Urinary schistosomiasis outbreak in a community basic school, la Nkwantanang-Madina Municipality, Ghana-2016

Abstract

Introduction : urinary schistosomiasis is a parasitic Neglected Tropical Disease caused by blood flukes called Schistosoma haematobium and characterized by terminal hematuria.School-aged children get infested through habits such as swimming and fishing in infested water bodies. Schistosomiasis is endemic in Ghana. On September 28, 2016, La Madina Nkwantanang Municipality (LaMNM) reported clusters of suspected schistosomiasis in a basic school. We investigated to determine the extent and risk factors of the outbreak and implement control and preventive measures. Methods : we screened all pupils with a questionnaire followed by testing urine of those with a history of hematuria. We conducted 14 case control study to determine the risk factors for schistosomiasis. A case of urinary schistosomiasis was any pupil from the affected school with Schistosoma ova identified in the urine. We interviewed case patients and their controls to obtain data on socio-demographic characteristics and their social play habits. We conducted an environmental assessment. Descriptive and inferential data analyses were done. Risk factors were assessed using adjusted odds ratio (AOR) and their corresponding 95% confidence intervals. Results : of 753 students, 81 case-patients were identified (attack rate 10.8%). Sex specific attack rates were 17.0% (68/401) for males and 3.7% (13/352) for females. Median age of case-patients was 13 years (IQR 11-14 years). Compared to controls, case-patients were more likely to be males [AOR=5.8 (CI=3.04; 11.96)]. After controlling for possible confounders, swimming in Silver land pond [AOR=9.0, 95%CI (2.18-33.55)] and swimming in Quotam pond [AOR=3.2, 95%CI (1.10-9.41)] were independent risk factors for contracting schistosomiasis. Conclusion : urinary schistosomiasis outbreak mainly affecting males occurred in LaMNM. Swimming in infested ponds was the major risk factor. Following our investigation, health education, mollusciciding and clearing of weeds in ponds, and preventive chemotherapy using Praziquantel were carried out.