Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

Abstract

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

Transmission Dynamics of Schistosoma haematobium among School-Aged Children: A Cohort Study on Prevalence, Reinfection and Incidence after Mass Drug Administration in the White Nile State of Sudan

“…More than 30% of residents depend on farming and animal husbandry. The coverage of improved water and sanitation at the household level was 44% and 15%, respectively [ 16 , 20 ]. More than 33% of people reported practicing open defecation.…”

“…The FMOH has implemented MDA against schistosomiasis every year, targeting school-aged children in the White Nile State in collaboration with the Korea International Cooperation Agency (KOICA) since 2009 [ 16 , 17 , 19 , 20 ]. The schistosomiasis prevalence was 28.5% in 2009 but decreased to 3.6% in 2019 [ 16 , 17 , 19 , 20 ].…”

“…The FMOH has implemented MDA against schistosomiasis every year, targeting school-aged children in the White Nile State in collaboration with the Korea International Cooperation Agency (KOICA) since 2009 [ 16 , 17 , 19 , 20 ]. The schistosomiasis prevalence was 28.5% in 2009 but decreased to 3.6% in 2019 [ 16 , 17 , 19 , 20 ]. Although water and sanitation improvements were conducted along the MDA, those interventions were restricted to a small portion of villages in the White Nile State.…”

“…Although water and sanitation improvements were conducted along the MDA, those interventions were restricted to a small portion of villages in the White Nile State. However, despite ongoing MDA interventions, high prevalence has been seen in some parts of the White Nile State until recently [ 16 , 17 , 19 , 20 ].…”

Urinary schistosomiasis and the associated bladder cancer: update

“…The mortality rates due to schistosomiasis and their complications have been estimated at 280,000 deaths per year. Schistosomiasis can cause many health problems to the extent that disability-adjusted life years due to schistosomiasis burden exceeds 70 million, worldwide [11]. Despite public health campaigns to eradicate schistosomiasis, it remains a major public health crisis.…”