at the school and household levels from individuals aged ≥ 4 years. Schistosoma haematobium infection was detected by urine filtration microscopy. Snail, parasitological and questionnaire-derived data were analyzed descriptively, spatially and with generalized estimated equation models.The intermediate host snail Bulinus globosus was detected in 19.8% (33/167) of HWCSs. The overall S. haematobium prevalence was 1.2% (26/2196) in school-aged children and 0.8% (31/3893) in community members, with 0.2% (4/2196) and 0.1% (3/3893) heavy-intensity infections, respectively. Children who studied 1 km away from HWCSs with B. globosus had significantly higher odds for a S. haematobium infection than those attending a school located 2 km away (odds ratio [OR]: 5.0; 95% confidence interval [CI]: 2.3-11.1). Individuals living in a house located 1 km away from HWCSs with B. globosus had higher odds than those residing in 2 km distance (OR: 18.0; 95% CI: 2.9-111.0). Self-reported praziquantel treatment coverage was 83.2% (2015/2423) in schoolchildren in the mass drug administration (MDA) conducted in August 2020. Coverage among adult community members was 59.9% (574/958), but only 34.8% (333/958) took praziquantel correctly.While the S. haematobium prevalence is very low in Pemba, there are many HWCSs with B. globosus situated close to schools or houses that pose a considerable risk of recrudescence. To maintain and accelerate the progress towards interruption of transmission, targeted and cost-effective interventions that are accepted by the community are needed; for example, snail control plus focal MDA, or test-and-treat in schools and households near infested waterbodies.

Drug utilization and payment estimates for standard-of-care treatment of schistosomiasis have not been reported previously in the United States. This study estimates the utilization of praziquantel (standard-of-care drug) among patients with schistosomiasis and outpatient payments among those who were treated with praziquantel, and investigates the factors associated with praziquantel use from 2013–19 using IBM’s MarketScan® Commercial Claims and Encounters database. Claims data showed that only 21% of patients with schistosomiasis diagnoses were treated with praziquantel. The mean total drug payments per patient treated with praziquantel increased from $110 in 2013–14 to $612 in 2015–18 (P < 0.01), and use decreased. These factors, including residing in a rural area, having a documented Schistosoma haematobium infection, or having a first schistosomiasis diagnosis in 2015–16, were associated with a decreased likelihood of patients receiving standard-of-care treatment. Policy solutions to exorbitant drug pricing, and better awareness and education among healthcare providers about schistosomiasis—especially those practicing in rural areas with high immigrant populations—are needed.

Bilharziasis is a tropical parasitic disease caused by different species of the genus Schistosoma. One species, S. haematobium, is widely spread in Sudan. There is a scarcity of information about S. haematobium infection among the fishermen in the country. Therefore, this study was designed to determine the prevalence of S. haematobium infection among fishermen, and the immune status among non-infected fishermen in two villages, El Hadib and Hawer-Ajowel at the White Nile state in Sudan. A cross-sectional survey was conducted among 119 fishermen in addition to 20 samples from non-endemic area which were included as a control group. Urine samples were examined by sedimentation method and faecal samples were examined by the Kato Katz method and formalin-ether concentration technique. Blood samples were examined for enumeration of IgE antibody and cytokines, interferon Gamma (IFN-γ), Tumor Necrosis Factor (TNF) and Interleukin10 (IL–10) levels using ELISA. The result of the study indicated that the overall prevalence of S. haematobium among the fishermen was 35 (29.41 %). Of the 35 positive participants, 23 (65.71 %) were infected for the first time, and 12 (34.29 %) for the second time (re-infection). Twenty-four candidates of the non-infected fishermen were included in the immunological study. The total IgE mean titer was 282.90 ±70.93 iu/ml, IFN-γ mean level was 9.62±4.60 pg/ml. TNF, 114.64±46.63 pg/ml and the IL–10 was 1.51±0.58 pg/ml. High prevalence of S. haematobium exists among fishermen and the non-infected fishermen from the endemic area showed high immune response similar to those exposed to the infection.

Background. Schistosomiasis caused by Schistosoma parasites is one of the most common parasitic infections worldwide. Genetic regulation of the genus Schistosoma, which has different developmental stages throughout its life, is quite complex. In these parasites, thousands of long noncoding RNAs (lncRNAs) estimated to be functional were identified. Identifying the transcripts expressed in common and detecting their functions for better understanding of the role of these lncRNAs require a comparative study. Methods. Assembled RNA-seq datasets belonging to S. mansoni and S. haematobium were obtained from the National Center for Biotechnology. A basic local alignment search tool (BLASTN) analysis was conducted against previously constructed lncRNA library to identify the common lncRNAs between two species. LncRNAs target genes and their gene ontology annotation was performed. Results. In S. mansoni and S. haematobium, 5132 and 3589 lncRNA transcripts were detected, respectively. These two species had 694 lncRNAs in common. A significant number of lncRNAs was determined to be transcribed from sex chromosomes. The frequently expressed lncRNAs appear to be involved in metabolic and biological regulation processes. Conclusions. These two species share similar lncRNAs; thus, this finding is a clue that they might have similar functions. In sexual development, they especially might play important roles. Our results will provide important clues to further studies about interactions between human hosts and parasites and the infection mechanisms of Schistosoma parasites.

Schistosomiasis is a chronic disease, and remains a major public health problem. It holds second place among parasitic endemics in the world. Schistosoma can infect various organs through the blood vessels. The genital form affects at least 16 million women in endemic areas, and the uterine cervix is the most common site. Two cases of cervical cancer associated with schistosomiasis of the cervix are presented. The aim of this study is to discuss the epidemiological, clinical and histopathological features. Both of the patients lived in Mahanjaga, aged respectively 57 and 43 years old. They complained of uterine bleeding disorder and presented cauliflower lesions with ulceration of the uterine cervix that extended to the vagina in one case. They were undergone cervical biopsies. The diagnosis was, in both cases, invasive, well-differentiated squamous cell carcinoma with cervical schistosomiasis.

Schistosomiasis and soil-transmitted helminthiases (STH) are two parasitic diseases mainly affecting school children. The purpose of this study was to estimate the current prevalence and infection intensity, in addition to the associations of these infections with age and sex, in children aged 4–17 years living in Osun State, Nigeria. From each participant (250 children), one urine and one stool sample were taken for the study, for the microscopic detection of eggs or larvae in faeces by means of the Kato–Katz method and eggs in filtrated urine. The overall prevalence of urinary schistosomiasis was 15.20%, with light infection. The intestinal helminthic species identified (and their prevalence) were S. stercoralis (10.80%), S. mansoni (8%), A. lumbricoides (7.20%), hookworm (1.20%), and T. trichiura (0.4%), all of them being classified as light infections. Single infections (67.95%) are more frequent than multiple infections (32.05%). With this study, schistosomiasis and STH are still endemic in Osun State, but with a light to moderate prevalence and light infection intensity. Urinary infection was the most prevalent, with higher prevalence in children over 10 years. The >10 years age group had the highest prevalence for all of the intestinal helminths. There were no statistically significant associations between gender and age and urogenital or intestinal parasites.

Schistosomiasis is a neglected tropical disease despite of being a major public health problem affecting nearly 240 million people in the world. Due to the migratory flow from endemic countries to Western countries, an increasing number of cases is being diagnosed in non-endemic areas, generally in migrants or people visiting these areas. Serology is the recommended method for screening and diagnosis of schistosomiasis in migrants from endemic regions. However, serological techniques have a highly variable sensitivity. The aim of this study was to evaluate retrospectively the sensitivity of three different serological tests used in real clinical practice for the screening and diagnosis of imported schistosomiasis in sub-Saharan migrant patients, using the detection of schistosome eggs in urine, faeces or tissues as the gold standard. We evaluated three different serological techniques in 405 sub-Saharan patients with confirmed schistosomiasis treated between 2004 and 2022: an enzyme-linked immunosorbent assay (ELISA), an indirect haemagglutination assay (IHA) and an immunochromatographic test (ICT). The overall sensitivity values obtained with the different techniques were: 44.4% for IHA, 71.2% for ELISA and 94.7% for ICT, respectively. According to species, ICT showed the highest sensitivity (S. haematobium: 94%, S. mansoni: 93.3%; and S. intercalatum/guineensis: 100%). In conclusion, our study shows that Schistosoma ICT has the best performance in real clinical practice, when compared to ELISA and IHA, in both S. mansoni and S. haematobium infections.

Urinary schistosomiasis is a major public health problem particularly in developing countries and is associated with high morbidity. The study aimed at determining the prevalence of urinary schistosomiasis among Qur’anic school pupils in Zaria, Kaduna State. One hundred and fifty-five (155) urine samples were collected from Qur’anic school pupils in Zaria. The samples were immediately transported to the laboratory of the Department of Microbiology, Ahmadu Bello University (A.B.U), Zaria and processed using sedimentation technique. The ova of Schistosoma haematobium were detected in fifty-eight (58) samples giving a prevalence of 37.4%. The infection was highest in age group 10-12 years with 41.9%, followed by those in age range 13-15years (41.0%) while the least was observed among pupils between the ages of7- 9years (27.5%). Risk factors observed to be associated with schistosomiasis include; swimming in river or dam, fishing and place of laundry. The infection was associated with clinical signs and symptoms including abdominal pain, haematuria, painful and frequent urination. Regular community-based treatment should be conducted using anti-helminthic drugs to reduce urinary schistosomiasis. Key words: Prevalence, Schistosoma haematobium, Qur’anic school pupils, Zaria, Kaduna State

Schistosomiasis is a major public health problem. Diagnosis by simple and rapid immunoassays is a priority. The magnetic bead immunoassay using magnetic nanoparticles conjugated with anti-schistosomal antibody was evaluated for di­agnosing human schistosomiasis infection. The present study was to evaluate the sandwich ELISA as a simple test for the detection of schistosomal antigen (CSA) in serum and urine samples of S. haematobium patients and compare it with ELISA. Investigation conducted on eighty six cases divided to three groups, 34 were positively for Schistosoma haematobium, 32 were positively for intestinal parasites ova and negative for S. haematobium ova in urine and 20 were negative urine and stool examination (Control). Immunomagnetical bead based Enzyme-linked immunosorbent assay (ELISA) using for detected for antigen in sera and urine infected by S. haematobium. Sandwich ELISA sensitivities was 79.4% (serum) and 73.5% (urine) and which increase by used nano-sandwich ELISA to 88.2% (serum) and 82.4% (urine), respectively. Sandwich ELISA specificities was 86.4% (serum) and 80.8% (urine) and which increase by used nano-sandwich ELISA to 93.3% (serum) and 88.5% (urine). We found that, nano-sandwich ELISA assay had highly sensitive and specifically and technical method was applicably, fast, cheaper, accurate and promising diagnostic method for schistosomiasis.

Current estimates of the prevalence of schistosomiasis depend on the use of well-established, but imperfect, diagnostic tests where specimens are processed by routine parasitological methods and parasitological cure is judged by inspection of a cohort of children before and after Praziqantel (PQZ) treatment. In this study, in order to evaluate the different immunodiagnostic antigen detection assays, the selection of a proper antigen and its purification followed by propagation of its specific antibodies and purification were mandatory. Measurement of Liver function and kidney function were performed and its relation to S. heamatobium infection in different age and sex individuals were studied. Serum samples from an infected human with S. haematobium gave a strong reaction against S. haematobium SWAP antigen and no cross-reacting. with other parasites. The produced anti-S. haematobium SWAP IgG-pAb diluted 1/250 in PBS/T buffer gave strong reactivity to S. haematobium SWAP. The highest percentages of S. haematobium infected patients were in the age group 21-30 years (25%) and the least percentages of patients were in the age group of 51-55 years (2.9%). Levels of ALT , AST and ALP in the serum of humans among schistosomiasis group recorded a highly significant increase compared to the healthy control group. In conclusion strong association between biochemical parameters and serum circulating antigens among schistosomiasis infection.

We estimated the financial costs of different interventions against urogenital schistosomiasis, implemented by the Zanzibar Elimination of Schistosomiasis Transmission (ZEST) project, on Pemba and Unguja islands, Tanzania. We used available data on project activities, resources used, and costs reported in the accounting information systems of ZEST partners. The costs were estimated for all the activities related to snail control, behavior change interventions, the impact assessment surveys, and management of the whole program. Costs are presented in US$ for the full duration of the ZEST project from 2011/2012 to 2017. The total financial costs of implementing snail control activities over 5 years, excluding the costs for donated Bayluscide, were US$55,796 on Pemba and US$73,581 on Unguja, mainly driven by personnel costs. The total financial costs of implementing behavior change activities were US$109,165 on Pemba and US$155,828 on Unguja, with costs for personnel accounting for 47% on Pemba and 69% on Unguja. Costs of implementing biannual mass drug administration refer to the estimated 2.4 million treatments provided on Pemba over 4 years (2013–2016), and do not include the costs of donated praziquantel. The total cost per provided treatment was, on average, US$0.21. This study showed the value of exploiting administrative data to estimate costs of major global health interventions. It also provides an evidence base for financial costs and main cost drivers of implementing multiple combinations of intervention sets that inform decisions regarding the feasibility and affordability of implementing schistosomiasis control and elimination strategies.

Background: Schistosomiasis is a public health problem of social and economic importance in thedeveloping world. Schistosomiasis haematobium is still endemic in many foci along the Nile valley,especially in El Fayoum and Beni-Suef governorates. Chemotherapy and snail eradication are the mostimportant control measures with few studies that dealt with its snail intermediate host, Bulinus truncatus.Because of drug resistance and recurrence of exposure to infection, snail control becomes a better methodfor control, keeping in mind that chemical molluscicides may have toxic effects on non-target organisms.Objectives: The aim of the study is to search for biologically derived molluscicides such as plant extracts,that are less expensive, available, biodegradable, non-toxic and easily applicable than synthetic ones.Material and Methods: The effect of oil extracts of three natural plants; Nigella sativa, Pelargoniumgraveolens and Azadirachta indica were investigated as molluscicidal agents against B. truncatus snail.Histopathological examination of the soft tissue of the snail was performed after its removal from the shelland its staining with hematoxylin and eosin (HE). Effect of the three plants on miracidia and cercariae ofS. haematobium was also evaluated.Results: The potent molluscicidal effect was demonstrated by disturbance of normal histology andpresence of vacuolated tissues evident by microscopical examination of the dead snails after HE staining.A schistosomicidal effect was also recorded against aquatic stages of the parasite, demonstrated byreduction in the movement of the miracidia, followed by their sinking down together with the cercariae.N. sativa showed the most potent molluscicidal, miracidicidal, as well as cercaricidal activities, followed byP. graveolens, while A. indica had the least effect.Conclusion: These findings recommend the use of the studied plant extracts as safe and effective agentsin the control of S. haematobium in Egypt.

Background This cross-sectional survey aimed to assess the knowledge, attitudes and practices (KAP) towards schistosomiasis among rural schoolchildren in Taiz governorate, southwestern Yemen. Methods A total of 406 children were screened for urogenital and intestinal schistosomiasis. A pretested questionnaire was used to collect the children's demographic and socio-economic information and their KAP towards schistosomiasis. Results Overall, 73 children (18%) were found to be infected by Schistosoma mansoni. None of the children were positive for Schistosoma haematobium. The prevalence of intestinal schistosomiasis was significantly higher among boys than girls (22.1% vs 12%; p=0.010). Approximately two-thirds (63.3% [257/406]) of the children had heard about schistosomiasis, however, only 38.5%, 53.6%, 28.4% and 38.1% had correct knowledge concerning the causes, symptoms, transmission and prevention, respectively. A significantly higher level of knowledge was observed among boys and Schistosoma-infected children compared with girls and non-infected children (p Conclusions Intestinal schistosomiasis is prevalent among schoolchildren in rural Yemen. The findings reveal that children's knowledge about schistosomiasis is inadequate. Therefore, besides mass drug administration, integrated control programmes should also include health education and the provision of improved drinking water and proper sanitation.

Background Genitourinary (GU) schistosomiasis is a chronic infection caused by a parasitic trematode, with Schistosoma haematobium (S. haematobium) being the prevalent species. The disease has a variable prevalence around the world, with a greater burden on, but not limited to Africa, South America, Asia, and the Middle East. Case summary We report the case of a 30-year-old man who presented with symptoms of bladder stones. During endoscopic cystolithalopaxy, we did not detect any stones in the bladder. Upon careful scanning of the urinary bladder trigone, sandy patches were detected. We performed endoscopic resection, which revealed a closed diverticulum with bladder stones. The diverticular wall was sent for histopathology and revealed features of chronic granulomatous inflammation with numerous embedded Schistosoma eggs, with some of the eggs having lateral spines. The patient was treated with praziquantel, and his symptoms completely resolved. Conclusion GU schistosomiasis is primarily caused by S. haematobium. However, Schistosoma mansoni mediated GU schistosomiasis is unusual, making this a quite interesting case.

Introduction Schistosomiasis is an important neglected tropical disease (NTD) in several developing countries. Praziquantel is the principle and efficacious chemotherapeutic agent that has been used to treat schistosomiasis for decades. Unfortunately, emerging resistance to praziquantel with accompanying reduced efficacy is reported in some localities. Hence, genetic diversity among parasite populations is of significant interest in assessing the effects of selective pressure generated by praziquantel therapy that might result in encouraging the emergence of new genotypes that are either non-susceptible or drug-resistant. The present study aimed to investigate the genetic diversity of Schistosoma haematobium among human populations using the RAPD technique to help clarify disease epidemiology and transmission. Materials and methods S. haematobium eggs were isolated from 50 of 134 patients from four different localities in Qena Governorate, Upper Egypt. These patients complained of terminal hematuria and burning micturition. Samples were used for molecular analysis using RAPD-PCR primers (A02, A07, A09, A10). Results Twenty S. haematobium isolates (40%) were amplified using the selected RAPD primers. Amplification patterns of these isolates showed distinct variation in the size and number of amplified fragments, indicating high genetic variation among these isolates. Conclusion To the best of our knowledge, this study is the first to characterize the genetic diversity of S. haematobium in human populations in Upper Egypt. Future studies on a larger geographic scale involving many districts in Upper Egypt should be encouraged. Information from such a study would provide better insight into clonal lineages of S. haematobium in this endemic area. In turn, understanding transmission of the parasite may have a major role in establishing control strategies for urogenital schistosomiasis in Upper Egypt.

Epidemiological study was conducted to determine the prevalence of urinary schistosomiasis and intestinal helminth co-infection among primary school pupils in Wamakko Local Government, Sokoto State, Nigeria. Urine and stool samples were collected from 400 pupils and analyzed using filtration and formol-ether concentration techniques respectively. Out of 400 samples, 63(32.8%) were co-infected with Schistosoma haematobium and one or more intestinal helminths. The co-infection of S. haematobium with Ascaris lumbricoides was most prevalent (74.6%), while S. haematobium with A. lumbricoides, hookworm, and S. haematobium with A. lumbricoides and S. mansoni had the least prevalence (1.6% each). Being male, 10-12 years of age and not washing hands before and after meals were the major risk factors for the spread of urinary schistosomiasis and intestinal helminths co-infection in the study area. An integrated strategy that involves the provision of health education to the communities, regular treatments, provision of safe water supply and sanitation facilities is highly recommended.

We report a patient with urogenital schistosomiasis and three cases of subclinical infection within one family acquired from Solenzara River, Corsica, in 2019. Our cases confirm that transmission of schistosomiasis in Corsica is ongoing and has been extended from the Cavu River to the Solenzara River. Solenzara River is clearly a transmission site for schistosomiasis in Corsica. Public health efforts are recommended to uncover and prevent further cases.

The last decades have brought important insight and updates in the diagnosis, management and immunopathology of female genital schistosomiasis (FGS) and male genital schistosomiasis (MGS). Despite sharing a common parasitic aetiological agent, FGS and MGS have typically been studied separately. Infection with Schistosoma haematobium manifests with gender-specific clinical manifestations and consequences of infection, albeit having a similar pathogenesis within the human genital tract. Schistosoma haematobium is a known urinary bladder carcinogen, but its potential causative role in other types of neoplasia, such as cervical cancer, is not fully understood. Furthermore, the impact of praziquantel treatment on clinical outcomes remains largely underexplored, as is the interplay of FGS/MGS with relevant reproductive tract infections such as HIV and Human Papillomavirus. In non-endemic settings, travel and immigrant health clinics need better guidance to correctly identify and treat FGS and MGS. Our review outlines the latest advances and remaining knowledge gaps in FGS and MGS research. We aim to pave a way forward to formulate more effective control measures and discuss elimination targets. With a growing community awareness in health practitioners, scientists and epidemiologists, alongside the sufferers from these diseases, we aspire to witness a new generation of young women and men free from the downstream disabling manifestations of disease.

Background The incidence of schistosomiasis‐induced male reproductive dysfunction and infertility is probably underestimated compared to female genital schistosomiasis. This study aimed to investigate the impact of Schistosoma haematobium or S. mansoni infection on the reproductive function of men of reproductive age in Tibati and Wouldé, two endemic schistosomiasis areas in the Adamawa region of Cameroon. Methods A total of 89 men of reproductive age (range 14–56 years) from two localities were enrolled in the study, with 51 in Tibati and 38 in Wouldé. Each participant was submitted to a questionnaire to document data on sociodemographic and stream contact behaviors. A medical examination was performed to measure the testes’ circumference and evaluate genital tract pathologies. Stool and urine samples were collected and screened for the presence of S. haematobium or S. mansoni ova. Blood serum was used to assess the levels of transaminases and testosterone. Results Schistosoma haematobium was present only in Tibati, with a prevalence of 31.37%. The S. mansoni prevalence was 3.92% at Tibati and 44.71% at Wouldé. The intensity of infection was 22.12 ± 9.57 eggs/10 mL for S. haematobium and 128.10 ± 3.76 epg for S. mansoni. Serum transaminase activity and the mean testicular circumference of Schistosoma-positive individuals were close to Schistosoma-negative individuals. However, the testes size was more prominent in S. mansoni-positive individuals than in S. haematobium-positive individuals (P S. haematobium- and S. mansoni-positive men were significantly reduced by 56.07% (P P Schistosoma-negative men. A significant and negative correlation was established between schistosomiasis and the low serum testosterone level. Male genital tract pathologies such as scrotal abnormalities, varicocele, nodular epididymis, inguinal hernia, and hydrocele were recorded in both Schistosoma-positive and Schistosoma-negative men. However, no significant link was established between schistosomiasis infection and these pathologies. Conclusion These results demonstrated that infection with S. haematobium or S. mansoni is associated with low production of the reproductive hormone testosterone and may be a significant cause of male infertility.

South Sudan is affected by a high burden of Neglected Tropical Diseases (NTDs). The country is very vulnerable to NTDs due to its favourable tropical climate and multiple risk factors. However, the distribution of the diseases and the populations at risk for the various NTDs is unknown. This paper described the distribution of schistosomiasis in 58 counties and 261 schools in South Sudan.a descriptive quantitative cross-sectional study of schistosomiasis in 58 counties in 8 states of South Sudan recruited school-aged children. Using different laboratory techniques, the children were tested for Schistosoma mansoni (the overall prevalence ofthe study had provided evidence of the distribution of schistosomiasis in South Sudan for policy direction and recommended annual preventive chemotherapy with praziquantel in all endemic areas.

To analyze the diagnosis and treatment of two imported cases with schistosomiasis haematobia, so as to provide insights into improving the diagnosis and treatment and avoiding misdiagnosis and mistreatment of imported schistosomiasis haematobia.The medical records and epidemiological data pertaining to the two cases were collected. The stool and urine samples were collected for identification ofThe patient 1, a Malagasy, was infected in Madagascar and returned to China for delivery. The case presented intermittent painless terminal hematuria symptoms, and showed no remarkable improvements following multiple-round treatments in several hospitals. In January 2017, she was found to be positive for anti-Overseas imported schistosomiasis haematobia is likely to be misdiagnosed. The training pertaining to schistosomiasis control knowledge requires to be improved among clinical professionals, in order to avoid misdiagnosis and mistreatment.

Background Schistosomiasis or bilharzia is one of the neglected tropical diseases affecting over 230 million people globally. In Zambia, the infection poses as one of the major public health burdens among parasitic infections. The diagnosis of schistosomiasis in endemic countries is still a challenge. The aim of this study was to evaluate the diagnostic performance of the Schistosoma immunochromatographic (ICT) IgG–IgM rapid diagnostic test in the detection of schistosome infections from Schistosoma haematobium and mansoni in Siavonga district in Zambia. Results The diagnostic performance of Schistosoma ICT IgG–IgM test was evaluated using 430 of the 440 participants’ samples which had complete data. The prevalence of S. haematobium and S. mansoni was 4.4% and 6%, respectively, while seroprevalence was 71.4%. The sensitivity and specificity of the Schistosoma ICT IgG–IgM test was found to be 100% and 32.2%, respectively. The associated positive predictive value was 13.8% and 100% for negative predictive value. Diagnostic accuracy [area under the curve (AUC)] was 0.57 [95% confidence interval (CI) 0.52, 0.62]. Conclusions The Schistosoma ICT IgG–IgM proved to have remarkably high sensitivity with a fairly good specificity and diagnostic accuracy for the detection of both urinary and intestinal schistosomiasis. We therefore recommend the test as it is ideal for screening in the light of current focus of disease elimination in endemic countries.

Background Schistosoma haematobium, soil transmitted helminthes (STH), and malaria lead to a double burden in pregnancy that eventually leads to poor immunity, increased susceptibility to other infections, and poor pregnancy outcomes. Many studies have been carried out on pre-school and school aged children but very little has been done among the at risk adult population including women of reproductive age (WRA). Our current study sought to establish the risk factors and burden of co-infection with S. haematobium, STH, and Plasmodium sp. among WRA in Kwale County, Coastal Kenya. Methods A total of 534 WRA between the ages of 15–50 were enrolled in this cross-sectional study from four villages; Bilashaka and Mwaluphamba in Matuga sub-County, and Mwachinga and Dumbule in Kinango sub-County. Socio-demographic information was collected using a pre-tested standardized questionnaire. Parasitological examination was done using urine filtration method for Schistosoma haematobium, Kato Katz for STH (Ascaris lumbricoides, Hookworm, Trichuris trichiura), and standard slide microscopy for Plasmodium sp. Statistical analyses were carried out using STATA version 15.1. Results The overall prevalence of S. haematobium was 3.8% (95% CI: 2.6–5.4) while that for malaria was 4.9% (95% CI: 2.0–11.7). The prevalence of STH was 5.6% (95% CI: 2.8–11.3) with overall prevalence of 5.3% (95% CI: 2.5–10.9) for hookworm and 0.6% (95% CI: 0.2–1.9) for T. trichiura. The occurrence of co-infection was low and was recorded between S. haematobium and P. falciparum (0.6%), followed by S. haematobium and STH (0.4%). Among pregnant women, 2.6% had co-infection with S. haematobium and P. falciparum. Only 1.3% had co-infection with S. haematobium and hookworm or T. trichiura. Among non-pregnant women, co-infection with S. haematobium and P. falciparum was 0.2%. Similarly, co-infection with S. haematobium and hookworm or T. trichiura was 0.2%. Bed net ownership and usage among pregnant women was 87.8 and 96.6%, respectively. 66.3% of the women reported using improved water sources for drinking while 78.1% reported using improved sanitation facilities. Conclusion The use of improved WASH activities might have contributed to the low prevalence of STHs and S. haematobium infections. Further, bed net ownership and usage might have resulted in the low prevalence of Plasmodium sp. infections observed.

Background Bulinus globosus, the main intermediate snail host of Schistosoma haematobium. The increased contacts between Africa and China could even lead to large-scale dissemination of B. globosus in China. Temperature is the key factor affecting fresh-water snail transmission. This study predicted potential risk of colonization of B. globosus in the mainland of China under climate change. Methods We investigated minimum and maximum temperatures for B. globosus eggs, juveniles and adult snails kept under laboratory conditions to find the most suitable range by pinpointing the median effective temperatures (ET50). We also assessed the influence of temperature on spawning and estimated the accumulated temperature (AT). The average air temperatures between 1955 and 2019 in January and July, the coldest and hottest months in China, respectively, were collected from national meteorological monitoring stations and investigated in a geographic information system (GIS) using empirical Bayesian Kriging to evaluate the theoretical possibility for distribution of B. globosus in southern China based on temperature. Results The effective minimum temperature (ET50min) for eggs, juveniles, adult snails and spawning were 8.5, 7.0, 7.0, 14.9 °C, respectively, with the corresponding maximum values (ET50max) of 36.6, 40.5, 40.2 and 38.1 °C. The AT was calculated at 712.1 ± 64.9 °C·d. In 1955, the potential B. globosus distribution would have had a northern boundary stretching from the coastal areas of Guangdong Province and Guangxi Autonomous Region to southern Yunnan Province. Since then, this line has gradually moved northward. Conclusions Annual regeneration of B. globosus can be supported by the current climate conditions in the mainland of China, and a gradual expansion trend from south to north is shown in the study from 2015 to 2019. Thus, there is a potential risk of colonization of B. globosus in the mainland of China under climate change. Graphical Abstract

The last decades have brought important insight and updates in the diagnosis, management and immunopathology of female genital schistosomiasis (FGS) and male genital schistosomiasis (MGS). Despite sharing a common parasitic aetiological agent, FGS and MGS have typically been studied separately. Infection with Schistosoma haematobium manifests with gender-specific clinical manifestations and consequences of infection, albeit having a similar pathogenesis within the human genital tract. Schistosoma haematobium is a known urinary bladder carcinogen, but its potential causative role in other types of neoplasia, such as cervical cancer, is not fully understood. Furthermore, the impact of praziquantel treatment on clinical outcomes remains largely underexplored, as is the interplay of FGS/MGS with relevant reproductive tract infections such as HIV and Human Papillomavirus. In non-endemic settings, travel and immigrant health clinics need better guidance to correctly identify and treat FGS and MGS. Our review outlines the latest advances and remaining knowledge gaps in FGS and MGS research. We aim to pave a way forward to formulate more effective control measures and discuss elimination targets. With a growing community awareness in health practitioners, scientists and epidemiologists, alongside the sufferers from these diseases, we aspire to witness a new generation of young women and men free from the downstream disabling manifestations of disease.

Schistosomiasis is the second most prevalent tropical parasitic disease after malaria, and one of the leading cause of morbidity and mortality in developing countries especially in Africa. This study was carried out among students, farmers and fishermen/women from four villages in the Central River Region of The Gambia. The aim of this study was to show the prevalence value of schistosomiasis in Central River Region of The Gambia. Questionnaires were administered to acquire data such as age, gender, prior schistosomiasis infection and treatment. One hundred and ninety-five blood and 192 urine samples collected from 117 females and 78 males were examined. Microscopy, ELISA and Polymerase Chain Reaction (PCR) techniques were used to detect and characterize schistosome isolates from the biological samples. Prevalence of Schistosoma haematobium was 28.7 with 41.0% in males and 23.9% in females. The highest prevalence value among the villages was in Brikama Ba with 53.1% while the age group 6-15 years had the highest prevalence of 50.0%. Schistosoma mansoni was only detected in Jahally village (1.5%). Schistosomiasis detection was highest using ELISA (40%) and lowest using microscopy (24.5%). PCR gave a 28.7% prevalence value. Key words: Prevalence, Schistosoma, diagnostic techniques, Central River Region.

Failure of the human host to elicit adequate immune responses to the adult Schistosoma haematobium worm and continuous strong inflammatory responses to the eggs have been the main causes of bladder pathology in chronic Schistosomiasis. Identification of susceptibility biomarkers for schistosomiasis- associated bladder pathology is necessary in order to detect genetic factors responsible for the infection and spread of the disease. The aim of this study was to identify candidate-biomarkers for susceptibility to schistosomiasis and its associated pathologies. A total of 371 adult participants, comprising 130 males and 241 females from Eggua community, Ogun State, Nigeria, were randomly recruited into a cross sectional study from August 2012 to May 2014. They were screened for S. haematobium ova and bladder pathologies by microscopy and ultrasonography, respectively. Human host susceptibility to schistosomiasis and its associated bladder pathologies were determined by PCR genotyping of Interleukin (IL4 and IL13) genes, and glutathione-S-transferase (GSTT1 and GSTM1) genes. The overall prevalence of S. haematobium in the population was 29.3% (108/369). Bladder pathologies were observed in 32.3% (117/362) of the population. Polymorphisms in IL 4-590 and IL 13-1055 were observed in 24.1% and 9.3% schistosomiasis cases, respectively. The IL 13-1055 polymorphism did not indicate susceptibility to schistosomiasis in males (OR 0.7, 95% CI 0.3-2.1) but a slight risk was found in females (OR 1.1, 95% CI 0.7-1.7). Participants with GSTM1 and GSTT1 polymorphisms expressed elevated risks of bladder pathologies (OR = 4.3, 95% CI 2.0 - 9.2 and OR = 4.2, 95% CI 1.5 – 12.0, respectively), with the pathology and schistosomiasis group having more GST polymorphisms than bladder pathologies. Keywords: Polymorphisms, Cytokines, GST, schistosomiasis and pathologies

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.