Abstract
Schistosomiasis remains a health burden in South Africa, especially in the province of Mpumalanga, and has infected more than four million people in the country (both children and adults), with Schistosoma haematobium as the most common schistosome. The schistosomiasis-endemic provinces of Limpopo, Mpumalanga, and KwaZulu-Natal were shown to be the most severely affected and there is continuous endemicity in the Eastern Cape Province. Mpumalanga Province is one of the schistosomiasis-endemic provinces with the highest burden of disease and Ehlanzeni district was chosen as no studies have examined the prevalence and distribution of schistosomiasis in this district. The study intended to add to the scant knowledge on this subject that is currently accessible at the district level by highlighting the prevalence of schistosomiasis and "hot spot" areas in the district, as well as the association between age, gender, and infection. A cross sectional study focusing on the population of Ehlanzeni district in Mpumalanga was undertaken looking at urine samples routinely collected from various health institutions in the district. The study focused on the four sub-districts (Nkomazi, City of Mbombela, Bushbuckridge and Thaba Chweu). The secondary data was from urine samples analysed at the NHLS (which is a reference laboratory for public health institutions). Data analyses was done using SPSS version 28. Pearson Chi-Square (χ2) was used to highlight the contrast in prevalence between age groups, and gender, ArcGIS Pro was used to establish the geographical distribution in the prevalent areas. Chi-square (χ2) was used to look at frequencies and proportions. The odds ratio of infection and confidence intervals for male vs females was determined through the linear regression model. The sub-district of Bushbuckridge, followed by the City of Mbombela have been flagged by the study as areas with the highest prevalence in Ehlanzeni and should be prioritized for mass treatment with praziquantel, with special attention to school-aged children as recommended by the World Health Organisation (WHO). Mass drug administration has been proven to be effective in combating the scourge of schistosomiasis in endemic areas that are highly burdened by the disease. Unfortunately, the mentioned strategies cannot be effected if there is no political will, because with political commitment, policies on schistosoma control can be drafted and employed, funding can be made available for schistosoma educational programmes, water and sanitation services can be improved and access to praziquantel can be a reality.
Keywords: schistosomiasis, prevalence, district, disease.