Browsing by Author "Wagner, A.D."

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Diagnostic accuracy of urine filtration and dipstick tests for Schistosoma haematobium infection in a lightly infected population of Ghanaian schoolchildren
(Acta Tropica, 2011-05) Kosinski, K.C.; Bosompem, K.M.; Stadecker, M.J.; Wagner, A.D.; Plummer, J.; Durant, J.L.; Gute, D.M.
Two screening methods, reagent dipsticks for hematuria and urine filtration for Schistosoma haematobium eggs, were evaluated for their sensitivity and specificity in diagnosing infection with S. haematobium in lightly infected Ghanaian children. Schoolchildren aged 8-18 years (n=255) provided urine samples on three occasions. Overall, 36.4% of girls and 50.7% of boys presented with eggs at least once; 3.3% of girls and 7.5% of boys presented with both eggs and hematuria three times. Many children presented with eggs but without hematuria, or with hematuria but without eggs. When each child was screened three times, the sensitivity of each test method improved by at least 22.9% as compared with single screening, but previously unidentified infections were detected at the third screening, indicating that even three screenings is insufficient. Nearly half of lightly infected children (<50 eggs/10. ml urine, by maximum egg count) were egg-positive during only one of three screenings. Thus, data presented here indicate that when individuals are screened repeatedly, infection status can be assessed more accurately, control programs can be properly evaluated, and population estimates of S. haematobium infection may be made with increased confidence, as compared with single screening. © 2011 Elsevier B.V.
Effective control of Schistosoma haematobium infection in a Ghanaian community following installation of a water recreation area
(Public Library of Science, 2012) Kosinski, K.C.; Adjei, M.N.; Bosompem, K.M.; Crocker, J.J.; Durant, J.L.; Osabutey, D.; Plummer, J.D.; Stadecker, M.J.; Wagner, A.D.; Woodin, M.; Gute, D.M.
Background: Urogenital schistosomiasis caused by Schistosoma haematobium was endemic in Adasawase, Ghana in 2007. Transmission was reported to be primarily through recreational water contact. Methods: We designed a water recreation area (WRA) to prevent transmission to school-aged children. The WRA features a concrete pool supplied by a borehole well and a gravity-driven rainwater collection system; it is 30 m 2 and is split into shallow and deep sections to accommodate a variety of age groups. The WRA opened in 2009 and children were encouraged to use it for recreation as opposed to the local river. We screened children annually for S. haematobium eggs in their urine in 2008, 2009, and 2010 and established differences in infection rates before (2008-09) and after (2009-10) installation of the WRA. After each annual screening, children were treated with praziquantel and rescreened to confirm parasite clearance. Principal Findings: Initial baseline testing in 2008 established that 105 of 247 (42.5%) children were egg-positive. In 2009, with drug treatment alone, the pre-WRA annual cumulative incidence of infection was 29 of 216 (13.4%). In 2010, this incidence rate fell significantly (p<0.001, chi-squared) to 9 of 245 (3.7%) children after installation of the WRA. Logistic regression analysis was used to determine correlates of infection among the variables age, sex, distance between home and river, minutes observed at the river, low height-for-age, low weight-for-age, low Body Mass Index (BMI)-for-age, and previous infection status. Conclusion/Significance: The installation and use of a WRA is a feasible and highly effective means to reduce the incidence of schistosomiasis in school-aged children in a rural Ghanaian community. In conjunction with drug treatment and education, such an intervention can represent a significant step towards the control of schistosomiasis. The WRA should be tested in other water-rich endemic areas to determine whether infection prevalence can be substantially reduced. © 2012 Kosinski et al.