Bugssa Gessessew, Teklehaymanot Tilahun, Medhin Girmay, Berhe Nega
Department of Medical Parasitology and Entomology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS Negl Trop Dis. 2024 Nov 25;18(11):e0012691. doi: 10.1371/journal.pntd.0012691. eCollection 2024 Nov.
Intestinal schistosomiasis caused by Schistosoma mansoni continues to be a significant public health problem in Ethiopia. This study investigated the prevalence and intensity of S.mansoni infection, and contributing factors in Alamata district of Tigray Region, Northern Ethiopia.
A community-based cross-sectional study was conducted and 1762 participants were enrolled from five clusters in Alamata district. A questionnaire was used to collect socio-demographic data and risk factors. Stool samples were examined using Kato-katz technique to determine the prevalence and intensity of infection. The data were analyzed using SPSS version 25. Median, inter quartile range (IQR), mean, frequency, and percentage were used to descriptively summarize data. The Wilcoxon Mann-Whitney and Kruskal-Wallis tests were used to compare the differences in mean rank of egg load between different groups. Bivariate and multivariable logistic regression models were used to investigate the association between the odds of being infected with S.mansoni and the different socio-demographic and other factors. The strength of these associations was reported using odds ratio with corresponding 95% confidence intervals, and a P-value below 5% was used to report statistical significance.
Out of 1762 residents included in the study 941 (53.4%) were females. The age varied from 5-80 years, with a median age of 25 years (IQR = 27), the overall prevalence of S.mansoni was 21.5% with males accounting for 26% (204/821) of the infections. The proportion of infection was higher among the age groups of 15-19 and 20-29 years at 32.7% and 33.1%, respectively. The mean egg count among the infected study participants was 146.82 eggs per gram of feces (epg) ± (243.17 SD). Factors significantly associated with increased odds of infection were living in Waja cluster (AOR:8.9; 95% CI, 3.5-23.2; P< 0.001); being in the age groups 10-14 (AOR:6.0, 95% CI: 3.1-11.7, P<0.001), 15-19 (AOR:5.8, 95% CI:2.8-12.2, P<0.001), and 20-29 (AOR:3.5, 95% CI:1.8-6.8; P<0.001) years; having direct contact with water while crossing river (AOR: 2.4, 95% CI: 1.5-3.8, P<0.001); and swimming (AOR: 1.4, 95% CI: 1.01-2.0, P = 0.035).
The study indicates a notable S.mansoni burden in the area, driven by various risk factors. To effectively address this, enhancing diagnostics, implementing targeted mass drug administration, and conducting comprehensive health education campaigns on disease transmission routes are imperative.
由曼氏血吸虫引起的肠道血吸虫病在埃塞俄比亚仍然是一个重大的公共卫生问题。本研究调查了埃塞俄比亚北部提格雷地区阿拉马塔区曼氏血吸虫感染的流行率和感染强度以及相关因素。
开展了一项基于社区的横断面研究，从阿拉马塔区的5个群组中招募了1762名参与者。使用问卷调查收集社会人口统计学数据和风险因素。采用加藤厚涂片法检查粪便样本，以确定感染的流行率和感染强度。使用SPSS 25版软件对数据进行分析。采用中位数、四分位间距（IQR）、均值、频数和百分比对数据进行描述性总结。采用Wilcoxon Mann-Whitney检验和Kruskal-Wallis检验比较不同组之间每克粪便虫卵数的平均秩次差异。采用二元和多变量逻辑回归模型研究曼氏血吸虫感染几率与不同社会人口统计学因素及其他因素之间的关联。使用比值比及相应的95%置信区间报告这些关联的强度，P值低于5%表示具有统计学意义。
在纳入研究的1762名居民中，941名（53.4%）为女性。年龄范围为5至80岁，中位年龄为25岁（IQR = 27），曼氏血吸虫的总体感染率为21.5%，其中男性感染率为26%（204/821）。15至19岁和20至29岁年龄组的感染比例较高，分别为32.7%和33.1%。在感染的研究参与者中，每克粪便的平均虫卵数为146.82个虫卵/克粪便（epg）±（标准差243.17）。与感染几率增加显著相关的因素包括居住在瓦贾群组（比值比：8.9；95%置信区间，3.5 - 23.2；P < 0.001）；年龄在10至14岁（比值比：6.0，95%置信区间：3.1 - 11.7，P < 0.001）、15至19岁（比值比：5.8，95%置信区间：2.8 - 12.2，P < 0.001）和20至29岁（比值比：3.5，95%置信区间：1.8 - 6.8；P < 0.001）；过河时直接接触水（比值比：2.4，95%置信区间：1.5 - 3.8，P < 0.001）；以及游泳（比值比：1.4，95%置信区间：1.01 - 2.0，P = 0.035）。
该研究表明该地区曼氏血吸虫负担显著，由多种风险因素所致。为有效解决这一问题，必须加强诊断、实施有针对性的群体药物治疗，并开展关于疾病传播途径的全面健康教育活动。
