Abstract
BackgroundRecent evidence indicates that pre-school children (PSC) living in S. mansoni highly endemic areas are at similar risk of schistosomiasis infection and morbidity as their school aged siblings. Recognizing this fact, the World Health Organization (WHO) is considering including this age group in highly endemic areas in control programmes using mass drug administration (MDA). However, detailed epidemiological information on S. mansoni infection among PSC is lacking for many endemic areas, specifically in Tanzania. This study was conducted to determine the prevalence of S. mansoni infection and its associated risk factors among PSC in Ukerewe Island, North-Western Tanzania.MethodsThis was a cross-sectional study, which studied 400 PSC aged 1–6 years. The Kato-Katz (K-K) technique and the point of care circulating cathodic antigen (CCA) immunodiagnostic test were used to diagnose S. mansoni infection in stool and urine samples respectively. A pre-tested questionnaire was used to collect demographic data and water contact behaviour of the children from their parents/guardians.ResultsBased on the K-K technique, 44.4 % (95 % CI: 39.4–49.4) pre-school children were infected with S. mansoni and the overall geometric mean eggs per gram of faeces (GM-epg) was 110.6 epg with 38.2 and 14.7 % having moderate and heavy intensity infections respectively. Based on the CCA, 80.1 %, (95 % CI: 76.0–84.0) were infected if a trace was considered positive, and 45.9 %, (95 % CI: 40.9–50.9), were infected if a trace was considered negative. Reported history of lake visits (AOR = 2.31, 95 % CI: 1.06–5.01, P < 0.03) and the proximity to the lake shore (<500 m) (AOR = 2.09, 95 % CI: 1.05–4.14, P < 0.03) were significantly associated with S. mansoni infection. Reported lake visit frequency (4–7 days/week) was associated with heavy intensities of S. mansoni infection (P < 0.00).ConclusionThe prevalence of S. mansoni infection in the study population using K-K and CCA-trace-negative was moderate. The frequency of lake visits and the proximity to the lake shore were associated with the infection of S. mansoni and its intensity. These findings call for the need to include the PSC in MDA programmes, public health education and provision of safe water for bathing.
Highlights
Recent evidence indicates that pre-school children (PSC) living in S. mansoni highly endemic areas are at similar risk of schistosomiasis infection and morbidity as their school aged siblings
The prevalence of egg patent S. mansoni infection was 44.39 % based on Kato-Katz, 45.85 % based on Cathodic Antigen test (CCA) when trace was considered as negative and 80.05 % on CCA when trace was considered as positive, of all the PSC who participated in the study
The prevalence estimates as determined by single stool double smear Kato-Katz and CCA with trace considered as negative (CCAt-) are broadly similar, the 35 % increment in prevalence observed when trace is considered as positive (CCAt+) is noted
Summary
Recent evidence indicates that pre-school children (PSC) living in S. mansoni highly endemic areas are at similar risk of schistosomiasis infection and morbidity as their school aged siblings. Given that the Kato-Katz technique, used for many years in epidemiological surveys of S. mansoni infection, has a low sensitivity for infection detection, the prevalence of infection among PSC may have been grossly under-estimated [22,23,24,25]. This could have resulted in the exclusion of the age group in the control programmes. As a matter of fact, a higher prevalence was recorded among school children in other endemic areas in sub-Saharan Africa when the CCA immunodiagnostic test was used alongside the Kato-Katz test [10, 11, 32]. The CCA test was used in the present study in addition to the Kato-Katz test
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