Assessment of prevalence and associated factors for urinary schistosomiasis among primary school going children in Mpongwe district,Zambia

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Sakubita, Patrick
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The University of Zambia
Schistosomiasis, also known as bilharziasis is a disease that results from infection with parasitic trematode worms of the genus Schistosoma. Schistosomiasis is acquired when free-swimming parasitic larvae known as cercariae penetrate the skin of people exposed to infested freshwater. The disease impedes school attendance and leads to absenteeism, ill-health and weak memory, poor performance and productivity, disability and death. In tropics and sub-tropics, human and water contacts can be potential risk factors of schistosomiasis. Domestic activities such as washing clothes and fetching water in infected water expose women and children to infection. In Zambia, urinary schistosomiasis caused by the trematode Schistosoma haematobium has been a major public health problem for many years. We conducted this study to investigate the prevalence of schistosomiasis among school going children and associated factors for contracting urinary schistosomiasis in Mpongwe district. We used a multi-stage cluster sampling method to select study participants. The first stage involved selection of schools, at second stage selection of classrooms and the third stage consisted of simple random sampling for selection of respondents from the various classes. Probability proportion sampling to size was applied in assigning appropriate numbers of pupils that constituted the sample size. Data were collected using structured questionnaires on electronic tablets. A questionnaire was administered to all selected pupils providing a urine sample to collect information on the sex, age, water contact activities, symptoms of urinary schistosomiasis, knowledge about the disease, and past praziquantel treatment. We collected urine samples to analyse for presence of schistosome eggs to determine prevalence and geographical distribution of the disease. Schistosomiasis risk factors were assessed by Fisher’s exact test to compare categorical variables. The level of significance was set at 95% and all p-values less than 0.05 were considered statistically significant. We interviewed a total of 390 (100%) pupils between the ages of 5-14years from 15 schools of which 206 (52.8%) were female and 184 (47.2%) were male. The median age for the study participants was 12 years (IQR 7, 14) and all the four positive cases were males accounting for 1% prevalence rate. Of the four positive male case-patients, two (50%) reported previous history of suffering from schistosomiasis atleast once prior to the current infection. The majority of the pupils, 330 (85.5%) reported taking preventive chemotherapy for Schistosomiasis during the mass drug administration conducted in May 2017 with a therapeutic coverage of 83%. Our study found that urinary schistosomiasis prevalence rate was currently at 1%. We found that previous history of schistosomiasis was associated with acquiring new infections. Mass drug administration may have contributed to the decreased prevalence rate. We recommend strengthened community health education to target the at-risk age groups, regular screening of children and the community in order to facilitate early access and linkage to health services. Active disease surveillance for schistosomiasis is also recommended for prompt detection of outbreaks. We also recommend that future studies should employ different study designs at different times of the year. Key words: Schistosomiasis, Mpongwe, Prevalence, Risk factors, Primary School Children
Schistosomiasis--Prevalence , Schistosomiasis--Prevalence--Risk factors , Schistosomiasis-- Primary school children