Intestinal schistosomiasis and the associated transmission factors in pre-school aged children in villages surrounding Lake Rweru in Bugesera District, Rwanda

Abstract

Background: Schistosomiasis is a waterborne snail-transmitted parasitic disease and is a major public health problem in sub-Saharan Africa, affecting populations living where water supply and sanitation are poor and inadequate. Pre-school aged children (PSAC) have often been ignored in disease control and prevention programs, as a result very little information is available on the prevalence or intensity of schistosomiasis in this age group.

Objective: This study was conducted to determine the prevalenceand intensity of intestinal schistosomiasis among PSAC, and determine factors associated with infection transmission in PSAC in villages surrounding Lake Rweru in Bugesera District, Rwanda.

Methods: This was a cross-sectional study involving 256 PSAC aged 12-59 months. Double Kato-Katz (KK) stool smears and the point of care circulating cathodic antigen (CCA) test were used to diagnose S. mansoni in stool and urine samples, respectively. A questionnaire in the local language (Kinyarwanda) was administered to parents/guardians of the PSAC to determine factors associated with schistosomiasis transmission in the area.

Results: Based on the KK stool smears, no S. mansoni infection was found in any of the PSAC identified. However, using the point of care CCA test, 16.9% of the PSAC tested positive, when trace was considered as positive. The information collected on questionnaire showed a significant association between infection with S. mansoni (based on the CCA test) and visits to the lake especially, when the children accompanied their parents/guardians, or older children (P<0.000).

Conclusion: The prevalence of S. mansoni in the study population was low on CCA test and the infection was associated with going to the lake by the children when they accompanied their parents/guardians or older siblings.The children who go to the lake should prevent direct contact with lake’s water.These results call for the need to consider including a point of care screening tool for S. mansoni infections among preschool children as well as a prevention program targeting this age group in the study area.

Keywords: Intestinal schistosomiasis prevalence, Pre-school children, Rwanda