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Title: Exposure, hazard, and vulnerability all contribute to Schistosoma haematobium re-infection in northern Senegal
Background 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. Methodology/Principal findings 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 (Ʃw i = 0.95) was the most important component of S . haematobium presence, followed by vulnerability (Ʃw i = 0.91). Exposure (Ʃw i = 1.00) was the most important component of S . haematobium intensity, followed by hazard (Ʃw i = 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) Conclusions/Significance 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.  more » « less
Award ID(s):
2011179 2024383 2022321
NSF-PAR ID:
10344571
Author(s) / Creator(s):
; ; ; ; ; ; ; ; ; ; ; ; ; ; ;
Editor(s):
Lamberton, Poppy H.
Date Published:
Journal Name:
PLOS Neglected Tropical Diseases
Volume:
15
Issue:
10
ISSN:
1935-2735
Page Range / eLocation ID:
e0009806
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
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