Research Article: Reduction of Urogenital Schistosomiasis with an Integrated Control Project in Sudan

Date Published: January 8, 2015

Publisher: Public Library of Science

Author(s): Young-Ha Lee, Hoo Gn Jeong, Woo Hyun Kong, Soon-Hyung Lee, Han-Ik Cho, Hae-Sung Nam, Hassan Ahmed Hassan Ahmed Ismail, Gibril Nouman Abd Alla, Chung Hyeon Oh, Sung-Tae Hong, Malcolm K. Jones.

Abstract: PurposeSchistosomiasis remains a major public health concern in Sudan, particularly Schistosoma haematobium infection. This study presents the disease-reduction outcomes of an integrated control program for schistosomiasis in Al Jabalain locality of White Nile State, Sudan from 2009 through 2011.MethodsThe total population of the project sites was 482,902, and the major target group for intervention among them was 78,615 primary school students. For the cross-sectional study of the prevalence, urine and stool specimens were examined using the urine sedimentation method and the Kato cellophane thick smear method, respectively. To assess the impacts of health education for students and a drinking water supply facility at Al Hidaib village, questionnaire survey was done.ResultsThe overall prevalence for S. haematobium and S. mansoni at baseline was 28.5% and 0.4%, respectively. At follow-up survey after 6–9 months post-treatment, the prevalence of S. haematobium infection was reduced to 13.5% (95% CI = 0.331–0.462). A higher reduction in prevalence was observed among girls, those with moderately infected status (around 20%), and residents in rural areas, than among boys, those with high prevalence (>40%), and residents in urban areas. After health education, increased awareness about schistosomiasis was checked by questionnaire survey. Also, a drinking water facility was constructed at Al Hidaib village, where infection rate was reduced more compared to that in a neighboring village within the same unit. However, we found no significant change in the prevalence of S. mansoni infection between baseline and follow-up survey (95% CI = 0.933–6.891).ConclusionsAt the end of the project, the prevalence of S. haematobium infection was reduced by more than 50% in comparison with the baseline rate. Approximately 200,000 subjects had received either praziquantel therapy, health education, or supply of clean water. To consolidate the achievements of this project, the integrated intervention should be adapted continuously.

Partial Text: Schistosomiasis is a parasitic trematodiasis caused by several species of the genus Schistosoma, of which S. mansoni, S. japonicum, S. mekongi, and S. haematobium are of public health importance. These worms live in the veins around the intestine or urinary bladder. Eggs are released in the stool or urine of the host and hatch in water [1]. Humans are usually infected when they come into contact with contaminated fresh water such as collecting water, washing, bathing, playing, fishing, or cultivating crops. In general, children, women, fishermen, and farmers are the high risk groups in schistosomiasis, also other people can infect in the irrigation channels or rivers and suffer from hematuria and anemia, enlargement of the liver and spleen, and growth retardation [1], [2].

The study was the partial results of comprehensive schistosomiasis control project implemented by KOICA in White Nile State, Sudan. The project reduced the prevalence of S. haematobium infection from 28.5% to 13.5% after 6–9 months and increased the awareness of students about the seriousness of schistosomiasis and the preventive measures by health education. This project also showed the importance of clean water supply facility for the control of schistosomiasis. Finally, approximately 200,000 students, teachers, or village residents have been benefited by providing either praziquantel medication, health education, or filtered water supply.



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