Abstract
BackgroundIncreased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity, and risk factors associated with the occurrence of UGS.MethodsIn this cross-sectional survey, 12 communities were purposively selected from four health areas (HAs) (Likomba, Holforth, Holforth-Likomba, and Mutengene) in South West Region of Cameroon between June and August 2018. Consenting individuals were enrolled using a convenient sampling technique and administered a semi-structured questionnaire to document information on socio-demographic and water contact behaviour. Urine samples were examined for Schistosomahaematobium infection using test strip, filtration, and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection.ResultsThe overall prevalence of UGS in Likomba, Holforth-Likomba and Holforth was 31.5% [95% confidence interval (CI): 28.3–34.8] with geometric mean (GM) egg count of 28.7 (range: 2–450) eggs per 10 ml of urine. S.haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (P < 0.001) among the affected communities, ranging from 12.0 to 56.9%. Infection status of the community related positively (P < 0.001) with proximity to stream (< 100 m), the degree of contact with water and number of improved water sources. Younger age group (5–14 years) [adjusted odds ratio (aOR): 3.7, 95% CI: 1.1–12.2] and intense water contact (degree II) (aOR: 5.2, 95% CI: 3.4–8.1) were associated with increased risk of infection. Similarly, significantly higher egg load was observed among younger aged groups (P = 0.02) and those who carried out intense water contact activities (P < 0.001).ConclusionsGenerally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50.0% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area.Graphic abstract
Highlights
Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon
Despite high access (84.5%) to improved water facilities, more than half of the population reported the use of stream water (Table 1)
The current study reports on the distribution of S. haematobium infection in Tiko Health District (THD) and an unmapped transmission focus in the Mount Cameroon area [24]
Summary
Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomia‐ sis (UGS), to assess the distribution, intensity, and risk factors associated with the occurrence of UGS. Schistosomiasis is the third highest burden among the neglected tropical diseases (NTDs) and is endemic in 78 countries worldwide, where an estimated 800 million people are at risk of the disease [1]. The current mainstay of schistosomiasis control is preventive chemotherapy—the periodic administration of praziquantel to at-risk groups (e.g., school-age children). While this strategy does not prevent infection or reinfection, it reduces morbidity and might impact on transmission [11]. Schistosomiasis can be prevented by avoiding contact with contaminated freshwater, and the risk of infection can be reduced through improved access to water, sanitation, and hygiene (WASH), information, education, and communication (IEC) [12]
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