Prevalence and Treatment Outcome of Schistosomiasis in Preschool-aged Children; A Systematic Review and Meta-analysis

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Addis Abeba University


Background: Schistosomiasis is a parasitic disease caused by worms of the genus Schistosoma. Almost 85% of infected individuals live in Africa. Infection among preschool-aged children (1-5 years) in endemic areas was underestimated and is currently excluded from preventive chemotherapy because of limited data on safety and efficacy, and partly due to a common thought that schistosomiasis is not common in preschool-aged children (PSAC). Objective: The aim of this study was to review evidences regarding the prevalence of schistosomiasis and its treatment outcome among preschool aged children. Methods: PRISMA guideline was followed during the conduct and reporting of this systematic review and meta-analysis. A comprehensive search was carried out from PubMed, Cochrane library, Google scholar and HINARI for studies published till April 2020. Extracted data in preliminary table from papers selected for full-text review and passed eligibility criteria. Quality assessment was based on Hoy 2012 tool using 10 criteria addressing internal and external validity. Random-effects model was used to pool measures of effects and to construct 95% confidence interval (CI) around the pooled effect sizes. In addition, subgroup analysis was conducted to improve the outcome. Results: 38 studies were eligible for final systematic review and meta-analysis. Among the total of 19592 children’s participated 18,509 examined and 5,143 were found to be infected with one or more species of schistosomiasis yielding an overall prevalence of 27.7% (95% CI: 22.833.5%). And the result shows there is significant variability between studies (Heterogeneity I =98.252 with Chi-square =2002.59, DF 35 and a P-value < 0.001). The result of meta regression showed diagnosis method used and study year had contributed significantly to the heterogeneity study results. Regarding treatment outcome, the overall CR was 88.9% (95% CI: 83.5-92.7%) and ERR 97.3% (95% CI: 95.4-98.5%). The result of meta regression showed diagnosis method used and study year had contributed significantly to the heterogeneity of study results. Conclusion: this systematic review and meta-analysis showed there was a moderate prevalence of schistosomiasis and also good treatment outcome of praziquantel in preschool-aged children; indicating to review strategies to consider these age groups in mass drug administration deworming programs until proper formulation accessible. 2



Prevalence, Schistosomiasis, Treatment outcome, Preschool-aged children