High levels of urinary schistosomiasis among children in Bunuso, a rural community in Ghana: an urgent call for increased surveillance and control programs.

ABSTRACT

We investigated the occurrence of urinary schistosomiasis and estimated predictors for risk of infection among children in the Bunuso community of Ashanti Region of Ghana, West Africa. The cross-sectional survey was conducted between June and December 2009. Information was obtained on socio-demographic characteristics, schistosomiasis symptoms and other risk factors through interviews and questionnaires. Urine samples were analysed for Schistosoma haematobium ova using centrifugation and sedimentation, filtration and microscopy. Bivariate estimations and multiple logistic regression modelling with odds ratios (OR) were used to assess risk factors for S. haematobium infections. Inspections at River Nanakwaw revealed snail vectors, Bulinus truncatus. Overall, 95 out of 100 (95 % confidence interval [CI] 88.8-97.6) children tested positive for S. haematobium infection. The mean ova density (eggs/10 ml of urine) of infections was 58.12 (95 % CI 31.3-71.6) and varied significantly between age-group distributions (P value = 0.001; Post Hoc, P > 0.05 for ≤8 vs 15-17 years, and 9-11 vs 12-14 years), sources of house-hold water (P value = 0.019; Post Hoc, P < 0.05 for Borehole vs River Nanakwaw), children activities in River Nanakwaw (P value = 0.001), and haematuria (P value = 0.007). Independent variables significantly associated with S. haematobium infections were the use of River Nanakwaw as source of household water (OR 12.54; 95 % CI 3.932-42.12, P value = 0.003), engaging activities in River Nanakwaw (OR 8.76; 95 % CI 1.759-31.871; P value = 0.008) and haematuria (OR 36.71; 95 % CI 10.18-48.47; P value = 0.001). The passage of blood urine was prognostic of urinary schistosomiasis with a positive predictive value of 97.5 %. Our results demonstrate the endemicity of urinary schistosomiasis in Bunuso. Schistosomiasis remains a disease of great public health importance in Ghana, and there is the urgent need to intensify surveillance and control programs in remote riparian communities.