Urogenital schistosomiasis and associated determinant factors among senior high school students in the Dutsin-Ma and Safana Local Government Areas of Katsina State, Nigeria

尼日利亚卡齐纳州杜钦-马和萨法纳地方政府辖区高中生泌尿生殖系统血吸虫病及其相关决定因素

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Abstract

BACKGROUND: Human schistosomiasis is a chronic parasitic disease of poverty caused by the cercariae of digenetic trematodes of the genus Schistosoma. The disease is a major source of morbidity and mortality in 77 low- and middle-income countries in the tropics where 700 million people are at risk. In a bid to provide relevant epidemiological information to boost control of urogenital schistosomiasis at the state level in Nigeria, we conducted this study with the aim of investigating the disease's prevalence and intensity, and the determinant factors responsible for its endemicity. METHODS: Data on risk factors were obtained from a total of 645 students aged 12─25 years using well- designed questionnaires. Samples were collected between 09:45 and 14:00 in universal bottles. Each10μl centrifuged sample was examined for the eggs of S. haematobium using Motic® (Binocular) Light Microscope (model S-10-P) with a x10 objective. Average infection intensity was recorded as number of eggs per 10 ml of urine sample. Survey data were entered into Microsoft Excel 2010 and analyzed using Epi Info™ 7. Associations among variables were determined using the chi square test and bivariate and multivariate logistic regressions. RESULTS: Prevalence of urogenital schistosomiasis was 30.54 % among the study population, with a mean infection intensity of 30.27 eggs/10 ml of urine. Prevalence and average intensity were higher in males (28.37 % and 32.21 eggs/10 ml of urine respectively) than in females (2.17 % and 5 eggs/10 ml of urine respectively). Water contact activities (X (2)   = 29.031, P = 0.0000), sex (male) [X (2) = 109.82; P<0.0001], location (Dutsin─Ma) [X (2)   = 7.19; P = 0.0073], age group 18-20 (X (2)   = 4.819, P = 0.0281), altitude (531─560 m) [X (2)   = 6.84, p = 0.0089], fathers doing other brown─collar jobs (X (2)   = 8.449, P = 0.0037) and mothers' occupation (X (2)   = 9.470, P = 0.0021) were found to be significantly associated with urogenital schistosomiasis. Boys were six times more likely to be infected with the cercariae of S. haematobium compared to girls [AOR (95 % CI): 6.34 (4.89─8.22)]. CONCLUSIONS: Dutsin-Ma and Safana were classified as moderate-risk Local Government Areas for urogenital schistosomiasis. The strong association between the disease and mother's occupation is of utmost importance and suggests a promising control measure: that is, directing health education as well as grassroots mass chemotherapeutic intervention with praziquantel at mothers. A good network including treated pipe-borne water, drainage system, and sewage disposal facilities available should be improved upon. Molluscicides should be provided at highly subsidized rate to help control the disease.

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