Impact assessment of effective rounds of mass drug administration against schistosomiasis and soil transmitted helminthiasis among school age children in Akwa Ibom State, Nigeria.

内容摘要

Schistosomiasis (SCH) and Soil-transmitted helminthiasis (STH) remain major neglected tropical diseases across sub-Saharan Africa. In Akwa Ibom State, preventive chemotherapy (PC) has been implemented in endemic Local Government Areas (LGAs). This study assessed the impact of five effective rounds of PC on the prevalence and intensity of SCH and STH in 26 endemic LGAs. This study was carried out in 26 LGAs of Akwa Ibom State between September and October 2025. A school-based cross-sectional survey was employed. Schools were purposefully selected from endemic wards, and a total of 200-300 samples were collected per LGA from school children of both sexes aged 8-14 years. Samples were collected using a systematic random sampling method. Questionnaires were administered using electronic data forms. Stool samples collected were analyzed using the Kato-Katz technique, while urine samples were analyzed using the urine filtration method. Conventional microscopy alongside a novel AiDx digital microscope was used to examine prepared specimen. Data obtained were analyzed using descriptive statistics, chi-square test, bivariate and multivariate logistic regression on SPSS, and maps were generated using ArcMap. No cases of Schistosoma mansoni or Schistosoma haematobium were detected across the 26 LGAs (0.0% prevalence). The overall prevalence of STH was 27.62% (95% CI: 26.54-28.72), ranging from 4.92% to 71.65% across LGAs. Species-specific prevalence was 15.38% (95% CI: 14.52-16.28, range: 3.3% to 38.3%) for hookworm, 15.10% (95% CI: 14.24-15.99, range: 1.6% to 67.0%) for Ascaris lumbricoides, and 1.52% (95% CI: 1.25-1.85, range: 0.4% to 9.3%) for Trichuris trichiura. Mbo (71.65%) and Udong Uko (62.04%) recorded the highest prevalences, whereas Ika (4.92%) had the lowest. Prevalence was significantly higher among children aged 11-14 years (31.77%; 95% CI: 29.95-33.64) compared with those aged 8-10 years (95% CI: 23.77-26.46), and among males (29.30%; 95% CI: 27.80-30.86) compared with females (25.73%; 95% CI: 24.24-27.35) (p&#x2009;<&#x2009;0.05). 98.66%, 99.09% and 100.0% of schoolchildren had light infections of A. lumbricoides, hookworms and T. trichiura respectively. Compared with baseline data, STH prevalence declined by 30.15%. Significant risk factors associated with STH include; males (aOR = 1.196, 95% CI: 1.072 - 1.335), age group of 11-14 years (aOR = 1.391, 95% C.I.: 1.244 - 1.554), dry pit latrine (aOR = 1.464, 95% C.I.&#x2009;=&#x2009;1.239 - 1.731), schools where children urinate (aOR = 2.620, 95% C.I.: 2.362 - 2.929) and defecate (aOR = 1.238, 95% C.I.&#x2009;=&#x2009;1.097 - 1.396) around school or wait to defecate after school (aOR = 1.830, 95% C.I.&#x2009;=&#x2009;1.365 - 2.454), schoolchildren that drinks from surface water (aOR = 1.731, 95% C.I.&#x2009;=&#x2009;1.486 - 2.017) or boreholes that uses hand pump (aOR = 1.666, 95% C.I.&#x2009;=&#x2009;1.412 - 1.965). Schistosomiasis was not reported in 26 LGAs of Akwa Ibom. Soil-transmitted helminths had a significant reduction in prevalence, but with varying prevalence across the states. There is a need for sustained preventive chemotherapy against STH in the State. Improvement in water, sanitation, and hygiene (WASH) infrastructures to create behavioural change, and strengthen the control efforts.