Designing new and inclusive diagnostic tools to detect Neglected Tropical Diseases (NTDs) to achieve rational disease control requires a co-design process where end-users’ input is important. Failure to involve all potential end-users in new diagnostics for NTDs can result in low use and adoption failure, leading to persistent infection hot spots and ineffective disease control. There are different categories of potential end-users of new diagnostic tools for NTD control, and it is unclear if there are differences between the user efficiency, effectiveness, perception, and acceptability across these end-user categories. This study evaluated the usability, user perception, contextual factors affecting the user’s experience, and acceptability of a new digital optical diagnostic device for NTDs across three types of potential end users. A total of 21 participants were tested. Laboratory scientists, technicians, and Community Health Extension Workers (CHEWs) in training achieved similar scores on the usability and user perception questionnaires with no statistically significant difference between end-user categories. All participants also have high scores for the user perception domains which strongly correlate with the acceptability of the AiDx NTDx Assist device. This study indicates that, by providing digital diagnostic tools in combination with minimal training and support, CHEWs undergoing training and, by extension, CHEWs post-training, can be involved in the diagnoses of NTDs, potentially enhancing a community’s capabilities to diagnose, treat, and control NTDs.

Background: Schistosomiasis (SCH) and soil transmitted helminthiasis (STH) have been targeted for elimination as a public health problem (EPHP) within the World Health Organization (WHO)’s Roadmap for Neglected Tropical Diseases (NTDs) 2021–2030. One of the global strategies for the control and elimination of these diseases is the mass administration of praziquantel and albendazole/mebendazole without prior individual diagnosis. To measure the progress towards the 2030 target, we conducted an assessment to determine the impact of the 3–5 rounds of annual mass drug administration among school age children in Ekiti State. Such scientific insights into the impact of these treatments will facilitate improved planning and targeting of resources towards reaching the last mile. Methodology: This assessment was conducted in 16 local government areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in 166 primary and junior secondary schools across 166 wards of the State. Urine and stool samples were collected from 7670 pupils of ages 5 to 14 years, following standard laboratory procedures. Urine membrane filtration techniques were used for urine preparation while the Kato–Katz technique was used for stool preparation. A novel AiDx digital microscope was used to examine the presence of any ova in the prepared specimen. Parasite ova in urine were reported as the number of ova/10 mL of urine, and were categorized as light infection (˂50 ova/10 mL of urine) or heavy infection (>50 ova/10 mL of urine) while ova of parasites in stool samples were reported as eggs per gram of stool (EPG) and categorized into light, moderate and heavy infection. Results: Overall, 0.76% (0.56–0.95) at 95% CI of the 7670 respondents were infected with Schistosomia haematobium. No Schistosoma mansoni infection was recorded in the study. Similarly, 3.9% (3.43–4.29) at 95% CI were infected with STHs. The overall prevalence of schistosomiasis had significantly reduced from 8.2% in 2008 to 0.8%, while the overall prevalence of STHs significantly reduced from 30.9% to 3.9% with Ascaris lumbricoides being the dominant species of STH. In the 16 LGAs assessed, Ekiti West had the highest S. haematobium prevalence of 4.26%. Ise/Orun and Oye ranked second and third with a prevalence of 3.48% and 2.40% respectively, while all other LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45% while Emure and Ikole Local Governments had the lowest prevalence of 0.31% and 0.38%, respectively. There was no significant difference in the prevalence of schistosomiasis between male (0.76%) and female (0.75%) as p ≥ 0.05. Similarly, the difference in prevalence for STH among males (3.95%) was not significantly different from their female counterparts (3.77%), p ≥ 0.05. Conclusions: Based on the WHO guidelines, this study demonstrated that only three LGAs require continued MDA every 2/3 years, seven require only surveillance while six are now non-endemic for schistosomiasis. Similarly, two of the LGAs require one round of MDA yearly, eight LGAs need one round of MDA every two to three years and six LGAs are now below the treatment threshold and no longer require treatment for STH.

One of the strategies for the control and elimination of schistosomiasis is the control of its snail vectors in an endemic area, as is done in other tropical diseases like malaria. However, the strategy currently practiced for the control of the disease in Nigeria is the annual mass administration of preventive chemotherapy (Praziquantel) among school-age children while neglecting the control of its snail intermediate host and other control components. The neglect of malacology and vector control will slow the elimination targets and timeline of 2030 set by the WHO. In this study, we investigated the abundance and seasonal variations in the snail vectors of schistosomiasis and the relationship between the disease among humans and infected snail vectors. A total of 21,282 snails were collected from 13 sites across the six area councils of the Federal Capital Territory (FCT). Of the collected snails, 1451 (6.8%) belong to three species: Biomphelaria pfeifferi (0.5%), Bulinus truncatus (2.1%) and Bulinus globosus (4.2%), which are known to be vectors of Schistosoma mansoni, Schistosoma haematobium and Schistosoma bovis, respectively. These three species were all shedding cercariae both at the time of collection and afterwards, when they were induced to shed cercariae. The association between the reported prevalence of the disease and the percentage of snails shedding cercaria were heterogenous across different communities. While Takushara, with a disease prevalence of 46%, had 60% of the cercaria shedding snails, Kwaita sabo pukafa and Guduji, with disease prevalences of 56% and 26% respectively, had no cercaria shedding snails. Similarly, Dagiri rafin shahu and Gwako 1, with disease prevalences of 60% and 38%, had cercaria shedding snails of less than 1%. Nonetheless, the presence of Bulinus and Biomphelaria species in these communities indicates a potential risk of infection for humans and other animals who may come in contact with the water. Consequently, integrated multisectoral control and elimination measures that combine malacological monitoring with behavioral, environmental, and historical epidemiological assessments with a deliberate health orientation of the people through sensitization and health education is advocated to reduce exposure to the disease risk factors and contribute towards elimination of the disease.

Background: Granular assessment of Schistosomiasis (SCH) and soil-transmitted helminthiasis (STHs) in a population with instituted treatment programs is a critical step in understanding the progress of control programs towards the 2030 elimination targets. Such scientific insight into the impact of recurrent rounds of mass treatment with Praziquantel and Albendazole/Mebendazole should facilitate improved planning and targeting of resources. Methodology: This schistosomiasis and STHs granular assessment was conducted in 16 Local Government Areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in166 primary and junior secondary schools across 166 wards/communities. Urine and stool samples were collected from 7670 pupils between 5 and 14 years, comprising 3823 (49.8%) males and 3847 (50.1%) females. When aggregated at individual LGA, the highest number of participants (658 children) was recorded in Ado Ekiti LGA. Emure recorded the lowest number of participants with 320 children across 9 out of 10 wards in the LGA. The result of this granular assessment was compared to the 2008 and 2015 baseline prevalence of each LGA to assess the level of reduction in both prevalence and intensity. Results: Overall, 58 (0.76%) out of 7670 pupils were infected with Schistosomia haematobium. No Schistosoma mansoni infection was recorded in any of the 7670 analyzed samples. Two hundred and ninety-six (3.86%) of the examined samples were infected with STHs. In the 16 LGAs assessed, Ekiti West had the highest S. haematobium prevalence of 4.26%. Ise/Orun and Oye ranked 2nd and 3rd with a prevalence of 3.48% & 2.40% respectively. There were no reported infection of S. haematobium in Efon, Ekiti-East, Ekiti South-west, Ido/Osi & Moba, LGAs while a further 7 LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45%. Gbonyin & Ise/Orun had the prevalence of 9.62% & 8.9% respectively, making them 2nd and 3rd in ranking accordingly. Emure, Ikole and Irepodun Local Governments had the lowest prevalence of 0.31%, 0.38% & 1.01% respectively. Conclusion: There was a sharp decline in the prevalence of S. haematobium & STHs in the State across the 16 LGAs as compared to the baseline prevalence obtained from the Federal Ministry of Health NTD program. Our assessment demonstrates that only 3 LGAs require continued MDA every 2/3 years based on the WHO guidelines, while 6 are now non-endemic and 7 require only surveillance. The prevalence of STHs has significantly reduced across the 16 LGAs. Comparative analysis of the computed and baseline prevalence shows that 6 LGAs are not endemic according to WHO guidelines. Two of the assessed LGAs require one round of MDA yearly and 8 LGAs need one round of MDA every two to three years.

Schistosomiasis remains a major public health concern in Nigeria. We molecularly characterized Schistosoma eggs obtained from human urine to identify species and assess the presence of hybrid schistosomes in Abuja, Nigeria. Urine samples were collected from 1887 participants aged five years and above. Samples were examined for Schistosoma eggs using light microscopy. A total of 507 (26.9%) were positive for any form of Schistosoma while 91 (4.8%) had atypical Schistosoma eggs. DNA extracted from pooled ova was analyzed using metagenomic sequencing, read mapping, phylogenetic analysis, and BLASTn confirmation. Molecular analyses identified genetic signatures associated with both S. haematobium and S. bovis within pooled human urine samples, indicating the co-circulation of multiple schistosome species in the study area. Phylogenetic analyses based on trans-ITS and mitochondrial COX1 markers supported the presence of distinct nuclear and mitochondrial schistosome lineages. However, because sequencing was performed on pooled egg samples, the findings cannot distinguish between true recombinants and mixed infections involving co-circulating parental species. These findings highlight the potential complexity of schistosome transmission dynamics in endemic communities and underscore the need for enhanced molecular surveillance, especially single-parasite genomic approaches, and integrated One Health investigations to better understand schistosome transmission and its implications for control and elimination efforts in Nigeria.

Schistosomiasis remains a major public health concern in Nigeria. We molecularly characterized Schistosoma eggs obtained from human urine to identify species and assess the presence of hybrid schistosomes in Abuja, Nigeria. Urine samples were collected from 1,887 participants aged five years and above. Samples were examined for Schistosoma eggs using light microscopy. A total of 507 (26.9%) were positive for any form of Schistosoma while 91 (4.8%) had atypical Schistosoma eggs. DNA extracted from pooled ova was analyzed using metagenomic sequencing, read mapping, phylogenetic analysis, and BLASTn confirmation. Molecular analyses identified genetic signatures associated with both S. haematobium and S. bovis within pooled human urine samples, indicating the co-circulation of multiple schistosome species in the study area. Phylogenetic analyses based on trans-ITS and mitochondrial COX1 markers supported the presence of distinct nuclear and mitochondrial schistosome lineages. However, because sequencing was performed on pooled egg samples, the findings cannot distinguish between true recombinants and mixed infections involving co-circulating parental species. These findings highlight the potential complexity of schistosome transmission dynamics in endemic communities and underscore the need for enhanced molecular surveillance especially single-parasite genomic approaches, and integrated One Health investigations to better understand schistosome transmission and its implications for control and elimination efforts in Nigeria.