Presence of an Unmapped Focus for Urogenital Schistosomiasis in the Tiko Health District in Cameroon: Implications for Control

Abstract

Background: Schistosomiasis is known to be endemic in all the 10 regions of Cameroon.  In the South West Region, it is concentrated in Meme Division [1] and Bafia health area, [2]. Treatment coverage has been limited to the areas known to be foci for the disease. We studied an area (Likomba) where no infected persons were recorded in the past but recently (June 2017), individuals infected with Schistosoma haematobium were identified at a hospital in that area.    Methodology: Demographic, socioeconomic and environmental information were collected via a validated questionnaire. In order to establish the prevalence of, and risk factors for infection with S. haematobium in the Tiko health district, urine samples were collected into dry containers from 264 children between the ages of 5 and 20 after administration of structured questionnaires. The samples were preserved appropriately and using the sedimentation technique of microscopy, samples were analysed for the presence of S. haematobium ova.                    Results: It was established that all the subjects had been resident there for at least five years and most of them, their whole lives. Out of 264 individuals, 101 persons were positive for S. haematobium. This gave a prevalence of 38%.  The prevalence of schistosomiasis was significantly higher (p=0.01) among children aged 5-8 and 17-20 years compared to those aged 9-12 and 13-16 years (P<0.05). A very significant difference was also seen in infection between males and females with males having a prevalence of 48% and females having a prevalence of 27%. Multivariate analysis confirmed that using unsafe sources for household chores and drinking water (P = 0.001), bathing in the stream (P = 0.00001) and visiting the stream more often (P = 0.0001) were the key factors significantly associated with schistosomiasis infection among these children. Conclusion: There is obviously an active transmission of urogenital schistosomiasis in the Tiko health district. Since the sedimentation method of diagnosis is less sensitive than the syringe filtration method, which is the gold standard, the prevalence is likely to be underestimated in this area. This health district should be included in any future control program in the country.