Clinical morbidity associated with Schistosoma haematobium infection in pre-school age children from an endemic district in Zimbabwe.

Abstract

To investigate Schistosoma haematobium morbidity in infected pre-school age children and establish their disease burden. Pre-school age children (1-5years) who were lifelong residents of the study area and had no other infections were included in the study. Participants underwent a physical examination with clinicians blinded to their infection status. Diagnosis of S. haematobium was by urine filtration. The prevalence of S. haematobium was 35.1% (146/416). The clinical features observed in patients with Schistosoma haematobium were as follows: wheezes (morbidity attributable factor (AF=93.9%), haematuria (AF=92.6%), ascites (AF=91.5%), atopy (AF=76.9%), inguinal lymphadenopathy (AF=68.4%), stunting (AF=38.2), malnutrition (MUAC)(AF=20%) and weight for height scales (AF=5%). Schistosoma. haematobium infected children were at greater odds ratio of presenting with inguinal lymphadenopathy (AOR)=99.2(95% CI 24.2 to 854.5), wheezes in the chest (AOR=35.4 95% CI 15.3 to 94.2), Distended abdomen with ascites (AOR=23.9 95% CI 11.4 to 54), haematuria (AOR=12.6 95% CI 11.6 to 14.1), atopy history (AOR=5.6 95% CI 1.85 to 20.2), malnutrition (AOR=2.3 95% CI 1.4 to 3.2) and stunting (AOR=1.9 95% CI 1.1 to2.7). The study is novel as it demonstrates for the first time clinical morbidity markers associated with S. haematobium infection in pre-school age children. Furthermore the study adds scientific evidence to the call for inclusion of pre-school age children in schistosomiasis control programmes. These morbidity markers highlight the need for early diagnosis and screening for S. haematobium in pre-school age children.