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The prevalence of Schistosoma mansoni infection among adults with chronic non-communicable diseases in Malawi

Nyangulu, Wongani, Sadimba, Christina, Nyirenda, Joyce, Twaibu, George, Kamwendo, John, Chawawa, Kelvin, Masano, Angella, Chilinda, Elizabeth, Kayuni, Sekeleghe, Muula, Adamson S. and Maleta, Kenneth (2022) 'The prevalence of Schistosoma mansoni infection among adults with chronic non-communicable diseases in Malawi'. Tropical Medicine and Health, Vol 50, Issue 1, e56.

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Background: Schistosomiasis is a parasitic infectious disease caused by flatworms of the Schistosoma genus. The global burden of schistosomiasis is high. In Malawi, schistosomiasis is among the top 20 causes of outpatient department visits in health facilities. Schistosomiasis is among the most important but neglected causes of non-communicable diseases (NCD) peculiar to tropical endemic settings. While much is known about the contribution of S. haematobium to the NCD burden in Malawi, the role of S. mansoni remains largely unknown.

Methods: We conducted a cross-sectional study at Mangochi District Hospital. Adults over 18 years diagnosed with NCDs (n = 414), admitted or attending weekly outpatient clinics were recruited between August 2021 and February 2022. Data were collected on sociodemographic characteristics, medical history, body weight, blood pressure, and fasting blood glucose. Stool and midstream urine were collected for Kato–Katz (KK) microscopy and urine point of care-circulating cathodic antigen (POC-CCA) tests, respectively. We computed prevalence of S. mansoni as number of positive KK and CCA tests, each divided by total submitted samples. Univariate and multivariable logistic regression were done to evaluate risk factors of NCDs and association between S. mansoni infection and NCDs.

Results: We recruited 414 participants, mean age 57 years (SD 16), 67% of whom were female. Prevalence of S. mansoni based on urine CCA was 15% (95% CI: 11–19) and 0% on KK microscopy. Hypertension was the most common condition with a prevalence of 85% (95% CI: 81–89), followed by diabetes mellitus with a prevalence of 42% (95% CI: 37–46) and heart disease with a prevalence of 3% (95% CI: 2–5). S. mansoni infection was not significantly associated with hypertension (OR: 1.2, 95% CI: 0.5–3.1), diabetes (OR: 0.6, 95% CI: 0.3–1.10) or heart disease (OR: 2.0, 95% CI: 0.4–10).

Conclusions: We observed moderate prevalence of S. mansoni infection among adults in the study per WHO classification of endemicity. This is within the range observed in children in Mangochi from 10 to 56.7%.

Item Type: Article
Subjects: QX Parasitology > QX 20 Research (General)
QX Parasitology > Helminths. Annelida > QX 355 Schistosoma
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Disorders and Injuries of Environmental Origin > WD 600 General works
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI):
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 13 Dec 2022 12:18
Last Modified: 06 Jun 2023 14:25


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