Spatial Distribution Of Urogenital Schistosomiasis In School-Aged Children In Togo: An Oversampling Survey In Three Districts In 2022

Abstract

Background Despite concerted global efforts, urogenital schistosomiasis remains an important public health chal lenge in sub-Saharan Africa. Understanding the local dynamics of this disease is crucial for effectively planning inter ventions to eliminate urogenital schistosomiasis as a public health concern. This study, conducted in southern Togo, aimed to comprehensively describe the epidemiology of Schistosoma haematobium infection among school-aged children after more than a decade of control using preventive chemotherapy. Methods A cross-sectional study was conducted from July to August 2022 among children aged 5 to 14 years in selected villages across three districts of the Plateaux region of Togo. Coordinates of each surveyed household were recorded, and sociodemographic data were gathered using a pre-tested questionnaire. Urine samples were visually examined for macrohematuria and tested for microhematuria. Urine filtration was performed to quantify S. haemato bium eggs. Results In total, 3146 households were enrolled, and 6400 school-aged children provided urine samples. The overall prevalence of macrohematuria was 4.48% (95% CI [4.21–4.75]) and of microhematuria was 16.11% (95% CI [15.65–16.57]), while 15.0% (95% CI [14.55–15.45]), of children were S. haematobium egg-positive. Prevalence varied across villages and districts, with Ogou district exhibiting the highest prevalence by all three indicators. The preva lence of heavy-intensity infection ranged from 0.92% (95% CI [0.69–1.15]) in the Est-Mono district to 12.91% (95% CI [12.3–13.52]) in the Ogou district, averaging 3.40% (95% CI [2.95–3.85]) in the Anié district. Conclusions This study highlights geographic variability in the distribution of S. haematobium, even after more than a decade of PC. The detailed data provided can support the development of more targeted treatment strategies, focusing on areas where S. haematobium remains prevalent. This approach may accelerate progress toward achieving the WHO goal of eliminating schistosomiasis as a public health concern.