Impact of community piped water coverage on re-infection with urogenital schistosomiasis in rural South Africa
- African Health Research Institute, South Africa
- University of KwaZulu-Natal, South Africa
- University of Cincinnati, United States
Abstract
Previously, we demonstrated that high coverage of piped water in the seven years preceding a parasitological survey was strongly predictive of Schistosomiasis haematobium infection in a nested cohort of 1,976 primary school children [1]. Here, we report on the prospective follow up of infected members of this nested cohort (N=333) for two successive rounds following treatment. Using a negative binomial regression fitted to egg count data, we found that every percentage point increase in piped water coverage was associated with 4.4% decline in intensity of re-infection (incidence rate ratio = 0.96, 95%CI: 0.93-0.98, P= 0.002) among the treated children. We therefore provide further compelling evidence in support of the scaleup of piped water as an effective control strategy against Schistosomiasis haematobium transmission.
Data availability
Data that support the findings presented in this manuscript are available from the African Health Research data repository upon request and agreeing to AHRI's terms and conditions for use. The datasets used here include homestead-level coordinates as an essential component and these data are personally identifiable. Request to access the data can be made through the AHRI's institutional website (https://www.ahri.org/research/#research-department) and by email to AHRI's data department (ITservicedesk@ahri.org).
Article and author information
Author details
Funding
National Institutes of Health
- Christopher Appleton
- Frank Tanser
Wellcome
- Frank Tanser
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: Ethical approval was provided by the Biomedical Research Ethics Committee of the university of KwaZulu-Natal (reference #E165/05). Written informed consent was sought from parents or guardians of the participating children for both rounds of follow-up in 2007 and 2008 and assent obtained from the children during the follow-up surveys.
Copyright
© 2020, Mogeni et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Impact of community piped water coverage on re-infection with urogenital schistosomiasis in rural South Africa
eLife 9:e54012.
https://doi.org/10.7554/eLife.54012
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Background:
In many settings, a large fraction of the population has both been vaccinated against and infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, quantifying the protection provided by post-infection vaccination has become critical for policy. We aimed to estimate the protective effect against SARS-CoV-2 reinfection of an additional vaccine dose after an initial Omicron variant infection.
Methods:
We report a retrospective, population-based cohort study performed in Shanghai, China, using electronic databases with information on SARS-CoV-2 infections and vaccination history. We compared reinfection incidence by post-infection vaccination status in individuals initially infected during the April–May 2022 Omicron variant surge in Shanghai and who had been vaccinated before that period. Cox models were fit to estimate adjusted hazard ratios (aHRs).
Results:
275,896 individuals were diagnosed with real-time polymerase chain reaction-confirmed SARS-CoV-2 infection in April–May 2022; 199,312/275,896 were included in analyses on the effect of a post-infection vaccine dose. Post-infection vaccination provided protection against reinfection (aHR 0.82; 95% confidence interval 0.79–0.85). For patients who had received one, two, or three vaccine doses before their first infection, hazard ratios for the post-infection vaccination effect were 0.84 (0.76–0.93), 0.87 (0.83–0.90), and 0.96 (0.74–1.23), respectively. Post-infection vaccination within 30 and 90 days before the second Omicron wave provided different degrees of protection (in aHR): 0.51 (0.44–0.58) and 0.67 (0.61–0.74), respectively. Moreover, for all vaccine types, but to different extents, a post-infection dose given to individuals who were fully vaccinated before first infection was protective.
Conclusions:
In previously vaccinated and infected individuals, an additional vaccine dose provided protection against Omicron variant reinfection. These observations will inform future policy decisions on COVID-19 vaccination in China and other countries.
Funding:
This study was funded the Key Discipline Program of Pudong New Area Health System (PWZxk2022-25), the Development and Application of Intelligent Epidemic Surveillance and AI Analysis System (21002411400), the Shanghai Public Health System Construction (GWVI-11.2-XD08), the Shanghai Health Commission Key Disciplines (GWVI-11.1-02), the Shanghai Health Commission Clinical Research Program (20214Y0020), the Shanghai Natural Science Foundation (22ZR1414600), and the Shanghai Young Health Talents Program (2022YQ076).
