Abstract
BackgroundSchistosomiasis, also known as bilharzia, is a chronic parasitic blood fluke infection acquired through contact with contaminated surface water. The illness may be mild or can cause significant morbidity with potentially serious complications. Children and those living in rural areas with limited access to piped water and services for healthcare are the most commonly infected. To address the prevalence of the disease in parts of South Africa (SA) effective national control measures are planned, but have not yet been implemented. This study aimed to estimate the prevalence and trends of public sector laboratory-confirmed schistosomiasis cases in SA over an eight-year (2011–2018) period, to inform future control measures.Methodology & principal findingsThis is a descriptive analysis of secondary data from the National Health Laboratory Service (NHLS). The study included all records of patients for whom microscopic examination detected Schistosoma species eggs in urine or stool specimens from January 2011 to December 2018. Crude estimates of the prevalence were calculated using national census mid-year provincial population estimates as denominators, and simple linear regression was used to analyse prevalence trends. A test rate ratio was developed to describe variations in testing volumes among different groups and to adjust prevalence estimates for testing variations.A total number of 135 627 schistosomiasis cases was analysed with the highest prevalence observed among males and individuals aged 5–19 years. We describe ongoing endemicity in the Eastern Cape Province, and indicate important differences in the testing between population groups.ConclusionWhile there was no overall change in the prevalence of schistosomiasis during the analysis period, an average of 36 people per 100 000 was infected annually. As such, this represents an opportunity to control the disease and improve quality of life of affected people. Laboratory-based surveillance is a useful method for reporting occurrence and evaluating future intervention programs where resources to implement active surveillance are limited.
Highlights
Schistosomiasis, known as bilharzia, is a chronic parasitic disease predominantly found in tropical and sub-tropical African regions [1,2,3]
While there was no overall change in the prevalence of schistosomiasis during the analysis period, an average of 36 people per 100 000 was infected annually
Following the standard guidelines for selecting patients that should be tested based on clinical suspicion of schistosomiasis, 135 627 patients were diagnosed with schistosomiasis in 2011– 2018
Summary
Schistosomiasis, known as bilharzia, is a chronic parasitic disease predominantly found in tropical and sub-tropical African regions [1,2,3]. Up to 70 million disability-adjusted life years (DALYs) are estimated to be lost annually due to schistosomiasis [8]. This is similar to the DALYs lost through HIV/AIDS and is higher than those of malaria and tuberculosis [9]. The illness may be mild or can cause significant morbidity with potentially serious complications Children and those living in rural areas with limited access to piped water and services for healthcare are the most commonly infected. This study aimed to estimate the prevalence and trends of public sector laboratory-confirmed schistosomiasis cases in SA over an eight-year (2011–2018) period, to inform future control measures
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