Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 18;7(1):47.
doi: 10.1186/s40249-018-0431-6.

Risk factors for schistosomiasis in an urban area in northern Côte d'Ivoire

Richard K M'Bra  1   2   3   4 , Brama Kone  5   6 , Yapi G Yapi  7 , Kigbafori D Silué  5   8 , Ibrahima Sy  9 , Danielle Vienneau  10   11 , Nagnin Soro  12 , Guéladio Cissé  10   11 , Jürg Utzinger  10   11
Affiliations

Risk factors for schistosomiasis in an urban area in northern Côte d'Ivoire

Richard K M'Bra et al. Infect Dis Poverty. .

Abstract

Background: Schistosomiasis is a water-based disease transmitted by trematodes belonging to the genus Schistosoma. The aim of this study was to assess the relationship between the prevalence of schistosomiasis and access to water, sanitation and hygiene (WASH) and environmental and socioeconomic factors in the city of Korhogo, northern Côte d'Ivoire.

Methods: A cross-sectional study including 728 randomly selected households was conducted in Korhogo in March 2015. The heads of the households were interviewed about access to WASH and environmental and socioeconomic factors. All children abed between 5 and 15 years living in the households were selected to provide stool and urine samples for parasitological diagnosis of Schistosoma mansoni and Schistosoma haematobium infection. The relationship between infection with S. mansoni and potential risk factors was analysed by a mixed logistic regression model with 'household' as a random factor. Likelihood ratio tests were used to identify factors that were significantly associated with a Schistosoma spp. infection.

Results: The overall prevalence of schistosomiasis among school-aged children in Korhogo was 1.9% (45/2341) composed of 0.3% (3/1248) S. haematobium and 3.5% (42/1202) S. mansoni. Due to the low prevalence of S. haematobium infection, risk factor analysis was limited to S. mansoni. Boys were 7.8 times more likely to be infected with S. mansoni than girls. Children between 10 and 15 years of age were 3.8 times more likely to be infected than their younger counterparts aged 5-10 years. Moreover, living in a house further away from a water access point (odds ratio [OR] = 0.29, 95% confidence interval [CI]: 0.13-0.70) and abstaining from swimming in open freshwater bodies (OR = 0.16, 95% CI: 0.04-0.56) were significantly associated with decreased odds of S. mansoni infection. The socioeconomic status did not appear to influence the prevalence of S. mansoni.

Conclusions: A strategy to reduce the incidence of schistosomiasis should focus on health education to change the behaviour of populations at risk and encourage communities to improve sanitation and infrastructure in order to reduce contact with surface water.

Keywords: Côte d’Ivoire; Schistosomiasis; School-aged children; Urban agriculture; Vulnerability index; Water, Sanitation and Hygiene (WASH).

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This research was carried out in the frame of a project entitled ‘Vulnerability and resilience to malaria and schistosomiasis in the northern and southern fringes of the sahelian belt in the context of climate change’ funded by TDR/WHO and implemented from 2013 to 2017 in Côte d’Ivoire and Mauritania. In Côte d’Ivoire, the National Ethics Committee cleared the research protocol (reference no. 10056/MSHP/CNER-dkn, dated 29 May 2013). Informed consent was obtained from parents (or legal guardians) before collection of samples of their school-aged children. Participation was voluntary, and hence, parents or children could withdraw anytime without further obligation. With the collaboration of the schistosomiasis control programme and the medical district officer, we treated child infected with Schistosoma spp. free of charge with praziquantel (40 mg/kg). At the beginning of the project, a workshop was organised with local decision makers, professionals and communities to discuss the objectives and methodology.

Competing interests

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Geographical distribution and type of drinking water sources in the households of Korhogo, stratified by neighbourhood (March 2015)
Fig. 2
Fig. 2
Geographical distribution and type of latrines used in the households of Korhogo, stratified by neighbourhood (March 2015)
Fig. 3
Fig. 3
Number of human-water contact sites and main activities at these sites in Korhogo, stratified by neighbourhood (March 2015)
Fig. 4
Fig. 4
Principal component analysis of variables related to environmental vulnerability in the city of Korhogo (March 2015) in the F1-F2 plane. The x- and y-coordinates of a variable are given by its correlations with the first (F1) and second factor (F2), respectively
Fig. 5
Fig. 5
Mean values of the first (x-coordinate) and second (y-coordinate) principal component score by neighbourhood. The mean value of the first score expresses environmental vulnerability of the respective neighbourhood (low values indicate higher vulnerability). Red lines indicate boundaries between consecutive categories of environmental vulnerability (defined by the k-means procedure)
Fig. 6
Fig. 6
Spatial distribution of households with schistosomiasis cases in Korhogo (March 2015)
See this image and copyright information in PMC

References

    1. Hotez PJ, Savioli L, Fenwick A. Neglected tropical diseases of the Middle East and North Africa: review of their prevalence, distribution, and opportunities for control. PLoS Negl Trop Dis. 2012;6:e1475. - PMC - PubMed
    1. Colley DG, Bustinduy AL, Secor WE, King CH. Human schistosomiasis. Lancet. 2014;383:2253–64. - PMC - PubMed
    1. Brooker S, Kabatereine NB, Smith JL, Mupfasoni D, Mwanje MT, et al. An updated atlas of human helminth infections: the example of East Africa. Int J Health Geogr. 2009;8:42. doi: 10.1186/1476-072X-8-42. - DOI - PMC - PubMed
    1. Sturrock RF. The intermediate hosts and host-parasite relationships. In: Jordan P, Webbe G, Sturrock RF, editors. Human schistosomiasis. Wallingford: CAB International; 1993. pp. 33–85.
    1. Cecchi P, Baldé S, Yapi YG. Mollusques hôtes intermédiaires. In: Cecchi P, Lévêque C, Aubertin C, editors. L’eau en partage: Les petits barrages de Côte d’Ivoire. Paris: IRD; 2007. p. 175–89. (in French).

MeSH terms