{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:50:07Z","timestamp":1790013007499,"version":"4.0.1"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Schistosomiasis is a major public health problem in Madagascar. The WHO recommends preventive chemotherapy by mass drug administration (MDA) with praziquantel as the primary approach to control <jats:italic>Schistosoma mansoni<\/jats:italic>\u2013related morbidity in endemic populations, alongside complementary interventions such as health education. The impact of annual MDA and health education programs was assessed in the hard-to-reach Marolambo district of eastern Madagascar, an area endemic for <jats:italic>S. mansoni<\/jats:italic>. Repeated cross-sectional studies undertaken 2015\u20132019 examined between 300 and 381 school-aged children (aged 5\u201314 years) annually. The prevalence and infection intensity of <jats:italic>S. mansoni<\/jats:italic> were assessed by urine-circulating cathodic antigen (CCA) dipsticks and coproscopy using Kato\u2013Katz (KK) methodologies. After four rounds of annual MDA, a reduction in <jats:italic>S. mansoni<\/jats:italic> prevalence was seen in CCA (93.9% in year 1\u201387.7% in year 5; <jats:italic>P<\/jats:italic> = 0.007) and KK (73.9% in year 1\u201359.4% in year 5; <jats:italic>P<\/jats:italic> &lt; 0.0001). The prevalence of heavy-intensity infections roughly halved from 23.7% to 10.1% (<jats:italic>P<\/jats:italic> &lt; 0.0001), and the mean intensity of infection fell by 55.0% (480.2\u2013216.3 eggs per gram of feces). A malacological survey found <jats:italic>Biomphalaria pfeifferi<\/jats:italic> snail intermediate hosts in multiple water contact sites including rice paddies, streams, and Nosivolo River. Despite reductions in infection prevalence and intensity, schistosomiasis still poses a significant public health challenge in Marolambo district. Twice yearly MDA cycles and\/or community-wide MDA are suggested to better reduce infections. Expanding health education, improving standards of water, sanitation and hygiene, and attention on snail-related control will also be important, especially in rice paddy irrigated areas.<\/jats:p>","DOI":"10.4269\/ajtmh.20-1433","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T22:33:17Z","timestamp":1615242797000},"page":"1841-1850","source":"Crossref","is-referenced-by-count":9,"title":["Five-Year Follow-Up on the Prevalence and Intensity of Infections of Schistosoma mansoni in a Hard-to-Reach District of Madagascar"],"prefix":"10.4269","volume":"104","author":[{"given":"Stephen A.","family":"Spencer","sequence":"first","affiliation":[{"name":"1Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom;"},{"name":"2The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cortland","family":"Linder","sequence":"additional","affiliation":[{"name":"2The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M. StJ.","family":"Penney","sequence":"additional","affiliation":[{"name":"2The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah J.","family":"Russell","sequence":"additional","affiliation":[{"name":"2The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Hyde","sequence":"additional","affiliation":[{"name":"2The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Sheehy","sequence":"additional","affiliation":[{"name":"2The University of Manchester Faculty of Biology Medicine and Health, Manchester Academic Health Centre, Manchester, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Reid","sequence":"additional","affiliation":[{"name":"3Unit\u00e9 d\u2019Epid\u00e9miologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel H.","family":"Andriamasy","sequence":"additional","affiliation":[{"name":"4Facult\u00e9 de M\u00e9decine, Universit\u00e9 d\u2019Antananarivo, Antananarivo, Madagascar;"},{"name":"5Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina U.","family":"Raderalazasoa","sequence":"additional","affiliation":[{"name":"5Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A. L.","family":"Rakotomampianina","sequence":"additional","affiliation":[{"name":"5Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjara M.","family":"Nandimbiniaina","sequence":"additional","affiliation":[{"name":"5Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahiry N.","family":"Ranaivoson","sequence":"additional","affiliation":[{"name":"5Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antsa","family":"Andrianiaina","sequence":"additional","affiliation":[{"name":"5Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena M.","family":"Cruickshank","sequence":"additional","affiliation":[{"name":"5Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaya L.","family":"Bustinduy","sequence":"additional","affiliation":[{"name":"6Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Russell","family":"Stothard","sequence":"additional","affiliation":[{"name":"3Unit\u00e9 d\u2019Epid\u00e9miologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn T.","family":"Edosoa","sequence":"additional","affiliation":[{"name":"7World Health Organization, Madagascar Country Office, Antananarivo, Madagascar;"},{"name":"8Minist\u00e8re de la Sant\u00e9 Publique de Madagascar, Antananarivo, Madagascar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain M.","family":"Rahetilahy","sequence":"additional","affiliation":[{"name":"8Minist\u00e8re de la Sant\u00e9 Publique de Madagascar, Antananarivo, Madagascar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/5\/article-p1841.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/5\/article-p1841.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T20:41:30Z","timestamp":1629924090000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/5\/article-p1841.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,5]]},"references-count":0,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-1433","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,5]]}}}