Abstract
BACKGROUND: Schistosomiasis persists as a public health problem in Hadhramout, the largest governorate in the eastern part of Yemen. Despite its endemicity, epidemiological patterns in many districts remain unclear. Therefore, this study aimed to determine the prevalence and factors associated with schistosomiasis among schoolchildren in the Amd District of Hadhramout Valley. METHODS: A cross-sectional study was conducted with 380 schoolchildren aged 6-16 years. Data on the children's sociodemographic characteristics, infection-related behaviors, and environmental factors were collected using a structured questionnaire. Urine filtration and Kato-Katz techniques were used to detect and count the eggs of Schistosoma haematobium and S. mansoni, respectively. Data were analyzed using appropriate statistical tests, and multivariable binary logistic regression analysis was performed to identify predictors of schistosomiasis. RESULTS: In Amd District, 33.7% (95% CI: 28.9-38.7) of schoolchildren had light-intensity infection with any Schistosoma species, indicating a moderate risk level, specifically S. haematobium among 31.6% (95% CI: 26.9-36.3) and S. mansoni among 2.1% (95% CI: 0.7-3.6) of children. Macrohematuria, microhematuria, and proteinuria were significantly associated with S. haematobium infection. However, neither hematochezia nor diarrhea was significantly associated with S. mansoni infection. Multivariable binary logistic regression analysis identified male gender (AOR = 4.2; 95% CI: 2.48-7.12; P <0.001), age ≥10 years (AOR = 3.1; 95% CI: 1.70-5.56; P <0.001), and contact with natural water sources (AOR = 2.0; 95% CI: 1.06-3.58; P = 0.032) as independent predictors of schistosomiasis. CONCLUSION: The risk of schistosomiasis in Amd District is moderate and predominated by S. haematobium, with light-intensity infections affecting approximately one-third of schoolchildren. Therefore, biannual preventive chemotherapy with praziquantel is recommended for all enrolled and non-enrolled school-age children. Macrohematuria, microhematuria, and proteinuria are important indicators of S. haematobium infection. Meanwhile, male gender, older age, and water contact can independently predict infection.