Abstract
BackgroundIn schistosomiasis control programmes using mass chemotherapy, epidemiological and morbidity aspects of the disease need to be studied so as to monitor the impact of treatment, and make recommendations accordingly. These aspects were examined in the community of Musoli village along Lake Victoria in Mayuge district, highly endemic for Schistosoma mansoni infection.Methodology and Principal FindingsA cross sectional descriptive study was undertaken in a randomly selected sample of 217 females and 229 males, with a mean age of 26 years (SD ±16, range 7–76 years). The prevalence of S. mansoni was 88.6% (95% CI: 85.6–91.5). The geometric mean intensity (GMI) of S. mansoni was 236.2 (95% CI: 198.5–460.9) eggs per gram (epg) faeces. Males had significantly higher GMI (370.2 epg) than females (132.6 epg) and age was also significantly associated with intensity of infection. Levels of water contact activities significantly influenced intensity of infection and the highest intensity of infection was found among people involved in fishing. However, organomegaly was not significantly associated with S. mansoni except for very heavy infection (>2000 epg). Liver image patterns C and D indicative of fibrosis were found in only 2.2% and 0.2%, respectively. S. mansoni intensity of infection was associated with portal vein dilation and abnormal spleen length. Anaemia was observed in 36.4% of the participants but it was not associated with S. mansoni infection intensity. Considering growth in children as one of the morbidity indicators of schistosomiasis, intensity of S. mansoni was significantly associated with stunting.ConclusionAlthough organ-related morbidity, with the exception of periportal fibrosis, and S. mansoni infections were highly prevalent, the two were only associated for individuals with very high infection intensities. These results contrast starkly with reports from Ugandan Lake Albert fishing communities in which periportal fibrosis is more prevalent.
Highlights
In Uganda, schistosomiasis is mainly caused by Schistosoma mansoni [1] and affects more than 10% of the population [2,3]
Hepatosplenic schistosomiasis is common in children and adolescents and may affect up to 80% of the infected individuals [6,9] and in the Kenyan study it was exacerbated by malaria otherwise, its severity is related to the intensity of infection [11] and duration of exposure to contaminated water [8]
We report on the epidemiology of S. mansoni infection and related morbidity in a community in Mayuge District along Lake Victoria in Uganda
Summary
In Uganda, schistosomiasis is mainly caused by Schistosoma mansoni [1] and affects more than 10% of the population [2,3]. It is one of the Neglected Tropical Diseases (NTDs) which perpetuate poverty. In schistosomiasis control programmes using mass chemotherapy, epidemiological and morbidity aspects of the disease need to be studied so as to monitor the impact of treatment, and make recommendations . These aspects were examined in the community of Musoli village along Lake Victoria in Mayuge district, highly endemic for Schistosoma mansoni infection
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