Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, Legon, Ghana.
Ghana Health Service, Ketu North District Health Directorate, Volta Region, Ghana.
Pan Afr Med J. 2022 Dec 13;43:191. doi: 10.11604/pamj.2022.43.191.33362. eCollection 2022.
schistosomiasis is a neglected parasitic infection caused by nematode worms. It affects approximately 200 million people globally. Prevalence in Ghana is 23.3%, mostly affecting school children. On November 28 2018, the Disease Surveillance Department received reports of increase in occurrence of bloody urine among students of a basic school in the Volta Region. We investigated to identify the agent and source, to determine the magnitude, risk factors and to implement control measures.
we conducted a case-control study. A suspected case was any student of the school, who has bloody urine with or without: dysuria, itching of the skin, frequent urination or lower abdominal pain from September 2018 to November 2018. A confirmed case was one with laboratory-isolation of Schistosoma ova in appropriate urine sample. We identified cases from the school and hospital records. We collected socio-demographic, clinical and exposure data from cases and controls. Descriptive and inferential analysis were performed to estimate odds ratios at 95% confidence intervals (CI) to determine associations.
of 880 students, 112 suspected cases were identified (attack rate = 12.7%). Mean age of suspected cases was 14-years (standard deviation = ±3.5). Confirmed cases were 76.8%(86/112). Males had twice odds of becoming cases (cOR = 2.3, 95% CI = 1.35-3.96). Fishing (cOR = 7.29, 95% CI = 4.08-13.04) and swimming (aOR = 44.63, 95% CI = 4.73-420.86) were factors significantly associated with infection. Students with previous history of bloody urine had greater odds of being cases (aOR = 47.9, 95% CI = 4.19-546.55).
Schistosoma haematobium was isolated in this outbreak. Fishing and swimming were risky water-related activities. WASH education and mass drug administration with Praziquantel were control measures.
血吸虫病是一种由线虫引起的被忽视的寄生虫感染。它影响着全球约 2 亿人。加纳的患病率为 23.3%，主要影响在校儿童。2018 年 11 月 28 日，疾病监测部门收到报告称，沃尔特地区一所基础学校的学生中出现血尿增多的情况。我们进行了调查，以确定病原体和来源，确定规模、危险因素，并实施控制措施。
我们进行了病例对照研究。疑似病例是指 2018 年 9 月至 11 月期间出现血尿伴有或不伴有以下症状的该校学生：尿痛、皮肤瘙痒、尿频或下腹痛。确诊病例是指在适当的尿液样本中分离出血吸虫卵的病例。我们从学校和医院记录中确定病例。我们从病例和对照中收集社会人口统计学、临床和暴露数据。采用描述性和推断性分析来估计 95%置信区间（CI）的比值比，以确定关联。
在 880 名学生中，发现 112 例疑似病例（发病率=12.7%）。疑似病例的平均年龄为 14 岁（标准差=±3.5）。确诊病例为 76.8%（86/112）。男性成为病例的可能性是女性的两倍（校正比值比[cOR]=2.3，95%置信区间[CI]=1.35-3.96）。钓鱼（校正比值比[cOR]=7.29，95%置信区间[CI]=4.08-13.04）和游泳（调整比值比[aOR]=44.63，95%置信区间[CI]=4.73-420.86）是与感染显著相关的因素。有血尿既往史的学生成为病例的可能性更大（调整比值比[aOR]=47.9，95%置信区间[CI]=4.19-546.55）。
在这次疫情中分离出了埃及血吸虫。钓鱼和游泳是有风险的水相关活动。WASH 教育和吡喹酮大规模药物治疗是控制措施。
