Prevalence Mapping of Schistosoma mansoni Among Pre-school Age Children in Rwanda

Abstract

Schistosoma mansoni is endemic in Rwanda, and control programs have been implemented with a special focus on school-age children (SAC), ignoring pre-school age children (pre-SAC) for which the actual prevalence of the disease is not well established. This study consisted of a cross-sectional quantitative mapping of the distribution of Schistosoma mansoni and identification of associated risk factors among pre-SAC throughout the country. The study covered all the 17 districts of Rwanda endemic for Schistosoma mansoni, with a total sample of 4,675 children enrolled from 80 purposively selected villages. The parasitological assessment of children’s urine and stool samples was conducted using CCA and Kato Katz methods, respectively, for infection detection. A standard questionnaire was used to collect data on the risk factors, and geospatial assessment was performed using tablets and GPS to record geographic coordinates for plotting locations on maps using ArcGIS software. The overall prevalence of S. mansoni infection across the surveyed areas was 24 and 0.8% by CCA and Kato-Katz, respectively. Infection was significantly associated with bathing children in open water bodies. Furthermore, pre-SAC looked after by siblings (sisters) were two times as much likely to be infected compared to those looked after by mothers. Schistosomiasis control interventions are needed for pre-SAC to limit their exposure to open water bodies with expectations of adapted chemotherapy to be availed. Community-based deworming campaigns may be the best way to ensure good treatment coverage of pre-SAC in Rwanda.

Unexpected rapid symptom response after praziquantel to intestinal Schistosoma mansoni symptoms: A case report from Rwanda

“…The patient originated from the highest Schistosoma endemic district of Rwanda, Nyagatare 6 and had been exposed multiple times with stagnant water by swimming according to his exposure interview. The presence of periportal fibrosis explains the chronicity of the infection while the 3-year history of abdominal complaints would likely be due to intra-abdominal Schistosoma nodules as seen by colonoscopy and abdominal CT scan.…”

Malacological Survey and Spatial Distribution of Intermediate Host Snails in Schistosomiasis Endemic Districts of Rwanda

“…Several earlier studies and predictive models focusing on the risk of schistosomiasis transmission have been based on human infections [ 26 , 27 , 41 , 45 ]. While control of schistosomiasis had previously been based on reducing morbidity among humans, understanding the distribution of snails becomes important in achieving the current disease elimination target.…”

“…Data on the infection of pre-school-aged children (PreSAC) was collected from all the 15 districts where snail sampling had been conducted. The data from a parasitological study on PreSAC [ 41 ] were used to assess and determine the link between human infection and snail distribution and infectivity.…”

“…The level of infection intensity was determined based on WHO guidelines [7]. This previously published study [41] was compared with the molecular data results from cercariae and confirmed the presence of S. mansoni in the surveyed districts.…”

Prevalence and Determinants of Schistosoma mansoni Infection among Pre-School Age Children in Southern Ethiopia

“…Some studies reported a higher prevalence of S. mansoni infection in pre-SAC ranging from 11.8% to 70.5% [ 16 , 17 , 18 , 19 , 20 , 21 ], while some reported a lower rate ranging from 0.9% to 5.9% [ 15 , 22 , 23 ]. Small-scale studies reported that daily exposure to infested water bodies and high levels of cumulative water contact in habitats where snail hosts are found is linked with the risk of transmission among pre-SAC [ 8 , 24 , 25 , 26 ]. Moreover, children’s habit of swimming as well as the frequency of swimming in rivers and children’s habit of crossing rivers barefoot are associated with intestinal schistosomiasis in Ethiopia [ 27 , 28 ].…”