Fig 1.
A-B. Mean (± 95% confidence interval) intensity of infection (eggs/10ml urine) amongst individuals from different age-groups at baseline and Year 5, pooled across treatment arms but within islands for Pemba (a) and Unguja (b). In Pemba, the baseline data includes 53 children aged 6–8, 31 children aged 9–12 and 26 adults aged 13–75, and the Year 5 data includes 102 children aged 9–12 and 12 adults aged 20–30. Unguja’s baseline data consists of 32 children aged 7–8, 57 children aged 9–12 and 18 adults aged 20–54. Unguja’s Year 5 data includes 44 children aged 9–12 and 13 adults aged 20–46.
Fig 2.
A-B. Mean (±95% confidence intervals) estimated number of Schistosoma haematobium female worms per host for (a) Pemba and (b) Unguja by treatment arm; where Pemba MDA arm n = 41 baseline, n = 22 year 5; Snail arm n = 40 baseline, n = 55 year 5; Behaviour arm n = 29 baseline, n = 37 Year 5; and where Unjuga MDA arm n = 20 baseline, n = 18 year 5; Snail arm n = 46 baseline; n = 8 year 5; Behaviour arm n = 43 baseline, n = 31 Year 5.
Fig 3.
A-B. Inferred mean (±95% confidence interval) fecundity (number of eggs per 10ml urine per Schistosoma haematobium female worm) in (a) Pemba and (b) Unguja by treatment arm and year; where Pemba MDA arm n = 41 baseline, n = 22 year 5; Snail arm n = 40 baseline, n = 55 year 5; Behaviour arm n = 29 baseline, n = 37 Year 5; and where Unjuga MDA arm n = 20 baseline, n = 18 year 5; Snail arm n = 46 baseline; n = 8 year 5; Behaviour arm n = 43 baseline, n = 31 Year 5.
Fig 4.
A-B. Mean fecundity of schistosomes (eggs per 10ml urine per female worm) within each shehia at Year 1 baseline (a) and Year 5 follow up (b) estimated using a mixed effects model with shehias as random effects. On the x-axis, shehias labelled in brown (bold) correspond to persistent hotspots defined by definition (b) where the infection prevalence was ≥ 15% in 9–12 year-old schoolchildren in at least one of the three cross-sectional parasitological surveys conducted in primary schools in 2012, 2013 and 2014 [36]. Shehias labelled in black (bold) correspond to hotspots defined by both definition (b) and definition (a) (i.e., category (c) hotspots, see Material and Methods, Persistent hotspots) where prevalence had not declined by at least 20% of its starting prevalence between baseline and Year 5 amongst the matched 9–12-year-old age group. (Error bars not included for visual clarity and because, as a mixed effects model was used, few efficient methodologies to incorporate uncertainty into random effects parameters are available).
Fig 5.
A–D. Mean fecundity of schistosomes (eggs per Schistosoma haematobium female worm) and location of each shehia in 2012 Year 1 baseline (a and b) and 2016 Year 5 follow up (c and d), in Pemba (a) and (c) and Unguja (b) and (d). Shehias labelled in brown correspond to persistent hotspots by definition (b) and shehias labelled in black correspond to hotspots given the definitions (a) and (b) (see Material and Methods, Persistent hotspots for definitions). Note that, whilst the colour schemes are the same in both figures, the scales are different between different years, as fecundity ranged from 6.5–62 in Year 1 and 4–17 in Year 5). The maps were created in RStudio, using the tmap package: https://data.humdata.org/m/dataset/451bdd28-d06d-46ea-91c0-2e081f884395?force_layout=light No changes were made. The License for these data can be found at: https://data.humdata.org/m/dataset/451bdd28-d06d-46ea-91c0-2e081f884395?force_layout=light and are freely-available under the CC BY-IGO license.
Fig 6.
A-D. Population structure by island and persistent hotspot status using Principal Component Analysis (PCA) where each point represents an individual miracidium. Each miracidia MLG was assigned as either being from island and/or hotspots versus non-hotspots populations from baseline using the definitions as above. Scale represented as Euclidean distance, d = 0.5. Inertia ellipses indicate the distribution of the individuals from different groups (island or hotspot status). 6b –Unguja hotspot definition A. 6c –Unguja hotspot definition B. 6d –Pemba hotspot definition A. 6e –Pemba hotspot definition B.