article · PLoS neglected tropical diseases
A cross-sectional survey evaluated the prevalence of urogenital and intestinal schistosomiasis among 466 school children in the Ilie and Ore communities of Osun State, Nigeria. Using urine filtration and Kato-Katz techniques, an overall schistosomiasis prevalence of 40 percent was identified. Single Schistosoma haematobium infection stood at 19 percent, while single Schistosoma mansoni infection affected 9 percent of participants. Mixed infections involving both species were found in 9.5 percent of the children, with a higher occurrence recorded among females. Additionally, 4.7 percent of participants exhibited ectopic excretion of Schistosoma mansoni eggs in urine, whereas no Schistosoma haematobium eggs were detected in stool samples. Infection intensity was higher among males, showing a significant difference for Schistosoma haematobium. Significant associations were observed between haematuria and single Schistosoma haematobium infection as well as mixed infections, pointing to potential interspecific parasite interactions.
Schistosomiasis causes substantial morbidity among children in sub-Saharan Africa. The simultaneous presence of both urogenital and intestinal schistosome species complicates diagnosis and disease management, as evidenced by ectopic egg shedding and mixed infections. These findings highlight the burden of co-infection in Nigerian school children and underscore the urgent requirement to scale up targeted mass drug administration programmes using praziquantel alongside broader disease control measures.
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BACKGROUND: The risk of co-infection with Schistosoma haematobium and S. mansoni and the potential harmful effect on morbidity and control is enhanced by the overlapping distribution of both species in sub-Saharan Africa. Despite the reported high endemicity of both species in Nigeria, studies on the spread and effect of their mixed infection are limited. Therefore, a cross-sectional survey was conducted among school children in two communities in South-west Nigeria to investigate the prevalence of mixed human schistosome infection, intensity, and possible ectopic egg elimination. METHODS: Urine and stool samples were collected from consenting school children in Ilie and Ore communities of Osun State, Nigeria. Schistosoma haematobium eggs were detected in urine using the urine filtration technique, while S. mansoni eggs were detected in stool using the Kato-Katz thick smear technique. RESULTS: The study enrolled 466 primary and secondary school children (211; 45.3% males vs. 255; 54.7% females; mean age 11.6 ± 3.16 years). The overall prevalence of schistosomiasis was 40% (185/466), with 19% (89/466) recording single S. haematobium infection while 9% (41/465) had a single S. mansoni infection. The geometric mean egg count for S. haematobium was 189.4 egg/10ml urine; 95% CI: range 115.9-262.9, while for S. mansoni, it was 115.7 epg; 95% CI: range 78.4-152.9. The prevalence of ectopic S mansoni (S. mansoni eggs in urine) was 4.7%, while no ectopic S. haematobium (S. haematobium eggs in stool) was recorded. Mixed infection of S. haematobium/S. mansoni had a prevalence of 9.5% (44/466). More females (54.5%) presented with S. haematobium/S. mansoni co-infection. For both parasites, males had higher infection intensity, with a significant difference observed with S. haematobium (p = 0.0004). Hematuria was significant in individuals with single S. haematobium infection (p = 0.002), mixed ectopic S. haematobium/S. mansoni (p = 0.009) and mixed S. haematobium/S. mansoni/ectopic S. mansoni (p = 0.0003). CONCLUSIONS: These findings suggest the probability of interspecific interactions between S. haematobium and S. mansoni. Scaling up of mass administration of praziquantel and control measures in the study areas is highly desirable.
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DOI: 10.1371/journal.pntd.0009628
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