Epidemiological Factors Causing the Spread of Schistosomiasis Among Pupils in Ipogun Community in Ifedore Local Government Area of Ondo State
CHAPTER ONE
Objectives
General objective
To explore the prevalence of schistosomiasis among pupils and factors associated with contracting schistosomiasis in Ipogun community in Ifedore Local Government Area of Ondo State.
Specific objectives
- To determine the prevalence of schistosomiasis among pupils aged 5-14 years in Ipogun community in Ifedore Local Government Area of Ondo State.
- To determine factors associated with schistosomiasis transmission in the pupils in Ipogun community in Ifedore Local Government Area of Ondo State.
- To map the distribution of schistosomiasis infestation among pupils using the geographical information system (GIS) in Ondo.
CHAPTER TWO
LITERATURE REVIEW
Global overview
Schistosomiasis affects almost 240 million people worldwide, and more than 700 million people live in endemic areas. The infection is prevalent in tropical and sub tropical areas, in poor communities without potable water and adequate sanitation. Urogenital schistosomiasis is caused by Schistosoma haematobium and intestinal schistosomiasis by any of the organisms S. guineensis, S. intercalatum, S. mansoni, S. japonicum, and S. mekongi. Several million people all over the world suffer from severe morbidity as a consequence of schistosomiasis (WHO, 2022).
Additionally, schistosomiasis is reported in more than 93 countries and it is reported in literature that globally, S. haematobium is the most prevalent species and accounts for 200, 000 deaths annually (Gurarie et al., 2015).
Burden of disease in Africa and Sub-Saharan region
More than 85% of infested populations are severe and mainly found in sub-Saharan Africa, where more than 20 million suffered from a severe form of schistosomiasis complications (Ntonifor et al., 2012).
In the region, as a neglected tropical disease of poverty, schistosomiasis ranks second among the most widespread parasitic diseases in Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and financial burden on economies of households and governments (Adenowo et al., 2015).
A review of disease burden estimated that more than 200, 000 deaths per year are due to schistosomiasis in sub-Saharan Africa. The burden of disease due to schistosomiasis is however reported to be underestimated (WHO, 2022).
Available data on Copperbelt province
There was paucity of information on studies conducted to characterize current burden of schistosomiasis on the Copperbelt province. There have been very few unpublished studies that have been conducted recently aimed at to characterizing the current distribution patterns of the disease. These were mainly undertaken in localized set ups especially following a rise in number of cases of schistosomiasis noted in some schools.
The most recent information on disease prevalence in the province was from a survey conducted in 2012/ 2014 by the Ministry of Health which reported the highest prevalence in Ipogun community in Ifedore Local Government Area of Ondo State and the lowest in Ndola district (MOH, 2014).
CHAPTER THREE
RESEARCH METHODOLOGY
Study design
The study employed a cross sectional study design using primary data collected from sampled primary schools in Ipogun community in Ifedore Local Government Area of Ondo State from 15 February 2023 to 25 March 2023.
Study population
The criteria needed to define and describe the population included primary pupils between ages 5 to 14 years in the Ondo state is given below. In accordance with central statistical office 2015 population estimates, the 2022 total population for Ondo state was projected at 129, 391. Out of this, the population for pupils between the ages 5 to 14 years for 2022 was estimated at 39, 515 (CSO, 2019).
CHAPTER FOUR
RESULTS
Sample characteristics
A total of 390 pupils were enrolled in the study from 15 different schools. The sex ratio (M/F) was 0.9, with 184 boys and 206 girls. The median age was 12 (IQR 7, 14 years). About 13% of the respondents came from households whose guardians did not work, 68% representing the majority were from homes whose guardians were in informal employment and about 18% from households whose guardians were in formal employment as shown in Table 4.1.
CHAPTER FIVE
DISCUSSION, CONCLUSION AND RECOMMENDATION
DISCUSSION
Schistosomiasis prevalence
In this study, I set out to investigate the prevalence of schistosomiasis among pupils from ages 5 to 14 years and risk factors associated with contracting schistosomiasis in Ipogun community in Ifedore Local Government Area of Ondo State.
I found four positive schistosomiasis cases following laboratory analysis of single urine samples submitted by participants. This accounted for an overall prevalence rate of 1% in all the sampled primary schools in the district. The Ministry of Health conducted a mapping of schistosomiasis countrywide in 2012/2013 among primary schools, S. haematobium was endemic in 69 districts while S. mansoni was prevalent in 49 districts. Ondo state had a reported prevalence rate of 12.8% for S. haematobium (MOH, 2014).
This prevalence rate for S. haematobium among the pupils was lower than prevalence rates reported in earlier studies and this was similar to findings from a study conducted in Mozambique where significant decrease in S. haematobium was observed in a 5 year period from 60.5% to 38.8% following implementation of chemotherapy (Phillips et al., 2022). A study in Namibia reported that the overall, schistosomiasis prevalence in the surveyed areas was 9.0% indicative of a decrease from previous rates which presented high prevalence areas of around 95% (Sousa-Figueiredo et al., 2015).
Strengths
Despite our limitations, our study was able to determine the prevalence and some factors associated with schistosomiasis in primary schools among the pupils. This we believe has provided an important epidemiological update on the disease that is useful for programming and evaluation of control strategies.
Conclusion
In conclusion, my study found that the prevalence rate for schistosomiasis amongst the primary pupils was currently at 1%. The study also found that previous history of schistosomiasis infection was an important associated factor for acquiring new infections in future. I also found that taking praziquantel tablets for chemotherapy during the last mass drug administration exercise in primary schools was protective against acquisition of schistosomiasis infection. The study demonstrated that schistosomiasis infestation was present in two school localities of the 15 samples schools that were sampled.
Recommendations
I recommend implementation of strengthened community health education programs to target the at-risk age groups in order to progressively bring the prevalence rate even lower. Regular screening of children in all schools and the community is therefore strongly recommended in order to facilitate early access and linkage to health services. Active surveillance for schistosomiasis is also recommended in the whole district for prompt detection of outbreaks and change in trends of the disease for informed decision making in intervention implementation. This will greatly contribute to Government of the Republic of Nigeria’s plan of eliminating neglected tropical diseases by the year 2020 in Nigeria which includes schistosomiasis.
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