Co-occurrence of alcohol use and Schistosoma mansoni infection: prevalence, patterns, and risk factors in rural Uganda

BackgroundDespite being known independently as important aetiological agents of liver disease, little is known about the prevalence, patterns, and risk factors associated with co-occurring alcohol use and Schistosoma mansoni infection in rural endemic settings. MethodsA cross-sectional analysis was completed of 3198 individuals aged 10-90 years from 52 rural villages in Uganda. Alcohol use was assessed using the World Health Organisation STEPwise Approach to Surveillance survey, and S. mansoni infection was diagnosed using Kato-Katz microscopy. Logistic regressions with biomedical, demographic, socioeconomic, and spatial variables were run. ResultsThe overall prevalence of S. mansoni infection was approximately 44% (1405/3198) and current alcohol use was reported by over 12% (392/3198) of participants. Among males aged [≥]20 years, the prevalence of co-occurring current alcohol use and S. mansoni infection was 18.7% (148/791). Females were less likely to have S. mansoni infection (odds ratio [OR] 0.83, 95% CI 0.69 - 0.99) or report current alcohol use (OR 0.44, 95% CI 0.32 - 0.62). Smoking (OR 9.43, 95% CI 6.66 - 13.37) and participating in fishing activity (OR 3.50, 95% CI 2.57 - 4.76) were associated with current alcohol use. Age (OR 0.95, 95% CI 0.94 - 0.97), fishing activity (OR 1.82, 95% CI 1.16 - 2.84), and smoking (OR 5.25, 95% CI 3.49 - 7.90) were associated with co-occurring current alcohol use and S. mansoni infection. ConclusionCo-occurrence of alcohol use and schistosome infection is common. Future research should investigate multi-sectoral public health interventions that simultaneously address the risk factors associated with both alcohol use and S. mansoni infection. Key messagesO_LIThis study aims to characterise the co-occurrence of alcohol use and S. mansoni infection, and to identify shared risk factors for these hepatotoxic exposures in a rural Ugandan population. C_LIO_LIAlcohol use was most prevalent among males aged [≥]20 years, and key risk factors for both alcohol use and S. mansoni infection were male sex, current smoking status, and participation in fishing activity. C_LIO_LIThe findings of this study highlight the need for integrated public health interventions that simultaneously target alcohol use and S. mansoni infection, focusing on high-risk occupational groups such as those involved with fishing and high-risk behaviours such as smoking. C_LI