Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.
Department of Medical Laboratory Sciences, Faculty of Health Sciences, The University of Bamenda, P.O. Box 39, Bambili, Cameroon.
Infect Dis Poverty. 2021 Apr 12;10(1):49. doi: 10.1186/s40249-021-00827-2.
Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity, and risk factors associated with the occurrence of UGS.
In this cross-sectional survey, 12 communities were purposively selected from four health areas (HAs) (Likomba, Holforth, Holforth-Likomba, and Mutengene) in South West Region of Cameroon between June and August 2018. Consenting individuals were enrolled using a convenient sampling technique and administered a semi-structured questionnaire to document information on socio-demographic and water contact behaviour. Urine samples were examined for Schistosoma haematobium infection using test strip, filtration, and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection.
The overall prevalence of UGS in Likomba, Holforth-Likomba and Holforth was 31.5% [95% confidence interval (CI): 28.3-34.8] with geometric mean (GM) egg count of 28.7 (range: 2-450) eggs per 10 ml of urine. S. haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (P < 0.001) among the affected communities, ranging from 12.0 to 56.9%. Infection status of the community related positively (P < 0.001) with proximity to stream (< 100 m), the degree of contact with water and number of improved water sources. Younger age group (5-14 years) [adjusted odds ratio (aOR): 3.7, 95% CI: 1.1-12.2] and intense water contact (degree II) (aOR: 5.2, 95% CI: 3.4-8.1) were associated with increased risk of infection. Similarly, significantly higher egg load was observed among younger aged groups (P = 0.02) and those who carried out intense water contact activities (P < 0.001).
Generally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50.0% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area.
城市周边和城市地区血吸虫病风险增加的情况并不少见。在 Tiko 卫生区（THD）进行了一项流行病学调查，该地区是尿路血吸虫病（UGS）的未映射传播焦点，旨在评估 UGS 发生的分布、强度和相关风险因素。
在这项横断面调查中，2018 年 6 月至 8 月期间，在喀麦隆西南地区的四个卫生区（Likomba、Holforth、Holforth-Likomba 和 Mutengene）中，有目的选择了 12 个社区。采用方便抽样技术，对同意参与的个人进行登记，并使用半结构式问卷记录社会人口学和与水接触行为的信息。使用测试条、过滤和显微镜方法检测尿液样本中是否存在 Schistosoma haematobium 感染。采用双变量和二元逻辑回归分析来确定感染的预测因素。
Likomba、Holforth-Likomba 和 Holforth 的 UGS 总患病率为 31.5%（95%置信区间：28.3-34.8），几何平均（GM）尿卵计数为 28.7（范围：2-450）个/10ml。Mutengene 卫生区未发现 S. haematobium 感染。感染在卫生区之间分布不均，Holforth-Likomba 和 Holforth 受影响最严重和最轻微。感染的流行情况在受影响的社区之间存在差异（P<0.001），范围为 12.0-56.9%。社区的感染状况与溪流的接近程度（<100m）、与水的接触程度和改进水源数量呈正相关（P<0.001）。年龄较小的年龄组（5-14 岁）（调整后的优势比[aOR]：3.7，95%置信区间：1.1-12.2）和高强度的水接触（程度 II）（aOR：5.2，95%置信区间：3.4-8.1）与感染风险增加相关。同样，年龄较小的组（P=0.02）和进行高强度水接触活动的组（P<0.001）观察到的卵负荷明显更高。
总的来说，THD 是一个中度风险的 UGS 流行地区，但在一些社区观察到的患病率高于 50.0%。这些发现需要立即用吡喹酮进行大规模化疗以降低发病率。建议提供便携式水和健康教育，以减少该地区的传播并最终消除传播。
