Kumba, a town with a population of mixed background and socio-economic status, is a new and intense focus of schistosomiasis. Although fountains provide clean water, the population still uses the river and streams which cross the town for most of its bathing, laundry and swimming. A multivariate analysis indicated that a local subject's age, ethnic group, knowledge about schistosomiasis and the intensity of his or her contact with the river and/or streams were all significantly associated with schistosome infection. Surprisingly, a high level of knowledge about schistosomiasis was positively associated with the infection.
PIP: Schistosomiasis is a disease that affects many people in the wet, warm regions of the world. Schistosoma haematobium affects the bladder wall, causing bladder damage. Bloody urine is often the first observable symptom. S. haematobium uses an intermediate snail host in its life cycle, from which the infective stages are released into the water. It is while humans are in contact with water that the infective stages attack exposed skin and burrow inside the body. In this article, the risk of various water-contact activities for schistosome infection is evaluated. The city of Kumba was selected for the study due to its varied cultural backgrounds and reported focus of schistosomiasis. City areas with a prevalence greater than 10% were studied via a complete census of all housing units, including the collection of urine samples. Main water-contact activities were also identified and knowledge about schistosomiasis was evaluated. 171 households with 1025 residents were identified for the study. 27 ethnic groups were classified into five main categories. A multifactorial analysis was performed. The relative risk (RR) for those aged 10-19 years was found to be the highest RR at 3.6. Individuals with high knowledge also had a high RR value of 3.0, suggesting that health education efforts alone are not completely effective. Ethnic group association to risk was unclear.