Assessment of the prevalence of schistosomiasis among school-aged children in rural Tanzania

Background: Schistosomiasis, a parasitic disease obtained from contact with contaminated water sources, is endemic to 74 countries, affects 200 million people worldwide and causes severe end-stage liver disease, intestinal and bladder ulcers, and bladder cancer. Tanzania has high levels of schistosomiasis, with 15.2 million infected (2000). Lake Victoria is a major source; research in shoreline villages (2011) found that 96% of children aged 4-14 tested positive. Method: The present study assessed schistosomiasis prevalence in an inland rural village, screening 148 schoolchildren in Roche for the CCA antigen with a urine test (Rapid Medical Diagnostics). A brief survey assessed knowledge, previous treatment, and water exposure. Results: Children had high infection rates (78%). Water exposure was through bathing, primarily in rivers/streams (97%), wells (14%), and lake (3%). Most students (60%) had heard of schistosomiasis, although only 22% learned about it in school. Males, older students, higher grade levels, distant residence from school, and greater number of siblings were associated with higher schistosomiasis knowledge levels. All were statistically significant. 37% knew that avoiding contaminated water prevents schistosomiasis, but avoiding contaminated water is difficult in rural areas. Conclusion: This study demonstrated that children in inland villages are also at risk for infection. Prevention requires a comprehensive approach of annual mass treatment with praziquantel and community education. Schools provide an ideal community site for intervention programs, and this research suggests that education should start with younger grade levels, incorporate gender roles and outreach to the entire community. An interdisciplinary intervention is planned for summer 2013.