Center for Global Health Research, Kenya Medical Research Institute, P,O, Box 1578-40100, Kisumu, Kenya.
Parasit Vectors. 2014 Mar 25;7:125. doi: 10.1186/1756-3305-7-125.
Schistosomiasis studies in western Kenya have mainly focused on the intestinal form, with evidence of urinary schistosomiasis remaining anecdotal. Detailed disease mapping has been carried out predominantly along the shores of Lake Victoria, but there is a paucity of information on intestinal and urinary schistosomiasis in inland sites.
This cross-sectional survey of 3,487 children aged 7-18 years from 95 schools in south Nyanza, western Kenya determined the prevalence, infection intensity, and geographical distribution of Schistosoma haematobium, evaluating its co-endemicity with Schistosoma mansoni and soil-transmitted helminths (STHs). Helminth eggs were analyzed from single urine (for S. haematobium) and stool (for S. mansoni and STHs) samples by centrifugation and Kato-Katz, respectively. Hematuria was used as a proxy indicator for S. haematobium. Schools and water bodies (ponds, water-points, streams, dams and rivers) were mapped using Geographical Information System and prevalence maps obtained using ArcView GIS Software.
S. haematobium infections with an overall prevalence of 9.3% (95% CI = 8.4-10.2%) were mostly prevalent in Rachuonyo, 22.4% (95% CI = 19.2-25.9% and 19.7 eggs/10 ml) and Migori, 10.7% (95% CI = 9.2-12.3% and 29.5 eggs/10 ml) districts, particularly around Kayuka pond and Ongoche river respectively. Overall infections correlated with hematuria (r = 0.9, P < 0.0001) and were more likely in boys (P < 0.0001, OR = 0.624). S. mansoni infections with an overall prevalence of 13% (95% CI =11.9-14.1%) were majorly confined along the shores of Lake Victoria. STH infections were homogenously distributed with A. lumbricoides occurring in 5.4% (95% CI = 4.7-6.3%) and T. trichiura in 2.8% (95% CI = 2.3-3.4%) of the children. Although S. mansoni infections were more co-endemic with S. haematobium, only A. lumbricoides infections were positively associated with S. haematobium (P = 0.0295, OR = 0.4585). Overall prevalence of S. haematobium monoinfection was 7.2% (95% CI = 6.4-8%), S. mansoni monoinfection was 12.3% (95% CI = 10.4-12.5%), and S. haematobium-S. mansoni coinfection was 1.2% (95% CI = 0.9-1.6%). There was no significant difference in infection intensity between mono and coinfections.
Prevalence distribution maps obtained are important for planning and implementing disease control programs in these areas.
在肯尼亚西部，血吸虫病研究主要集中在肠道形式，有关尿路血吸虫病的证据仍然是传闻。主要沿着维多利亚湖的岸边进行了详细的疾病绘图，但内陆地区有关肠道和尿路血吸虫病的信息很少。
本横断面调查了来自肯尼亚西部南纳安扎省 95 所学校的 3487 名 7-18 岁儿童，确定了曼氏血吸虫和土壤传播性蠕虫（STH）的曼氏血吸虫、感染强度和地理分布。通过离心法从单一尿液（用于检测 S. haematobium）和粪便（用于检测 S. mansoni 和 STH）样本中分析了寄生虫卵。使用 Kato-Katz 分别对 S. mansoni 和 STH 进行分析。血尿用作 S. haematobium 的替代指标。使用地理信息系统（GIS）对学校和水体（池塘、水源、溪流、水坝和河流）进行绘图，并使用 ArcView GIS 软件获得患病率地图。
总体上，曼氏血吸虫感染的流行率为 9.3%（95%CI=8.4-10.2%），主要集中在 Rachuonyo 地区（22.4%[95%CI=19.2-25.9%和 19.7 条/10ml]）和 Migori 地区（10.7%[95%CI=9.2-12.3%和 29.5 条/10ml]），特别是 Kayuka 池塘和 Ongoche 河周围。总体感染率与血尿相关（r=0.9，P<0.0001），且男孩更易感染（P<0.0001，OR=0.624）。曼氏血吸虫的总体流行率为 13%（95%CI=11.9-14.1%），主要局限于维多利亚湖沿岸。 STH 感染分布均匀，A. lumbricoides 感染率为 5.4%（95%CI=4.7-6.3%），T. trichiura 感染率为 2.8%（95%CI=2.3-3.4%）。尽管曼氏血吸虫感染与曼氏血吸虫感染更为普遍，但只有 A. lumbricoides 感染与曼氏血吸虫感染呈正相关（P=0.0295，OR=0.4585）。曼氏血吸虫单感染的总流行率为 7.2%（95%CI=6.4-8%），曼氏血吸虫单感染的流行率为 12.3%（95%CI=10.4-12.5%），曼氏血吸虫和曼氏血吸虫合并感染的流行率为 1.2%（95%CI=0.9-1.6%）。单感染和合并感染之间的感染强度无显著差异。
获得的流行率分布图对于这些地区的疾病控制规划的规划和实施非常重要。
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