Evaluation of a novel preventative measure for the control of urinary schistosomiasis: A pilot intervention in Adasawase, Ghana

In Adasawase, Ghana, urinary schistosomiasis is caused by Schistosoma haematobium, a parasitic blood fluke transmitted through skin contact with excreta-contaminated water. Local schoolchildren contract schistosomiasis by playing, bathing, and washing clothes in a local river. Novel methods of primary prevention of schistosomiasis are being explored for use in this location. As part of a baseline survey of disease prevalence, schoolchildren aged 8 to 16 years (n = 247) submitted 4 urine samples for testing. 47 girls and 69 boys presented with eggs at least once. The majority of infected children in this population had mean egg counts lower than 50 eggs/10ml urine, but egg counts do not necessarily correspond to risk of morbidity or long-term sequelae. Only 5 of 247 children presented with both eggs and blood on all 4 test days, suggesting that accuracy in determining true infection status is improved by collecting and testing multiple urine samples. Of the 247 children tested 4 times for schistosomiasis, 234 (94.7%) were treated by Ghana Health Services with praziquantel during normal school hours. Local school heads and teachers communicated with parents regarding treatment, organized schoolchildren, and assisted with weighing children to ensure correct dosage. Treatment of all schoolchildren took place in June, 2008. Of the 116 schoolchildren who presented with eggs at least once, 105 were retested for schistosomiasis once in July 2008 to estimate treatment efficacy; 1 boy remained egg-positive. Program costs associated with urine testing and drug distribution will be reported.