Prevalence and factors associated with schistosomiasis among primary school children in Buhigwe District Tanzania

Abstract

ABSTRACT Introduction: Schistosomiasis remains one of the most prevalent neglected tropical diseases among school children. School-based Mass Drug Administration with Praziquantel and Albendazole has been implemented annually in Buhigwe district Tanzania since 2012. However, there has been no survey conducted in this district to determine the current prevalence of this disease which has a high re-infection rate in endemic areas. This study was conducted to provide information on the prevalence and intensity of Schistosomiasis and factors associated with its transmission in the area after scale-up of school-based Mass Drug Administration.

Method: A cross-sectional study was conducted among 421 school children from Buhigwe district in Kigoma region. School children were interviewed using a structured questionnaire. Fecal samples were examined for the presence of Schistosoma mansoni eggs using the Kato-Katz method while the urine samples were examined using the filtration technique for the presence of Schistosoma hematobium eggs. Multivariate logistic regression adjusted for age and sex was used to estimate the odds ratio for factors associated with transmission.

Results: Out of 421 pupils enrolled, 406 pupils provided urine and stool specimens with a response rate of 96.4%. The prevalence of S. mansoni was 33.3% while S. hematobium infection was not detected in all urine samples examined. The prevalence of S. mansoni was significantly higher among children in the age group 6-10 years 40.10% (95% C.I 35.30% - 51.70%, p<0.01) compared to the prevalence of 26.79% (95% C.I 22.00-33.20) among those in the age group of 11-17 years. Children of standard one to three were having a higher prevalence of 39.41% (95% C.I 33.2-47.00, p=0.02) compared to the prevalence of 27.09% (95% C.I; 20.70-33.10) of those of standard four to seven. An intensity level status was created among those positive (n=135) following WHO guideline with 71.0%, 9.6% and 19.3% for light, moderate and heavy infections intensity respectively. Four variables were significantly independent risk factors for S. mansoni transmission among school children such as age (AOR=2.46; 95% C.I 1.62-3.74), crossing the river with bare feet (AOR = 1.98; 95% C.I; 1.26-3.12), swimming in rivers (AOR = 1.64; 95% CI; 1.02-2.81), and fishing (AOR 2.82 95% C.I. 1.59-4.97).

Conclusion: Prevalence of S. mansoni is high among school children in Buhigwe district despite the school based MDA conducted one year before the study. This study recommends all schools to provide health education about Schistosomiasis. The parents should prohibit their children to contact with river water to reduce the transmission of this disease.