Prevalence and determinants of urogenital schistosomiasis among Tanzanian primary school children.

Abstract

Urogenital schistosomiasis remains a significant public health problem among school-aged children in Tanzania despite ongoing preventive chemotherapy. This study determined the prevalence of laboratory-confirmed Schistosoma haematobium infection and assessed knowledge and behavioural factors associated with infection among primary school children in an urban district of Tanzania. A school-based cross-sectional analytical study was conducted among 384 children selected using a multistage sampling technique. Data were collected using a structured interviewer-administered questionnaire and laboratory examination of urine specimens by the standard urine filtration technique. Logistic regression analyses were performed to identify factors independently associated with laboratory-confirmed infection. The overall prevalence of S. haematobium infection was 11.2% (95% CI: 8.1-14.4), with 90.7% of infected children having light-intensity infections. Younger children aged 9-11 years were at significantly higher risk of infection than older children. Previous schistosomiasis diagnosis (adjusted odds ratio (AOR) = 4.15, 95% confidence interval (CI): 1.52-11.33; p = 0.005) and unemployment of the head of household (AOR = 5.92, 95% CI: 1.16-30.32; p = 0.033) were independently associated with infection. Overall, 45.3% of participants demonstrated good knowledge of urogenital schistosomiasis; however, infection persisted despite relatively high levels of awareness. Urogenital schistosomiasis remains endemic among primary school children in this urban setting, indicating ongoing transmission despite school-based control programmes. Strengthening integrated control strategies that combine preventive chemotherapy with health education, improved water, sanitation, and hygiene, and interventions that reduce exposure to contaminated freshwater is essential to accelerate progress towards schistosomiasis elimination.