Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal.
<h4>Background</h4>Infectious disease risk is driven by three interrelated components: exposure, hazard, and vulnerability. For schistosomiasis, exposure occurs through contact with water, which is often tied to daily activities. Water contact, however, does not imply risk unless the env...
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oai:doaj.org-article:3b063f7864e146c59b46f653f72dbf592021-11-25T06:33:07ZExposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal.1935-27271935-273510.1371/journal.pntd.0009806https://doaj.org/article/3b063f7864e146c59b46f653f72dbf592021-10-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009806https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Infectious disease risk is driven by three interrelated components: exposure, hazard, and vulnerability. For schistosomiasis, exposure occurs through contact with water, which is often tied to daily activities. Water contact, however, does not imply risk unless the environmental hazard of snails and parasites is also present in the water. By increasing reliance on hazardous activities and environments, socio-economic vulnerability can hinder reductions in exposure to a hazard. We aimed to quantify the contributions of exposure, hazard, and vulnerability to the presence and intensity of Schistosoma haematobium re-infection.<h4>Methodology/principal findings</h4>In 13 villages along the Senegal River, we collected parasitological data from 821 school-aged children, survey data from 411 households where those children resided, and ecological data from all 24 village water access sites. We fit mixed-effects logistic and negative binomial regressions with indices of exposure, hazard, and vulnerability as explanatory variables of Schistosoma haematobium presence and intensity, respectively, controlling for demographic variables. Using multi-model inference to calculate the relative importance of each component of risk, we found that hazard (Ʃwi = 0.95) was the most important component of S. haematobium presence, followed by vulnerability (Ʃwi = 0.91). Exposure (Ʃwi = 1.00) was the most important component of S. haematobium intensity, followed by hazard (Ʃwi = 0.77). Model averaging quantified associations between each infection outcome and indices of exposure, hazard, and vulnerability, revealing a positive association between hazard and infection presence (OR = 1.49, 95% CI 1.12, 1.97), and a positive association between exposure and infection intensity (RR 2.59-3.86, depending on the category; all 95% CIs above 1).<h4>Conclusions/significance</h4>Our findings underscore the linkages between social (exposure and vulnerability) and environmental (hazard) processes in the acquisition and accumulation of S. haematobium infection. This approach highlights the importance of implementing both social and environmental interventions to complement mass drug administration.Andrea J LundSusanne H SokolowIsabel J JonesChelsea L WoodSofia AliAndrew ChamberlinAlioune Badara SyM Moustapha SamNicolas JouanardAnne-Marie SchachtSimon SenghorAssane FallRaphael NdioneGilles RiveauGiulio A De LeoDavid López-CarrPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 10, p e0009806 (2021) |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Andrea J Lund Susanne H Sokolow Isabel J Jones Chelsea L Wood Sofia Ali Andrew Chamberlin Alioune Badara Sy M Moustapha Sam Nicolas Jouanard Anne-Marie Schacht Simon Senghor Assane Fall Raphael Ndione Gilles Riveau Giulio A De Leo David López-Carr Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. |
| description |
<h4>Background</h4>Infectious disease risk is driven by three interrelated components: exposure, hazard, and vulnerability. For schistosomiasis, exposure occurs through contact with water, which is often tied to daily activities. Water contact, however, does not imply risk unless the environmental hazard of snails and parasites is also present in the water. By increasing reliance on hazardous activities and environments, socio-economic vulnerability can hinder reductions in exposure to a hazard. We aimed to quantify the contributions of exposure, hazard, and vulnerability to the presence and intensity of Schistosoma haematobium re-infection.<h4>Methodology/principal findings</h4>In 13 villages along the Senegal River, we collected parasitological data from 821 school-aged children, survey data from 411 households where those children resided, and ecological data from all 24 village water access sites. We fit mixed-effects logistic and negative binomial regressions with indices of exposure, hazard, and vulnerability as explanatory variables of Schistosoma haematobium presence and intensity, respectively, controlling for demographic variables. Using multi-model inference to calculate the relative importance of each component of risk, we found that hazard (Ʃwi = 0.95) was the most important component of S. haematobium presence, followed by vulnerability (Ʃwi = 0.91). Exposure (Ʃwi = 1.00) was the most important component of S. haematobium intensity, followed by hazard (Ʃwi = 0.77). Model averaging quantified associations between each infection outcome and indices of exposure, hazard, and vulnerability, revealing a positive association between hazard and infection presence (OR = 1.49, 95% CI 1.12, 1.97), and a positive association between exposure and infection intensity (RR 2.59-3.86, depending on the category; all 95% CIs above 1).<h4>Conclusions/significance</h4>Our findings underscore the linkages between social (exposure and vulnerability) and environmental (hazard) processes in the acquisition and accumulation of S. haematobium infection. This approach highlights the importance of implementing both social and environmental interventions to complement mass drug administration. |
| format |
article |
| author |
Andrea J Lund Susanne H Sokolow Isabel J Jones Chelsea L Wood Sofia Ali Andrew Chamberlin Alioune Badara Sy M Moustapha Sam Nicolas Jouanard Anne-Marie Schacht Simon Senghor Assane Fall Raphael Ndione Gilles Riveau Giulio A De Leo David López-Carr |
| author_facet |
Andrea J Lund Susanne H Sokolow Isabel J Jones Chelsea L Wood Sofia Ali Andrew Chamberlin Alioune Badara Sy M Moustapha Sam Nicolas Jouanard Anne-Marie Schacht Simon Senghor Assane Fall Raphael Ndione Gilles Riveau Giulio A De Leo David López-Carr |
| author_sort |
Andrea J Lund |
| title |
Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. |
| title_short |
Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. |
| title_full |
Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. |
| title_fullStr |
Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. |
| title_full_unstemmed |
Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal. |
| title_sort |
exposure, hazard, and vulnerability all contribute to schistosoma haematobium re-infection in northern senegal. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/3b063f7864e146c59b46f653f72dbf59 |
| work_keys_str_mv |
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| _version_ |
1718413674821976064 |