Schistosomiasis and soil-transmitted helminthiasis in Rwanda: an update on their epidemiology and control

Abstract

Even though Rwanda lies within a region that has a high prevalence of schistosomiasis and soil-transmitted helminth (STH) infections, epidemiological information regarding these infections in the country remains scarce. The present review attempts to compile the available data on schistosomiasis and STHs, from 1940 to 2014, to provide an insight on the epidemiological profile of these infections. This information will, in turn, support the design and implementation of sustainable control measures. The available records indicate that only Schistosoma mansoni and all the major species of STHs are endemic in Rwanda. In 2008, the national prevalence of S. mansoni was reported to be 2.7%, ranging from 0 to 69.5%, and that of STH infections was 65.8% (diagnosed using the Kato-Katz technique). The prevalence of these infections varies from one district to another, with schoolchildren remaining a highly affected group. The main control approach is mass drug administration using albendazole and praziquantel, mostly targeting school-aged children in school environments. In 2008, adult individuals living in areas with a prevalence of S. mansoni ≥30% were also included in the mass drug administration programme. However, despite Rwanda achieving an almost 100% coverage of this programme in 2008-2010, the transmission of S. mansoni and STHs continues to take place, as illustrated by the most recent surveys. If Rwanda is to achieve sustainable control and elimination of schistosomiasis and STHs, there is a need to revise the country's control strategy and adopt an integrated control approach that involves a combination of measures.

Keywords: Control; Epidemiology; Rwanda; Schistosomiasis; Soil-transmitted helminths.

Fig. 1

Distribution of schistosomiasis in Rwanda. Map shows maximum point prevalence of schistosome infections and locations of S. mansoni and S. haematobium surveys in Rwanda. (http://www.thiswormyworld.org/maps/2013/distribution-of-schistosomiasis-survey-data-in-rwanda)

Fig. 2

Distribution of STHs in Rwanda. The map shows the maximum point prevalence of STH infections and locations of STH surveys in Rwanda. http://www.thiswormyworld.org/maps/by-worm/soil-transmitted-helminths

Fig. 3

Schistosomiasis treatment coverage for the period 2008–2009 among SAC in Rwanda. Preventive Chemotherapy (PC)- population requiring preventive chemotherapy for schistosomiasis refers to estimates of the number of children needing preventive chemotherapy and the number of treatments for a given period. National coverage refers to the proportion (%) of individuals in the population requiring preventive chemotherapy against schistosomiasis who have been treated

Fig. 4

Treatment coverage for STHs for the period 2005–2010 among SAC in Rwanda No data were available on treatment coverage and national coverage for the period of 2005–2007 among SAC. Preventive Chemotherapy (PC)- population requiring preventive chemotherapy for schistosomiasis refers to estimates of the number of children needing preventive chemotherapy and number of treatments for a given period. National coverage refers to the proportion (%) of individuals in the population requiring preventive chemotherapy against schistosomiasis who have been treated