Prevalence and Trend of Urinary Schistosomiasis in West Africa: A Systematic Review and Meta-Analysis

Abstract

Background: Urinary schistosomiasis remains a major cause of public health concern with the global burden predominant in Sub-Sahara Africa. Over 78 countries are affected and approximately 800 million people are exposed to the disease in Sub-Saharan Africa (SSA) accounting for 90% of cases and an estimated 280,000 deaths each year. The disease poses a substantial public health challenge causing an estimated 70 million Disability-Adjusted Life Years. There is however no consolidated data on the prevalence of urinary schistosomiasis in West Africa. Aim: This study assessed the prevalence of urinary schistosomiasis in West Africa. Methods: This research employed a systematic literature review to meticulously gather and analyze existing data, with the primary aim of establishing the weighted prevalence of S. haematobium infection in West Africa rigorously adhering to the PRISMA guidelines between March 1 and March 12, 2023, spanning key databases including MEDLINE via PubMed, Scopus, and Google Scholar. Prevalence metrics were presented using proportion. Random effects model was used as significantly large heterogeneity was observed among the studies. The DerSimonian-Laird random effects method was used as the between study variance estimator in estimating the pooled proportion estimate and its confidence interval. Publication bias was assessed using the Egger’s test and the Beggs test as well as funnel plots. The MedCalc statistical software version 14 and OpenMeta [Analyst] meta-analysis tools were used for the meta-analysis. A p-value of <0.05 was considered statistically significant. Results: This review included 133 articles out of which 91 (68.40%) representing the majority were contributed by Nigeria. Overall, this review comprised 126508 participants out of which 40019 were identified to be infected with S. haematobium. The pooled prevalence based on the random effect model was 37.6% (95%CI: 33.9% - 41.3%). Pooled prevalence rates of 41.4% (95% CI: 36.1% - 46.7%), 40.2% (95% CI: 24.7% – 55.6%) and 23.9% (95% CI: 16.8% - 30.9%) were recorded among rural, suburban and urban dwellers respectively. A meta regression analysis revealed a significantly decreasing trend in the prevalence of schistosomiasis with advancement in year of publication (Coeff. -0.007, p=0.004). Conclusion: The result from this study highlights the positive impact of control measures instituted in fighting urinary schistosomiais in West Africa. Targeted interventions, especially in rural areas may further aid in the elimination of the schistosomiasis menace in the subregion. Age-specific disparities underscore the need for tailored approaches. This review emphasizes the importance of sustained control measures and continued research to achieve long-term disease reduction and, ultimately, elimination.