Epidemiological screening of pinworm, schistosomiasis, and intestinal parasites in Eswatini preschoolers.

Abstract

Preschool children in the Kingdom of Eswatini are excluded from the national school-based deworming programme and had never been surveyed for parasitic infection. During June 2019 we conducted a cross-sectional baseline survey of 261 children (mean age 4.8 ± 0.75 years) attending 16 kindergartens and community care points across 4 provinces. Enterobius vermicularis was sought on peri-anal cellophane/Scotch-tape swabs (n = 261); Schistosoma haematobium in single urine specimens by the chamber-tube microscope-slide (CTMS) sedimentation method (n = 232); and intestinal helminths and protozoa in single stool specimens by the merthiolate-iodine-formaldehyde (MIF) concentration method (n = 175). Pinworm prevalence was 3.8% (10/261) and did not differ by sex (p = 0.76) or province (p = 0.83). S. haematobium ova were found in 0.9% (2/232), both in boys from recognised endemic foci. Intestinal parasites were detected in 41.1% (72/175), with no significant sex (p = 0.64) or regional (p = 0.70) variation; protozoa predominated (97.2% of positives) over helminths (4.2%; all Ascaris lumbricoides), the commonest species being Blastocystis hominis (61.1%) and Giardia lamblia (34.7%). These first baseline data reveal a high burden of intestinal protozoa alongside a low but measurable burden of pinworm and urogenital schistosomiasis in Eswatini preschool children, and support extending screening and preventive chemotherapy to this previously unmonitored age group using the simple, field-deployable cellophane-swab, CTMS and MIF methods.