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

Background

Despite 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.

Methods

A 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.

Results

The 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.

Conclusion

Co-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 messages

• This 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.

• Alcohol 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.

• The 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.