Urogenital schistosomiasis prevalence, knowledge, practices and compliance to MDA among school-age children in an endemic district, southern East Tanzania

BACKGROUND: Tanzania has a high prevalence of urogenital schistosomiasis. Praziquantel is administered to school-age children on an annual basis as part of efforts to reduce transmission and morbidity associated with heavy infections. We investigated the prevalence, knowledge, and practices of urogenital schistosomiasis transmission, as well as compliance with mass drug administration (MDA) among schoolchildren in Masasi District. MATERIALS AND METHODS: A cross-sectional survey was conducted in five primary schools. A pre-tested questionnaire was used to assess knowledge and practice related to the transmission of urogenital schistosomiasis, as well as compliance with MDA. Collected urine samples were examined macroscopically for macrohematuria. They were then tested for microhematuria and Schistosoma haematobium (S. haematobium) eggs with urine dipsticks and filtration technique, respectively. FINDINGS: The study included 389 primary school children in total. Overall, 27 (6.9%) of children had S. haematobium infection, and 37 (9.5%) had microhematuria. The mean (SD) intensity was 123.4 (247.4) eggs per 10 ml of urine. A total of 10 (2.6%) had heavy intensity of infection. The majority (94.9%) reported having complied to the previous round of MDA six months prior to this study, and 308 (79.2%) were aware that water contact is associated with an increased risk of urogenital schistosomiasis infection. Nevertheless, 182 (46.8%) of the participants engaged in swimming activities, with 92 (50.9%) of the participants being female. The prevalence of urogenital schistosomiasis was higher (10.9%) among children who participated in swimming activities versus those who did not (3.4%) (P = 0.003). CONCLUSION: Despite high MDA compliance, urogenital schistosomiasis is still prevalent among primary school children in Masasi District. Children who swim in freshwater bodies such as rivers and ponds are more likely to contract urogenital schistosomiasis.