Extending Helminth Control beyond STH and Schistosomiasis: The Case of Human Hymenolepiasis

Similarly to schistosomiasis, a single dose of PZQ eliminates the vast majority of Hymenolepis egg excretion [10–12]. However, it is likely that a PZQ gap exists in many communities being targeted by MDA in that the geographical location of Hymenolepis infections may not necessarily overlap with that of schistosomiasis. Guiding PZQ delivery solely on the basis of the distribution of schistosomiasis may miss communities endemic to Hymenolepis infection also in need of PZQ. This means that the populations at risk of hymenolepiasis may need to also be identified so that PZQ delivery can be extended to those areas. In order to test our proposition, we have analysed data from a parasitic disease survey of 2,168 children aged #15 years, including 1,098 girls and 1,070 boys in the Dande municipality in Northern Angola. Previous analysis of this dataset revealed that children were at significantly increased risk of H. nana infection (prevalence of 6.2% [95% CI: 4.9–7.8%] in preschool children and 7.3% [95% CI: 5.8–9.0%] in school-age children) compared to adults (prevalence of 1.9% [95% CI: 1.1–3.1%]) [13]. Using these data, we aimed to describe the epidemiology of H. nana infection by quantifying the role of individual and household factors and the physical environment (land surface temperature, distance to irrigation canals and rivers) in H. nana infection; quantify the role of H. nana infection on morbidity outcomes such as anaemia, diarrhoea, abdominal pain, and growth; quantify the geographical variation in H. nana infection prevalence in children aged #15 years; generate the first high-resolution H. nana infection map; and compare this map with a preexisting S. haematobium