Infection with Schistosoma mansoni has an Effect on Quality of Life, but not on Physical Fitness in Schoolchildren in Mwanza Region, North-Western Tanzania: A Cross-Sectional Study

Abstract

BackgroundInfection with Schistosoma mansoni negatively impact children’s physical health and may influence their general well-being. The aim of this study was to investigate the effect of S. mansoni infections on a panel of morbidity indicators with emphasis on quality of life (PedsQL; measured in four different dimensions) and physical fitness (measured as VO2 max) among 572 schoolchildren aged 7–8 years.Methodology/Principal findingsPrevalence of S. mansoni infections was 58.7%, with an arithmetic mean (95% CI) among positives of 207.3 (169.2–245.4) eggs per gram (epg). Most infections were light (56.5%), while 16.4% had heavy infections. Girls had significantly higher arithmetic mean intensities (95% CI) than boys (247.4 (189.2–305.6) vs. 153.2 (110.6–195.8); P = 0.004). A total of 30.1% were anaemic with no sex difference. Stunting and wasting was found in less than 10% of the population. There was no association between S. mansoni prevalence or intensities and the following parameters: anthropometry, anaemia, liver or spleen pathology in neither univariable nor multivariable linear regression analyses. However, in univariable analyses children with S. mansoni infection had a significantly lower score in emotional PedsQL (95% CI) than uninfected (77.3 (74.5–80.1) vs. 82.7 (79.9–85.5); P = 0.033) and infected children had a higher VO2 max (95% CI) compared to uninfected (51.4 (51.0–51.8) vs. 50.8 (50.3–51.3); P = 0.042). In multivariable linear regression analyses, age, S. mansoni infection, haemoglobin and VO2 max were significant predictors for emotional PedsQL while significant predictors for VO2 max were physical PedsQL, height, age and haemoglobin. S. mansoni infection was thus not retained in the multivariable regression analyses on VO2 max.Conclusions/SignificanceOf the measured morbidity parameters, S. mansoni infection had a significant effect on the emotional dimension of quality of life, but not on physical fitness. If PedsQL should be a useful tool to measure schistosome related morbidity, more in depth studies are needed in order to refine the tool so it focuses more on aspects of quality of life that may be affected by schistosome infections.

Diet and hygiene practices influence morbidity in schoolchildren living in Schistosomiasis endemic areas along Lake Victoria in Kenya and Tanzania—A cross-sectional study

“…Thus, being a boy, being taller than average, having animal proteins at least once a day and knowing where to wash hands after toilet visits were significant predictors of physical fitness. The lack of association between physical fitness and infection in the multivariable analysis is in accordance with other recent studies using the 20mSRT [ 16 , 17 , 29 ] and with the baseline results of the two cohorts investigated in this study [ 9 , 10 ]. However, in line with the present study, boys had better physical fitness compared to girls in the three studies reporting the associations [ 16 , 17 , 29 ], an association which was lacking at baseline in Tanzania [ 10 ] and not investigated in Kenya [ 9 ].…”

“…The methods for collection of cohort data are described in detail elsewhere [ 9 , 10 ], but are briefly presented below.…”

Protocol and baseline data for a multi-year cohort study of the effects of different mass drug treatment approaches on functional morbidities from schistosomiasis in four African countries

“…Kenya and Tanzania used two different versions of the PedsQL survey. Kenya used a longer 23-question version than did Tanzania, which used the 16-question version with 15 of them adopted but the last question left out due to irrelevance [ 24 ]. To check the validity of combining the PedsQL scores from the two S. mansoni countries, we abstracted a subset of Kenya questions that were the same as Tanzania’s and performed a sensitivity comparison.…”

Changes in Morbidity, Physical Fitness, and Perceived Quality of Life among Schoolchildren following Four Years of Different Mass Drug Administration Strategies against Schistosoma mansoni Infection in Mwanza Region, Northwestern Tanzania

“…Evaluation of quality of life was performed using the validated Pediatric Quality of Life Inventory 4.0 Short Form 15 (PedsQL4.0 SF15) instrument for children. 8 The questionnaire consists of 15 questions and is divided into four parts with three to five questions each. The four parts describe four dimensions of functioning: problems with physical activities (physical), problems with feelings (emotional), problems with getting along with others (social), and problems with keeping up in school (school).…”

“…A previous article described anthropometric indices, hemoglobin (Hb) levels, physical fitness, quality of life, and USdetected organ pathology in the cohort of children aged 7-8 years at baseline. 8 The aim of the present study was to investigate whether different morbidity markers among cohort children differ by study arm at year 5 and whether the development in morbidity markers among cohort children from baseline to follow-up differs by study arm.…”