Risk factors for schistosoma haematobium infection among school pupils in areas receiving annual mass treatment with praziquantel in Morogoro region, Tanzania

Abstract

Introduction

There is a gap in the area of linking prevalence of Schictosoma haematobium infection, praziquantel benefits and associated risk factors together with behavior of the primary school pupils that expose them to infection. This has led to an increase in the urban transmission of S. haematobium causing urinary schistosomiasis; therefore, data from urban settings was needed to help in formulating and evaluating control policies and strategies.

Objective

This study aimed at determining the prevalence and intensity of S. haematobium infection among primary school children and associated risk factors in an area with annual administration of praziquantel in Morogoro municipality.

Methods

A cross sectional, stage wise random sampling survey of S. haematobium infection, factors influencing its transmission and praziquantel intake were studied among primary school pupils in Morogoro Municipality. A semi-structured questionnaire was used and urine from each pupil was collected in a plastic container and examined under a light microscope. Results were analyzed using SPSS version 12.0.

Results

The overall prevalence was 35.2% based on microscopic examination of urine sample. The proportion of students that did receive Praziquantel in the last general distribution was found to be 14.3% while 25.8% of the students had low infection intensity and 9.3% had high infection intensity. The contributing risk factors included playing in water, bathing in rivers, fishing in rivers and helping parents work in rice fields, were all found to be statistically significant (p -value<O.OOl) associated with S. haematobium infection.

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Conclusion

The prevalence and intensity is high enough to cause re-infection. Still more effort is needed to enforce mass praziquantel administration among primary school pupils, alternative water sources for recreational activities, provision of proper latrines and further studies needed to explore the risk factors.

Recommendations

More effort should be directed at Morogoro municipal to restore the faith of community in mass administration of praziquantel. The factors that do put these children at risk, also needs to be further assessed and explored and more data needed so as to draw a reasonable conclusion that reflects the true population of the primary school children of Morogoro municipal. Pupils should also be instructed to correct personal habits which are conducive to infection and practice good personal hygiene can be an effective and safe substitute for repeated de-worming, reducing the opportunity for the emergence of drug-resistance, which should prolong the time anti-helminthic drugs such as praziquantel may be used for treatment of urinary schistosomiasis In addition, complementary integrated control activities, such as environmental management measures, should be planned with other sectors such as agriculture and water resource development programs. It is also important to ensure that any development activity likely to favor the emergence or spread of schistosomiasis and other parasitic diseases is preceded by a proper health impact assessment and accompanied by preventive measures to limit their impact