Prevalence and intensity of Schistosoma haematobium in KwaZulu-Natal, South Africa.

Abstract

Background and objectives: Urogenital schistosomiasis is a neglected tropical disease caused by the parasite Schistosoma haematobium, which is receiving increased attention, due to its reported association with diseases such as the Human Immunodeficiency Virus, genital cancers, sexually transmitted diseases and liver diseases. Symptoms of urogenital schistosomiasis include haematuria, frequent urination, tiredness and a decrease in the cognitive ability of children. The prevalence of S. haematobium infection needs to be known and mass treatment programmes against the disease implemented. The aim of this study was to investigate the prevalence and intensity of S. haematobium infection. The objectives were to determine the prevalence and intensity of S. haematobium among school going children in ILembe and uThungulu Health Districts of KwaZulu-Natal province, to determine if there is an association between school location, sex, altitude, temperature and the prevalence of schistosomiasis and to assess the need for mass treatment campaigns. Methods: In this study, 6265urine samples were collected for analysis using dipsticks from boys and girls attending rural public schools in these health districts. The prevalence and intensity of S. haematobium infection was calculated and thereafter associations with temperature, altitude and distance to the nearest river were investigated. Descriptive and analytical statistics were undertaken, the latter using a correlation coefficient and a linear regression (p˂0.05) (Confidence Interval (CI) 95%). Results: The prevalence of schistosomiasis for boys in ILembe was 40% and girls 39% and in uThungulu was 56% and 53% in girls and boys respectively. Most infection was the dominant intensity in both the Districts. There was a significant inverse relationship between prevalence of schistosomiasis and altitude (p˂0.05). Associations between prevalence and distance of school to the nearest river were non-significant, and the average minimum summer temperature also showed a positive relationship but that was non-significant (p˃0.05). Conclusion: In both the Districts, the prevalence fell in the category that is recommended by the World Health Organisation for mass treatment. This information alerts health care workers to take the necessary actions to combat schistosomiasis infection and the transmission of urogenital schistosomiasis by providing mass treatment with praziquantel. Mass treatment in endemic communities impacted by schistosomiasis can significantly reduce the morbidity caused by the disease. Furthermore, treatment at an early age can help avoid complications that would predispose individuals to the risk of HIV. In endemic areas, public education about the disease should be prioritized. Furthermore clean water sources should be provided for communities at risk to prevent reinfection