Abstract

Objective: To examine the magnitude of Schistosoma haematobium (S. haematobium) infection and the factors associated with exposure of preschool children in Kigogo Ward, Kinondoni District, Dar es Salaam. Methods: A quantitative cross-sectional survey of Class I pupils (preschool-age in 2015) was carried out from May to June 2016 to examine the prevalence and intensity of S. haematobium infection and associated factors. Urine samples were examined for haematuria, S. haematobium eggs and intensity. Parents or guardians were interviewed on their awareness and level of knowledge on urinary schistosomiasis disease (symptoms, mode of transmission, treatment and prevention), as well as their perceived risk of infection to young children. Potential sites of transmission were identified and searched for Bulinus spp., snails and the activities that exposed young children to infection were recorded. Results: A total of 424 pupils and 408 female parents or guardians were recruited. Haematuria was detected in 51 (12.0%) pupils, S. haematobium eggs were observed in 8 (1.9%) pupils and all were light infection. Bulinus spp., snails were identified mostly at cross-points of rivers. The large majority (91.7%) of parents or guardians were aware of urinary schistosomiasis disease, but three quarter (76%) did not consider it as a health problem. More than two thirds (71.3%) reported that anybody could get urinary schistosomiasis; two thirds (65.9%) reported that infection was likely to be acquired at cross-points of rivers. The large majority (> 90%) had the notion that young children could be exposed; and all the activities that might lead a child to come into contact with potentially infested waters were judged to be risk factors. The larger majority (83.6%) had a high level of knowledge on urinary schistosomiasis (transmission, symptoms, availability of modern treatment and the preventive measures), reflecting the ongoing advocacy campaigns. Conclusions: Young children left out in praziquantel preventive chemotherapy harbor S. haematobium infection and are likely to be the source of environmental contamination frustrating the national efforts for control. Presence of Bulinus spp. snails shows the potential for the continuity of S. haematobium transmission.

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