High Schistosomiasis Prevalence in Urban and Rural Primary School Children from Kimpese Health District, Democratic Republic of the Congo

Background Schistosomiasis is a parasitic disease caused by flatworms known as schistosomes. The infection cycle starts when people shed eggs through the stool or the urine. Larva infects freshwater snails to later infect humans through the skin during water based activities. Schistosomiasis is commonly associated with rural areas. In this study, we wanted to see if the schistosomiasis distribution is different in rural and urban areas, along with potential risk factors associated with schistosomiasis distribution. Methodology Fresh urine samples were collected from 1,699 school-aged children (5 - 15 years old) in urban and rural sites in the Kimpese health district. Prevalence of haematobium and mansoni schistosomiasis was determined using, respectively, the urine sedimentation and the Point-of-Care Circulating Cathodic Antigen test with a quantitative estimate of infection intensity obtained with an RDT-Reader. Collected risk factors were tested for association with schistosomiasis infection and its intensity. Results The overall prevalence of schistosomiasis found in urban and rural areas was 75% and 82% respectively, with higher prevalence of S. mansoni in rural schools, and higher S. haematobium prevalence in urban schools. The difference in total prevalence between schools in urban and rural areas was significant, X2 (1, N = 1699) = 13.03, p = .0003. S. mansoni intensity of infection was also higher in rural children (mean = 162 mV) compared to those in urban areas (mean = 76 mV) (p < 2e-16). Male gender, washing dishes in the river, and swimming were associated with schistosomiasis in urban areas. Age, Springs, and rivers were significant factors in rural sites. Age, river, and washing dishes in the river were factors associated with the intensity of infection. Conclusion Our results showed very high prevalence in both rural and urban areas, which implies that control programs should consider them with the same interest and also revise control strategies.