Abstract
Schistosomiasis is a parasitic disease affecting more than 250 million people, primarily in sub-Saharan Africa. In Côte d’Ivoire both Schistosoma haematobium (causing urogenital schistosomiasis) and Schistosoma mansoni (causing intestinal schistosomiasis) co-exist. This study aimed to determine the prevalence of S. haematobium and S. mansoni and to identify risk factors among schoolchildren in the western and southern parts of Côte d’Ivoire. From January to April 2018, a cross-sectional study was carried out including 1187 schoolchildren aged 5–14 years. Urine samples were examined by a filtration method to identify and count S. haematobium eggs, while stool samples were subjected to duplicate Kato-Katz thick smears to quantify eggs of S. mansoni and soil-transmitted helminths. Data on sociodemographic, socioeconomic, and environmental factors were obtained using a pretested questionnaire. Multivariate logistic regression was employed to test for associations between variables. We found a prevalence of S. haematobium of 14.0% (166 of 1187 schoolchildren infected) and a prevalence of S. mansoni of 6.1% (66 of 1089 schoolchildren infected). In the southern part of Côte d’Ivoire, the prevalence of S. haematobium was 16.1% with a particularly high prevalence observed in Sikensi (35.6%), while S. mansoni was most prevalent in Agboville (11.2%). Swimming in open freshwater bodies was the main risk factor for S. haematobium infection (adjusted odds ratio (AOR) = 127.0, 95% confidence interval (CI): 25.0–634.0, p < 0.001). Fishing and washing clothes in open freshwater bodies were positively associated with S. haematobium and S. mansoni infection, respectively. Preventive chemotherapy using praziquantel should be combined with setting-specific information, education, and communication strategies in order to change children’s behavior, thus avoiding contact with unprotected open freshwater.
Highlights
Schistosomiasis is a water-based chronic parasitic disease caused by trematode worms of the genus Schistosoma
We found an overall prevalence of 14.0% for S. haematobium and 6.1% for S. mansoni, which classify our study settings as moderate and low endemic areas, respectively, for urogenital schistosomiasis and intestinal schistosomiasis, according to World Health Organization (WHO) guidelines [23]
The low prevalence rate of S. haematobium and S. mansoni infections reported in our study is most likely the result of preventive chemotherapy campaigns pursued on an annual basis since several years by the PNLMTN-CP in Côte d’Ivoire[25]
Summary
Schistosomiasis is a water-based chronic parasitic disease caused by trematode worms of the genus Schistosoma. Humans are the definitive host for adult parasites, while specific freshwater snails act as intermediate hosts [3,4]. The transmission of schistosomiasis is governed by social-ecological systems (e.g., conditions of poverty and living near open freshwater bodies) [5]. Schistosome cercariae penetrate the unbroken skin of humans during domestic (e.g., washing clothes or dishes) and recreational activities (e.g., bathing and swimming in unprotected open freshwater bodies). Various factors have been shown to facilitate transmission of schistosomiasis in Africa, such as living in close proximity to freshwater bodies (e.g., rivers, small dams, irrigation schemes, and lakes), socioeconomic factors which influence occupational activities (e.g., poor people without running water at home are likely to contact freshwater bodies) and climate change [6,7,8]. The lack of access to improved sanitation contributes to open defecation, which results in environmental contamination that enhances the transmission of schistosomiasis [9]
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