The Nelson Mandela African Institution of Science and Technology, School of Life Sciences and Bioengineering, Arusha, Tanzania.
Mbeya University of Science and Technology, College of Science and Technical Education, Mbeya, Tanzania.
PLoS Negl Trop Dis. 2024 Sep 9;18(9):e0012462. doi: 10.1371/journal.pntd.0012462. eCollection 2024 Sep.
Schistosomiasis is a significant public health problem in Tanzania, particularly for the people living in the marginalized settings. We have conducted a systematic review with meta-analysis on the prevalence of schistosomiasis to add knowledge towards the development of effective approaches to control the disease in Tanzania. Online databases namely, Pub Med, SCOPUS and AJOL, were systematically searched and a random effect model was used to calculate the pooled prevalence of the disease. Heterogeneity and the between studies variances were determined using Cochran (Q) and Higgins (I2) tests, respectively. A total of 55 articles met the inclusion criterion for this review and all have satisfactory quality scores. The pooled prevalence of the disease in Tanzania was 26.40%. Tanzania mainland had the highest schistosomiasis prevalence (28.89%) than Zanzibar (8.95%). Sub-group analyses based on the year of publication revealed the going up of the pooled prevalence, whereby for (2013-2018) and (2018-2023) the prevalence was 23.41% and 30.06%, respectively. The prevalence of the Schistosoma mansoni and Schistosoma hematobium were 37.91% and 8.86% respectively. Mara, Simuyu, and Mwanza were the most prevalent regions, with a pooled prevalence of 77.39%, 72.26%, and 51.19%, respectively. The pooled prevalence based on the diagnostic method was 64.11% for PCR and 56.46% for POC-CCA, which is relatively high compared to other tests. Cochrans and Higgins (I2) test has shown significant heterogeneity (p-value = 0.001 and I2 = 99.6). Factors including age, region, diagnostic method and sample size have shown significant contribution to the displayed heterogeneity. The pronounced and increasing prevalence of the disease suggests potential low coverage and possibly lack of involvement of some regions in the control of the disease. This, therefore, calls for an intensive implementation of control interventions in all endemic regions, preferably using an integrated approach that targets several stages of the disease lifecycle.
在坦桑尼亚，血吸虫病是一个严重的公共卫生问题，特别是对生活在边缘化环境中的人来说。我们进行了一项系统评价和荟萃分析，以了解血吸虫病的流行情况，为在坦桑尼亚制定有效的疾病控制方法提供知识。我们系统地搜索了在线数据库，如 Pub Med、SCOPUS 和 AJOL，并使用随机效应模型计算了该病的 pooled prevalence。使用 Cochran (Q) 和 Higgins (I2) 检验分别确定异质性和研究间方差。共有 55 篇文章符合本综述的纳入标准，且所有文章的质量评分都令人满意。坦桑尼亚的血吸虫病总体流行率为 26.40%。坦桑尼亚大陆的血吸虫病流行率最高（28.89%），而桑给巴尔岛的流行率最低（8.95%）。基于出版年份的亚组分析显示，pooled prevalence 呈上升趋势，2013-2018 年和 2018-2023 年的流行率分别为 23.41%和 30.06%。曼氏血吸虫和埃及血吸虫的流行率分别为 37.91%和 8.86%。 Mara、Simuyu 和 Mwanza 是最流行的地区，pooled prevalence 分别为 77.39%、72.26%和 51.19%。基于诊断方法的 pooled prevalence 为 PCR 检测法的 64.11%和 POCT-CCA 检测法的 56.46%，与其他检测方法相比相对较高。Cochrans 和 Higgins (I2) 检验显示存在显著异质性（p 值=0.001，I2=99.6）。年龄、地区、诊断方法和样本量等因素对显示的异质性有显著贡献。该疾病显著且不断增加的流行率表明潜在的覆盖率较低，并且可能存在一些地区未参与疾病的控制。因此，需要在所有流行地区加强控制干预措施的实施，最好采用针对疾病生命周期多个阶段的综合方法。
