SCHISTOSOMIASIS OUTBREAK AND RISK FACTORS OF INFECTION AMONG SCHOOL CHILDREN IN KOINADUGU DISTRICT, SIERRA LEONE, MARCH 2023

Abstract

Schistosomiasis, a parasitic infection caused by Schistosoma species, is among the neglected tropical diseases and is a public health problem, particularly in sub-Saharan Africa. On the 6th of March 2023, the Community Health Officer in Alkalia Community Health Center, Koinadugu district, reported an increased number of school children complaining of blood in their urine and stool. We investigated the cases to identify risk factors associated with the outbreak.

We described the outbreak and conducted an unmatched case-control study (138 cases and 138 controls) to identify risk factors associated with it. We reviewed clinical records and interviewed cases and relatives to collect demographic, clinical, and epidemiological data. Urine and stool samples were collected to investigate the presence of Schistosoma haematobium and Schistosoma mansoni. Multivariate analysis was used to calculate adjusted odd ratios (aOR) at the 95% Confidence level to identify risk factors associated with the outbreak.

A total of 421 suspected cases were identified; 71.7% (302) were males, and median age was 10 years (range: 2 to 50 years). Of the total, 62.7% (264) were positive for Schistosomiasis (S. heamatobium and mansoni), and 98.5% (260) were positive for Schistosomiasis haematobium. Almost 98% (260) of the positive cases were school children. Of the positive cases, 95% (252) were presented with bloody urine. The case-control study identified bathing 5.4 (1.8-16.1), and drinking river/stream water 6.6 (2.4-18.2) factors associated with Schistosomiasis outbreak at the multivariate level.

This study confirmed a Schistosomiasis outbreak in the Koinadugu district, particularly among school-aged children. Risk factors associated with Schistosomiasis infection included drinking water from rivers or streams, bathing in rivers or streams, and exposure to the Teria River. We recommend providing clean and safe drinking water sources to limit exposure to rivers or streams, promote health education, and effectively distribute drugs.

keywords: Assessment, risk factors, Schistosomiasis outbreak, school children, Koinadugu, Sierra Leone