High levels of urinary schistosomiasis among children in Bunuso, a rural community in Ghana: an urgent call for increased surveillance and control programs

Abstract

We investigated the occurrence of urinary schistosomiasis and estimated predictors for risk of infection among children in the Bunuso community of Ashanti Region of Ghana, West Africa. The cross-sectional survey was conducted between June and December 2009. Information was obtained on socio-demographic characteristics, schistosomiasis symptoms and other risk factors through interviews and questionnaires. Urine samples were analysed for Schistosoma haematobium ova using centrifugation and sedimentation, filtration and microscopy. Bivariate estimations and multiple logistic regression modelling with odds ratios (OR) were used to assess risk factors for S. haematobium infections. Inspections at River Nanakwaw revealed snail vectors, Bulinus truncatus. Overall, 95 out of 100 (95 % confidence interval [CI] 88.8-97.6) children tested positive for S. haematobium infection. The mean ova density (eggs/10 ml of urine) of infections was 58.12 (95 % CI 31.3-71.6) and varied significantly between agegroup distributions (P value = 0.001; Post Hoc, P [ 0.05 for B8 vs 15-17 years, and 9-11 vs 12-14 years), sources of house-hold water (P value = 0.019; Post Hoc, P \ 0.05 for Borehole vs River Nanakwaw), children activities in River Nanakwaw (P value = 0.001), and haematuria (P value = 0.007). Independent variables significantly associated with S. haematobium infections were the use of River Nanakwaw as source of household water (OR 12.54; 95 % CI 3.932-42.12, P value = 0.003), engaging activities in River Nanakwaw (OR 8.76;; P value = 0.008) and haematuria (OR 36.71;; P value = 0.001). The passage of blood urine was prognostic of urinary schistosomiasis with a positive predictive value of 97.5 %. Our results demonstrate the endemicity of urinary schistosomiasis in Bunuso. Schistosomiasis remains a disease of great public health importance in Ghana, and there is the urgent need to intensify surveillance and control programs in remote riparian communities.

Schistosoma haematobium co-infection with soil-transmitted helminthes: prevalence and risk factors from two communities in the central region of Ghana

“…However, comparison of some reported prevalence estimates for S. haematobium infection from some communities together with the present prevalence estimate, it is tempting to speculate that average prevalence rate of S. haematobium infection in Ghana may be high despite increasing national efforts in terms of education and mass treatment. Compared with S. haematobium infectionprevalence estimates from some studied communities in some African countries such as in Malawi (10.4 %), [26] Sudan (0.0 %), [27] Senegal, [28] and Kenya (9.3 %), [29] that of the present study is relatively high despite been lower compared to estimates from communities in Zimbabwe (68 %), [29] Nigeria (51-59.5 %), [31,32] and Benue state in Nigeria (41.5 %). [5] S. haematobium co-infection with S. mansoni and other soil-transmitted helminthes is reported elsewhere.…”

“…[26] Previous studies have shown that children from age 6-13 years are more at risk of S. haematobium infection while those above 13 years tend to have lower risk. [26] Unlike these reports, [26] it was observed that children aged between 16-19 years were more at risk of S. haematobium infection compared to younger children (< 15 years) (table 2) and this observation adds credence to an earlier report from Nigeria which showed that older children are more at risk than younger children.…”

“…[26] Previous studies have shown that children from age 6-13 years are more at risk of S. haematobium infection while those above 13 years tend to have lower risk. [26] Unlike these reports, [26] it was observed that children aged between 16-19 years were more at risk of S. haematobium infection compared to younger children (< 15 years) (table 2) and this observation adds credence to an earlier report from Nigeria which showed that older children are more at risk than younger children. [5] With these varying reports in respect of age of children and risk of S. haematobium infection, it is possible that the contribution of age to the risk of S. haematobium infection may not be acting in isolation but may reflect on other contributing factors that influence childcare such as parental economic and social status, and educational level.…”

“…Symptomatic S. haematobium infection is pathologically characterized by chronic haematuria, dysuria, pollakisura, and proteinuria [26] , impaired ureters and bladders, and kidney failure. [33,37] The most common and easily reported sign of S. haematobium infection is haematuria, while urinary analysis may also show proteinuria and leukocyturia.…”

Malaria, helminths and malnutrition: a cross-sectional survey of school children in the South-Tongu district of Ghana

“…The results is also in keeping with previous mass deworming, malarial prevention and schistosomiasis control exercises in this region [ 2 – 5 ]. Our data however suggest that despite the improved control efforts, there remain many inhabitants of riparian communities that suffer from urinary schistosomiasis [ 26 ]. Although we are not privy to the full repertoire of drugs admitted during these sessions, children had mostly been on praziquantel in various combinations with other drugs including antimalarial.…”