Urinary schistosomiasis among preschool children in Malengachanzi, Nkhotakota District, Malawi: Prevalence and risk factors

Abstract

AimThis study was designed to determine the prevalence of and risk factors for schistosomiasis among a group of preschool children in Malawi. Schistosomiasis burden among preschoolers in Malawi is not well documented in the literature. MethodsThis study used field research (in the form of a snail survey), laboratory work (urinalysis and microscopy for parasite identification), and questionnaireguided interviews to determine the prevalence of and risk factors for urinary schistosomiasis among children, aged between 6 and 60 months, in Malengachanzi, Nkhotakota District, Malawi. ResultsUrinary schistosomiasis prevalence among preschool children was 13%. Of the factors evaluated, only age (P = 0.027) was statistically significantly associated with urinary schistosomiasis risk. Four-year-old preschool children were five times more likely to contract urinary schistosomiasis than twoyear-old children (odds ratio [OR] = 5.255; 95% confidence interval [CI] = 1.014-27.237; P = 0.048). Increased contact with infested water among older children likely explains much of their increased risk. Infestation was evidenced by the presence of infected Bulinus globosus snails in the water contact points surveyed. Multiple regression analysis showed that visiting water contact sites daily (OR = 0.898, 95% CI = 0.185-4.350, P = 0.894), bathing in these sites (OR = 9.462, 95% CI = 0.036-0.00, P = 0.430) and lack of knowledge, among caregivers, regarding the causes of urinary schistosomiasis (OR = 0.235, 95% CI = 0.005-1.102, P = 0.066) posed statistically insignificant risk increases for preschoolers contracting urinary schistosomiasis. ConclusionsUrinary schistosomiasis was prevalent among preschool children in Malengachanzi, Nkhotakota District. Contact with infested water puts these children and the general population at risk of infection and reinfection. Inclusion of preschool children in treatment programmes should be considered imperative, along with safe treatment guidelines. To prevent infection, the population in the area should be provided with health education and safe alternative water sources.

Prevalence and Intensity of Urinary Schistosomiasis among Residence: A Case Study in River Benue, Adamawa State, North Eastern Nigeria

“…Those within age bracket 5-14 years old had the highest prevalence (39.2%) and intensity (161±1.96 eggs/10 mls of urine) rates of infection followed by age bracket 15-24 years old (30.3%, 119±0.97), than other age groups. This is similar to other findings reported by Salwa et al [7], Moyo et al [34], Olulabi et al [35], Hottez et al (2009) and Mbata et al [24]. This could be attributed to their frequent visit to streams and rivers in the quest to swim, bath as well as farming and fishing both in the dry season (irrigation) and rice cultivation during the raining season; thus, they are more exposed than the other age groups.…”

Reinfection of urogenital schistosomiasis in pre-school children in a highly endemic district in Northern Zimbabwe: a 12 months compliance study

“…Primary school aged children, children aged five years and below (pre-school aged children, PSAC) and women in endemic foci are all considered to be high risk groups but until now preventive chemotherapy is mostly targeted at primary school aged children only [ 2 , 5 , 6 ]. This leaves out PSAC and women who also experience severe morbidity related to schistosomiasis [ 7 – 14 ]. Although these studies show that PSAC are also infected with schistosomes, there is scarcity of data showing the dynamics of reinfections to inform current and future control strategies.…”

“…In light of the epidemiological data revealing that PSAC might be a continuous reservoir of infection [ 6 , 7 , 9 – 12 , 14 ], the World Health Organization (WHO) in 2010 [ 5 ] recommended treatment following observations that the current praziquantel formulation is efficacious and safe in this age group. However, WHO still recommends the exclusion of this group in mass drug administration programmes indicating that they are treated on an individual case basis, by qualified medical personnel, [ 5 , 16 ] mainly because of lack of an appropriate paediatric praziquantel formulation [ 7 , 9 , 10 , 17 – 20 ].…”

“…The PSAC should be able to submit samples required for diagnosis to understand disease epidemiology [ 10 , 12 , 14 , 29 ] which, is crucial for focal control towards schistosomiasis elimination [ 30 – 32 ]. Due to day-to-day variability in egg production, the analysis of multiple consecutive urine samples is essential for parasitological urogenital schistosomiasis diagnosis [ 33 ].…”

Toward Health Management of Major Labour Force Generation by Using Infection Control Countermeasures for Haematobium Schistosomiasis –assumed to be related to occupational risk- in the Republic of Malawi

“…Pre-school children frequently accompany their guardians into the freshwater areas [27]. Although it is known that pre-school children also face schistosome infection [28], there is still room for further study on the safety of administering praziquantel to children less than 4 years of age. MDA, however, may be a more promising approach to disease control in Malawi [29].…”