Changes in schistosomiasis prevalence after 2 years of an integrated intervention in the Itilima district of Tanzania
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Schistosomiasis remains one of the most prevalent neglected tropical diseases in Tanzania. World Vision Tanzania, in collaboration with the Ministry of Health through the National Neglected Tropical Diseases Control Programme, implemented school- and community-based mass drug administrations, community-led total sanitation, and community voice and action from 2020 to 2022. This study assessed changes in the prevalence of schistosomiasis in the Itilima district of northwestern Tanzania following the implementation of these integrated interventions. A total of 1,405 students from 22 schools participated in the baseline survey in August to September 2020, and 1,320 in September 2022. Additionally, 368 adults from 8 villages participated in the baseline survey, and 401 in the endline survey. The prevalence difference was calculated to assess changes before and after the integrated interventions. We also investigated risk factors for Schistosoma haematobium infection using endline data. The prevalence difference between 2020 and 2022 was -20.0% (95% confidence interval (CI)=-22.2%–-17.7%, P<0.001) for students and -19.6% (95% CI=-22.2%–-17.7%, P<0.001) for adults. Individuals without a latrine were more likely to have schistosomiasis (adjusted odds ratio=5.9, 95% CI=1.7–21.5, P=0.01) compared to those who had a latrine. The findings indicate substantial changes in schistosomiasis prevalence in the study area following the implementation of integrated interventions. To sustain these achievements in Itilima, a multi-sectorial approach is highly recommended to integrate additional measures for eliminating schistosomiasis as a public health problem.
Abstract
Schistosomiasis remains one of the most prevalent neglected tropical diseases in Tanzania. World Vision Tanzania, in collaboration with the Ministry of Health through the National Neglected Tropical Diseases Control Programme, implemented school- and community-based mass drug administrations, community-led total sanitation, and community voice and action from 2020 to 2022. This study assessed changes in the prevalence of schistosomiasis in the Itilima district of northwestern Tanzania following the implementation of these integrated interventions. A total of 1,405 students from 22 schools participated in the baseline survey in August to September 2020, and 1,320 in September 2022. Additionally, 368 adults from 8 villages participated in the baseline survey, and 401 in the endline survey. The prevalence difference was calculated to assess changes before and after the integrated interventions. We also investigated risk factors for Schistosoma haematobium infection using endline data. The prevalence difference between 2020 and 2022 was -20.0% (95% confidence interval (CI)=-22.2%–-17.7%, P<0.001) for students and -19.6% (95% CI=-22.2%–-17.7%, P<0.001) for adults. Individuals without a latrine were more likely to have schistosomiasis (adjusted odds ratio=5.9, 95% CI=1.7–21.5, P=0.01) compared to those who had a latrine. The findings indicate substantial changes in schistosomiasis prevalence in the study area following the implementation of integrated interventions. To sustain these achievements in Itilima, a multi-sectorial approach is highly recommended to integrate additional measures for eliminating schistosomiasis as a public health problem.