Impact of Praziquantel Distribution on the Epidemiology of Paragonimiasis Among School-Aged Children: A Cross Sectional Study in the Most Endemic Focus in Cameroon

BackgroundParagonimiasis is a parasitic disease affecting humans and other mammals, caused by infestation with lung flukes of the genus Paragonimus. The peri-urban area of Kumba is co-endemic for paragonimiasis and schistosomiasis. The National Schistosomiasis and Soil-Transmitted Helminthiasis Control Program distributes praziquantel annually for schistosomiasis control. The primary objective of this study was to describe the shellfish cooking habits among schoolchildren and to assess the impact of praziquantel mass distribution on the paragonimiasis burden in the most endemic focus in Cameroon. MethodsWe carried out a cross-sectional descriptive study from November 2013 to March 2014. Pupils of five government primary schools in five villages around Kumba underwent both clinical and parasitological investigations in search of signs and symptoms of paragonimiasis. The Chi square and Fisher exact tests were used to compared proportions. p-values<0.05 were considered statistically significant. ResultsWe recruited 175 children, comprising 96 females and 79 males, with a sex ratio (F/M) of 1.2. Their ages ranged from 5 to 15 years, with a mean age of 10 {+/-} 3.74 years. The age group 6-10 years was the most represented. All participants reported consuming crabs. The prevalence of paragonimiasis among the school children was 0.57% (95% CI: 0.0143%-3.143%). This result was statistically significantly lower than that of the last study conducted ten years prior, which used the same diagnostic method in this area (12.3%). Slightly more than half of the students (58.9%) reported preparing their crabs by boiling, and two-thirds (69%) estimated the cooking time to be more than 30 minutes. More than two-thirds (78%) of the children who estimated the cooking time to be more than 30 minutes consumed shrimp with their family. Pulmonary symptoms were the most common, with cough being the most prevalent. Notably, we did not register any cases of hemoptysis. Coinfections were also found in the population studied. ConclusionsThe prevalence of paragonimiasis has decreased in this focus, known to be the most endemic for this disease in Cameroon. This is due to the large distribution of praziquantel in this area and probably to changes from unhealthy cooking habits to healthier ones.