BackgroundThe control of schistosomiasis in Nigeria is mainly by mass treatment with praziquantel through the school system, with an absence of any provision for pre-school children. We therefore determined the prevalence and intensity of urinary schistosomiasis in pre-school children between the ages of 1-6 years in Ilewo-Orile a rural and endemic community, near Abeokuta, Nigeria as part of providing information on the neglected tropical diseases among this age group. Two urine samples were collected from each pre-school child. The samples were tested for microhaematuria using reagent strips and then processed and examined with a microscope for Schistosoma haematobium ova.ResultsOf the 167 children examined 97 (58.1%) had infection, with no significant difference (P = 0.809) in infection rates between boys (57.1%) and girls (59.2%). Both prevalence and intensity of infection did not increase significantly with age (P = 0.732). The overall geometric mean egg count was 1.17 eggs/10 ml urine. There was no significant association (P = 0.387) between intensity in boys (1.16 eggs/10 ml urine) and girls (1.19 eggs/10 ml urine). 47.4% of the children had microhaematuria which did not increase significantly with age (P = 0.526). Focus group discussions with guardians and caregivers revealed that infection of pre-school children early in life was due to exposures through bathing in the stream by their mothers, while the older children would visit the stream for washing, fetching of water, bathing and swimming.ConclusionCommunity participatory health education is needed in this community as a first step in reducing infection and transmission of the disease, while the rehabilitation and repair of the existing water borehole system in the community should be effected. The results of this study have shown that pre-school children also harbour infection and are a source of transmission of schistosomiasis in endemic communities. Planning and provision for their treatment should be considered in control programmes.

Until recently, the epidemiology and control of schistosomiasis in sub-Saharan Africa have focused primarily on infections in school-aged children and to a lesser extent on adults. Now there is growing evidence and reports of infection in infants and pre-school-aged children (≤ 6 years old) in Ghana, Kenya, Mali, Niger, Nigeria and Uganda, with reported prevalence from 14% to 86%. In this review, we provide available information on the epidemiology, transmission and control of schistosomiasis in this age group, generally not considered or included in national schistosomiasis control programmes that are being implemented in several sub-Saharan African countries. Contrary to previous assumptions, we show that schistosomiasis infection starts from early childhood in many endemic communities and factors associated with exposure of infants and pre-school-aged children to infection are yet to be determined. The development of morbidity early in childhood may contribute to long-term clinical impact and severity of schistosomiasis before they receive treatment. Consistently, these issues are overlooked in most schistosomiasis control programmes. It is, therefore, necessary to review current policy of schistosomiasis control programmes in sub-Saharan Africa to consider the treatment of infant and pre-school-aged children and the health education to mothers.

BackgroundThe acceleration of the control of soil-transmitted helminth (STH) infections in Nigeria, emphasizing preventive chemotherapy, has become imperative in light of the global fight against neglected tropical diseases. Predictive risk maps are an important tool to guide and support control activities.MethodologySTH infection prevalence data were obtained from surveys carried out in 2011 using standard protocols. Data were geo-referenced and collated in a nationwide, geographic information system database. Bayesian geostatistical models with remotely sensed environmental covariates and variable selection procedures were utilized to predict the spatial distribution of STH infections in Nigeria.Principal FindingsWe found that hookworm, Ascaris lumbricoides, and Trichuris trichiura infections are endemic in 482 (86.8%), 305 (55.0%), and 55 (9.9%) locations, respectively. Hookworm and A. lumbricoides infection co-exist in 16 states, while the three species are co-endemic in 12 states. Overall, STHs are endemic in 20 of the 36 states of Nigeria, including the Federal Capital Territory of Abuja. The observed prevalence at endemic locations ranged from 1.7% to 51.7% for hookworm, from 1.6% to 77.8% for A. lumbricoides, and from 1.0% to 25.5% for T. trichiura. Model-based predictions ranged from 0.7% to 51.0% for hookworm, from 0.1% to 82.6% for A. lumbricoides, and from 0.0% to 18.5% for T. trichiura. Our models suggest that day land surface temperature and dense vegetation are important predictors of the spatial distribution of STH infection in Nigeria. In 2011, a total of 5.7 million (13.8%) school-aged children were predicted to be infected with STHs in Nigeria. Mass treatment at the local government area level for annual or bi-annual treatment of the school-aged population in Nigeria in 2011, based on World Health Organization prevalence thresholds, were estimated at 10.2 million tablets.Conclusions/SignificanceThe predictive risk maps and estimated deworming needs presented here will be helpful for escalating the control and spatial targeting of interventions against STH infections in Nigeria.

S U M M A R YThe Nigerian national control programme (NCP) for schistosomiasis does not have a specific action plan for female genital schistosomiasis (FGS), mainly due to gaps in epidemiological and clinical surveillance. To address this, we conducted a pilot investigation for FGS in girls (>5 and ≤15 years) and adult women (≥16 years) in four rural communities near Abeokuta, Ogun State. Urine samples were collected from 317 participants [children (n = 187), adults (n = 130)] and examined for ova of Schistosoma haematobium by microscopy. A total of 149 participants (47·0%) had egg-patent urogenital schistosomiasis [children (64·7%), adults (21·6%)], reported blood in urine was common (44·5%) as well as sign-post symptoms of FGS. To verify FGS directly, 20 adult women each underwent a gynaecological investigation by colposcopy with observed lesions classified according to the WHO FGS pocket atlas. Fourteen (70·0%) women presented with FGS as grainy-sandy patches (n = 10), homogenous yellow sandy patches (n = 6), nabothian cysts and rubbery papules (n = 1). Our study confirms FGS in Ogun State and calls for further appraisals of this disease in other areas where urogenital schistosomiasis is endemic. The Nigerian NCP should be encouraged to develop an appropriate response to FGS not only to detect it, but also to prevent it.

BackgroundAscariasis, Trichuriasis and Hookworm infections poses a considerable public health burden in Sub-Saharan Africa, and a sound understanding of their spatial distribution facilitates to better target control interventions. This study, therefore, assessed the prevalence of the trio, and mapped their spatial distribution in the 20 administrative regions of Ogun State, Nigeria. MethodsParasitological surveys were carried out in 1,499 households across 33 spatially selected communities. Fresh stool samples were collected from 1,027 consenting participants and processed using ether concentration method. The locations of the communities were georeferenced using a GPS device while demographic data were obtained using a standardized form. Data were analysed using SPSS software and visualizations and plotting maps were made in ArcGIS software. ResultsFindings showed that 19 of the 20 regions were endemic for one or more kind of the three infections, with an aggregated prevalence of 17.2%. Ascariasis was the most frequently observed parasitic infection in 28 communities with a prevalence of 13.6%, followed by hookworm infections with a prevalence of 4.6% while Trichuriasis was the least encountered with a prevalence of 1.7%. The spatial distribution of infections ranges between 5.3-49.2% across the regions. The highest and lowest distribution of overall helminth infections was