Community-level prevalence and determinants of Schistosoma mansoni infection in river-crossing Kebeles of Mizan-Aman Town, Southwest Ethiopia, where mass drug administration targets only school-aged children

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INTRODUCTION: Schistosomiasis remains a major neglected tropical disease, particularly in sub-Saharan Africa, where Schistosoma mansoni (S. mansoni) causes intestinal schistosomiasis through contact with cercariae-infested freshwater. In Ethiopia, control relies mainly on school-based mass drug administration (MDA) targeting school-aged children (SAC), while adults and other at-risk groups are often untreated. This study assessed the community-level prevalence and determinants of S. mansoni infection in Mizan-Aman Town following implementation of SAC-focused MDA. METHODS: A community-based cross-sectional study was conducted from October 2021 to February 2022 in Mizan-Aman Town. A total of 349 participants from selected households were enrolled using systematic sampling. Socio-demographic and risk factor data were collected through interviewer-administered questionnaires. Stool samples (~5 g) were collected and examined using duplicate Kato-Katz thick smears (41.7 mg template). Bivariate and multivariable logistic regression analyses were performed to identify associated factors, with significance set at p < 0.05. RESULTS: The prevalence of S. mansoni infection was 23.2% (95% CI: 18.9-28.0). Poly parasitism was observed in 12.3% of participants and the overall intestinal parasitic infection prevalence was 50.7%. Moreover, use of river water for domestic purposes (AOR = 5.86, 95% CI: 2.90-11.83), bathing in rivers (AOR = 2.98, 95% CI: 1.32-6.73), swimming in rivers (AOR = 2.62, 95% CI: 1.28-5.34), and farmland proximity to rivers (AOR = 2.28, 95% CI: 1.10-4.75) were statistically significant predictors. Age and sex were not significantly associated with infection. CONCLUSION: The current study revealed a moderate prevalence of S. mansoni, suggesting that untreated community members may serve as reservoirs of infection for SAC and indicating ongoing transmission despite school-based MDA. Therefore, expanding treatment to include adults, together with improved water, sanitation, and hygiene interventions and continuous epidemiological surveillance, is essential for sustainable reduction of transmission.

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