The prevalence of Schistosoma haematobium infection has been shown to be about 23.7% among children living in the lakeshore areas of Malawi, with
reinfection rates of about 30% to 40%. This study aimed to determine the current prevalence and distribution of S. haematobium infection in school
children along the southwestern shores of Lake Malawi and examine the control interventions present in the area.
Methods
This prospective cross-sectional study was conducted in primary schools. School children were enrolled, demographic data were collected, and urine
samples were submitted for analysis on macrohaematuria, microhaematuria, and S. haematobium eggs. A questionnaire was administered to 3 health
facilities on diagnosis and treatment of schistosomiasis, as well as the control interventions against it.
Results
Four hundred children (174 males and 226 females) were enrolled from 7 primary schools. Mean participant age was 9.57 years (range 7 to 12 years).
Fifty children (12.5%) had S. haematobium eggs detected in their urine, with the mean egg count being 15/10 mL. The highest infection intensity category
(≥ 50 eggs/10mL) was seen in 10 children (2.5%). Prevalence varied significantly between the schools, with rates ranging from 0% to 20%. Schools with
higher prevalence rates were located farther away from the nearest public hospital that provides treatment free of charge. Prevalence correlated with
previous history of mass chemotherapy in schools.
Mass chemotherapy, health education, and improved water supply and sanitation were some of the interventions that contributed to lower prevalence
rates in some areas.
Conclusions
Schistosomiasis prevalence around southwestern Lake Malawi was lower than previously reported, owing to control interventions focusing on health
education, improved water supply, sanitation, and mass chemotherapy. Consistent and uniform interventions can reduce prevalence further and sustain
control. As prevalence falls, diagnostics can identify high transmission areas, monitor disease trends, and guide evidence-based control strategies.