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Advisor(s)
Abstract(s)
Background: Mozambique is one of the countries with the highest prevalence of schistosomiasis, although there is little data on the prevalence of the disease and associated morbidity in the adult population. This study aimed to describe and characterize the morbidity associated with schistosomiasis in the adult population of the Chókwè district and to explore the use of anamnestic questionnaires and urine dipsticks, as well as point-of-care ultrasound for urinary-related findings, to better characterize disease prevalence and morbidity. Methodology: Between April and October 2018, we conducted a cross-sectional study embedded within the Chókwè Health Research and Training Centre. Data were collected on sociodemographic variables, signs and symptoms of schistosomiasis, and water-related activities. Infection status was determined by urine filtration, Kato-Katz thick smear, and DNA detection. Point-of-care urinary tract ultrasonography was performed to assess structural morbidity associated with Schistosoma haematobium infection. Multivariate logistic regression was used to search for associations between risk factors, signs and symptoms, infection status, and ultrasound abnormalities. Principal findings: Our study included 1033 participants with a mean age of 32 years old. The prevalence of Schistosoma haematobium, Schistosoma mansoni, and ultrasound-detected urinary tract abnormalities was 11.3% (95% CI 9.5%-13.4%), 5.7% (95% CI 4.3%-7.5%) and 37.9% (95% CI 34.8%-41.2%), respectively. Of the 37.9% with urinary tract abnormalities, 14.5% were positive for Schistosoma haematobium. Reported hematuria in the last month (p = 0.004, aOR 4.385) and blood in the urine dipstick (p = 0.004, aOR 3.958) were markers of Schistosoma haematobium infection. Reporting lower abdominal pain (p = 0.017, aOR 1.599) was associated with ultrasound abnormalities. Conclusion: Using microscopy and DNA analysis for both Schistosoma haematobium and Schistosoma mansoni in conjunction with urinary ultrasound abnormalities gives us several insights into correlations between disease prevalence (microscopic and anatomical) and demographic details in a high-risk population.
Description
This work was funded by the "Joint WHO-AFRO/TDR/EDCTP Small Grants Scheme for Implementation Research on Infectious Diseases of Poverty 2017”, whose responsible investigator was RT. Additionally, it received financial support from “Associação para Desenvolvimento da Medicina Tropical”, whose responsible investigator was JTS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Keywords
Public health Schistosomiasis Morbidity Mozambique Chókwè district
Citation
Serra JT, Silva C, Sidat M, Belo S, Ferreira P, Ferracini N, et al. Morbidity associated with schistosomiasis in adult population of Chókwè district, Mozambique. PLoS Negl Trop Dis. 2024;18(12):e0012738.
Publisher
PLoS