09 Fév Temporal trends in schistosomiasis in Burundi, from 2011 to 2015
P. Bizimana, J. P. Van Geertruyden, K. Polman, P. Niyongabo, F. Munezero and G. Ortu
Tenth European Congress on Tropical Medicine and International HealthOctober 16 – 20, 2017
Intestinal schistosomiasis has been a public health problem for several decades in Burundi. Since 2008, annual mass drug administrations (MDA) of praziquantel have been rolled out targeting school age children, in 11 (out of 45) districts at high risk of schistosomiasis.
To assess whether schistosomiasis cases reported by health facilities via the national health management information system could be used to verify the impact of MDA in those districts where annual treatment was performed.
From the aggregated data available by district from 2011 to 2015, number of schistosomiasis cases, diagnosed by direct smear of stools, was collected. Schistosomiasis trends were assessed by Poisson regression by comparing years 2012, 2013, 2014 and 2015, to year 2011. To verify whether changes in schistosomiasis trends over time were due to MDA of praziquantel and not to other potential factors, like environmental factors, a comparison with schistosomiasis trends in districts without MDA (1) and with malaria burden as a disease representing general morbidity in these 11 districts (2) was done.
The number of schistosomiasis cases decreased significantly each year (b2012 = 0.267, P = 0.000; b2013 = 0.356, P = 0.000; b2014 = 0.760, P = 0.000; b2015 = 1.172, P = 0.000) in the 11 districts where MDA was performed. For schistosomiasis trends in districts where MDA was not delivered, there was a non-significant decrease over the time. For malaria, number of cases reported by health facilities via the same health management information, changed significantly, with a steady increase of this disease each year.
Based on the number of confirmed cases reported by health facilities over the period 2011–2015, MDA have shown a significant effect on annual schistosomiasis trends. Hence, data from the health management information system on schistosomiasis, could be used to assess the effect of routine praziquantel administration on morbidity over time, and replace costly annual impact surveys routinely performed in the country. However, further operational research is needed to assess whether schistosomiasis reported by health facilities could still be used to assess impact of MDA in a low disease prevalence context.