Epidemiology of urinary schistosomiasis and Soil-transmitted helminthiasis among women of Reproductive age in kwale county, kenya

Abstract

Schistosomiasis and soil-transmitted helminthiasis (STH) are prevalent infections in Sub-Saharan Africa especially in low-income setting. School aged children have been the main target of preventive chemotherapy in the national school-based deworming program. This study investigated the epidemiology of urinary schistosomiasis and soiltransmitted helminthiasis among women of reproductive age in Mwaluphamba, Kwale County, Kenya. A community-based cross-sectional study design was employed with a systematic random sampling to recruit 422 women of reproductive age (15-49 years) from four villages in Mwaluphamba location. Stool specimens were collected and examined using the Kato Katz method, while filtration technique was used to analyze urine specimens. Participants’ sociodemographic details were obtained using a standardized questionnaire. Statistical analyses were carried out using SPSS version 25, with a significance level set at p≤0.05. The prevalence of urinary schistosomiasis was 4.7% (95% CI 2.8%-6.9%), while the prevalence of soil-transmitted helminthiasis infection was 4.5% (95% CI 2.6%-6.7%). There were no significant differences in the prevalence of urinary schistosomiasis among different age groups (F=4.454, p=0.196), as well as for hookworms (p=0.235) and Trichuris trichiura (p=0.099). Urinary schistosomiasis showed a statistically significant association with haematuria, proteinuria, and leukocyturia. In terms of infection intensities, urinary schistosomiasis ranged from 1 to 120 eggs/10 mL of urine, with a median egg count of 18.45 eggs/10 mL. Patients were diagnosed with light infections of 56.16 eggs/gram and 48.48 eggs/gram for Trichuris trichiura and hookworms, respectively. The study revealed that women without latrines had a 15.70 times higher risk of urinary schistosomiasis compared to those with access to latrines. Additionally, the use of surface water (aOR=1.032, 95% CI 1.023-1.432, p=0.010) and crossing rivers (aOR=1.13, 95% CI 0.290-1.611, p=0.009) were identified as statistically significant risk factors for urinary schistosomiasis. In univariable regression analysis, defecating around water sources (OR=4.34, CI 1.466-12.883) was significantly associated with the prevalence of soil-transmitted helminthiasis (p=0.008). This study provides valuable insights into the prevalence and intensity of urinary schistosomiasis and geohelminths in Mwaluphamba location, which can inform the strengthening of control and elimination programs for these neglected tropical diseases. Based on these findings, it is recommended that comprehensive and sustained intervention strategies be implemented, focusing on improving water, sanitation, and hygiene (WASH) practices, enhancing health education, and ensuring regular mass drug administration (MDA) programs