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Am. J. Trop. Med. Hyg., 75(6), 2006, pp. 1034-1041
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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SPATIAL AND TEMPORAL VARIATIONS IN LOCAL TRANSMISSION OF SCHISTOSOMA HAEMATOBIUM IN MSAMBWENI, KENYA

JULIE A. CLENNON*, PETER L. MUNGAI, ERIC M. MUCHIRI, CHARLES H. KING, AND URIEL KITRON
Department of Pathobiology, University of Illinois, Urbana, Illinois; Division of Vector Borne Diseases, Ministry of Health, Nairobi, Kenya; Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio

As part of an extensive study of the eco-epidemiology of urinary schistosomiasis along the southern coast of Kenya, spatial and temporal transmission patterns were associated with various ponds infested with Bulinus snails. The household-level spatial pattern of infection for children of various age groups in 2000 was contrasted with historical data from 1984. Significant local clustering of high and low infection levels among school age children was detected, and the spatial extent of clusters and their direction from specific water sources were measured. High infection levels were clustered around ponds known to contain Bulinus nasutus snails that shed Schistosoma haematobium cercariae, and low infection levels were concentrated near a river where intermediate host snails were rarely found. The spatial patterns of infection varied between 2000 and 1984 and between age groups. High levels of infection were clustered around different transmission foci in the two study periods, and, for younger children in 2000, were clustered nearer to the transmission foci than for the older children. Simultaneous consideration of the effects of different foci on transmission will allow for targeted application of control measures aimed at interrupting S. haematobium transmission at a local level.

Received February 8, 2006. Accepted for publication August 21, 2006.

Acknowledgments: We thank the residents of Nganja, Milalani, Vidungeni, Maragiza, Mabatani, Sawa Sawa, Bomani, Mwaembe, Kisimachande, Vingujini and Vidungeni villages in Msambweni Division, Kwale District, Kenya for their involvement in this study. We also thank Idi Masemo, Anthony Chome, Joyce Bongo, Robinson Ireri, and Jackson Muinde for helping locate households, and Anna Schot-thoefer and Gonzalo Vazquez-Prokopec for helpful discussions. The directional Gi(d) was developed in a collaborative effort with Gonzalo Vazquez-Prokopec. Publication of this paper is done with the kind permission of the Director of Medical Services, Ministry of Health, Kenya. This research was conducted in partial fulfillment of Ph.D. degree requirements by Julie A. Clennon.

Financial support: This research was supported by the National Institutes of Health/National Science Foundation Ecology of Infectious Disease program grant (AI45473) and by the Fogarty International Center grant (TW/ES01543) to Charles H. King. Additional support for this study was provided by TerraSeer Inc., (Ann Arbor, MI) through a graduate student research award to Julie A. Clennon.

* Address correspondence to Julie A. Clennon, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205. E-mail: jclennon{at}jhsph.edu

Authors’ addresses: Julie A. Clennon, Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, E-mail: jclennon{at}jhsph.edu. Peter L. Mungai, c/o Case Western Reserve University/Division of Vector-Borne Diseases/Kenya Medical Research Institute Filariasis-Schistosomiasis Research Unit, PO Box 8, Msambweni, Kenya, Telephone: 254-40-52267, E-mail: dvbdcwru{at}wananchi.com. Eric M. Muchiri, Division of Vector Borne Diseases, Ministry of Health, PO Box 20750, Nairobi, Kenya, Telephone: 254-20-725833, Fax: 254-20-720030, E-mail: schisto{at}wananchi.com. Charles H. King, Center for Global Health and Diseases, W137, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106-4983, Telephone: 216-368-4818, Fax: 216-368-4825, E-mail: chk{at}po.cwru.edu. Uriel Kitron, Division of Epidemiology and Preventive Medicine, Department of Pathobiology, University of Illinois, 2001 South Lincoln Avenue, Urbana, IL 61802, Telephone: 217-265-0714, Fax: 217-244-7421, E-mail: ukitrom{at}uiuc.edu.

Reprint requests: Uriel Kitron, Division of Epidemiology and Preventive Medicine, Department of Pathobiology, University of Illinois, 2001 South Lincoln Avenue, Urbana, IL 61802.






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