BackgroundSchistosomiasis remains a global public health challenge, with 93% of the ∼237 million infections occurring in sub-Saharan Africa. Though rarely fatal, its recurring nature makes it a lifetime disorder with significant chronic health burdens. Much of its negative health impact is due to non-specific conditions such as anemia, undernutrition, pain, exercise intolerance, poor school performance, and decreased work capacity. This makes it difficult to estimate the disease burden specific to schistosomiasis using the standard DALY metric.Methodology/Principal FindingsIn our study, we used Pediatric Quality of Life Inventory (PedsQL), a modular instrument available for ages 2–18 years, to assess health-related quality of life (HrQoL) among children living in a Schistosoma haematobium-endemic area in coastal Kenya. The PedsQL questionnaires were administered by interview to children aged 5–18 years (and their parents) in five villages spread across three districts. HrQoL (total score) was significantly lower in villages with high prevalence of S. haematobium (−4.0%, p<0.001) and among the lower socioeconomic quartiles (−2.0%, p<0.05). A greater effect was seen in the psychosocial scales as compared to the physical function scale. In moderate prevalence villages, detection of any parasite eggs in the urine was associated with a significant 2.1% (p<0.05) reduction in total score. The PedsQL reliabilities were generally high (Cronbach alphas ≥0.70), floor effects were acceptable, and identification of children from low socioeconomic standing was valid.Conclusions/SignificanceWe conclude that exposure to urogenital schistosomiasis is associated with a 2–4% reduction in HrQoL. Further research is warranted to determine the reproducibility and responsiveness properties of QoL testing in relation to schistosomiasis. We anticipate that a case definition based on more sensitive parasitological diagnosis among younger children will better define the immediate and long-term HrQoL impact of Schistosoma infection.

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Abstract. The cercarial density in natural water and number of infected Bulinus globosus were monitored over a one-year period to identify the transmission foci in an endemic area of schistosomiasis haematobia in Kenya. Overall prevalence and intensity of infection of the study community were 59.2% and 10.9 eggs/10 ml of urine. Cercariometry was carried out on 456 occasions at 20 study sites while snail sampling was done on 465 occasions at the same sites over a one-year period. Cercariometry was exclusively done at flowing water habitats. The results showed the focality and seasonality of transmission. Cercariae were detected on 44 occasions at 11 sites. The detections were made on seven occasions at two study sites, six occasions at one site, four occasions at four sites, three occasions at one site, two occasions at two sites, and one occasion at one site. Densities of 1-4 cercariae/100 liters of water were found on 31 occasions. Five to nine cercariae/100 liters of water were found on seven occasions, 10-19 cercariae/100 liters of water were found on two occasions, and high cercarial densities greater than 20 cercariae/100 liters of water were found on four occasions. The highest count was 52 cercariae/100 liters of water. The presence of cercariae in natural water was shown to depend on the water temperature, but the intensity and duration of sunlight did not affect the presence of cercariae in water. The monthly variability of cercarial density was proportional to the number of infected snails. Cercarial density was highest in March and April, in the middle of the rainy season, whereas no cercariae were detected in cool dry season. The snail population peaked late in March, the beginning of the long rainy season, remained high for two months, and decreased rapidly late in May when heavy rain occurred. The overall infection rate of snails was 7.3% and the majority of infected snails were collected from March to May. There was no definite correlation between the presence or absence of cercariae and infected snails. Cercariae were frequently found where infected snails were absent and cercariae were sometimes absent where infected snails were present. Cercariometry and snail sampling remain quite complementary in identifying the transmission foci of schistosomiasis.Several technologies have been proposed for identifying water bodies that are transmission sites for schistosomiasis. The large-scale use of sentinel rodents to detect transmission foci has already been shown to be logistically difficult, ex pensive, and too slow for an effective response.1 Snail col lection shows the general pattern of transmission for indi vidual sites and for the area as a whole, but it provides in formation about the intensity of the parasite flux from the vertebrate to the snail vectors and thereafter the rate of de position of schistosome eggs in the sites.2 Cercariometry al lows direct evaluation of the cercarial density depending on the volume of filtered water, although the presence of cer cariae other than those of human ...

Abstract.The effect of a piped water supply on human water contact in a Schistosoma haematobiumâ€"endemic area in Coast Province, Kenya was studied. After the construction of five community standpipes and one shower unit, there was a 35 . 1% reduction in the number of people observed using river water, a 44. 1% reduction in the frequency of contact with river water, and a 25.4% reduction in the amount of contact. The frequency of river water contact per person also decreased significantly, but the amount of contact per person did not decrease. The total frequency of contact decreased significantly except for washing clothes by the river, washing utensils, and fishing. The frequency per person did not change for most of the activities and significantly increased for washing clothes. The frequency of river water contact in households with high piped water consumption showed a significant decrease compared with those with low piped water consumption. The volume of consumption of piped water was inversely proportional to the distance from the home to the community standpipe. These results indicate that in the study area, the effect of a piped water supply on river water contact behavior was heterologous while the total river water contact decreased significantly, and that the piped water had a beneficial effect on some villagers but very little effect on others.Humans are responsible for the spread of schistosome in fection, and the pattern of schistosome infection depends on human behavior, especially contact with infested water. Mea sures that reduce this contact will reduce schistosome infec tion. A safe water supply, used in conjunction with mass chemotherapy, is an effective measure in the control of schistosomiasis.'It reduces the frequency and degree of hu man contact with infested water and subsequently leads to a lower equilibrium level of transmission. However, the effect of a water supply on the transmission of schistosomiasis has not been fully understood. There are many reports on the impact of a safe water supply on the prevalence and/or the intensity of infection in particular communities.2'4 However, among them, only a few reports have examined the impact of a safe water supply on water contact behavior.9-@@@12 Since 1981, we have been conducting a schistosomiasis haematobia control program in a small village in Kenya. In the study area, a combination of mass chemotherapy and the introduction of a safe water supply was started in February 1984. Community standpipes were constructed and a shower unit was built at a primary school. The present work cx amines to what extent the provision of a safe water supply reduced contact with river water in the study area. Since the records at one com munity standpipe were not complete, we excluded the house holds using this community standpipe from analysis. Water contact study. Water contact was measured by direct observation.'8-15 The study sites were 16 major points that had been identified as busy sites by a questionnaire. The study sites were divided into two...