Urogenital Schistosomiasis Infection Research Articles

Attitude, Knowledge, Perception, Behavioural, Cultural and Religious Practices Influencing Transmission of Urogenital Schistosomiasis in Owena, Kajola and Baiken Communities Bordering Owena Reservoir/Dam, Ondo East Local Government Area, Ondo State, Nigeria

Background: Human urogenital schistosomiasis remains an important public health problem in Nigeria, especially in three communities, Owena, Kajola and Baiken bordering Owena Reservoir/Dam, Ondo East Local Government Area, Ondo State, Nigeria. Unfortunately, scientific-based facts about attitude, knowledge, perception, behavioural, cultural and religious practices influencing the transmission of urogenital schistosomiasis are grossly scanty and without which sustainable control strategies cannot be planned. The aim of the study was to identify the roles played by the aforementioned variables in the transmission of the disease with a view to fashioning out sustainable control strategies of the disease. Materials and Methods: A structured questionnaire was used to collect basic information on personal biodata, perception, health history, etc from the subjects. Data obtained were analyzed using Chi-square test, Analysis of variance (ANOVA) and correlation analysis. Results: Summary of significant associations between knowledge and socio-demographic characteristics of the three communities combined showed the following: gender status (p<0.000), distribution of latrine facilities in the communities (p<0.000), ignorance of how urogenital schistosomiasis is transmitted (p<0.002), self-medication urogenital schistosomiasis treatment (p<0.000), frequency of visits to the reservoir (p<0.001) (see Table I). Further results of this study revealed that participants’ perception, behavioural, cultural, religious practices were not significantly associated with the danger of urogenital schistosomiasis (p<0.110), snails seen around reservoir (p<0.259), reservoir ever visited before (p<0.24), household having toilet facilities (p<0.32), blood passed in urine (p<0.86), treatment ever received for urogenital schistosomiasis infection (p<0.86) (see Table III). Conclusion: The overall findings of this twenty-four-month (August 2013 – July 2015) study showed that people orientations such as attitude, knowledge, perception, behavioural, cultural, religious practices about the causal factors, transmission cycles, negative impacts of urogenital schistosomiasis are grossly scanty and these could pose a threat to sound intervention strategies of the control of the disease. Control strategies should involve mass sensitization focused on health education, and on transmission to emphasise the role commonly played by water contact activities. Frequency of occurrence of snails’ host and urination habits should be looked into, as well. Enlightening teachers, parents to control the water contact behaviour of their wards especially the age group 5-15 years which accounts for 52% of total index of exposure. Adequate provision of modern alternative sources of water supply (e.g. pipe-borne water) with a view to reducing the population index of exposure, should be encouraged.

Use of rivers' water, inadequate hygiene, and sanitation as exposure of internally displaced persons (IDPs) to urogenital schistosomiasis and soil-transmitted helminthiasis in Jalingo Local Government Area (LGA), Taraba State, Nigeria

Abstract Water- and soil-transmitted helminthiasis in relation to socio-demographic status and risk factors of internally displaced persons in Jalingo Local Government Area (LGA) were determined. The nutritional status was also studied among infected individuals. Urine filtration and Kato-Katz techniques were used to examine urine and faecal samples, respectively. Urogenital schistosomiasis infection was found at a moderate level of 52 (17.6%), whereas ascariasis and hookworm infection were 48 (16.3%) and 8 (2.7%), respectively. Participants in Jauro Gbadi camp as well as the age group (41–50) years significantly had the highest infection with hookworm, 8 (8.2%) (χ2 = 16.70; p = 0.000) and 2 (11.7%)(χ2 = 17.59, p = 0.003), respectively. Farmers were significantly infected with urogenital schistosomiasis (20.1%) (χ2 = 14.03; p = 0.043). Fishing in rivers exposed individuals to urogenital schistosomiasis with an adjusted odds ratio (aOR) = 8.60 (95% CI: 0.86–85.52; p = 0.046). The lack of hygienic measures exposed individuals who ‘don't wash their hands before eating’ to soil-transmitted helminthiasis with an aOR = 4.13 (95% CI: 0.77–21.99; p = 0.045). In sanitation, individuals who ‘don't use pit latrines and do use the bush for defaecating’ were exposed to soil-transmitted helminthiasis with an aOR = 2.14 (95% CI: 1.30–3.52; p = 0.002). Farmers were infected with urogenital schistosomiasis. Participants in the Jauro Gbadi camp and individuals within the age group (41–50) years had high hookworm infection. Use of river water, inappropriate hygiene, and sanitation exposed individuals to infection.

Urogenital schistosomiasis prevalence, knowledge, practices and compliance to MDA among school-age children in an endemic district, southern East Tanzania

BackgroundTanzania has a high prevalence of urogenital schistosomiasis. Praziquantel is administered to school-age children on an annual basis as part of efforts to reduce transmission and morbidity associated with heavy infections. We investigated the prevalence, knowledge, and practices of urogenital schistosomiasis transmission, as well as compliance with mass drug administration (MDA) among schoolchildren in Masasi District. Materials and methodsA cross-sectional survey was conducted in five primary schools. A pre-tested questionnaire was used to assess knowledge and practice related to the transmission of urogenital schistosomiasis, as well as compliance with MDA. Collected urine samples were examined macroscopically for macrohematuria. They were then tested for microhematuria and Schistosoma haematobium (S. haematobium) eggs with urine dipsticks and filtration technique, respectively. FindingsThe study included 389 primary school children in total. Overall, 27 (6.9%) of children had S. haematobium infection, and 37 (9.5%) had microhematuria. The mean (SD) intensity was 123.4 (247.4) eggs per 10 ml of urine. A total of 10 (2.6%) had heavy intensity of infection. The majority (94.9%) reported having complied to the previous round of MDA six months prior to this study, and 308 (79.2%) were aware that water contact is associated with an increased risk of urogenital schistosomiasis infection. Nevertheless, 182 (46.8%) of the participants engaged in swimming activities, with 92 (50.9%) of the participants being female. The prevalence of urogenital schistosomiasis was higher (10.9%) among children who participated in swimming activities versus those who did not (3.4%) (P = 0.003). ConclusionDespite high MDA compliance, urogenital schistosomiasis is still prevalent among primary school children in Masasi District. Children who swim in freshwater bodies such as rivers and ponds are more likely to contract urogenital schistosomiasis.

Chronic Urogenital Schistosomiasis among In-School Adolescents in Sokoto, North-Western Nigeria

Aims: To assess the prevalence, intensity, associated factors and predictors of chronic urogenital schistosomiasis among in-school adolescents in Sokoto.
 Study Design: Descriptive cross-sectional survey.
 Place and Duration of Study: Secondary Schools in Sokoto metropolis, Sokoto State, Nigeria, between January and April 2018.
 Methodology: A total of 590 apparently healthy secondary school students aged between 10 and 19 years in Sokoto metropolis were selected using multi-stage random sampling technique. Designed pretested semi-structured questionnaire was used to obtain relevant socio-demographic and clinical information. Urine specimen was obtained and subjected to urine analysis and microscopy for ova of Schistosoma haematobium. Data was analyzed using IBM-SPSS version 25.0.
 Results: Mean age of subjects was 15.1 ±2.6 years. There were 334 (56.6%) males and 256 (43.4%) females. Majority 371 (62.9%) attended public secondary schools, most 264 (44.7%) were of middle socio-economic family status, and 300 (50.8%) were from rural community setting. The commonest source of water for domestic use was pipe-borne 203 (34.4%), and swimming was the predominant 55(9.3%) recreational water- related activity. The overall prevalence of chronic urogenital schistosomiasis was 22.9%, significantly (p<0.001) higher among males, with age group category 15-17 years mostly 59 (29.6%) affected. All 135 (100%) of the infected subjects had microscopic haematuria, 119 (88.2%) had proteinuria, and 108(80.0%) had leucocyturia. Age group category 15-17 years (p=0.027), male gender (p<0.001), low and middle social classes (p<0.001) respectively, and residence in rural community setting were independent predictors of chronic urogenital schistosomiasis infection. Majority 81(60.0%) of the infected respondents had light infection. Male gender was the only predictor (p=0.003) of intensity of infection.
 Conclusions: Chronic urogenital schistosomiasis is prevalent among the subjects. Middle adolescence, male gender, swimming, rural community setting and low-middle socio-economic classes were independent predictors of infection.

Leave No Preschool-Aged Children Behind: Urogenital Schistosomiasis in Four Communities of a Metropolitan City in Central Nigeria

There have been several demands for preschool-aged children to get prophylactic chemotherapy, such as praziquantel, first due to a presumed schistosomiasis among this age group. In order to determine the prevalence and risk variables related to urogenital schistosomiasis infection among preschool-aged children, this study conducted surveys in four areas inside a major city in Central Nigeria. A total of 240 preschool-aged children were randomly selected from the four areas surveyed. Demographic data and their knowledge on the transmission of urogenital schistosomiasis were obtained by administering questionnaire to mothers and caregivers, urine samples of the recruited subjects were collected using a sterile sampling bottles and were tested for hematuria using Urino-Combi-11 reagent test strip (ACON laboratories). Subsequently, samples were screened in the laboratory for Schistosoma haematobium infection. Of the 235 preschool-aged children that returned their sample bottles, only 8.51% (20/235) were infected with urogenital schistosomiasis. Four years old subjects were the most infected 13.95% (6/43) followed by age two 10.56% (2/19) then age five with 8.93% (10/112), age three 3.70% (2/54) while no age one child was infected 0% (0/7), although variations in prevalence across the ages showed no significant difference (P˃0.05). The overall geometric mean intensity (GMI) was 1.03526 eggs/10ml of urine. The prevalence of the infection among preschool-aged children in relation to locations as well as sex showed no significant difference (P˃0.05). About 52% (122) of the preschool-aged children bath in water bodies, but only 51.1% (120) are aware that some freshwater snails are harmful. In conclusion, preschool-aged children in the metropolitan city of Lafia should not bath, wash or swim in water bodies around. More awareness should be created on the risk factors associated with the disease. Also, the government should provide sufficient potable water in the city, and prioritization of treatment of preschool-aged children with preventive chemotherapy to curb urogenital schistosomiasis prevalence among the age group is very necessary and cannot be overemphasized.

Assessing Potential Intermediate Host Snails of Urogenital Schistosomiasis, Human Water Contact Behavior and Water Physico-chemical Characteristics in Alwero Dam Reservoir, Ethiopia.

Introduction:Urogenital schistosomiasis is one of public health problems in lowland areas of Ethiopia. The disease is caused by Schistosoma haematobium. Freshwater Bulinus snails are intermediate hosts for the parasite transmission. The aim of the study was to assess intermediate host snails of urogenital schistosomiasis, human water contact behavior and physico-chemical characteristics of Alwero Dam reservoir.Methods:Bulinus snails were sampled from 12 sites of Alwero Dam. Bulinus snails were collected, identified and examined for natural schistosome infections. A total of 206 people were interviewed to determine human water contact behavior. The water temperature, pH, dissolved oxygen, total dissolved solid, salinity and conductivity of the water were determined.Results:Of 1125 Bulinus snails collected, 72 (6.4%) were infected with echinostome cercariae but none of them were infected with schistosome cercariae. The abundance of Bulinus species did not show significant variation across seasons (P = .61). Occurrence of Bulinus species was significantly higher in stony substratum than sandy substratum (P = .01). Of the total 206 participants, 119 (57.8%) had water contact activities like washing clothes, bathing or swimming. Majority of respondents (70.0%) reported that they visited the dam reservoir once or twice a week, while 16.5% and 13.6% reported that they visited the dam 3 to 5 times a week and daily, respectively. Moreover, 72.3% of the respondents had reported they had history of urogenital schistosomiasis infection. The mean water temperature, pH, dissolved oxygen, total dissolved solid, electric conductivity, and salinity of the dam water was 28.6°C, 7.07, 5.75 mg/l, 90.0 ppm, 124.8 µS/cm, and 50.0 ppm, respectively.Conclusion:At Alwero Dam, Bulinus snails were highly abundant and the human water contact activities were frequent. Therefore, the community awareness creation should be made to reduce water contact with snail infested water to prevent risk of urogenital schistosomiasis infection.

Urogenital schistosomiasis infection prevalence targets to determine elimination as a public health problem based on microhematuria prevalence in school-age children.

BackgroundRecent research suggests that schistosomiasis targets for morbidity control and elimination as a public health problem could benefit from a reanalysis. These analyses would define evidence-based targets that control programs could use to confidently assert that they had controlled or eliminated schistosomiasis as a public health problem. We estimated how low Schistosoma haematobium infection levels diagnosed by urine filtration in school-age children should be decreased so that microhematuria prevalence was at, or below, a “background” level of morbidity.MethodologyData obtained from school-age children in Burkina Faso, Mali, Niger, Tanzania, and Zambia who participated in schistosomiasis monitoring and evaluation cohorts were reanalyzed before and after initiation of preventive chemotherapy. Bayesian models estimated the infection level prevalence probabilities associated with microhematuria thresholds ≤10%, 13%, or 15%.Principal findingsAn infection prevalence of 5% could be a sensible target for urogenital schistosomiasis morbidity control in children as microhematuria prevalence was highly likely to be below 10% in all surveys. Targets of 8% and 11% infection prevalence were highly likely to result in microhematuria levels less than 13% and 15%, respectively. By contrast, measuring heavy-intensity infections only achieves these thresholds at impractically low prevalence levels.Conclusions/significanceA target of 5%, 8%, or 11% urogenital schistosomiasis infection prevalence in school-age children could be used to determine whether a geographic area has controlled or eliminated schistosomiasis as a public health problem depending on the local background threshold of microhematuria.

Prevalence, Intensity, and Factors Associated with Urogenital Schistosomiasis among Women of Reproductive Age in Mbogwe District Council, Geita Region, Tanzania.

Background Urogenital schistosomiasis remains a public health problem in Tanzania. Control programs mostly target school-going children ignoring other vulnerable groups like women of child bearing age. Previous evidence has shown that women of reproductive age suffer greatest morbidities in endemic areas. This study sought to determine the prevalence, intensity, and factors associated with urogenital schistosomiasis among women of reproductive age in the Mbogwe District. Methods A population-based analytical cross-section study was conducted in the Mbogwe District. A semistructured questionnaire was administered. Urine samples of 20-30 mils collected between 10.00 am to 02.00 pm and examined for Schistosoma eggs and infection intensity microscopically. Data analysis was done using SPSS version 20. Results A total of 426 women of reproductive age, with median age of 26, and interquartile range of 11years were recruited and assessed. The prevalence of urogenital schistosomiasis was 4.5% and mean egg intensity of 19.5eggs/10mil of urine. After adjusting for confounders, lower level of education was associated with an increased risk of urogenital schistosomiasis infections (AOR 8.355, 95% CI 3.055-23.001). Conclusion Urogenital schistosomiasis among women of reproductive age in the Mbogwe District is a problem. Education is the factor associated with the disease; the neglected tropical disease control program should develop strategies that should include provision of health education and should involve women of reproductive age as they act as infection reservoir. More studies are recommended to explore the possibility of reproductive complications among infected women in endemic areas.

Urogenital schistosomiasis and risk factors of infection in mothers and preschool children in an endemic district in Zimbabwe

BackgroundTo design appropriate schistosomiasis control programmes that include women and preschool-aged children (PSAC) it is essential to assess their disease profile and the risk factors predisposing them to infection. This study aimed to determine the prevalence of urogenital schistosomiasis and the risk factors of infection among PSAC and their caregivers in an endemic area of Zimbabwe.MethodsA cross-sectional study involving screening for urogenital schistosomiasis infections and treatment of 860 participants [535 children aged ≤ 5 years and 325 caregivers (≥ 15 years)] was carried out in five communities, namely Chihuri, Mupfure, Chakondora, Nduna and Kaziro, in February 2016. Haematuria was recorded for each participant and urine filtration was performed to determine the presence and infection intensity of Schistosoma haematobium. A pre-tested questionnaire was administered to the caregivers seeking knowledge, practices and perceptions regarding schistosomiasis. Data analysis was performed using descriptive statistics and logistic regression.ResultsOverall 132 (15.4%) of the 860 participants had S. haematobium infections. Among these, 61 (18.7%) of the 325 caregivers and 71 (13.3%) of the 535 children were infected. The infection prevalence was significantly different between caregivers and PSAC (χ2 = 4.7040, df = 1, P = 0.030). Children whose caregivers used river water for bathing were more likely to be infected compared to children whose caregivers used protected well water (OR: 2.2, 95% CI: 1.3–3.7). The risks of being infected with schistosomiasis were higher in children whose caregivers were infected compared to children whose caregivers had no infection (AOR: 3.9, 95% CI: 1.7–8.6). In caregivers, those who bathed in river water were at higher risk of schistosomiasis infection compared to those who used water from a protected well (AOR: 3.0, 95% CI: 1.4–6.4).ConclusionsAccording to the World Health Organization guidelines, the observed overall prevalence of urogenital schistosomiasis qualifies this area as a moderate risk area requiring mass chemotherapy once every two years. Water contact practices of caregivers, and their perceptions and knowledge regarding schistosomiasis are risk factors for infection in both themselves and PSAC. Thus, disease control efforts targeting caregivers or PSAC should include health education and provision of alternative clean and safe water sources.

Impact of the scale-up of piped water on urogenital schistosomiasis infection in rural South Africa.

Recent work has estimated that sub-Saharan Africa could lose US$3.5 billion of economic productivity every year as a result of schistosomiasis and soil-transmitted helminthiasis. One of the main interventions to control schistosomiasis is the provision of safe water to limit the contact with infected water bodies and break the cycle of transmission. To date, a rigorous quantification of the impact of safe water supplies on schistosomiasis is lacking. Using data from one of Africa's largest population-based cohorts, we establish the impact of the scale-up of piped water in a typical rural South African population over a seven-year time horizon. High coverage of piped water in the community decreased a child's risk of urogenital schistosomiasis infection eight-fold (adjusted odds ratio = 0.12, 95% CI 0.06-0.26, p<0.001). The provision of safe water could drive levels of urogenital schistosomiasis infection to low levels of endemicity in rural African settings.

Urogenital Schistosomiasis—Evidence-Based Benefits of Treatment Initiated Early During Childhood

Urogenital schistosomiasis, caused by the helminth parasite Schistosoma haematobium, is one of the most important childhood public health problems in Africa, compromising child growth and development and usually causing irreversible damage in life leading to increased susceptibility to HIV coinfection in adulthood. Naturally acquired immunity develops slowly, and with no vaccine available, infection and morbidity are controlled by treatment with the antihelminthic drug praziquantel. Treatment is believed to accelerate development of protective immunity. In our recent research, we demonstrated that morbidity occurs in young children and that the markers of morbidity can be used for diagnosis, while development of pathology is reduced by a single antihelminthic treatment. Many gaps exist in the control efforts of schistosomiasis that could be initiated during early years of growth to avoid childhood schistosomiasis with immense benefits in adulthood susceptibility or increased HIV transmission. Treating urogenital schistosomiasis infection during earlier childhood age is a relatively cheap strategy to benefit child health and provide opportunity to develop protective immune responses. Studies on the association of urogenital schistosomiasis with HIV transmission indicate that prevention and protective immunity could be achieved by administering treatment earlier during childhood.

Decrease in Seminal HIV-1 RNA Load After Praziquantel Treatment of Urogenital Schistosomiasis Coinfection in HIV-Positive Men-An Observational Study.

BackgroundUrogenital schistosomiasis due to Schistosoma hematobium infection is hypothesized to cause increased HIV-1 RNA shedding in semen in HIV co-infected men as result of chronic egg-induced inflammation in the prostate and the seminal vesicles. The effect of treatment with the antihelminthic agent praziquantel on seminal HIV-1 RNA load was assessed in this study.MethodsHIV-1 RNA load was determined in blood plasma and semen at baseline and at 10-week follow-up. Praziquantel was administered at baseline and two weeks later.ResultsEighteen HIV-positive men with S. haematobium co-infection were enrolled into the study. Status of antiretroviral therapy (ART): 6 ART-naïve and 12 ART-experienced. All participants became egg-negative in urine at follow-up. Among the ART-naïve men, the mean HIV-1 RNA load decreased by 0.32 log10 copies per mL (4.41 vs 4.09) in blood plasma from baseline to follow-up, and in semen by 1.06 log10 copies per mL (4.06 vs 3.00).ConclusionsThis study demonstrated a decline in seminal HIV-1 RNA load following praziquantel treatment of urogenital schistosomiasis infection in HIV-positive men. The finding needs further exploration in a larger randomized study targeting praziquantel as a supplementary preventive measure of sexual transmission of HIV-1 in S. haematobium endemic areas in sub-Saharan Africa.

The microbiome in urogenital schistosomiasis and induced bladder pathologies.

BackgroundHuman schistosomiasis is a highly prevalent neglected tropical disease (NTD) caused by Schistosoma species. Research on the molecular mechanisms influencing the outcomes of bladder infection by Schistosoma haematobium is urgently needed to develop new diagnostics, therapeutics and infection prevention strategies. The objective of the research study was to determine the microbiome features and changes in urine during urogenital schistosomiasis and induced bladder pathologies.MethodologySeventy participants from Eggua, southwestern Nigeria provided morning urine samples and were screened for urogenital schistosomiasis infection and bladder pathologies in a cross-sectional study. Highthroughput NGS sequencing was carried out, targeting the 16S V3 region. Filtered reads were processed and analyzed in a bioinformatics pipeline.Principal findingsThe study participants (36 males and 34 females, between ages 15 and 65) were categorized into four groups according to status of schistosomiasis infection and bladder pathology. Data analytics of the next-generation sequencing reads revealed that Proteobacteria and Firmicutes dominated and had influence on microbiome structure of both non-infected persons and persons with urogenital schistosomiasis. Furthermore, gender and age influenced taxa abundance independent of infection or bladder pathology. Several taxa distinguished urogenital schistosomiasis induced bladder pathologies from urogenital schistosomiasis infection alone and from healthy persons, including known immune-stimulatory taxa such as Fusobacterium, Sphingobacterium and Enterococcus. Some of these significant taxa, especially Sphingobacterium were projected as markers of infection, while several genera including potentially beneficial taxa such as Trabulsiella and Weissella, were markers of the non-infected. Finally, expected changes in protein functional categories were observed to relate to cellular maintenance and lipid metabolism.ConclusionThe urinary microbiome is a factor to be considered in developing biomarkers, diagnostic tools, and new treatment for urogenital schistosomiasis and induced bladder pathologies.

Urogenital Schistosomiasis among Fulani Pastoralists in Rivers State

Aim: To determine the distribution and endemicity of Urogenital schistosomiasis infection among Fulani Pastoralists in their various bush encampments in Rivers State, Nigeria. Study Design: Cross ‐sectional, descriptive study. Place and Duration of Study: Rivers State, Nigeria, between November 2009 and January 2011. Methodology: Urine samples were collected from 593 Fulani pastoralists from six bush encampments and examined for schistosome eggs using centrifugation method. The number of eggs obtained per 10ml of urine specimen was counted and quantified as