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Reviews of "Current Schistosoma Mansoni Exposure and Infection have Distinct Determinants: A Data-driven Population-Based Study in Rural Uganda"

Reviewers: R Spear (UC Berkeley ) | 📘📘📘📘📘 • L Espira (University of Michigan) | 📘📘📘📘📘

Published onJun 04, 2024
Reviews of "Current Schistosoma Mansoni Exposure and Infection have Distinct Determinants: A Data-driven Population-Based Study in Rural Uganda"
key-enterThis Pub is a Review of
Current Schistosoma mansoni exposure and infection have distinct determinants: a data-driven population-based study in rural Uganda
Current Schistosoma mansoni exposure and infection have distinct determinants: a data-driven population-based study in rural Uganda
Description

Abstract Exposure to parasitic flatworms causing schistosomiasis is a complex set of human-environment interactions. Yet, exposure often is equated to current infection. Here we studied risk factors and population patterns of exposure (water contact) within the SchistoTrack Cohort for 2867 individuals aged 5-90 years in Eastern and Western Uganda. Households within 0.34 km of waterbodies accounted for 80% of all water contact. We found a 15-year gap between population-level peak in water contact (age 30) and infection (age 15) with practically no correlation (ρ=0.03) of individual-level water contact and current infection. Bayesian selection for 30 biosocial variables was used to separately predict water contact and current infection. Water contact was positively associated with older age, female gender, fishing occupation, lack of site contamination, unsafe village drinking water, number of sites and type (beach/pond), lower village-level infection prevalence, and fewer village roads. Among these variables, only older age and fishing were positively, though inconsistently associated with infection status/intensity. Water, sanitation, and hygiene influenced water contact but not infection. Our findings highlight that exposure was highly focal and at-risk groups for exposure and infection were different. Precision mapping and targeted treatment/interventions directly focused on exposure are needed to save medicines and reduce transmission.

To read the original manuscript, click the link above.

Summary of Reviews: The reviewers commend the study for its comprehensive analysis of water contact and Schistosoma mansoni infection in rural Uganda but express concerns about using the term "exposure" to refer to water contact rather than contact with cercariae, the actual infectious agents. They highlight that assessing water contact alone is inadequate for determining infection risk without considering the presence of cercariae or infected snails. The reviewers appreciate the study's rich dataset and thorough methodology, noting that risk factors for water contact and infection are distinct. A reviewer suggests exploring findings like reduced water contact in contaminated areas, while both emphasize the importance of these insights for informing targeted public health interventions and policies.

Reviewer 1 (Robert S…) | 📘📘📘📘📘

Reviewer 2 (Leon E…) | 📘📘📘📘📘

RR:C19 Strength of Evidence Scale Key

📕 ◻️◻️◻️◻️ = Misleading

📙📙 ◻️◻️◻️ = Not Informative

📒📒📒 ◻️◻️ = Potentially Informative

📗📗📗📗◻️ = Reliable

📘📘📘📘📘 = Strong

To read the reviews, click the links below. 

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