03365nas a2200373   4500000000100000008004100001653001700042653002400059653001600083653003900099653002800138653001300166653001800179100001100197700001200208700001200220700001400232700001200246700001100258700001600269700001600285700001500301700001800316700001200334700001300346700001500359700001300374245011800387856009800505300001300603490000700616520235400623022001402977       2017                            d10aRisk Factors10aHelminth infections10aSchistosoma10aNeglected tropical diseases (NTDs)10aPreschool-aged children10aTanzania10aDar es Salaam1 aSaid K1 aHella J1 aKnopp S1 aNassoro T1 aShija N1 aAziz F1 aMhimbira FA1 aSchindler C1 aMwingira U1 aMandalakas AM1 aManji K1 aTanner M1 aUtzinger J1 aFenner L00aSchistosoma, other helminth infections, and associated risk factors in preschool-aged children in urban Tanzania.  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006017&type=printable  ae00060170 v113 a<p><strong>BACKGROUND: </strong>Despite the high prevalence of helminth infections among preschool-aged children, control programs in sub-Saharan countries primarily focus on school-aged populations. We assessed the prevalence of helminth infections and determined risk factors for infection among preschool-aged children in the urban setting of Dar es Salaam, Tanzania.</p>

<p><strong>METHODOLOGY: </strong>Starting in October 2015, we conducted a 12-month prospective study among tuberculosis (TB)-exposed children under the age of 5 years and unexposed controls from neighboring households. At the time of recruitment, we collected medical histories, assessed development and cognitive functions, and performed medical examinations. We performed full blood cell counts and screened for HIV and malaria. Point-of-care circulating cathodic antigen (POC-CCA), urine filtration, Kato-Katz, FLOTAC, and Baermann tests were employed to detect helminth infections in urine and stool. Helminth infections were stratified for Schistosoma and other helminths to identify risk factors, using logistic regression.</p>

<p><strong>PRINCIPAL FINDINGS: </strong>We included 310 children with a median age of 26 months (inter quartile range 17-42 month) in the study. Among these, 189 were TB-exposed and 121 TB-unexposed. Two thirds of the children were anemic (hemoglobin level &lt;11 g/dl) and the HIV prevalence was 1.3%. Schistosoma spp. was the predominant helminth species (16.0%; 95% confidence interval [CI] 12.1-20.3%). Other helminth infections were less frequent (9.0%, 95% CI 6.3-12.8%). Poor hygiene, use of household water sources, and TB-exposure were not associated with helminth infection. Development and cognitive scores did not significantly differ in helminth-infected and uninfected peers, but hemoglobin levels were significantly lower in helminth-infected children (10.1 g/dlvs. 10.4 g/dl, p = 0.027).</p>

<p><strong>CONCLUSIONS/SIGNIFICANCE: </strong>In Dar es Salaam, a city with more than 4 million people, the prevalence of Schistosoma spp. infection among preschool-aged children was surprisingly high. Setting-specific interventions that target preschool-aged children and urban settlements should be considered to reduce the transmission of Schistosoma and other helminth infections and to improve children's health.</p>
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