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Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi

BACKGROUND: Schistosomiasis is a public health problem in Malawi but estimates of its prevalence vary widely. There is need for updated information on the extent of disease burden, communities at risk and factors associated with infection at the district and sub-district level to facilitate effectiv...

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Autores principales: Kapito-Tembo, Atupele P., Mwapasa, Victor, Meshnick, Steven R., Samanyika, Young, Banda, Dan, Bowie, Cameron, Radke, Sarah
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614474/
https://www.ncbi.nlm.nih.gov/pubmed/19156193
http://dx.doi.org/10.1371/journal.pntd.0000361
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author Kapito-Tembo, Atupele P.
Mwapasa, Victor
Meshnick, Steven R.
Samanyika, Young
Banda, Dan
Bowie, Cameron
Radke, Sarah
author_facet Kapito-Tembo, Atupele P.
Mwapasa, Victor
Meshnick, Steven R.
Samanyika, Young
Banda, Dan
Bowie, Cameron
Radke, Sarah
author_sort Kapito-Tembo, Atupele P.
collection PubMed
description BACKGROUND: Schistosomiasis is a public health problem in Malawi but estimates of its prevalence vary widely. There is need for updated information on the extent of disease burden, communities at risk and factors associated with infection at the district and sub-district level to facilitate effective prioritization and monitoring while ensuring ownership and sustainability of prevention and control programs at the local level. METHODS AND FINDINGS: We conducted a cross-sectional study between May and July 2006 among pupils in Blantyre district from a stratified random sample of 23 primary schools. Information on socio-demographic factors, schistosomiasis symptoms and other risk factors was obtained using questionnaires. Urine samples were examined for Schistosoma hematobium ova using filtration method. Bivariate and multiple logistic regressions with robust estimates were used to assess risk factors for S. hematobium. One thousand one hundred and fifty (1,150) pupils were enrolled with a mean age of 10.5 years and 51.5% of them were boys. One thousand one hundred and thirty-nine (1,139) pupils submitted urine and S. hematobium ova were detected in 10.4% (95%CI 5.43–15.41%). Male gender (OR 1.81; 95% CI 1.06–3.07), child's knowledge of an existing open water source (includes river, dam, springs, lake, etc.) in the area (OR 1.90; 95% CI 1.14–3.46), history of urinary schistosomiasis in the past month (OR 3.65; 95% CI 2.22–6.00), distance of less than 1 km from school to the nearest open water source (OR 5.39; 95% CI 1.67–17.42) and age 8–10 years (OR 4.55; 95% CI 1.53–13.50) compared to those 14 years or older were associated with infection. Using urine microscopy as a gold standard, the sensitivity and specificity of self-reported hematuria was 68.3% and 73.6%, respectively. However, the positive predictive value was low at 23.9% and was associated with age. CONCLUSION: The study provides an important update on the status of infection in this part of sub-Saharan Africa and exemplifies the success of deliberate national efforts to advance active participation in schistosomiasis prevention and control activities at the sub-national or sub-district levels. In this population, children who attend schools close to open water sources are at an increased risk of infection and self-reported hematuria may still be useful in older children in this region.
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spelling pubmed-26144742009-01-20 Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi Kapito-Tembo, Atupele P. Mwapasa, Victor Meshnick, Steven R. Samanyika, Young Banda, Dan Bowie, Cameron Radke, Sarah PLoS Negl Trop Dis Research Article BACKGROUND: Schistosomiasis is a public health problem in Malawi but estimates of its prevalence vary widely. There is need for updated information on the extent of disease burden, communities at risk and factors associated with infection at the district and sub-district level to facilitate effective prioritization and monitoring while ensuring ownership and sustainability of prevention and control programs at the local level. METHODS AND FINDINGS: We conducted a cross-sectional study between May and July 2006 among pupils in Blantyre district from a stratified random sample of 23 primary schools. Information on socio-demographic factors, schistosomiasis symptoms and other risk factors was obtained using questionnaires. Urine samples were examined for Schistosoma hematobium ova using filtration method. Bivariate and multiple logistic regressions with robust estimates were used to assess risk factors for S. hematobium. One thousand one hundred and fifty (1,150) pupils were enrolled with a mean age of 10.5 years and 51.5% of them were boys. One thousand one hundred and thirty-nine (1,139) pupils submitted urine and S. hematobium ova were detected in 10.4% (95%CI 5.43–15.41%). Male gender (OR 1.81; 95% CI 1.06–3.07), child's knowledge of an existing open water source (includes river, dam, springs, lake, etc.) in the area (OR 1.90; 95% CI 1.14–3.46), history of urinary schistosomiasis in the past month (OR 3.65; 95% CI 2.22–6.00), distance of less than 1 km from school to the nearest open water source (OR 5.39; 95% CI 1.67–17.42) and age 8–10 years (OR 4.55; 95% CI 1.53–13.50) compared to those 14 years or older were associated with infection. Using urine microscopy as a gold standard, the sensitivity and specificity of self-reported hematuria was 68.3% and 73.6%, respectively. However, the positive predictive value was low at 23.9% and was associated with age. CONCLUSION: The study provides an important update on the status of infection in this part of sub-Saharan Africa and exemplifies the success of deliberate national efforts to advance active participation in schistosomiasis prevention and control activities at the sub-national or sub-district levels. In this population, children who attend schools close to open water sources are at an increased risk of infection and self-reported hematuria may still be useful in older children in this region. Public Library of Science 2009-01-20 /pmc/articles/PMC2614474/ /pubmed/19156193 http://dx.doi.org/10.1371/journal.pntd.0000361 Text en Kapito-Tembo et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Kapito-Tembo, Atupele P.
Mwapasa, Victor
Meshnick, Steven R.
Samanyika, Young
Banda, Dan
Bowie, Cameron
Radke, Sarah
Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi
title Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi
title_full Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi
title_fullStr Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi
title_full_unstemmed Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi
title_short Prevalence Distribution and Risk Factors for Schistosoma hematobium Infection among School Children in Blantyre, Malawi
title_sort prevalence distribution and risk factors for schistosoma hematobium infection among school children in blantyre, malawi
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614474/
https://www.ncbi.nlm.nih.gov/pubmed/19156193
http://dx.doi.org/10.1371/journal.pntd.0000361
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