Prevalence and Risk Factors for Urinary Schistososmiasis Among School Children in Uwandani Shehia, Pemba, Zanzibar - Tanzania

Résumé

Abstract Despite repeated rounds of mass drug administratiion (MDA) of praziquantel, Uwandani Shehia in Pemba, Zanzibar-Tanzani, remains a hotspot of transmission of Schistosoma haematobium. This study was designed to determine the prevalence and risk-factors of urinary schistosomiasis among school children in Uwandani. We adopted a mixed methods approach. Data were collected using a structured questionnaire, and the filtration technique was used to detect S. haematobium eggs in 10 ml of urine from 300 school children. We also conducted 30 in-depth interviews with parents and teachers, 4 focus group discussions with adult community members, and 8 group discussions with the students between May & June 2017. The S. haematobium infection prevalence was 11%. Schistosoma haematobium infection prevalence was significantly higher in the age group 13-15 years, compared to the younger age groups. About 67.0% of the school children infected with S. haematobium had the light intensity infection, shedding fewer than or equal to 50 eggs per 10 ml of urine, while the heavy intensity of infection (>50 eggs/10 ml) was found in 33 % of infected primary school children. Results of ANOVA revealed significant differences in praziquantel uptake by age-group. There was low community knowledge of S. haematobium risk factors, high engagement in risky behavior and high awareness of S. haematobium infection symptoms. Although uptake of praziquantel is high, this did not translate to a lowering of S. haematobium infection prevalence among school children. Frequency of contact with open water sources – an important risk factor for S. haematobium infection is high in the study population. We conclude that barriers to health behavior change continue to exist, and the prevalence of urinary schistosomiasis appears to be increasing among school aged children in Uwandani Shehia, Pemba, Zanzibar-Tanzania. We suggest combining MDA praziquantel uptake programs with affordable snail control interventions for reducing urinary schistosomiasis prevalence.

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