Abstract
Introduction: This study focuses on the persistence of urogenital schistosomiasis (8%) in the Tambacounda Health District, despite mass treatment efforts with Praziquantel targeting individuals aged 5–14 in 2023. The main objectives are to evaluate the current prevalence of the disease, identify factors contributing to its persistence, and assess the acceptability of implemented preventive measures. Methods: A descriptive and analytical study was conducted in August 2024, targeting individuals aged 10 and above. Data collection was performed using Kobo Collect, and analysis was carried out with R 4.4.1. Binary logistic regression was applied to identify factors associated with the occurrence of urogenital schistosomiasis. Results: Preventive measures were accepted by 83.47% of participants, while 14.6% reported a history of hematuria, but only 7.5% presented hematuria during the survey. Urine dipstick testing detected hematuria in 22.5% of participants, and 5.7% tested positive for Schistosoma haematobium eggs, corresponding to a prevalence of 1.98% among individuals aged 10–14 and 7.44% among those aged 15 and above. Therapeutic coverage was high among individuals aged 10–14 (88.12%). In multivariate analysis, the factors significantly associated with the occurrence of urogenital schistosomiasis were knowledge of the disease (ORa = 6.32 [1.61–31.8], p = 0.026), seeking medical care (ORa = 10.87 [2.83–48.1], p < 0.001), experiencing side effects after treatment (ORa = 43.71 [2.9–70.7], p = 0.003), and positive results on the urine dipstick test (ORa = 118.44 [11.12–126.12], p < 0.001). Conclusion: The Tambacounda Health District remains endemic for urogenital schistosomiasis despite mass treatment campaigns targeting individuals aged 5–14. Recommendations include strengthening health education, systematic urine dipstick screening, and implementing two rounds of Praziquantel treatment.
Published in
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World Journal of Public Health (Volume 10, Issue 1)
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DOI
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10.11648/j.wjph.20251001.14
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Page(s)
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26-33 |
Creative Commons
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
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Copyright
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Copyright © The Author(s), 2025. Published by Science Publishing Group
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Keywords
Urogenital, Schistosomiasis, Tambacounda, Senegal
1. Introduction
Urogenital schistosomiasis (UGS) is a parasitic disease caused by the trematode
Schistosoma haematobium, which infects the urinary tract and surrounding tissues
. Transmission occurs primarily through contact with contaminated freshwater, where the cercariae, the parasite’s larvae, penetrate the skin causing dermatitis
[2] | ePILLY Trop Maladies infectieuses tropicales. 2022 [cited 2024 Jan 27]; Available from: www.infectiologie.com |
[2]
. In the chronic phase, symptoms include hematuria, pelvic pain, and recurrent urinary infections, which can lead to severe complications such as chronic bladder lesions
.
Endemic mainly in sub-Saharan Africa, urogenital schistosomiasis affects more than 700 million people across 78 countries, with particularly high prevalence in 51 of these countries, where nearly 90% of global cases and deaths occur
. The diagnosis of urogenital schistosomiasis is made by microscopic examination of urine, and treatment relies on the use of Praziquantel
.
The World Health Organization (WHO) classifies the endemicity of schistosomiasis into three categories: low when the prevalence is below 10%, moderate when it ranges from 10% to 50%, and high when it exceeds 50%
. In 2013, mapping in Senegal revealed that 59 out of 72 districts were endemic for schistosomiasis, with high endemicity in the regions of Tambacounda and Kédougou. Despite annual mass distribution of Praziquantel, which reaches over 80% coverage in these districts, the disease remains highly prevalent
[7] | Plan République du Sénégal. Ministére de la santé et de l’action sociale. Plan national stratégique de lutte contre les maladies tropicales négligées. Dakar, Fann, 2020. 97 p. |
[7]
. In 2017, a study recorded an average incidence of 28% of schistosomiasis at the regional hospital in Tambacounda from 2017
[8] | Oumar Ka. Incidence de la bilharziose urogénitale au centre hospitalier de Tambacounda de 2015 à 2017. Mémoire de DES de Biologie Clinique. Université Cheikh Anta Diop de Dakar. N°106.2020. 62 p. |
[8]
.
In 2023, an impact assessment of urogenital schistosomiasis treatment revealed a low prevalence of 8% for the district, with variations ranging from 0% in 10 of the 15 surveyed health posts to 91% at the Bohé Balédji health post
[9] | Département de Tambacounda. Résultats d’évaluation d’impact du traitement contre la schistosomiase de 2023. 4 p. |
[9]
. This situation highlights the complexity of controlling urogenital schistosomiasis and underscores the need to understand the factors underlying its persistence despite mass treatment with Praziquantel.
The persistence of the disease is exacerbated by factors such as poor hygiene, outdoor urination practices, activities in freshwater environments
, and disruptions caused by the COVID-19 pandemic, which limited access to preventive treatments
[11] | Toor J, Adams ER, Aliee M, Amoah B, Anderson RM, Ayabina D, et al. Predicted impact of COVID-19 on neglected tropical disease programs and the opportunity for innovation. Clinical Infectious Diseases. 2021; 72(8): 1463–6. Available from: http://dx.doi.org/10.1093/cid/ciaa933 |
[11]
. This situation emphasizes the urgency of adapting prevention and control strategies to local conditions to improve the effectiveness of interventions and better understand the barriers to the acceptability of the preventive measures proposed to the population.
It is therefore crucial to evaluate the prevalence of urogenital schistosomiasis in the Tambacounda health district, focusing particularly on the age groups under 10 to 14 years and over 14 years. Additionally, it is important to identify the determinants and factors associated with its persistence and to evaluate the acceptability of preventive measures against urogenital schistosomiasis by these individuals. Moreover, the acceptability of preventive measures may vary between health posts and be influenced by awareness, cultural perceptions, and access to care in these different areas.
The objectives of the research are to determine the prevalence of urogenital schistosomiasis in the Tambacounda health district for those aged 10 and older, identify the determinants and factors associated with this prevalence such as hygiene conditions and practices in freshwater areas, and evaluate the acceptability of the recommended preventive measures, taking into account awareness, cultural perceptions, and access to care within the district.
2. Methodology
2.1. Study Framework
Our study was conducted in the Tambacounda health district, which had a population of 340,805 inhabitants in 2024, covering an area of 11,416 km², with a population density of 29.85 inhabitants per km². It had a level II hospital, one reference health center, five secondary health centers, 28 health posts, and 27 health huts
[12] | ANSD/SRSD. Situation économique et sociale Région Tambacounda 2019. Service Régional de la Statistique et de la Démographie de Sédhiou. 2015; 107. |
[12]
.
In 2023, the impact assessment of urogenital schistosomiasis treatment revealed a low overall prevalence of 8%, with variations ranging from 0% in 10 of the 15 surveyed health posts to 91% at the Bohé Balédji health post
[9] | Département de Tambacounda. Résultats d’évaluation d’impact du traitement contre la schistosomiase de 2023. 4 p. |
[9]
.
2.2. Study Type, Period, and Population
We conducted a descriptive and analytical study during the August 2024. The target population for this study consisted of the inhabitants of the Tambacounda health district.
2.3. Inclusion and Non-inclusion Criteria
All individuals aged above 10 years residing in the Tambacounda department who were present in the targeted households and had given their informed consent to participate in the study were included.
Excluded from the study were individuals aged above 10 years but not residing in the department, absentees, refusals, and those with circumstances preventing their participation.
2.4. Sampling
The sample size was calculated using Swartz’s formula
[13] | Swartz, D. (1960) La méthode statistique en médecine: Etiological Surveys. Journal of Applied Statistics, 8, 5-27. |
[14] | Serhier Z, Bendahhou K, Ben Abdelaziz A, Othmani MB, Maghrébin R, Ahmed C, et al. Fiche Méthodologique n°1: Comment calculer la taille d’un échantillon pour une étude observationnelle? Tunis Med. 2020; 98(01): 1–7. Available from: www.r-project.org/ |
[13, 14]
: n = Z² × p × (1 - p) / E², where:
1) Z is the value corresponding to a 95% confidence level, which is 1.96;
2) p is the estimated proportion of the population having the characteristic, set at 30% by averaging the prevalence rates from the impact assessment
[7] | Plan République du Sénégal. Ministére de la santé et de l’action sociale. Plan national stratégique de lutte contre les maladies tropicales négligées. Dakar, Fann, 2020. 97 p. |
[7]
and those found during the district mapping
[9] | Département de Tambacounda. Résultats d’évaluation d’impact du traitement contre la schistosomiase de 2023. 4 p. |
[9]
;
3) E is the desired margin of error, set at 5%.
This calculation gave a sample size of n = 336. Adding the cluster effect, which was set at 1.5, gives n’ = 336 × 1.5 = 504. With an additional 10% for non-respondents, we obtain n’’ = 554. The final sample size is set at 576 individuals, distributed into 24 clusters of 24 people each, with one cluster per village or neighborhood, consisting of 12 boys and 12 girls, and 6 individuals in each age group (1-5 years, 5-10 years, 10-14 years, and 14 years and older). A two-stage stratified survey was used to ensure representativeness. Thus, 12 health posts were selected by simple random sampling without replacement, and for each of them, 2 villages or neighborhoods were randomly selected, with 48 individuals per structure. In each village, households were chosen randomly, and all individuals present in the selected households were included in the study. For individuals aged 1 to 10 years of age, mothers or guardians were interviewed, while individuals aged 10 years and older were interviewed directly. This article includes only the data collected from mothers or guardians of children under 10 years old, with an expected 288 individuals.
2.5. Data Collection
Data collection was carried out using a structured closed questionnaire via Kobo Collect. The interviewers conducted face-to-face interviews with mothers or guardians and individuals aged 10 years and older in the 4 selected villages for each health post. Responses were recorded on forms, and each session lasted about 15 to 20 minutes.
The urine samples (50 ml) from children under 10 years old were collected in the morning, with the consent of the mothers or guardians and the assent of the children, following aseptic procedures. The samples were transported to the laboratory, where the filtration method was used for analysis. The results were then assigned based on microscopic examination.
2.6. Operational Definition of Variables
The dependent variable was the presence or no of Schistosoma haematobium eggs in the characteristic microscopic examination for urogenital schistosomiasis (UGS), using the filtration technique
.
The independent variables were related to knowledge, attitudes, practices, the acceptability of preventive measures, and clinical and therapeutic data.
2.7. Data Analysis
Descriptive analysis was used to assess knowledge, attitudes, practices, the acceptability of preventive measures, as well as clinical and therapeutic data. Chi-squared or Fisher’s tests were used in bivariate analysis to examine factors associated with UGS for categorical variables. Logistic regression was used to identify factors associated with the occurrence of urogenital schistosomiasis at a significance level of 0.5%
.
2.8. Ethical Considerations
The protocol received approval from the National Ethics Committee for Health Research (CNERS) under N
o. 179/MSAS/CNERS/SP on July 15, 2024
[20] | Comité national d’éthique de la recherche en santé. Avis technique favorable N°SEN2462. Dakar. 2023. |
[20]
and the administrative authorization from the Directorate of Planning, Statistics, and Research (DPSR) under N
o. 1062 on July 16, 2024
[21] | Direction de la prévention, de la recherche et des statistiques. Autorisation administrative N°SEN2095. Dakar. 2023. |
[21]
. Informed consent from mothers or guardians was obtained by explaining the study’s objectives, procedures, risks, and benefits.
3. Results
3.1. Descriptive Study
A total of 316 individuals aged 10 to 72 years were surveyed.
3.1.1. Distribution According to Sociodemographic Characteristics, Knowledge, and Attitudes Towards UGS
There sample (316 individuals, aged 10–72 years) and was predominantly composed of women (63.9%) and individuals aged 15 and older (68%), with a majority having some level of education (56.6%). Knowledge of UGS is relatively low (46.8%), although most of those informed are familiar with the main symptoms (75.68%). Knowledge of transmission modes (59.46%) and curative treatment (63.51%) is moderate, as is knowledge of preventive methods (54.73%). A large majority of participants are willing to discuss the disease (73.7%) and intend to seek care if needed (81%). However, 53.5% of participants do not intend to expose themselves to freshwater sources. (
Table 1).
Table 1. Distribution according to socio-demographic characteristics and knowledge of urogenital schistosomiasis (UGS).
Variables | Absolutes frequencies (n) | Relatives frequencies (%) |
1. Distribution by sex |
Male | 114 | 36.1 |
Female | 202 | 63.9 |
2. Distribution by education |
Yes | 179 | 56.6 |
No | 137 | 43.1 |
2. Distribution by age |
Under 5 years | 101 | 32 |
5 to 10 years | 215 | 68 |
4. Knowledge of UGS |
Yes | 148 | 46.8 |
No | 168 | 53.2 |
5. Information on UGS |
Yes | 129 | 87.16 |
Np | 19 | 12.84 |
6. Knowledge of main symptoms |
Yes | 112 | 75.68 |
No | 36 | 24.32 |
7. Knowledge of modes of transmission |
Yes | 88 | 59.46 |
No | 60 | 40.54 |
8. Knowledge of curative treatment |
Yes | 94 | 63.51 |
No | 54 | 36.49 |
9. Knowledge of prevention methods |
Yes | 81 | 54.73 |
No | 67 | 42.57 |
10. Wiling ness to discuss the disease |
Yes | 233 | 73.7 |
No | 83 | 26.3 |
11. Intention to seek care |
Yes | 256 | 81 |
No | 60 | 19 |
12. Intention to allow freshwater exposure |
Yes | 147 | 46.5 |
No | 169 | 53.5 |
3.1.2. Distribution According to Attitudes, Practices, Medical History, Clinical, Paraclinical, and Therapeutic Characteristics
The results show that 71.74% of participants have discussed their illness with someone, and 95.65% sought medical care. Also 42.1% reported frequenting freshwater sources, while 87% accepted preventive measures. A history of hematuria was reported by 14.6% of participants, but only 2.2% had hematuria during the survey. Urine test strip results were positive in 22.5% of cases, and therapeutic coverage was particularly high among the 10-14 age group (88.12%). Only 3.37% experienced side effects from the treatment. Microscopic examination revealed the presence of
Schistosoma haematobium eggs in 5.7% of participants, with a prevalence of 1.98% in the 10-14 age group and 7.44% in those aged 15 and older (
Table 2).
Table 2. Distribution according to attitudes, practices, medical history, clinical, paraclinical, and therapeutic characteristics.
Variables | Absolutes frequencies (n) | Relatives frequencies (%) |
1. Allowed to frequent freshwater |
Yes | 133 | 42,1 |
No | 183 | 57.9 |
2. Discussed the disease with someone |
Yes | 33 | 71.74 |
No | 13 | 28.26 |
3. Sought medical care |
Yes | 44 | 95.65 |
No | 2 | 4.45 |
4. Acceptability of preventive measures |
Yes | 275 | 87 |
No | 41 | 13 |
5. Notion of previous hematuria |
Yes | 46 | 14.6 |
No | 270 | 85,4 |
6. Hematuria at the time of the survey |
Yes | 7 | 2.2 |
No | 309 | 97.8 |
7. Treatment for schistosomiasis (10 to 14 years) |
Yes | 89 | 88.12 |
No | 12 | 11.88 |
8. Existence of side effects |
Yes | 6 | 6.74 |
No | 83 | 93.26 |
9. Urine test strip results |
Yes | 71 | 22.5 |
No | 245 | 77,5 |
10. Presence of schistosoma haematobium |
Yes | 18 | 5.7 |
No | 289 | 94.3 |
11. Prevalence by age group: |
10 to 14 years old | 2 | 1.98 |
15 years and above | 16 | 7.44 |
3.2. Analytical Study
3.2.1. Identification of Factors Associated with UGS in Bivariate Analysis
In the bivariate analysis, the factors significantly associated with the presence of urogenital schistosomiasis were: lack of education (ORb = 3.60 [1.14–11.41]; p = 0.021), seeking medical care (ORb = 4.58 [1.55–13.58]; p = 0.006), a history of hematuria (ORb = 4.18 [1.44–12.1]; p = 0.008), a positive urine strip test (ORb = 21.52 [6.02–76.96]; p < 0.001), and treatment-related side effects (OR = 8.92 [1.5–53.13]; p = 0.04) (
Table 3).
Table 3. Identification of factors associated with urogenital schistosomiasis (UGS) in bivariate analysis.
Variables | p value | ORb | CI95% |
Aged 10 to 14 years | 0.046* | 3.72 | [1.02-26] |
Female sex | 0.997 | 1.14 | [0.4-3.3] |
School education | 0.013* | 3.57 | [1.3-11.16] |
Knowledge of UGS | 0.056 | 3.18 | [1.1-11.7] |
Informed about UGS | 0.16 | 2.46 | [0.851-9.1] |
Knowledge of symptoms | 0.144 | 2.76 | [0.88-12.7] |
Knowledge of transmission | 0.214 | 3.7 | [0.73-90.2] |
Knowledge of treatment | 0.13 | 3.34 | [0.57-14.7] |
Knowledge of prevention | 0.382 | 2.09 | [0.43-3.23] |
Frequent freshwater contact | 0.97 | 1.14 | [0.87-7.14] |
Preventive measures acceptance | 0.668 | 2.83 | [0.85-8.12] |
Talked about the disease | 0.105 | 2.7 | [0.71-8.25] |
Seeking medical care | 0.006* | 4.49 | [1.54-12.3] |
History of hematuria | 0.008* | 4.23 | [1.45-11.6] |
Hematuria in the survey | 0.339 | 3.16 | [0,12-20.8] |
Treated against UGS | 0.054 | 6.26 | [1.26-15.2] |
Presence of side effects | 0.04* | 9.32 | [1.09-54.8] |
Positive urine test strip | <0.001* | 20.5 | [6.42-94.9] |
3.2.2. Factors Associated with UGS in Multi Variate Analysis
In multivariate analysis, the factors statistically significantly associated with the occurrence of urogenital schistosomiasis were: knowledge of the disease (ORa = 6.32 [1.61–31.8], p = 0.026), seeking medical care (ORa = 10.87 [2.83–48.1], p < 0.001), the presence of side effects after treatment (ORa = 43.71 [2.9–70.7], p = 0.003), and a positive urinary strip test (ORa = 118.44 [11.12–126], p < 0.001) (
Table 4).
Table 4. Identification of factors associated with urogenital schistosomiasis (UGS) in multivariate analysis.
Variables | p value | ORa | CI95% |
Aged 10 to 14 years | 0.319 | 4.01 | [0.26-61.52] |
Female sex | 0.793 | 1.31 | [0.9-7.65] |
School education | 0.694 | 1.36 | [0.3-6.16] |
Knowledge of UGS | 0.026* | 6.32 | [1.61-31.8] |
Informed about UGS | 0.798 | 2.54 | [0.81-7.87] |
Knowledge of symptoms | 0.819 | 1.6 | [0.3-89.8] |
Knowledge of transmission | 0.523 | 4.02 | [0.6-28.9] |
Knowledge of treatment | 0.826 | 0.67 | [0.2-24.5] |
Knowledge of prevention | 0.142 | 0.6 | [0.2-5] |
Frequent freshwater contact | 0.093 | 3.62 | [0.81-16.29] |
Accepted prevention | 0.186 | 3.01 | [0.59-15.41] |
Talked about the disease | 0.879 | 1.25 | [0.7-23.34] |
Seeking medical care | <0.001* | 10.87 | [2.83-48.1] |
History of hematuria | 0.402 | 5.55 | [0.1-30.48] |
Hematuria in the survey | 0.078 | 10.5 | [1.13-29.12] |
Treated against UGS | 0.782 | 0.59 | [0.1-23.65] |
Presence of side effects | 0.003* | 43.71 | [2.9-70.7] |
Positive urine test strip | <0.001* | 118.4 | [11.12-126] |
4. Discussion
4.1. Socio-demographic Characteristics, Knowledge, and Attitudes Regarding UGS
Knowledge of urogenital schistosomiasis (UGS) remains insufficient, with a rate of 46.8%, although it is slightly higher than the 42.7% reported in Togo in 2019 by Djagadou et
al.
[21] | Direction de la prévention, de la recherche et des statistiques. Autorisation administrative N°SEN2095. Dakar. 2023. |
[21]
. Among those who were informed, 87.16% received information from healthcare workers, highlighting their central role in raising awareness. While symptom recognition is high (75.68%), understanding of transmission modes (59.46%), curative treatment (63.51%), and preventive measures (54.73%) remains moderate. These findings reflect similar gaps observed in Benin, where only 25.89% of participants had sufficient knowledge
[23] | Djagadou KA, Tchamdja T, Némi KD, Balaka A, Djibril MA. Knowledge, attitudes and practices of the populations of the city of Lomé relating to prevention of schistosomiasis: A case study conducted in the canton of Légbassito. Pan African Medical Journal. 2019; 34: 1–6. Available from: http://dx.doi.org/10.11604/pamj.2019.34.19.18918 |
[23]
. This emphasizes the need to strengthen awareness campaigns to improve the prevention and management of UGS
[21] | Direction de la prévention, de la recherche et des statistiques. Autorisation administrative N°SEN2095. Dakar. 2023. |
[22] | Hambury SD, Grobler AD, Melariri PE. Knowledge, attitudes, and practices on urinary schistosomiasis among primary schoolchildren in Nelson Mandela Bay, South Africa. J Parasitol Res. 2021; 2021. Available from: http://dx.doi.org/10.1155/2021/6774434 |
[23] | Djagadou KA, Tchamdja T, Némi KD, Balaka A, Djibril MA. Knowledge, attitudes and practices of the populations of the city of Lomé relating to prevention of schistosomiasis: A case study conducted in the canton of Légbassito. Pan African Medical Journal. 2019; 34: 1–6. Available from: http://dx.doi.org/10.11604/pamj.2019.34.19.18918 |
[21-23]
.
4.2. Attitudes, Practices, Clinical, Paraclinical, and Therapeutic Characteristics
Side effects following treatment were reported by only 3.37% of participants, a significantly lower rate compared to the 92% of children affected in Sulawesi as observed by Putri et
al. [24] | Folefac LN, Nde-Fon P, Verla VS, Tangye MN, Njunda AL, Luma HN. Knowledge, attitudes and practices regarding urinary schistosomiasis among adults in the Ekombe Bonji health area, Cameroon. Pan African Medical Journal. 2018 Mar 19; 29. Available from: http://dx.doi.org/10.11604/pamj.2018.29.161.14980 |
[24]
. This discrepancy may result from differences in study populations, treatment conditions, or methodologies. Although 95.56% of participants discussed their illness and 71.14% shared their experiences with others, 42.1% continued frequenting freshwater sources, a high-risk behavior for reinfection
. Despite strong acceptance of preventive measures (87%), ongoing exposure to contaminated water highlights the urgent need for improved education on risky behaviors and more effective prevention strategies
[9] | Département de Tambacounda. Résultats d’évaluation d’impact du traitement contre la schistosomiase de 2023. 4 p. |
[26] | Sacolo H, Chimbari M, Kalinda C. Knowledge, attitudes and practices on schistosomiasis in sub-Saharan Africa: A systematic review. BMC Infect Dis. 2018; 18(1). Available from: http://dx.doi.org/10.1186/s12879-017-2923-6 |
[9, 26]
.
A history of hematuria was noted by 14.6% of participants, though only 2.2% showed symptoms during the survey. Urine dipstick tests were positive in 22.5% of cases, and 5.7% of samples contained Schistosoma haematobium eggs. The prevalence of UGS was 1.98% in the 10–14 age group and 7.44% in those aged 15 and above. These prevalence rates are lower than in Nigeria (69%)
[27] | Balogun JB, Adewale B, Balogun SU, Lawan A, Haladu IS, Dogara MM, et al. Prevalence and associated risk factors of urinary schistosomiasis among primary school pupils in the Jidawa and Zobiya communities of Jigawa State, Nigeria. Ann Glob Health. 2022; 88(1): 1–14. Available from http://dx.doi.org/10.5334/aogh.3704 |
[27]
, higher than in Tanzania (6.9%)
[28] | Nazareth LC, Lupenza ET, Zacharia A, Ngasala BE. Urogenital schistosomiasis prevalence, knowledge, practices and compliance to MDA among school-age children in an endemic district, southern East Tanzania. Parasite Epidemiol Control [Internet]. 2022; 18(June). Available from: https://doi.org/10.1016/j.parepi.2022.e00257 |
[28]
, and similar to Cameroon (31.5%)
[26] | Sacolo H, Chimbari M, Kalinda C. Knowledge, attitudes and practices on schistosomiasis in sub-Saharan Africa: A systematic review. BMC Infect Dis. 2018; 18(1). Available from: http://dx.doi.org/10.1186/s12879-017-2923-6 |
[26]
, differences likely reflecting variations in environmental conditions, control program effectiveness, or diagnostic techniques.
Regarding treatment, 88.12% of participants received care for UGS, exceeding the 54.29% coverage observed in Benin by Agossoukpe et
al. [23] | Djagadou KA, Tchamdja T, Némi KD, Balaka A, Djibril MA. Knowledge, attitudes and practices of the populations of the city of Lomé relating to prevention of schistosomiasis: A case study conducted in the canton of Légbassito. Pan African Medical Journal. 2019; 34: 1–6. Available from: http://dx.doi.org/10.11604/pamj.2019.34.19.18918 |
[23]
but below the national target of 80%
[14] | Serhier Z, Bendahhou K, Ben Abdelaziz A, Othmani MB, Maghrébin R, Ahmed C, et al. Fiche Méthodologique n°1: Comment calculer la taille d’un échantillon pour une étude observationnelle? Tunis Med. 2020; 98(01): 1–7. Available from: www.r-project.org/ |
[14]
. This emphasizes better treatment outcomes among younger individuals while highlighting the need for targeted efforts to boost coverage in older age groups.
4.3. Factors Associated with Urogenital Schistosomiasis (UGS)
Knowledge of urogenital schistosomiasis (UGS) is strongly associated with an increased risk of infection (ORa = 6.32 [1.61–31.8], p = 0.026), indicating that such knowledge is vital for early detection and diagnosis
[29] | Green AE, Anchang-Kimbi JK, Wepnje GB, Ndassi VD, Kimbi HK. Distribution and factors associated with urogenital schistosomiasis in the Tiko Health District, a semi-urban setting, South West Region, Cameroon. Infect Dis Poverty [Internet]. 2021; 10(1): 1–15. Available from: Available from: https://doi.org/10.1186/s40249-021-00827-2 |
[29]
. In our study, frequent contact with freshwater sources (ORa = 3.62 [0.81–16.29], p = 0.093) and the rejection of preventive measures (ORa = 3.01 [0.59–15.41], p = 0.186) were not significantly linked to the occurrence of UGS. However, similar connections between freshwater exposure and UGS were found in studies in Nigeria (Balogun et
al.)
[27] | Balogun JB, Adewale B, Balogun SU, Lawan A, Haladu IS, Dogara MM, et al. Prevalence and associated risk factors of urinary schistosomiasis among primary school pupils in the Jidawa and Zobiya communities of Jigawa State, Nigeria. Ann Glob Health. 2022; 88(1): 1–14. Available from http://dx.doi.org/10.5334/aogh.3704 |
[27]
and Tanzania (Nazareth et
al.)
[28] | Nazareth LC, Lupenza ET, Zacharia A, Ngasala BE. Urogenital schistosomiasis prevalence, knowledge, practices and compliance to MDA among school-age children in an endemic district, southern East Tanzania. Parasite Epidemiol Control [Internet]. 2022; 18(June). Available from: https://doi.org/10.1016/j.parepi.2022.e00257 |
[28]
. These discrepancies may be due to the relatively low prevalence of the disease (5.7%) in the study area, where freshwater sources may be less contaminated compared to higher-prevalence regions (26.34%)
[30] | King CH, Bertsch D. Meta-analysis of urine heme dipstick diagnosis of Schistosoma haematobium infection, including low-prevalence and previously-treated populations. PLoS Negl Trop Dis. 2013; 7(9). Available from: https://doi.org/10.1371/journal.pntd.0002431 |
[30]
.
Seeking medical care was strongly associated with the occurrence of UGS (ORa = 10.87 [2.83–48.1], p < 0.001), emphasizing the impact of symptoms in driving individuals to seek care and highlighting the importance of screening and health education to improve early detection and treatment. Experiencing side effects from Praziquantel treatment (ORa = 43.71 [2.9–70.7], p = 0.003) was also associated with the persistence of UGS, underscoring the need for effective management of adverse reactions and additional treatment rounds.
Although a history of hematuria (p = 0.402) and its presence at the time of the survey (p = 0.078) were not found to be significantly associated with UGS, a positive urine dipstick test (ORa = 118.44 [11.12–126.12], p < 0.001) showed a strong correlation with infection. This suggests that the urine dipstick is a reliable diagnostic tool for detecting UGS, especially in areas with high disease prevalence (≥50%), and should be utilized for systematic early screening in such regions
.
4.4. Study Limitations
The study may be subject to response biases, compromising the accuracy of the information provided. The diagnostic methods used may also underestimate the prevalence of infections. Furthermore, the assessment of knowledge and attitudes may not reflect actual behaviors, and the persistence of risky behaviors suggests that the interventions may not be sufficient.
5. Conclusions
This study reveals ongoing gaps in knowledge and behavior regarding urogenital schistosomiasis in the Tambacounda region, despite higher levels of awareness compared to other settings. While most participants are familiar with the symptoms and preventive measures, the risk of reinfection remains high due to continued exposure to contaminated freshwater sources. The positive associations between seeking medical care, urine strip test results, and side effects after treatment highlight the need for improvements in both healthcare access and the management of treatment side effects to promote better adherence. The findings stress the urgent need to enhance education, prevention, and treatment efforts, particularly among the most vulnerable groups, in order to reduce urogenital schistosomiasis prevalence. Finally, the limitations of the study point to the necessity of further research to refine strategies for addressing this endemic disease.
Abbreviations
UGS | Uro Genital Schistosomiasis |
WHO | World Health Organization |
COVID | Corona Virus Disease |
* | Asterisk Indicates Statistical Significance |
ORb | Brute Odds Ratio |
ORa | Adjusted Odds Radio |
Acknowledgments
We would like to thank the National Program for the Control of Neglected Tropical Diseases (PLMNT) and the project Accelerating the Resilient and Sustainable Elimination of Neglected Tropical Diseases (ARISE) for funding this research. We also express our gratitude to all the investigators from the extended team of the Tambacounda health district, as well as to all the individuals who kindly agreed to participate in this study.
Author Contributions
El Hadji Cheikh Abdoulaye Diop: Project conceptualization, funding acquisition, project administration, data processing and analysis, manuscript writing
Mamadou Makhtar Mbacké Leye: project conceptualization, project administration, data analysis, manuscript validation
Adélaïde Ndew Dog: Project conceptualization and administration, data analysis, manuscript writing
Dossolo Sanogo: Project conceptualization, Data analysis, Project co administration
Bayal Cisse: Project conceptualization, Funding acquisition, Project co administration
Ndèye Mbacké Kane: Project conceptualization, funding acquisition, Project administration
Funding
This study received a grant from the Accelerating Resilient and Sustainable Elimination of Neglected Tropical Diseases (ARISE) project for research activities and publication fees.
Data Availability Statement
The data supporting the outcome of this research work has been reported in this manuscript.
Conflicts of Interest
The authors declare no conflicts of interest.
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Cite This Article
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APA Style
Diop, E. H. C. A., Leye, M. M. M., Dog, A. N., Kane, N. M., Cisse, B., et al. (2025). Urogenital Schistosomiasis: Survey Among Aged 10 and Above in the Tambacounda Health District (Senegal). World Journal of Public Health, 10(1), 26-33. https://doi.org/10.11648/j.wjph.20251001.14
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Diop, E. H. C. A.; Leye, M. M. M.; Dog, A. N.; Kane, N. M.; Cisse, B., et al. Urogenital Schistosomiasis: Survey Among Aged 10 and Above in the Tambacounda Health District (Senegal). World J. Public Health 2025, 10(1), 26-33. doi: 10.11648/j.wjph.20251001.14
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Diop EHCA, Leye MMM, Dog AN, Kane NM, Cisse B, et al. Urogenital Schistosomiasis: Survey Among Aged 10 and Above in the Tambacounda Health District (Senegal). World J Public Health. 2025;10(1):26-33. doi: 10.11648/j.wjph.20251001.14
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@article{10.11648/j.wjph.20251001.14,
author = {El Hadji Cheikh Abdoulaye Diop and Mamadou Makhtar Mbacké Leye and Adélaïde Ndew Dog and Ndèye Mbacké Kane and Bayal Cisse and Dossolo Sanogo},
title = {Urogenital Schistosomiasis: Survey Among Aged 10 and Above in the Tambacounda Health District (Senegal)
},
journal = {World Journal of Public Health},
volume = {10},
number = {1},
pages = {26-33},
doi = {10.11648/j.wjph.20251001.14},
url = {https://doi.org/10.11648/j.wjph.20251001.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20251001.14},
abstract = {Introduction: This study focuses on the persistence of urogenital schistosomiasis (8%) in the Tambacounda Health District, despite mass treatment efforts with Praziquantel targeting individuals aged 5–14 in 2023. The main objectives are to evaluate the current prevalence of the disease, identify factors contributing to its persistence, and assess the acceptability of implemented preventive measures. Methods: A descriptive and analytical study was conducted in August 2024, targeting individuals aged 10 and above. Data collection was performed using Kobo Collect, and analysis was carried out with R 4.4.1. Binary logistic regression was applied to identify factors associated with the occurrence of urogenital schistosomiasis. Results: Preventive measures were accepted by 83.47% of participants, while 14.6% reported a history of hematuria, but only 7.5% presented hematuria during the survey. Urine dipstick testing detected hematuria in 22.5% of participants, and 5.7% tested positive for Schistosoma haematobium eggs, corresponding to a prevalence of 1.98% among individuals aged 10–14 and 7.44% among those aged 15 and above. Therapeutic coverage was high among individuals aged 10–14 (88.12%). In multivariate analysis, the factors significantly associated with the occurrence of urogenital schistosomiasis were knowledge of the disease (ORa = 6.32 [1.61–31.8], p = 0.026), seeking medical care (ORa = 10.87 [2.83–48.1], p Conclusion: The Tambacounda Health District remains endemic for urogenital schistosomiasis despite mass treatment campaigns targeting individuals aged 5–14. Recommendations include strengthening health education, systematic urine dipstick screening, and implementing two rounds of Praziquantel treatment.
},
year = {2025}
}
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TY - JOUR
T1 - Urogenital Schistosomiasis: Survey Among Aged 10 and Above in the Tambacounda Health District (Senegal)
AU - El Hadji Cheikh Abdoulaye Diop
AU - Mamadou Makhtar Mbacké Leye
AU - Adélaïde Ndew Dog
AU - Ndèye Mbacké Kane
AU - Bayal Cisse
AU - Dossolo Sanogo
Y1 - 2025/02/10
PY - 2025
N1 - https://doi.org/10.11648/j.wjph.20251001.14
DO - 10.11648/j.wjph.20251001.14
T2 - World Journal of Public Health
JF - World Journal of Public Health
JO - World Journal of Public Health
SP - 26
EP - 33
PB - Science Publishing Group
SN - 2637-6059
UR - https://doi.org/10.11648/j.wjph.20251001.14
AB - Introduction: This study focuses on the persistence of urogenital schistosomiasis (8%) in the Tambacounda Health District, despite mass treatment efforts with Praziquantel targeting individuals aged 5–14 in 2023. The main objectives are to evaluate the current prevalence of the disease, identify factors contributing to its persistence, and assess the acceptability of implemented preventive measures. Methods: A descriptive and analytical study was conducted in August 2024, targeting individuals aged 10 and above. Data collection was performed using Kobo Collect, and analysis was carried out with R 4.4.1. Binary logistic regression was applied to identify factors associated with the occurrence of urogenital schistosomiasis. Results: Preventive measures were accepted by 83.47% of participants, while 14.6% reported a history of hematuria, but only 7.5% presented hematuria during the survey. Urine dipstick testing detected hematuria in 22.5% of participants, and 5.7% tested positive for Schistosoma haematobium eggs, corresponding to a prevalence of 1.98% among individuals aged 10–14 and 7.44% among those aged 15 and above. Therapeutic coverage was high among individuals aged 10–14 (88.12%). In multivariate analysis, the factors significantly associated with the occurrence of urogenital schistosomiasis were knowledge of the disease (ORa = 6.32 [1.61–31.8], p = 0.026), seeking medical care (ORa = 10.87 [2.83–48.1], p Conclusion: The Tambacounda Health District remains endemic for urogenital schistosomiasis despite mass treatment campaigns targeting individuals aged 5–14. Recommendations include strengthening health education, systematic urine dipstick screening, and implementing two rounds of Praziquantel treatment.
VL - 10
IS - 1
ER -
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