Co-infection with Schistosoma haematobium and soil-transmitted helminths in rural South Africa

Abstract

Schistosomiasis and soil-transmitted helminthiasis are among the most prevalent neglected tropical diseases and may lead to severe consequences. We assessed the extent of co-infection between Schistosoma haematobium and the soil-transmitted helminths (STHs) Ascaris lumbricoides and Trichuris trichiura in schoolgirls in the rural areas of KwaZulu-Natal, South Africa. We also explored if S. haematobium can serve as a predictor for soil-transmitted helminths in this area. From 15 selected schools, 726 primary schoolgirls aged 10–12 years provided both urine and stool samples. The samples were examined for the presence of eggs using the urine sedimentation technique for S. haematobium and the Kato Katz technique for STHs. Pearson’s chi-square test was used to calculate the association and Spearman’s rank correlation was used for the correlation analysis. There was a highly significant correlation between S. haematobium and STHs at a school level (Spearman’s correlation coefficient =0.93; p bigger than 0.001). The prevalences were found to be 36.9% and 38.8% for S. haematobium and STHs, respectively. A significant association was found between S. haematobium and STHs (odds ratio =2.05; confidence interval =1.58–2.93; p bigger than 0.001). Indirect indicators of urogenital schistosomiasis (e.g. water contact and haematuria) were significantly associated with A. lumbricoides and T. trichiura infection. We have demonstrated a highly significant correlation and overall association between urogenital schistosomiasis and A. lumbricoides and T. trichiura. We cautiously suggest that all S. haematobium endemic areas should be treated for STH infections.

Impact of informal settlements and wastewater treatment plants on helminth egg contamination of urban rivers and risks associated with exposure

“…The dominance of Ascaris spp. and hookworm eggs in the water and sediments could be attributed to the human infections reported in South Africa (Appleton et al 2009;Mkhize-Kwitshana and Mabaso 2014;Molvik et al 2017). Additionally, our previous studies in the area gave a similar profile of helminth eggs in wastewater and sludge (Amoah et al 2018).…”

“…This is therefore a major gap in ensuring the protection of public health, especially in areas where helminth infections are high. For instance, although the total number of people infected with soil-transmitted helminths (STHs) in South Africa is unknown (Molvik et al 2017), it is estimated that over 3 million children require treatment (WHO 2014). Therefore, rivers within urban areas with poor sanitation and in areas receiving wastewater effluents could be impacted by faecal contamination and in turn act as a transmission route.…”

Epidemiology of Schistosomiasis and Soil-Transmitted Helminth Coinfections among Schoolchildren Living in Lambaréné, Gabon

“…[44][45][46] Assessing the coinfection with both trematodes and intestinal nematodes, we found an increase in risk of having schistosomiasis when infected with STHs, particularly with T. trichiura and A. lumbricoides. Although some authors found no association between schistosomiasis and STH infections, such as Njaanake et al 45 in Kenyan schoolchildren from two villages, our results are in line with what was reported by Molvik et al 44 on South African schoolchildren living in moderate prevalence areas for schistosomiasis and STH infections. Even some immunological mechanism can explain that fact; we hypothesize that this association could be due to the fact that both types of infection share the same environmental risk factors.…”

Prevalence, Risk Factors, and Coinfection of Urogenital Schistosomiasis and Soil-Transmitted Helminthiasis among Primary School Children in Biase, Southern Nigeria

“…The prevalence of these parasites was also lower than the prevalence of 62.2% and 32.7% observed in school children in Sarki, Oyo State, Nigeria [ 25 ], for S. haematobium and soil-transmitted helminths, respectively. In the rural areas of KwaZulu-Natal, South Africa [ 26 ], prevalence of 36.8% and 38.8% was observed for S. haematobium and STHs, respectively. The higher prevalence in previous studies and the variation in prevalence among the communities in this study might be due to differences in environmental conditions, cultural practices, inequality in safe water resources, sanitation, and personal hygiene of the pupils.…”