Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
PLoS Negl Trop Dis. 2022 Apr 20;16(4):e0010381. doi: 10.1371/journal.pntd.0010381. eCollection 2022 Apr.
Despite the ongoing intervention for schistosomiasis control among school-age children in the Lindi region of Tanzania, urogenital schistosomiasis continues to be a public health problem, presumably because other at-risk populations are not covered in praziquantel deworming campaigns. Evidence shows that under-fives become infected in their early life hence the need to understand the disease profile and the risk factors for exposure to infection so as to plan effective control strategies in this group. This study examined the prevalence and risk factors of urogenital schistosomiasis among under-fives in the Mtama district, Lindi region of Tanzania.
METHODOLOGY/PRINCIPAL FINDINGS: A quantitative community-based cross-sectional study was carried out among 770 participants (385 under-fives and their 385 parents/guardians) in the Mtama district to investigate the burden and the risk factors associated with S. haematobium infection. A single urine specimen was collected from the under-fives and tested for macro and microhaematuria, presence of S. haematobium ova, and intensity of infection. A structured questionnaire gathered on risk factors for S. haematobium exposure in under-fives from their parents/guardians. Data analysis was performed using descriptive statistics, chi-square test, and logistic regression. Prevalence of S. haematobium ova was 16.9%, and that of macro and microhaematuria was 6% and 17.9%, respectively. Of the 65 positive under-fives, 49 (75.4%) 95% CI 65.4-86.3 had a light infection intensity, and 16 (24.6%) 95% CI 13.7-35.5 had a heavy infection intensity. Among the assessed risk factors, the parents/guardians habit of visiting water bodies for domestic routines (AOR: 1.44, 95% CI: 1.13-1.74), especially the river (AOR: 6.00, 95% CI: 1.20-35.12), was found to be a significant risk factor for infection of S. haematobium in under-fives.
CONCLUSION/SIGNIFICANCE: A moderate prevalence of S. haematobium was found among the under-fives conceivably with adverse health events. The infected under-fives could be a source of continuity for transmission in the community. An intervention that covers this group is necessary and should be complemented with regular screening, health education campaigns, and an adequate supply of safe water.
尽管坦桑尼亚林迪地区一直在对学龄儿童进行血吸虫病控制干预，但泌尿生殖系统血吸虫病仍然是一个公共卫生问题，这可能是因为其他高危人群没有被纳入吡喹酮驱虫活动。有证据表明，五岁以下儿童在其生命早期就会受到感染，因此有必要了解疾病特征和感染风险因素，以便为该群体制定有效的控制策略。本研究调查了坦桑尼亚林迪地区 Mtama 区五岁以下儿童泌尿生殖系统血吸虫病的流行情况和危险因素。
方法/主要发现：在 Mtama 区进行了一项基于社区的定量横断面研究，共有 770 名参与者（385 名五岁以下儿童及其 385 名父母/监护人）参与，旨在调查 S. haematobium 感染的负担和相关危险因素。从五岁以下儿童中采集了一份尿液样本，用于检测宏观和微观血尿、存在 S. haematobium 卵和感染强度。从父母/监护人那里收集了一份关于五岁以下儿童接触 S. haematobium 危险因素的结构化问卷。使用描述性统计、卡方检验和逻辑回归进行数据分析。S. haematobium 卵的流行率为 16.9%，宏观血尿和微观血尿的流行率分别为 6%和 17.9%。在 65 名阳性五岁以下儿童中，49 名（75.4%）95%CI65.4-86.3 为轻度感染强度，16 名（24.6%）95%CI13.7-35.5 为重度感染强度。在所评估的危险因素中，父母/监护人为家庭日常生活而访问水体的习惯（AOR：1.44，95%CI：1.13-1.74），特别是河流（AOR：6.00，95%CI：1.20-35.12），被发现是五岁以下儿童感染 S. haematobium 的一个重要危险因素。
结论/意义：在五岁以下儿童中发现了中等流行率的 S. haematobium，这可能会导致不良的健康事件。受感染的五岁以下儿童可能是社区传播的连续性来源。有必要针对这一群体进行干预，并应辅以定期筛查、健康教育运动和充足的安全用水供应。
