Schistosomiasis outbreak investigation, Empandeni Ward, Mangwe District, Matabeleland South Province, June 2012; a case control study

Abstract

BackgroundOn 20th of June 2012, 31 pupils from Kwite primary school reported to the local clinic complaining of passing bloody urine. A study was conducted to identify factors, the etiology and risks of contracting the disease.MethodsAn unmatched 1:2 case control study was conducted at Kwite primary school. A case was defined as any child aged between seven to fifteen years, resident in Empandeni Ward for not less than two months, who had passed bloody urine with or without dysuria, fever, fatigue or lower abdominal pains from the 01/06/12 to 07/07/12. A control was a classmate of a case, staying in the same ward, who had not passed bloody urine. Controls were chosen by lottery method. A pretested questionnaire was administered to pupils and their caregivers. Environmental assessment was conducted; line lists, case notes, and district outbreak preparedness and response were reviewed using standard checklists.ResultsAll the 42 cases, and 84 controls were enrolled into the study. The median age for cases and controls was 10 years (Q1 = 9, Q3 = 12) and 10 years (Q1 = 8, Q3 = 11), respectively. Swimming in Kwite dam [AOR = 9.02, 95% CI (2.29-35.53)] and bathing in the dam [AOR = 3.22, 95% CI (1.10-9.41)] were independent factors associated with contracting schistosomiasis. Schistosoma hematobium was isolated in 31 out of 100 urine specimens examined. Bulinus globosus snails were identified at Kwite dam.ConclusionThe outbreak was driven by human contact with S. hematobium infested Kwite dam water, while poor knowledge on prevention of schistosomiasis by the Kwite community was evident. As a result of this study, health education to pupils and the community, mass drug administration on school pupils and mollusciding at the dam were done. The provincial health team adopted as on-going activities, the inclusion of schistosomiasis prevention and control in malaria pre-elimination activities.

Factors associated with Schistosomiasis outbreak at Omindamba primary school, Omusati region, Namibia: a case-control study, March 2016

“…From our case-control study we found that swimming in the canal, and using water from the Etaka- pond were the independent factors for being a case for dysuria and haematuria. These findings are similar to a study done in Zimbabwe, where there were significant associations between having schistosomiasis infection and participating in swimming, bathing in the dam, fishing using a fishing line and fishing with legs in water [ 13 ]. However, drinking from the canal was not found to be significantly associated with Schistosomiasis in our study because only 33 (26.4%) of cases drank from the canal as opposed to 121 (96.8%) of cases who swam in the Canal.…”

“…This finding is consistent with studies conducted in Ethiopia, Nigeria, Malawi, and Namibia [ 15 - 18 ]. On the contrary, studies carried out in Zimbabwe, Ghana and Nigeria showed a higher prevalence of urinary schistosomiasis among females than males [ 13 , 19 , 20 ]. This discrepancy with our findings could be due to the differences in cultural practices that expose females to Schistosomiasis risks.…”