Abstract
Schistosomiasis is a neglected tropical disease (NTD) found throughout tropical and subtropical Africa. In Madagascar, the condition is widespread and endemic in 74% of all administrative districts in the country. Despite the significant burden of the disease, high-resolution risk maps have yet to be produced to guide national control programs. This study used an ecological niche modeling (ENM) and precision mapping approach to estimate environmental suitability and disease transmission risk. The results show that suitability for schistosomiasis is widespread and covers 264,781 km2 (102,232 sq miles). Covariates of significance to the model were the accessibility to cities, distance to water, enhanced vegetation index (EVI), annual mean temperature, land surface temperature (LST), clay content, and annual precipitation. Disease transmission risk is greatest in the central highlands, tropical east coast, arid-southwest, and northwest. An estimated 14.9 million people could be at risk of schistosomiasis; 11.4 million reside in rural areas, while 3.5 million are in urban areas. This study provides valuable insight into the geography of schistosomiasis in Madagascar and its potential risk to human populations. Because of the focal nature of the disease, these maps can inform national surveillance programs while improving understanding of areas in need of medical interventions.
Highlights
Schistosomiasis is an acute and chronic parasitic infection caused by trematodes of the genus Schistosoma [1]
Environmental suitability is concentrated throughout Sofia, Boeny, Bongolava, Itasy, Analamanga, Betsiboka, Alaotra-Mangoro, Atsinanana, Vakinankaratra, Amoron’I mania, Vatovavy Fitovinany, Haute Matsiatra, Menabe, Atsimo–Andrefana, Ihorombe, Anosy, Androy, and Atsimo-Atsinana
The disease transmission risk to human populations is significant within the central highland region, humid tropical eastern coast, dry-arid southwest, northwest, and to a lesser extent, the north and east
Summary
Schistosomiasis is an acute and chronic parasitic infection caused by trematodes of the genus Schistosoma [1]. The disease is widespread throughout sub-Saharan Africa (SSA), where an estimated 800 million people are at risk of infection [1,2]. Schistosomiasis is estimated to account for between 200,000 and 535,000 deaths in SSA alone [1,3]. Children are especially at risk of the disease when swimming or playing in infected water [7,8]. After Malaria, schistosomiasis is ranked as the second most devastating parasitic disease in terms of its socioeconomic impact on people [7]. Like many neglected tropical diseases (NTDs), schistosomiasis is associated with regions of high poverty and poor sanitation [9,10]
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