Concurrent Schistosoma mansoni and Schistosoma haematobium infections in a peri-urban community along the Weija dam in Ghana: A wake up call for effective National Control Programme
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Date
2019-07-25
Journal Title
Journal ISSN
Volume Title
Publisher
Acta Tropica
Abstract
Globally over 200 million people are infected with schistosomiasis, and approximately 80% are caused by just
two of five species, Schistosoma haematobium and Schitosoma mansoni that are broadly distributed, and often
overlap across sub-Saharan Africa. Like most neglected tropical diseases, mortality is low (an estimated 200,000
deaths annually) and morbidity is considerably high and probably underestimated. Surprisingly, little attention
has been given to co-infection with these two species. We have studied co-infection with S. mansoni and S.
haematobium in a peri-urban community in Ghana, one of the most highly endemic countries for schistosomiasis.
We collected and examined snails of the two intermediate host species from the reservoir adjacent to the
community. We also used microscopical examination of stool and urine samples to determine the level of
concurrent S. mansoni and S. haematobium infections in school and administered questionnaires to assess water
contact activities that predispose pupils to infections
Examination of the snail hosts revealed that 0.7% (7/896) of Bulinus truncatus and 1.7% (14/780) of
Biomphalaria pfeifferi snails were found to be hosting cercariae morphologically consistent with that of S.
haematobium and S. mansoni respectively. The overall prevalence values for urogenital and intestinal schistosomiasis
were 66.8% (135/202) and 90.1% (163/181) respectively. Only 50 of 181 schistosome-infected pupils
had single-species infections and the remaining 131 pupils presented concurrent infections. Among the 131
infected with both species were 50 individuals having only S. mansoni eggs in stool and S. haematobium eggs in
urine (conventional presentation). Eighty-one children (81) had eggs of both species in either urine and/or stool
(ectopic presentation). From these 81, 63 had eggs of both species in urine, 6 had both species in stool, and 12
had eggs of both species present in both urine and stool. A comparatively large number of individuals from the
concurrent infected group presented high and moderate infection intensities than the single infected groups. The
overwhelmingly high prevalence of concurrent infections indicates further study of co-infection is needed, and
points to a need call for a holistic disease control plan so Ghana can be part of nations to achieve the WHO
roadmap target for schistosomiasis control by 2020.
Description
Research Article
Keywords
Schistosoma haematobium, Schistosoma mansoni, Concurrent infection, Single infection, Bulinus, Biomphalaria