PREVALENCE AND RISK FACTORS FOR RE-INFECTION OF URINARY SCHISTOSOMIASIS AMONG PUBLIC SECONDARY SCHOOL STUDENTS IN ISE/ORUN LGA, EKITI STATE

Abstract

Schistosomiasis is one of the most serious and prevalent neglected tropical diseases (NTDs) in Africa. It is a serious debilitating and sometimes fatal parasitic disease. This study aimed to determine the prevalence, risk factors for re-infection and knowledge of urinary schistosomiasis among public secondary school students of Ise/Orun LGA. There has been increase in the prevalence months after MAM activities in Ise/Orun LGA. Also, most studies centered on epidemiology of the disease with little or no attention towards accessing their knowledge about schistosomiasis. A descriptive cross sectional survey was carried out in four selected communities in Ise/Orun LGA, Ekiti State. A total of 635 students from four public secondary schools were interviewed using multi-stage sampling technique. Data was collected using semi- structured interviewer administered questionnaire. Terminal urine samples were collected from 635 students for microscopic examination of the sediments for ova of S. heamatobiun. Respondents with positive urine samples were referred for treatment to comprehensive health centre in the community. Data obtained were entered and analyzed using Epi Info 7 software package. Six hundred and thirty five questionnaires were administered translating to 98% response rate, mean age of respondents was 14 years, and 77% of respondents were in junior secondary school. Orun community has the largest proportion of respondents (43%). Well water, 351 (55.3%) was the commonest sorurce of water for domestic and open defeacation was 307 (48%). Sixty five (10.2%) samples were positive for ova of S. heamatobium with boys accounting for 41 (63.1%). Ogbese and Obada communities were the most affected with 32.2% and 14.8% community specific attack rate. Ninety-three (14.6%) admitted ever passed bloody urine, while 54(8.5%) were currently passing bloody urine. Many, 429 (67.6%) heard information about schistosomiasis and the school, 434 (67.6%) was the commonest source of information. Good knowledge about urinary schistosomiasis was 63.6%. while 36.4% had poor knowledge about the disease. Use of drug, 352 (55.4%) and behavioural change by stopping urinating in rivers, 75 (11:8%) were some of the suggested schistosomiasis control measures. Use of open defecation (OR 1.4, p values <0.05, 95% Cl.1.4 - 4.2), ever and currently passing bloody urine had OR 1.9, p values <0.01, 95% CI.1.9 - 5.9 and OR 1.2, p values 0.02, 95% CI.1.2 - 5.1 respectively. Swim or wade in river (OR 1.8, p values <0.01, 95% Cl.1.8 - 6.1 ), urinate in the river (OR 2.4, p values <0.05, 95% CI.1.4 - 4.l) and not seek treatment for schistosomiasis (OR 0.4, p values <0.05, 95% CI.0.2 - 0.7) were significant factors. Determinants of knowledge about schistosomiasis were age of respondents not <= 14 years (OR 1.5, 95% Cl.l -2.1) and level of education not below JSS 3 (OR 1.7, 95% CL (1.2-2.4). Others include if the respondents had sought treatment for bloody urine, had not heard or use praziquantel. Among the communities, living at Ise and Ogbese were significant to having prior knowledge of schistosomiasis. Predictors of schistosomiasis infection in the Ise/Orun LGA communities were respondents residing at Ogbese community (AOR 10.95% C.l., (5 - 50), not seeking treatment for schistosomiasis (AOR 4.3, 95% Cl. (1.3 - 14.4), and heard of schistosomiasis (bloody urine), AOR 0.3, 95% CI 0.2-0.8 was a protective factor for schistosomiasis transmission. The prevalence of urinary schistosomiasis from the study was high and intensity of infection associated with age and gender. High proportion engaged in wadding and swimming in rivers while some do urinate: in water bodies while swimming. Parental occupation (farming) of most respondent exposed them to contact with water bodies frequently putting them at higher risk. School was identified as major source of information about urinary schistosomiasis during school health programmes. Most respondents had average knowledge about the disease and preventive strategies, with poor knowledge about its transmission. Findings from the study will enhance proper interventional strategy planning towards reducing morbidity due to urinary schistosomiasis.