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

• 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

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（通常称为比哈尔西亚）是一种寄生疾病，在全球范围内感染了超过2.4亿人。这些人中有90％居住在撒哈拉以南非洲的贫困农村社区中。该疾病会导致贫血，腹痛，发育迟缓，患者的认知发育降低以及每年多达200,000人死亡。超过6亿人生活在有感染风险的地区。寄生虫血吸虫的卵在人的粪便中排出，在淡水中孵化并感染蜗牛，在那里它们每天可无性繁殖以产生1000秒的幼虫（称为cercariae）。这些cercariae通过直接钻入皮肤并发育成成年蠕虫来感染人类。生命周期是通过开放式排便或不足的人类粪便遏制，使卵能够到达淡水来源，然后通过沐浴，游泳，洗衣服或钓鱼等活动与受感染的水接触。每年在全国范围内对小学生进行药物治疗。但是，尽管乌干达等国家有十多年的国家控制计划，但热点地区的高感染水平仍然存在。仅凭药物治疗将不会减少这些地区的疾病，需要进行其他干预措施。众所周知，改善的卫生设施和清洁安全的水供应可以阻止人们被感染。但是，许多患有这种疾病的领域缺乏改善卫生和资源的资源，此外，当改善卫生设施时，并不总是使用它。我们也不完全了解什么使人们甚至在良好设施的存在下都改变了以水和卫生为目的的行为。因此，该项目旨在更好地了解居住在流行社区的人们如何管理血吸虫病的风险，以及如果提供其他资源，他们如何改变其行为。该项目有两个重叠的部分。在第一部分中，我们将直接与经历许多血吸虫病的社区合作，以确定人们目前如何试图减少自己及其家人感染的风险，以及通过公开排便传递这些感染的风险。我们将使用社会科学方法在乌干达的三个村庄工作，以观察人们的日常生活。我们将分组和单独采访他们对疾病的理解，其影响，它们如何感染以及当前和期望的策略减少整个社区的感染。这些数据将用于建立高风险实践和对疾病风险的看法的图片，以及实践和看法如何因性别，年龄，职业和其他因素而异。第二部分，该信息将纳入家庭调查中，以衡量改变个人行为所需的内容。我们的方法使我们能够量化人们目前对血吸虫病构成的风险做出反应的方式，以及如果对其社区的洗涤，卫生和卫生资源进行投资，他们将如何做出反应。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了解他人行为的了解。我们的发现将帮助我们确定可能减少可能在长期使用的传播和重新感染的投资的“最佳选择”。结果将为未来的研究提供信息，其中这些干预措施在村庄和区域级别进行了尝试。我们计划的工作计划将共同通知我们如何在给定领域最好地控制和消除比哈尔西亚，从而帮助改善受感染社区的儿童的健康。

项目成果

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.

Wicked-Schisto: The wicked public health problem of Schistosomiasis and the interdisciplinary research helping to control it

邪恶的血吸虫病：血吸虫病的邪恶公共卫生问题以及有助于控制它的跨学科研究

• DOI: 10.56367/oag-037-10604
• 发表时间: 2023
• 期刊: Open Access Government
• 作者: Lamberton P

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
• 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