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Epidemiology, serology and chemotherapy of schistosoma mansoni infections ina recently exposed community near Richard Toll, Senegal

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This project, an extension of an addendum to a STD2-project, is part of a collaborative effort ("ESPOIR") to study ànd control a recent outbreak of schistosomiasis mansoni in the Richard Toll area in Northern Senegal. The projected study would take place mainly in Ndombo, a village of 4,000 near Richard Toll, where preliminary studies have indicated a prevalence of 95%, egg counts of uP to 36,000 epg, well-circumscribed transmission sites, and a well organized and motivated community. The objectives of the project are 1. to study infection and re-infection patterns,as related to transmission patterns, and humoral immune responses in this non-immune Population, in order to test hypotheses concerning the role of acquired immunity in human schistosomiasis; 2. to use and evaluate to that end antigen detection assays in serum and urine besides classical parasitological methods; 3. to develop optimal strategies for community-based chemotherapy as a short-term strategy for morbidity control in this and other epidemic foci; 4. to provide baseline data for, and contribute to other immunological, epidemiological and intervention studies in this area as well as to the development of an appropriate, integrated control programme. The research protocol will consist of the follow-up of parasitological (faecal egg counts) and serological (circulating antigens in serum and urine, isotype-specific antibodies) parameters of infection in two cohorts, each consisting of randomly chosen 400 subjects, before and 2 Weeks, 8 weeks, 6 months, 1 Year and 2 Years afterchemotherapy with praziquantel 40 mg/kg. The two respective study groups will be treated and followed-up With an interval of 6 months, in order to study seasonal variations in reinfection, and to allow adaptations of the protocol for the second group in function of questions raised by results in the first group e.g. with respect to the efficacy of the standard drug regimen in the absence of immunity. Over the follow-up period, snail populations and infection rates, and individual and group-specific water Contact patterns Will be closely monitored. on the basis:of the results of the study, an optimal chemotherapeutic strategy Will be developed and implemented in the community in the 2d or 3d Year of the project. A third population sample Will at that moment be examined and its epidemiological,immunological and morbidity profile compared to those in the first two groups.

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LEIDEN UNIVERSITY
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