Distribution and Factors Associated With Urogenital Schistosomiasis in Tiko Health District, A Semi-urban Setting, South West Region, Cameroon

Abstract

Background: Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity and risk factors associated with the occurrence of UGS in the District. Methods: In this cross-sectional survey, 1029 individuals were enrolled from twelve communities purposively selected from four health areas (Likomba, Holforth, Holforth-Likomba and Mutengene) between June and August 2018. A semi-structured questionnaire was used to collect information on sociodemographic and water contact behaviour. Urine samples were examined for S. haematobium infection using test strip, filtration and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection. Results: The overall prevalence of UGS in the Likomba, Holforth-Likomba and Holforth was 31.5% (95% CI: 28.3 – 34.8). Schistosoma haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (p < 0.001) among the affected communities, ranging from 0 – 56.9%. Infection status of the community related positively (p < 0.001) with proximity to stream (< 100m), the degree of contact (II) with water and number of improved water sources. Younger age group (5 – 14 years) (aOR = 3.6, 95% CI: 1.1 – 12.0) and intense water contact (Degree II) (aOR = 5.2, 95% CI: 3.4 – 8.1) were associated with increased risk of infection as well as higher worm egg load excretion. Conclusion: Generally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area.