Prevalence, intensity, and risk factors of Schistosomiasis and Intestinal Parasitic Infections among primary school children in northern Uganda: Implications for public health interventions

Background

Schistosomiasis and intestinal parasitic infections are major public health challenges in Uganda, particularly among school-aged children. These infections contribute to malnutrition, anemia, and impaired cognitive development, limiting children’s educational and overall well-being. The Lango sub-region in Northern Uganda is endemic for Schistosoma mansoni , but limited epidemiological data exist to inform targeted control strategies. This study aimed to determine the prevalence, intensity, and risk factors associated with schistosomiasis and intestinal parasitic infections among primary school children in the region.

Methodology/Principal Findings

We conducted a cross-sectional study between January and March 2023, involving 802 primary school children from randomly selected schools in Lira District, Lira City, and Kole District. Stool and urine samples were examined using the Odongo-Aginya method, urine filtration, and Point-of-Care Circulating Cathodic Antigen (POC-CCA) test to detect S. mansoni , S. haematobium , and intestinal parasites. Data on potential risk factors were collected via structured interviews and analyzed using logistic regression in SPSS version 25.0.

The overall prevalence of schistosomiasis was 34.5% ( S. mansoni ), with light (11.6%), moderate (5.4%), and heavy (2.9%) infection intensities. Other intestinal parasites were detected in 20.3% of participants, including Ascaris lumbricoides (11.6%) and hookworms (6.4%). Key risk factors for schistosomiasis included bathing with borehole water (OR = 6.017, p = 0.019) and low paternal education level (p = 0.05), while recent praziquantel treatment was protective (OR = 0.122, p = 0.009).

Conclusions/Significance

Our findings highlight a high burden of schistosomiasis and intestinal parasitic infections in Northern Uganda, emphasizing the need for strengthened mass drug administration (MDA), improved water, sanitation, and hygiene (WASH) infrastructure, and targeted health education. Addressing these factors through integrated, community-driven interventions is essential for sustainable disease control and prevention.

Author Summary

Schistosomiasis and intestinal parasitic infections are significant public health challenges, especially in low-resource settings like Northern Uganda. These infections can lead to malnutrition, anemia, and impaired cognitive development, particularly in school-aged children. In this study, we investigated the prevalence, intensity, and risk factors for these infections among primary school children in the Lango sub-region of Northern Uganda.

We examined stool and urine samples from over 800 children and found that more than one-third were infected with Schistosoma mansoni , the parasite responsible for intestinal schistosomiasis. Additionally, we identified other intestinal parasites, such as Ascaris lumbricoides (roundworms) and hookworms . Our findings show that factors like bathing with borehole water, low parental education levels, and district of residence were linked to a higher risk of infection. However, children who had recently received treatment with praziquantel, the main drug used for schistosomiasis, were less likely to be infected.

These results highlight the urgent need for expanded treatment programs, improved sanitation, and targeted health education efforts to reduce the burden of parasitic infections in Ugandan schoolchildren. By identifying key risk factors, our study provides valuable insights to guide policymakers and public health professionals in designing more effective intervention strategies.