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

A review of latrine front-end characteristics associated with microbial infection risk; reveals a lack of pathogen density data

Unsafe sanitation accounts for an estimated 898,000 global deaths annually. The faecal pathogen transmission pathway is complex with several possible routes. Latrine front-end characteristics and usage behaviours are one key transmission pathway for microbial pathogens, however, there has not yet been a synthesis of the available research. This review aims to compare the microbial infection risks with latrine front-end components including any quantified microbial densities within the household latrines. This review was conducted with no restriction on the geographical location of the research. Of 118 studies reviewed, only ten (8%) have quantified the microbial density inside the household latrines compared to 109 (92%) measuring the infection risks. The reported risks were most frequent for specific bacterial (n = 34), and helminths infections (n = 32) compared to diarrhoea (n = 23), combined (n = 15), protozoan (n = 4), and viral (n = 4) infections. The infections risk decreased for using latrines lying at a higher position on the sanitation ladder (for example flush latrines) compared to those lying lower (for example pit latrines). The trend was similar for using floor materials that were easier to clean and less favourable for pathogen survival inside the latrines (for example, concrete as opposed to earth). Faecal coliforms were reported highest on the surface of the squat pan (743 CFU/cm2) of pour-flush latrines and helminths on earth floors of pit latrines (1.5 eggs and larvae per gram of soil). Irrespective of latrine type and its position on the sanitation ladder, a dirty latrine, evidenced by a visible lack of cleanliness, significantly increased the risk for all infections. This study recommends that effective microbial infection risk reduction in latrines can be gained efficiently by ensuring washable surfaces and consistent cleaning practices. Future studies should include more rigorous measurements of microbial densities in various latrine types incorporating the different front-end components and usage behaviours.

Prevalence and risk factors associated with urogenital schistosomiasis among primary school pupils in Nigeria

Urogenital schistosomiasis is a neglected tropical disease that is endemic to Nigeria and one which continues to pose a public health problem especially among school-age children in rural communities. This study was carried out in remote areas where most people depend on natural water bodies and rainwater for their daily water needs. The present research investigates the prevalence of urogenital schistosomiasis and the significant risk factors associated with the infection among primary school children in Nigeria. From August 2019 to December 2019, a total of 5514 primary school-age children from twelve sites were diagnosed with the presence of Schistosoma haematobium eggs in their urine. Socio-demographic, sociocultural, and socioeconomic indices and data on behaviors (e.g contact frequency with freshwater bodies) were also collected for each diagnosed individual through the use of a questionnaire. Associations between each of these variables and disease infection were tested using a multivariate logistic regression. A total of 392 of the 5514-urine samples were positive for the infection, the overall prevalence reached 7.1% and ranged from 4.6% (East Nigeria) to 15,9% (West Nigeria). Multivariate logistic regression analyses showed that the significant risk factors associated with S. haematobium infection are frequent contact with freshwater bodies (rivers/steams), with an adjusted odds ratio (AOR) of 4.92; 3.34–7.24, washing/swimming, AOR: 46.49; 27.64–78.19, and fishing, AOR: 11.57; 8.74–15.32. For socioeconomic factors, primary education of fathers which resulted in an AOR of 1.63; 1.01–2.45 was significantly associated with the infection. The socio-demographic factor for the 12–14 year age group had an AOR of 1.68; 1.21–2.33, and was also significantly associated with the disease. Nigeria remains endemic for urogenital schistosomiasis as indicated by the data obtained from all the studied sites, and it is clear that efforts need to be intensified in order to control and eradicate the disease throughout the country.

Detecting Schistosoma haematobium infection by microscopy and polymerase chain reaction (PCR) in school children in three senatorial districts of Cross River State, Nigeria

As a result of the poor sensitivity and specificity of the standard parasitological diagnostic methods currently being used, this study was conducted to compare the standard parasitological diagnostic methods and Polymerase Chain Reaction (PCR) in determining the prevalence of urinary schistosomiasis in Cross River State (CRS). The study was conducted between April 2015 and March 2016. Seven hundred and seventy seven (777) urine samples were randomly collected from selected school-age children. The urine samples were subjected to standard parasitological and molecular examinations. Chi-square test was used to test the differences between the data on subgroups and the results from specimen examinations. An overall prevalence of 1.7% was recorded using microscopy and 34.7% recorded using PCR. The highest prevalence of infection by microscopy occurred in the Southern Senatorial District (2.3%), while the Northern Senatorial District recorded the highest prevalence of infection by PCR (53.2%) (p < 0.05). Males were more infected (2.4%) than females (0.6%) using microscopy. With PCR, males were also more infected (35.7%) compared to females (33.3%) (p < 0.05). The highest prevalence of infection using microscopy and PCR both occurred in school-age children aged 5-8 years (3.6% and 47.8% respectively), while the lowest prevalence for both methods occurred in participants aged 17 - 20 years (0% for both methods) (p < 0.05). This study has shown PCR to be effective in detecting schistosomiasis infection and also re-affirms the endemicity of urinary schistosomiasis in the three Senatorial Districts of CRS.