Abstract
BackgroundIntestinal schistosomiasis continues to be a significant cause of morbidity among communities located around Lake Victoria and on its islands. Although epidemiological surveys have been conducted in other areas bordering the lake in western Kenya, Mbita district and its adjacent islands have never been surveyed, largely due to logistical challenges in accessing these areas. Consequently, there is a paucity of data on prevalence of schistosomiasis and soil-transmitted helminth (STH) infections that are endemic in this region.MethodsThis cross-sectional study determined the prevalence, intensity of infection and geographical distribution of schistosome and STH infections among 4,065 children aged 5–19 years in 84 primary schools in Mbita and nearby islands of Lake Victoria (Mfangano, Ringiti, Rusinga and Takawiri), in western Kenya. Single stool samples were collected and examined for eggs of Schistosoma mansoni and STHs (Hookworms, Ascaris lumbricoides and Trichuris trichiura) using the Kato-Katz technique. Primary schools were mapped using geographical information system data on PDAs and prevalence maps generated using ArcView GIS software.ResultsOverall, 65.6% (95% CI = 64.2-67.1%) of children were infected with one or more helminth species; 12.4% (95% CI = 11.4-13.4%) of children were infected with one or more STH species. Mean school prevalence of S. mansoni infection was 60.5% (95% CI = 59.0-62.0%), hookworms 8.4% (95% CI = 7.6-9.3%), A. lumbricoides 3.3% (95% CI = 2.7-3.8%), and T. trichiura 1.6% (95% CI = 1.2-2.0%). Interestingly, the mean S. mansoni prevalence was 2-fold higher on the islands (82%) compared to the mainland (41%) (z = 5.8755, P < 0.0001). Similarly, intensity of infection was 54% higher on the islands (217.2 ± 99.3) compared to the mainland (141.3 ± 123.7) (z = 3.9374, P < 0.0001). Schools in closest proximity to Lake Victoria had the highest S. mansoni prevalence while prevalence of STHs was more homogenously distributed.ConclusionsThe very high prevalence of schistosomiasis in Mbita and the 4 islands is quite alarming, and indicates an urgent and critical need for control interventions. Findings from this survey indicate the need to implement treatment in remote areas not previously covered by mass drug administration programs.
Highlights
Intestinal schistosomiasis continues to be a significant cause of morbidity among communities located around Lake Victoria and on its islands
Communities around the shores of Lake Victoria in western Kenya are populated with individuals who suffer significant morbidities associated with Schistosoma mansoni infection [1,2], this despite the availability of effective and safe drugs, and the fact that mass treatment of school-aged children is hailed as a cornerstone of schistosomiasis and soil-transmitted helminth (STH) control activities [3,4]
The situation is further exacerbated in remote areas and Islands on Lake Victoria that have perennially received few health interventions, due in part to logistical challenges in accessing these areas
Summary
Intestinal schistosomiasis continues to be a significant cause of morbidity among communities located around Lake Victoria and on its islands. Communities around the shores of Lake Victoria in western Kenya are populated with individuals who suffer significant morbidities associated with Schistosoma mansoni infection [1,2], this despite the availability of effective and safe drugs, and the fact that mass treatment of school-aged children is hailed as a cornerstone of schistosomiasis and soil-transmitted helminth (STH) control activities [3,4]. The situation is further exacerbated in remote areas and Islands on Lake Victoria that have perennially received few health interventions, due in part to logistical challenges in accessing these areas Such rural areas are usually underserved and marginalized, and their voices are not heard sufficiently to firmly establish theneed for interventions targeting schistosomiasis and STHs within the national political agenda [5]. Molecular studies around Lake Victoria have revealed higher genetic diversity of S. mansoni [8,9], with the potential to modify the clinical pattern and morbidity among infected individuals
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