Prevalence and factors associated with transmission of schistosomiasis in school-aged children in South Sudan: a cross-sectional study

Abstract

Introduction: South Sudan is affected by a high burden of Neglected Tropical Diseases (NTDs). The country is very vulnerable to NTDs due to its favourable tropical climate and multiple risk factors. However, the distribution of the diseases and the populations at risk for the various NTDs is unknown. This paper described the distribution of schistosomiasis in 58 counties and 261 schools in South Sudan.

Methods: a descriptive quantitative cross-sectional study of schistosomiasis in 58 counties in 8 states of South Sudan recruited school-aged children. Using different laboratory techniques, the children were tested for Schistosoma mansoni (S. mansoni) and Schistosoma haematobium (S. haematobium). A quantitative descriptive statistical was performed to determine the prevalence rates and the endemicity of schistosomiasis among 13,286 school-aged children.

Results: the overall prevalence of S. mansoni and S. haematobium were 6.1% and 3.7% using Kato Katz and urine filtration concentration testing techniques. The highest state prevalence was reported in Western Equatoria for both S. mansoni (14.7%) and S. haematobium (7.3%). The age of the participants varied from 4 to 18 years; of these, children 10 to 12 years old had the highest prevalence of S. mansoni (6.8%) and S. haematobium (3.7%). The prevalence of S. mansoni (7% male vs 5% female) and S. haematobium (3.6% male vs 3.1% female) were higher in males than females. The likelihood of the prevalence of S. mansoni in males was 1.42 (95% CI:1.23, 1.64) higher than in females, while for S. haematobium, 1.36 (95% CI:1.12, 1.65) higher than in females. The prevalence of S. mansoni and S. haematobium showed a statistically significant gender difference (P< 0.05).

Conclusion: the study had provided evidence of the distribution of schistosomiasis in South Sudan for policy direction and recommended annual preventive chemotherapy with praziquantel in all endemic areas.

Keywords: Kato Katz; S. haematobium; S. mansoni; Schistosomiasis; South Sudan; bilharzia; circulating cathodic antigen; haematuria; mapping surveys; urine filtration.