Burden and risk factors for Schistosoma mansoni infection among primary school children: A quantitative school-based cross-sectional survey in Busega district, Northern Tanzania

BACKGROUND: Intestinal schistosomiasis is one of the most common neglected tropical diseases in Tanzania. Despite massive praziquantel administration, data from Northern Tanzania have reported a prevalence of up to 93.2%. Because the disease is focal, depending on host, environmental and intermediate host factors, there is a need to acquire data in specific settings to better tailor interventions. Therefore, the study assessed the prevalence and factors associated with persistent transmission of intestinal schistosomiasis among school-age children in Busega district, Northern Tanzania. METHODS: A school-based cross-sectional study was conducted among 363 primary school children, randomly selected from school clusters in the Busega district. A single stool sample was collected from each child for S. mansoni ova and infection intensity examination using Kato-Katz. Factors related to intestinal schistosomiasis transmission were acquired through a questionnaire. A malacological survey was carried out to determine the Biomphalaria infectivity rate. Descriptive statistics and logistic regression analysis were conducted to analyse the association between schistosoma infection and factors related to transmission in this setting. RESULTS: The prevalence of S. mansoni infection was 41.3% (95% CI: 36.3–46.5), statistically significantly higher among the younger group aged less than 11 years (46.4% vs 35.3%, p = 0.032). The intensity of infection was heavy in 1.6% of participants, moderate in 9.6%, and light in 30.9%. Studying at Mwamayombo Primary School (AOR = 2.50, 95% CI: 1.12–5.60) was the only factor significantly associated with S. mansoni infestations. The snail intermediate host belonged to Biomphalaria sudanica species, whose infectivity rate was quantified as 0.97%, thus confirming ongoing transmission in the area. CONCLUSIONS: There was a high prevalence of S. mansoni infection among school-age children in the Busega district. The presence of the infected Biomphalaria sudanica in the area documents the persistent transmission of the disease, favored by low knowledge and negative attitudes among school-aged children. Hence, the need for multi-approach intervention for schistosomiasis prevention and elimination.