Department of Parasitology, Faculty of Medicine, Sana'a University, Sana'a, Yemen.
Tropical Disease Research Center, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen.
PLoS One. 2022 Aug 25;17(8):e0273503. doi: 10.1371/journal.pone.0273503. eCollection 2022.
The Ministry of Public Health in Yemen continues the implementation of school and community-based preventive chemotherapy with praziquantel and albendazole for the control and elimination of schistosomiasis and soil-transmitted helminths (STH). The latest remapping to update the distribution of schistosomiasis and STH was conducted seven years ago. This study aimed to estimate the prevalence, intensity and associated risk factors of Schistosoma mansoni and STH among schoolchildren in An-Nadirah District, Ibb Governorate, Yemen. A cross-sectional study was carried out among schoolchildren aged 6-15 years in four selected schools. Biological, demographic, socioeconomic and environmental data were collected using a pre-tested questionnaire. S. mansoni and STH eggs were detected and counted by the microscopic examination of Kato-Katz fecal smears. Out of 417 schoolchildren, 17.0% were infected with at least one intestinal helminth. Prevalence of S. mansoni and STH were 6.5% and 9.1%, respectively. The most prevalent parasite among STH was Ascaris lumbricoides (8.4%). Unemployed fathers (Adjusted Odds Ratio (AOR) = 3.2; 95% Confidence interval (CI): 1.23, 8.52; P = 0.018), eating exposed food (AOR: 2.9; 95%CI = 1.24, 6.89; P = 0.014), not washing hands before eating and after defecation (AOR: 4.8; 95%CI = 1.77, 12.81; P = 0.002), and schools located close to water stream (AOR: 22.1; 95%CI = 5.12, 95.46; P <0.001) were independent risk factors of ascariasis. Swimming in ponds/stream (AOR: 3.9; 95%CI = 1.63, 9.55; P = 0.002), and schools close to the stream (AOR: 24.7; 95%CI = 3.05, 200.07; P = 0.003) were independent risk factors of intestinal schistosomiasis. The present study does not indicate a reduction in the prevalence of intestinal schistosomiasis in this rural area since the latest remapping conducted in 2014, although ascariasis was reduced by half. The prevalence of the two parasites was highly focal in areas close to the valley, suggesting a significant role of the stream in sustaining and accelerating the parasitic infection. Children practicing swimming and having poor hygienic practices were at high exposure to S. mansoni and A. lumbricoides, respectively. Water, Sanitation and Hygiene intervention, school-based health education, and snail control, in addition to mass drug administration, will help in the interruption of transmission of schistosomiasis and STH.
也门公共卫生部继续实施以吡喹酮和阿苯达唑为基础的学校和社区预防性化疗,以控制和消除血吸虫病和土壤传播性蠕虫(STH)。最新的重绘工作是在七年前进行的,目的是更新血吸虫病和 STH 的分布情况。本研究旨在评估也门伊卜省安纳迪拉区学龄儿童中曼氏血吸虫和 STH 的流行率、强度和相关危险因素。在四所选定的学校中,对年龄在 6-15 岁的学龄儿童进行了横断面研究。使用经过预测试的问卷收集了生物、人口统计学、社会经济和环境数据。通过显微镜检查加藤氏粪便涂片检测和计数曼氏血吸虫和 STH 卵。在 417 名学龄儿童中,有 17.0%至少感染了一种肠道蠕虫。曼氏血吸虫和 STH 的流行率分别为 6.5%和 9.1%。STH 中最常见的寄生虫是蛔虫(8.4%)。失业的父亲(调整后的优势比(AOR)=3.2;95%置信区间(CI):1.23,8.52;P=0.018)、食用暴露食物(AOR:2.9;95%CI=1.24,6.89;P=0.014)、饭前便后不洗手(AOR:4.8;95%CI=1.77,12.81;P=0.002)和学校靠近溪流(AOR:22.1;95%CI=5.12,95.46;P<0.001)是蛔虫病的独立危险因素。在池塘/溪流中游泳(AOR:3.9;95%CI=1.63,9.55;P=0.002)和靠近溪流的学校(AOR:24.7;95%CI=3.05,200.07;P=0.003)是肠道血吸虫病的独立危险因素。本研究表明,尽管蛔虫病的流行率减半,但在 2014 年进行的最新重绘后,农村地区肠道血吸虫病的流行率并没有下降。两种寄生虫的流行率在靠近山谷的地区高度集中,这表明溪流在维持和加速寄生虫感染方面发挥了重要作用。游泳和卫生习惯差的儿童分别面临感染曼氏血吸虫和蛔虫的高风险。水、环境卫生和个人卫生干预、学校为基础的健康教育以及钉螺控制,除了大规模药物治疗外,将有助于阻断血吸虫病和 STH 的传播。