Epidemiological Factors Causing the Spread of Schistosomiasis Among Pupils in Ipogun Community in Ifedore Local Government Area of Ondo State
CHAPTER ONE
Objectives
Generalย objectiveย
To explore the prevalence of schistosomiasis among pupils and factorsย associatedย with contractingย schistosomiasis in Ipogun community in Ifedore Local Government Area of Ondo State.
Specificย objectives
- To determine the prevalence of schistosomiasis among pupils aged 5-14 years in Ipogun community in Ifedore Local Government Area of Ondo State.
- To determine factors associated with schistosomiasis transmission in the pupils in Ipogun community in Ifedore Local Government Area of Ondo State.
- To map the distribution of schistosomiasis infestation among pupils using the geographical information system (GIS) in Ondo.
CHAPTERย TWO
LITERATUREย REVIEW
Globalย overview
Schistosomiasis affects almost 240 million people worldwide, and more than 700 million people live in endemic areas. The infection is prevalent in tropical and sub tropical areas, in poor communities without potable water and adequate sanitation. Urogenital schistosomiasis is caused by Schistosomaย haematobiumย andย intestinalย schistosomiasisย byย any of the organisms S. guineensis, S. intercalatum, S. mansoni, S. japonicum, and S.ย mekongi. Several million people all over the world suffer from severe morbidity as a consequence of schistosomiasis (WHO, 2022).
Additionally, schistosomiasis is reported in more than 93 countries and it is reported inย literature that globally, S. haematobium is the most prevalent species and accounts forย 200,ย 000 deaths annuallyย (Gurarieย et al., 2015).
Burdenย ofย diseaseย inย Africaย and Sub-Saharanย region
More than 85% of infested populations are severe and mainly found in sub-Saharanย Africa, where more than 20 million suffered from a severe form of schistosomiasisย complicationsย (Ntoniforย et al., 2012).
In the region, as a neglected tropical disease of poverty, schistosomiasis ranks second among the most widespread parasitic diseases in Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and financial burden on economies of households and governments (Adenowo et al.,ย 2015).
A review of disease burden estimated that more than 200, 000 deaths per year are due toย schistosomiasis in sub-Saharan Africa. The burden of disease due to schistosomiasis isย however reported to be underestimated (WHO, 2022).
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Availableย dataย onย Copperbeltย province
There was paucity of information on studies conducted to characterize current burden of schistosomiasis on the Copperbelt province. There have been very few unpublished studies that have been conducted recently aimed at to characterizing the current distribution patterns of the disease. These were mainly undertaken in localized set ups especially following a rise in number of cases of schistosomiasis noted in some schools.
The most recent information on disease prevalence in the province was from a survey conducted in 2012/ 2014 by the Ministry of Health which reported the highest prevalence in Ipogun community in Ifedore Local Government Area of Ondo State and the lowest in Ndola district (MOH, 2014).
CHAPTER THREEย
RESEARCHย METHODOLOGY
Studyย designย
The study employed a cross sectional study design using primary data collected fromย sampledย primaryย schoolsย in Ipogun community in Ifedore Local Government Area of Ondo State fromย 15ย Februaryย 2023ย toย 25ย Marchย 2023.
Studyย population
The criteria needed to define and describe the population included primary pupils between ages 5 to 14 years in the Ondo state is given below. In accordance with central statistical office 2015 population estimates, the 2022 total population for Ondo state was projected at 129, 391. Out of this, the population for pupils between the ages 5 to 14 years for 2022 was estimated at 39, 515 (CSO, 2019).
CHAPTERย FOURย
RESULTS
Sampleย characteristics
Aย totalย ofย 390ย pupilsย wereย enrolledย inย theย studyย fromย 15ย differentย schools.ย The sex ratio (M/F) was 0.9, with 184 boys and 206 girls. The median age was 12 (IQRย 7, 14 years). About 13% of the respondents came from households whose guardians didย not work, 68% representing the majority were from homes whose guardians were inย informal employment and about 18% from households whose guardians were in formalย employmentย as shown inย Tableย 4.1.
CHAPTER FIVE
DISCUSSION, CONCLUSION AND RECOMMENDATION
DISCUSSION
Schistosomiasisย prevalence
Inย thisย study,ย Iย setย outย toย investigateย theย prevalenceย ofย schistosomiasisย amongย pupils from ages 5 to 14 years and risk factors associated with contracting schistosomiasisย in Ipogun community in Ifedore Local Government Area of Ondo State.
Iย foundย fourย positiveย schistosomiasisย casesย followingย laboratoryย analysisย ofย singleย urineย samplesย submittedย byย participants.ย Thisย accountedย forย anย overallย prevalenceย rateย ofย 1%ย inย allย theย sampledย primaryย schoolsย inย theย district.ย Theย Ministryย ofย Healthย conductedย a mapping of schistosomiasis countrywide in 2012/2013 among primary schools, S.ย haematobium was endemic in 69 districts while S. mansoni was prevalent in 49 districts.ย Ondo state had a reported prevalence rate of 12.8% for S. haematobium (MOH,ย 2014).
Thisย prevalenceย rateย forย S.ย haematobiumย amongย theย pupilsย wasย lowerย thanย prevalence rates reported in earlier studies and this was similar to findings from a studyย conducted in Mozambique where significant decrease in S. haematobium was observedย in a 5 year period from 60.5% to 38.8% following implementation of chemotherapyย (Phillips et al., 2022). A study in Namibia reported that the overall, schistosomiasisย prevalence in the surveyed areas was 9.0% indicative of a decrease from previous ratesย whichย presentedย highย prevalence areasย ofย aroundย 95%ย (Sousa-Figueiredoย etย al.,ย 2015).
Strengths
Despite our limitations, our study was able to determine the prevalence and someย factors associated with schistosomiasis in primary schools among the pupils. This we believe has provided an important epidemiological update onย theย diseaseย thatย is useful forย programmingย andย evaluationย of controlย strategies.
Conclusionย
Inย conclusion,ย my study foundย thatย theย prevalenceย rateย for schistosomiasisย amongst the primary pupils was currently at 1%.ย The study also foundย that previous history of schistosomiasis infection was an important associatedย factor for acquiring new infections in future. I also found that taking praziquantel tabletsย for chemotherapy during the last mass drug administration exercise in primary schoolsย was protective against acquisition of schistosomiasis infection. The study demonstratedย that schistosomiasis infestation was present in two school localities of the 15 samplesย schoolsย that wereย sampled.
Recommendations
I recommend implementation of strengthened community health education programs toย target the at-risk age groups in order to progressively bring the prevalence rate evenย lower. Regular screening of children in all schools and the community is thereforeย strongly recommended in order to facilitate early access and linkage to health services.ย Active surveillance for schistosomiasis is also recommended in the whole district forย prompt detection of outbreaks and change in trends of the disease for informed decisionย makingย inย interventionย implementation.ย Thisย willย greatlyย contributeย toย Governmentย ofย theย Republicย ofย Nigeriaโsย planย ofย eliminatingย neglectedย tropicalย diseasesย byย theย yearย 2020ย inย Nigeria which includes schistosomiasis.
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