Publications

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quantification of infection with schistosoma haematobium in relation to epidemiology and selective population chemotherapy. i. minimal number of daily egg counts in urine necessary to establish intensity of infection.the intensity of infection with schistosoma haematobium (worm burden) can be approximated by quantifying the number of parasite eggs excreted in the urine. a new method of egg counting has been developed in which urine samples are passed through transparent nuclepore filters (nuclepore corp., pleasanton, calif.). the method requires no staining, is rapid, and can be performed in the field. it has previously been reported, however, that there is a significant daily fluctuation in output of eggs i ...1978570210
parasitic infections, anaemia and nutritional status: a study of their interrelationships and the effect of prophylaxis and treatment on workers in kwale district, kenya.a study was conducted between january and august 1979 on 150 male roadworkers in kwale district in the coastal lowlands of kenya. at the baseline examination 59% had hookworm (mean of 227 epg +/- 541), 38% had infections of schistosoma haematobium (mean 52 +/- 82 ova per 10 ml urine), 23% had a blood film positive for malarial parasites, 47% had anaemia (hb below 13g/dl), and 31% had a percentage weight for height below 80% of a reference value for healthy men. it was found that anaemia was sign ...19836679363
effect of mass chemotherapy and piped water on numbers of schistosoma haematobium and prevalence in bulinus globosus in kwale, kenya.from june 1982 to may 1986 in a small village in kwale, kenya, we studied seasonal fluctuations in populations of bulinus globosus, prevalence of schistosoma haematobium infection in this snail, and effects of chemotherapy and piped water supply on infection rate of snails. in the perennially-flowing pemba river, relatively small numbers of snails were collected; they were found only during the hot dry season (december to march). in a tributary stream, the kadingo river, whose flow ceased at the ...19883152776
urinary tract morbidity in schistosomiasis haematobia: associations with age and intensity of infection in an endemic area of coast province, kenya.to gain better understanding of the natural history of schistosoma haematobium associated disease, age- and intensity-related urinary tract morbidity were assessed in a cross-sectional study of kilole (population 719) in coast province, kenya. overall prevalence of infection was 65% (39% light, 16% moderate, 9% heavy). infection prevalence and mean intensity of infection were highest in the 5-14-year-old bracket for both sexes. although significant intensity-associated increases in hematuria pre ...19883142286
chemotherapy-based control of schistosomiasis haematobia. i. metrifonate versus praziquantel in control of intensity and prevalence of infection.to determine the effect of targeted field administration of oral chemotherapeutic agents on the prevalence, intensity, and morbidity of schistosoma haematobium infections, we initiated a long-term school-based program in the msambweni area of kwale district, coast province, kenya. prior to treatment, 69% of the children examined (ages 4-21, n = 2,628) were infected; 34% had moderate or heavy infections (greater than 100 eggs/10 ml urine). infected individuals were randomized to receive, during o ...19883140683
efficacy of metrifonate in a highly endemic area of urinary schistosomiasis in kenya.in a community in kwale district, kenya, selective mass chemotherapy with metrifonate caused a marked reduction in the intensity of schistosoma haematobium infection from 46.5 to 9.4 eggs/hr and a sharp fall in prevalence of gross hematuria from 18.3% to 5.1%, although overall prevalence was reduced only slightly from 67.4% to 54%. the effect of metrifonate on cure rate and reduction of infection intensity was limited by both age and pretreatment infection intensity. rate of improvement from gro ...19883124647
effects of borehole wells on water utilization in schistosoma haematobium endemic communities in coast province, kenya.to determine the impact of the introduction of borehole wells on water use patterns and the consequent risk of transmission of schistosoma haematobium in 3 endemic villages in kenya, we performed a survey (a 1:6 sample of affected households) to identify sources of water and types of water utilization before and after well introduction. water usage was also determined in 2 unaffected neighboring villages not given borehole wells, but having continuous access to piped water from communal taps. pr ...19892505626
dose-finding study for praziquantel therapy of schistosoma haematobium in coast province, kenya.to assess the efficacy of low dose praziquantel regimens in comparison with standard 40 mg/kg dosing in the treatment of urinary schistosomiasis, a random allocation dose-finding trial was performed in children and adults from a schistosoma haematobium endemic region in coast province, kenya. following an initial screening, 280 individuals with greater than or equal to 50 eggs/10 ml urine were randomly assigned to receive either 10, 20, 30, or 40 mg/kg of the drug in a single oral dose. two to t ...19892499203
chemotherapy-based control of schistosomiasis haematobia. iv. impact of repeated annual chemotherapy on prevalence and intensity of schistosoma haematobium infection in an endemic area of kenya.to determine the effect of repeated, annual, age-targeted therapy on prevalence and intensity of schistosoma haematobium infection in an endemic area, we treated all available, infected, school-age children (n = 2, 493) in the msambweni area of coast province, kenya with a randomized protocol of oral metrifonate (10 mg/kg for three doses each year) or praziquantel therapy (40 mg/kg as a single dose each year) for a period of one to three years. during 1984-1987, 1, 101 children completed three y ...19911951859
hourly change in cercarial densities of schistosoma haematobium and s. bovis at different depths in the water and distances from the shore of a dam in kwale district, kenya.hourly change in cercarial densities was studied at different depths in the water and distances from the shore at a dam in kwale district (kenya), where schistosoma haematobium is highly endemic, by using a filtration apparatus for detecting cercariae. the peak of cercarial density at the surface of water (2-3 cm deep) was at 11:00 hours. those at the middle point (25 cm deep) and the bottom (50 cm deep) were at 12:00 and 13:00 hours respectively. in the morning, the majority of cercariae (79% o ...19947939159
effect of piped water supply on human water contact patterns in a schistosoma haematobium-endemic area in coast province, kenya.the effect of a piped water supply on human water contact in a schistosoma haematobium-endemic area in coast province, kenya was studied. after the construction of five community standpipes and one shower unit, there was a 35.1% reduction in the number of people observed using river water, a 44.1% reduction in the frequency of contact with river water, and a 25.4% reduction in the amount of contact. the frequency of river water contact per person also decreased significantly, but the amount of c ...19979080867
detection and quantification of soluble egg antigen in urine of schistosoma haematobium-infected children from kenya.while research on alternative diagnostic and morbidity markers for infection with schistosoma haematobium has been going on for a long time, egg counts continue to be used as the gold standard, and infection intensity is thought to reflect the severity of the disease. however, this relationship is not always clear and fluctuation in egg output makes it difficult to classify prevalence correctly. the use of circulating adult worm antigen detection as an alternative diagnostic technique has been a ...19989840595
parameters associated with schistosoma haematobium infection before and after chemotherapy in school children from two villages in the coast province of kenya.we evaluated the impact of praziquantel therapy (40 mg/kg body weight) on indicators of infection with schistosoma haematobium by following a cohort of infected children from schools located 12 km apart in the coast province of kenya, at 0, 2, 4, 6, 12 and 18 months after treatment. within this period, measurements of infection parameters pertaining to egg counts and haematuria (micro-, macro- and history) were evaluated at all time points. the initial prevalence of 100% dropped significantly 8 ...199910402968
predisposition to urinary tract epithelial metaplasia in schistosoma haematobium infection.although there is strong epidemiologic evidence linking schistosoma haematobium infection with carcinoma of the bladder, the utility of cytologic screening for urinary tract cancer has not been critically evaluated in s. haematobium-endemic populations. the present cross-sectional study examined urine cytology findings among 1,014 residents (ages 1 to 91) of the s. haematobium-endemic msambweni area of coast province, kenya. among 705 evaluable cytology specimens, prevalence of inflammation (39% ...200011388504
randomized comparison of low-dose versus standard-dose praziquantel therapy in treatment of urinary tract morbidity due to schistosoma haema tobium infection.at present, anthelmintic therapy with praziquantel at a dose of 40 mg/kg of body weight is the recommended treatment for control of urinary tract morbidity caused by schistosoma haematobium. although this standard regimen is effective, drug cost may represent a significant barrier to implementation of large-scale schistosomiasis control programs in developing areas. previous comparison trials have established that low-dose (20-30 mg/kg) praziquantel regimens can effectively suppress the intensit ...200212224581
distribution patterns and cercarial shedding of bulinus nasutus and other snails in the msambweni area, coast province, kenya.in the msambweni area of the kwale district in kenya, an area endemic for schistosoma haematobium, potential intermediate-host snails were systematically surveyed in water bodies associated with human contact that were previously surveyed in the 1980s. bulinus (africanus) nasutus, which accounted for 67% of the snails collected, was the only snail shedding s. haematobium cercariae. lanistes purpureus was the second most common snail (25%); lower numbers of bulinus forskalii and melanoides tuberc ...200415100463
low heritable component of risk for infection intensity and infection-associated disease in urinary schistosomiasis among wadigo village populations in coast province, kenya.to estimate their heritable component of risk for schistosoma haematobium infection intensity and disease, we performed a community-based family study among an endemic population in coastal kenya. demography and family linkages were defined by house-to-house interviews, and infection prevalence and disease severity were assessed by standard parasitologic testing and by ultrasound. the total population was 4,408 among 912 households, with 241 identified pedigree-household groups. although age- an ...200414971699
late benefits 10-18 years after drug therapy for infection with schistosoma haematobium in kwale district, coast province, kenya.late benefits of remote antischistosomal therapy were estimated among long-term residents of an area with high transmission of schistosoma haematobium (msambweni, kenya) by comparing infection and disease prevalence in two local adult cohorts. we compared 132 formerly treated adults (given treatment in childhood or adolescence > or = 10 years previously) compared with 132 age- and sex-matched adults from the same villages who had not received prior treatment. the prevalence of current infection, ...200516103604
long-term outcomes of school-based treatment for control of urinary schistosomiasis: a review of experience in coast province, kenya.urinary schistosomiasis remains a significant burden for africa and the middle east. the success of population-based control programs will depend on their impact, over many years, on schistosoma haematobium reinfection and associated disease. in a multi-year (1984-1992) control program in kenya, we examined risk for s. haematobium reinfection and late disease during and after annual school-based treatment. in this setting, long-term risk of new infection was independently associated with locatio ...200617308786
factors affecting infection or reinfection with schistosoma haematobium in coastal kenya: survival analysis during a nine-year, school-based treatment program.urinary schistosomiasis remains a significant burden for africa and the middle east. success of regional control strategies will depend, in part, on what influence local environmental and behavioral factors have on individual risk for primary infection and/or reinfection. based on experience in a multi-year (1984-1992), school-based schistosoma haematobium control program in coast province, kenya, we examined risk for infection outcomes as a function of age, sex, pretreatment morbidity, treatmen ...200616837713
assessment of voiding function in inhabitants infected with schistosoma haematobium.voiding function of schistosoma haematobium infected students was evaluated in 45 schoolboys in kwale district, coast province, kenya, using a questionnaire and uroflowmetry. sixty-eight schoolboys who were s. haematobium negative were also examined. symptoms related to the lower urinary tract were qualitatively assessed using the international prostate symptoms score (i-pss) questionnaire. the i-pss showed that s. haematobium infected boys felt the need to strain to urinate and post voiding som ...201020427427
adult population as potential reservoir of ntd infections in rural villages of kwale district, coastal kenya: implications for preventive chemotherapy interventions policy.neglected tropical diseases (ntds) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. as part of a research project started in september 2009 in kwale district, coast region, kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of ntds, including urinary schistosomiasis, soil-transmitted helminthiasis (sth), and lymphatic filariasis. this paper presents the ...201121917166
cross-sectional study of the burden of vector-borne and soil-transmitted polyparasitism in rural communities of coast province, kenya.in coastal kenya, infection of human populations by a variety of parasites often results in co-infection or poly-parasitism. these parasitic infections, separately and in conjunction, are a major cause of chronic clinical and sub-clinical human disease and exert a long-term toll on economic welfare of affected populations. risk factors for these infections are often shared and overlap in space, resulting in interrelated patterns of transmission that need to be considered at different spatial sca ...201425057825
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