Burden and Risk Factors of Urinary Schistosomiasis and Bacteriuria Coinfections Among Schoolchildren in an Endemic District in the Ashanti Region, Ghana.

Abstract

This study assessed the prevalence and risk factors for urinary schistosomiasis coinfection with bacteriuria among schoolchildren in an endemic District of the Ashanti Region of Ghana. A cross-sectional study design was employed to assess the prevalence and coinfection of urinary schistosomiasis with bacteriuria among 312 participants. Urine samples were collected from each participant and examined microscopically for Schistosoma haematobium eggs and also cultured for bacteriuria. The overall prevalence of urinary schistosomiasis among the participants was 27.2%. Children aged 12-13 years had the highest rate (33.8%, p = 0.04), and males had a higher rate (37.5%, p = 0.01) than females (16.4%). Users of streams/rivers and boreholes as water sources had schistosomiasis rates of 40.1% and 31.7%, respectively. Prevalence rates of 42.9%, 32.5%, and 28.2% were recorded among children who swam, fished, or used stream water for domestic activities, respectively. The majority of schoolchildren (51.6%) had bacteriuria, with Escherichia coli (27.9%) and Staphylococcus aureus (18.6%) being the predominant isolates. The prevalence of coinfection of urinary schistosomiasis with bacteriuria among schoolchildren was 17%, with E. coli (28.3%) and S. aureus (18.9%) the most common causes. Swimming in rivers/streams and being male increase the odds of schistosomiasis infection by 2.00 (95% CI = 1.50-2.70, p = 0.01) and 3.20 (95%CI = 2.80-3.80, p = 0.04), respectively. Water-contact activities, such as fishing (OR = 1.35, 95% CI = 0.82-2.23, p = 0.03) and domestic activities (OR = 1.12, 95% CI = 0.86-1.86, p = 0.04), significantly increased the risk of bacteriuria. These findings suggest that these infections were linked to environmental exposure and inadequate hygiene. It is recommended that integrated control strategies that address both schistosomiasis and bacterial coinfections, including regular praziquantel administration, improved sanitation, snail vector control, and school-based hygiene education, be implemented to curb the transmission of the dual burden in endemic communities.