Schistosoma mansoni infection and its association with nutrition and health outcomes: a household survey in school-aged children living in Kasansa, Democratic Republic of the Congo.

ABSTRACT

INTRODUCTION: Schistosomiasis (SCH) is an important public health problem in developing countries and school-aged children are the most affected. This study explored health and nutritional status and their correlation with SCH in children attending primary school (3rd to 6th class) living in the area of Kasansa in the Democratic Republic of Congo. METHODS: Across-sectional household survey was carried out in Kasansa health area in February 2011. Children whose parents reported to attend primary school (3rd to 6th class) were included. Socio-demographic characteristics, information on morbidity history and risk factor were collected using a semi-structured questionnaire. S. mansoni and malaria infection were assessed using the Kato-katz technique and rapid diagnostic test, respectively. Haemoglobin concentration was also performed using a portable HemoControl device. Bivariate and multiple logistic regressions were used to assess risk factors for S. mansoni. RESULTS: A total of 197 school aged children participated in the study with a median age of 12 years and 53.8% of them were boys. The overall health status of the children was poor with very high prevalences of S. mansoni infection (89.3%), malaria infection (65.1%), anaemia (61.4%) and stunting (61.0%). Regular contact with river water was the most important risk factor (OR 11.7; p<0.001) related to SCH infection. A low haemoglobin concentration was significantly associated with a SCH infection (OR 12.3; p=0.003) and egg load was associated with stunting (OR 12.4; p=0.04). Children from farmers were more at risk for low school performance (OR 5.3; p=0.03). CONCLUSION: High prevalence of Schistosoma mansoni and malaria infection was observed in the study population living in Kasansa area. Moreover, they presented a high burden of anaemia, chronic malnutrition and low school performance. An integrated disease control and management of these diseases and their consequences, endorsed by surveillance, is needed.