University of Namibia, Katima Mulilo Campus, Box 1096, Katima Mulilo, Namibia.
Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, Durban, 4001, South Africa.
Parasitol Res. 2020 Jan;119(1):1-10. doi: 10.1007/s00436-019-06534-0. Epub 2019 Nov 26.
Schistosomiasis affects more than 4 million school-aged children in Zambia, mostly in rural communities due to unsafe water and inadequate sanitation facilities. Although several studies were done in Zambia between 1976 and 2019, empirical estimates of the disease burden remain unavailable. Therefore, appraisal of the current schistosomiasis burden is pertinent in the re-evaluation of schistosomiasis-control strategies in Zambia. A random-effect model was used to estimate the prevalence of schistosomiasis infection in Zambia across different age groups for the period between 1976 and 2019. A literature search was done in the following databases: PubMed, ISI Web of Science, Google Scholar, CINAHL, and African Journals Online. Twenty-eight studies with relevant prevalence data were identified and included in the analysis. The pooled prevalence estimate of Schistosoma haematobium and Schistosoma mansoni across studies for the entire period was 35.5% (95% CI: 25.8-45.9) and 34.9% (95% CI: 20.7-50.6), respectively. Prevalence estimates among school-aged children for S. haematobium and S. mansoni were 32.2% (95% CI: 21.1-44.7) and 18.1% (95% CI: 3.0-38.4), respectively. The reported pooled prevalence estimate for S. haematobium among the adults was 54% (95% CI: 23.2-83.7). Only two studies collected information from preschool aged children. Substantial heterogeneity (I = 100%, p < 0.0001) was observed among the studies. Although a reduction in disease prevalence was observed from 1990 to 2010, this was not sustained after 2010. In this meta-analysis, S. haematobium was more prevalent compared to S. mansoni, with more cases observed among school-aged children (SAC). Thus, control programs should target age groups that are highly infected or are at high risk of infection.
血吸虫病影响赞比亚超过 400 万学龄儿童，主要集中在农村社区，原因是不安全的水和卫生设施不足。尽管 1976 年至 2019 年期间在赞比亚进行了几项研究，但仍缺乏对该病负担的实证估计。因此，评估当前的血吸虫病负担对于重新评估赞比亚的血吸虫病控制策略至关重要。使用随机效应模型估算了 1976 年至 2019 年期间不同年龄组赞比亚血吸虫病感染的流行率。在以下数据库中进行了文献检索：PubMed、ISI Web of Science、Google Scholar、CINAHL 和 African Journals Online。确定了 28 项具有相关流行率数据的研究，并将其纳入分析。整个时期，所有研究中曼氏血吸虫和埃及血吸虫的合并流行率估计值分别为 35.5%（95%CI：25.8-45.9）和 34.9%（95%CI：20.7-50.6）。学龄儿童中曼氏血吸虫和埃及血吸虫的流行率估计值分别为 32.2%（95%CI：21.1-44.7）和 18.1%（95%CI：3.0-38.4）。报告的成年人中曼氏血吸虫的合并流行率估计值为 54%（95%CI：23.2-83.7）。只有两项研究从学龄前儿童收集信息。研究之间存在很大的异质性（I = 100%，p < 0.0001）。尽管 1990 年至 2010 年期间疾病流行率有所下降，但 2010 年后并未持续下降。在这项荟萃分析中，曼氏血吸虫比埃及血吸虫更为普遍，在学龄儿童（SAC）中观察到更多病例。因此，控制计划应针对感染率高或感染风险高的年龄段。
