Endemicity and environmental reservoirs of schistosomiasis and soil-transmitted helminth infections in Ghanaian rural communities

Abstract

BACKGROUND: Schistosomiasis and soil-transmitted helminth (STH) infections remain major neglected tropical diseases in low- and middle-income countries despite ongoing preventive chemotherapy programmes. This study assessed the prevalence, associated risk factors, and household environmental contamination related to schistosomiasis and STH infections among children in Banda District, Ghana. METHODOLOGY: A community-based cross-sectional study was conducted in four endemic communities in the Banda District, Ghana, from February to April 2025. Pre-school and school-aged children (2-15 years) were recruited using systematic sampling. Urine samples were examined with urine sedimentation for S. haematobium ova, and stool samples were analyzed using Kato-Katz for STHs and S. mansoni ova. Household soil and animal faecal samples were examined using flotation and formalin-ether concentration techniques. Risk factors were assessed through structured questionnaires. Bivariate and multivariate logistic regression analyses were performed; variables with p ≤ 0.25 were included in the multivariate model, with a p < 0.05 considered statistically significant. RESULTS: The overall prevalence of schistosomiasis was 26.3%, and the prevalence of STH infections was 28.0%. In multivariate analysis, non-school attendance (AOR = 4.59; 95% CI: 2.49-8.47; p < 0.001) and children drinking from rivers/streams (AOR = 4.58; 95% CI: 1.73 - 12.10; p = 0.009) were associated with a higher odds of schistosomiasis. For STH infections, children aged 2-9 years (AOR = 2.18; 95% CI: 1.24-3.85; p = 0.007), non-school attendance (AOR = 5.91; 95% CI: 3.41-10.24; p < 0.001) and rearing of animal within house (AOR = 4.78; 95% CI: 2.32-9.86; p < 0.001) were associated with a higher odds of infection. Both soil and animal faecal samples harbored STHs with differing species distributions between matrices (soil: 7.08% positive; animal faeces: 10.67%). CONCLUSION: This study revealed that schistosomiasis and helminth infections are prevalent among humans, animals, and the surrounding soil within shared environments. The findings support extending MDA to the community level and implement WASH, improved livestock management and health education to reduce transmission.