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Although schistosomiasis burden is greatest among school-age children (SAC) (6–15 years of age), infection among preschool-age children (PSAC) (1–5 years), may be underestimated in endemic areas. We conducted a cross-sectional study evaluating Schistosoma mansoni infection among children 1–15 years of age in a highly endemic community in Kenya. Diagnostic tests included stool exam (Kato/Katz technique), serum testing for schistosome-specific antibodies, and urine testing for circulating cathodic antigen (CCA). Overall, 268 SAC and 216 PSAC were enrolled; prevalence increased with age, with 14% of 1 year olds and more than 90% of children > 10 years of age infected. Stool exam was more sensitive among SAC than PSAC, but performance was similar after adjusting for infection intensity (based on CCA). Schistosomiasis poses a threat to PSAC in endemic areas, and stool exam may underestimate the prevalence of infection. Control programs in such areas should consider PSAC in addition to SAC.
Disclosure: This work is published with the permission of the Director, Kenya Medical Research Institute.
Authors' addresses: Jennifer R. Verani, Susan P. Montgomery, Sara E. Butler, and W. Evan Secor, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: QZR7@cdc.gov, ZQU6@cdc.gov, CSU8@cdc.gov, and WAS4@cdc.gov. Bernard Abudho, Pauline N. M. Mwinzi, and Diana M. S. Karanja, Kenya Medical Research Institute, Kisumu, Kenya, E-mails: firstname.lastname@example.org, PMwinzi@ke.cdc.gov, and DKaranja@ke.cdc.gov. Hillary L. Shane, Department of Cellular Biology, University of Georgia, Athens, GA, E-mail: email@example.com.