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Cultural, social and economic influences on ongoing Schistosoma mansoni transmission, despite a decade of mass treatment, and the potential for change

尽管进行了十年的大规模治疗，但文化、社会和经济对曼氏血吸虫传播的影响以及改变的潜力

基本信息

批准号：
MR/P025447/1
负责人：
Poppy Lamberton
金额：
$ 46.4万
依托单位：
University of Glasgow
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2017
资助国家：
英国
起止时间：
2017 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FP025447%2F1
关键词：
Cultural social economic influences ongoing

项目摘要

Schistosomiasis, commonly known as Bilharzia, is a parasitic disease which infects over 240 million people worldwide. Over 90% of these people live in poor rural communities in sub-Saharan Africa. The disease causes anaemia, abdominal pain, stunted growth and reduced cognitive development in children, and up to 200,000 deaths per year. Over 600 million people live in areas where they are at risk of infection. The eggs of the parasite Schistosoma mansoni, are excreted in human stool, hatch in fresh water and infect snails, where they reproduce asexually to produce 1000s of larvae (called cercariae) per day. These cercariae infect humans by directly burrowing through the skin, and developing into adult worms. The life-cycle is maintained by open defecation, or inadequate containment of human faeces, enabling eggs to reach fresh water sources, followed by contact with infected water through activities such as bathing, swimming, washing clothes or fishing.Current control focuses on drug treatments given annually on a national scale to school children. However, despite over a decade of national control programmes in countries such as Uganda, high infection levels persist in hotspot areas. Drug treatment alone will not reduce the disease in these areas and additional interventions are needed. It is known that improved sanitation and access to clean safe water supplies can stop people from getting infected. However, many areas with the disease lack money and resources to improve sanitation and furthermore, when sanitation is improved, it is not always used. We do not fully understand what makes people alter water and sanitation focused behaviours even in the presence of good facilities.Therefore, the project aims to understand better how people living in endemic communities manage their risk of schistosomiasis and how they might change their behaviour if additional resources were provided.This project has two overlapping parts. In part one, we will work directly with communities who experience a lot of schistosomiasis to establish how people currently try to reduce the risk of infection for themselves and their families as well as the risk of passing those infections on through open defecation. We will work in three villages in Uganda using social science methods to observe people going about their everyday life. We will interview them in groups and individually about their understanding of the disease, its effects, how they get infected and their current and desired strategies for reducing infections in the whole community. These data will be used to build up a picture of high and low risk practices and perceptions of disease risk, and how practices and perceptions vary by gender, age, occupation and other factors.In the second part, this information will be incorporated into household surveys to measure what is needed to change an individual's behaviour. Our methodologies allow us to quantify the ways in which people currently respond to the risks posed by schistosomiasis, and how they might respond if investments in washing, sanitation and hygiene resources in their communities were made. We will also use these models to show how human behaviour is influenced by an understanding of the lifecycle of the parasite, and by knowledge of other people's behaviour.Our findings will help us identify "best bets" for investments likely to reduce transmission and re-infection which are likely to work in the long-term. Results will inform future research studies, where these interventions are tried out at village and regional levels. Together the programme of work we plan will inform us on how best to control and potentially eliminate bilharzia in given areas, helping to improve the health of children in infected communities.

血吸虫病，通常称为血吸虫病，是一种寄生虫病，感染全球超过2.4亿人。其中90%以上的人生活在撒哈拉以南非洲的贫困农村社区。这种疾病导致儿童贫血、腹痛、生长发育迟缓和认知发育下降，每年造成多达20万人死亡。超过6亿人生活在他们有感染风险的地区。寄生虫曼氏血吸虫的卵在人类粪便中排泄，在淡水中孵化并感染蜗牛，在那里它们无性繁殖，每天产生1000个幼虫（称为尾蚴）。这些尾蚴通过直接穿透皮肤并发育成蠕虫来感染人类。通过露天排便或对人类粪便的不适当控制，使虫卵能够到达淡水来源，然后通过洗澡、游泳、洗衣服或钓鱼等活动接触受感染的水，维持生命周期，目前的控制重点是每年在全国范围内对在校儿童进行药物治疗。然而，尽管乌干达等国实施了十多年的国家控制方案，但热点地区的感染率仍然很高。单靠药物治疗不能减少这些地区的疾病，需要采取额外的干预措施。众所周知，改善卫生条件和获得清洁安全的水供应可以防止人们受到感染。然而，许多有这种疾病的地区缺乏资金和资源来改善卫生设施，而且，即使卫生设施得到改善，也不总是得到利用。我们并不完全了解是什么使人们即使在有良好设施的情况下也改变以水和卫生设施为重点的行为。因此，该项目旨在更好地了解生活在流行社区的人们如何管理他们的血吸虫病风险，以及如果提供额外资源，他们如何改变他们的行为。在第一部分中，我们将直接与经历了大量血吸虫病的社区合作，以确定人们目前如何努力降低自己和家人的感染风险，以及通过露天排便传播这些感染的风险。我们将在乌干达的三个村庄工作，使用社会科学方法观察人们的日常生活。我们将以小组和个人的方式采访他们，了解他们对疾病的理解，其影响，他们如何感染以及他们目前和希望采取的减少整个社区感染的战略。这些数据将用于建立高风险和低风险做法以及对疾病风险的看法的图景，以及这些做法和看法如何因性别、年龄、职业和其他因素而有所不同，在第二部分，这些信息将被纳入住户调查，以衡量改变个人行为所需的措施。我们的方法使我们能够量化人们目前应对血吸虫病带来的风险的方式，以及如果对社区的洗涤，环境卫生和个人卫生资源进行投资，他们可能会如何应对。我们还将使用这些模型来展示人类行为如何受到对寄生虫生命周期的理解以及对其他人行为的了解的影响。我们的发现将帮助我们确定可能减少传播和再感染的投资的“最佳选择”，这些投资可能会长期有效。研究结果将为今后的研究提供信息，在这些研究中，这些干预措施将在村庄和地区一级试行。我们计划的工作方案将使我们了解如何在特定地区最好地控制和可能消除血吸虫病，帮助改善受感染社区儿童的健康。

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Schistosomiasis Control: Leave No Age Group Behind.

DOI：
10.1016/j.pt.2020.04.012
发表时间：
2020-07
期刊：
Trends in parasitology
影响因子：
9.6
作者：
Faust CL;Osakunor DNM;Downs JA;Kayuni S;Stothard JR;Lamberton PHL;Reinhard-Rupp J;Rollinson D
通讯作者：
Rollinson D

ABO Blood Groups Do Not Predict Schistosoma mansoni Infection Profiles in Highly Endemic Villages of Uganda.

DOI：
10.3390/microorganisms9122448
发表时间：
2021-11-27
期刊：
Microorganisms
影响因子：
4.5
作者：
Francoeur R;Atuhaire A;Arinaitwe M;Adriko M;Ajambo D;Nankasi A;Babayan SA;Lamberton PHL
通讯作者：
Lamberton PHL

A Call for Systems Epidemiology to Tackle the Complexity of Schistosomiasis, Its Control, and Its Elimination

DOI：
10.3390/tropicalmed4010021
发表时间：
2019-03-01
期刊：
TROPICAL MEDICINE AND INFECTIOUS DISEASE
影响因子：
2.9
作者：
Krauth, Stefanie J.;Balen, Julie;Lamberton, Poppy H. L.
通讯作者：
Lamberton, Poppy H. L.

Translating From Egg- to Antigen-Based Indicators for Schistosoma mansoni Elimination Targets: A Bayesian Latent Class Analysis Study.

DOI：
10.3389/fitd.2022.825721
发表时间：
2022-02-18
期刊：
Frontiers in tropical diseases
影响因子：
0
作者：
Clark J;Moses A;Nankasi A;Faust CL;Adriko M;Ajambo D;Besigye F;Atuhaire A;Wamboko A;Rowel C;Carruthers LV;Francoeur R;Tukahebwa EM;Lamberton PHL;Prada JM
通讯作者：
Prada JM