Evaluating the Status of Schistosomiasis in Dabban, Lavun LGA, Niger State

Evaluating the Status of Schistosomiasis in Dabban, Lavun LGA, Niger State

CHAPTER ONE

1.0 INTRODUCTION

1.1 Background to the Study

Human Schistosomiasis (Bilhariziasis) is second only to Malaria in Sub–Sahara Africa causing severe morbidity. Killing 280 00 people each year in the African region alone (Shashieet al.,2005). Of the world’s 207 million estimated cases of Schistosomiasis, 93% occur in Sub Sahara Africa. Nigeria has the highest burden of schistosomiasis in the region (Humpheyet al.,2012). Studies have indicated that Urinary Schistosomiasis is a major health problem in the rural areas of the Middle East and most African countries. It remains one of the major health problems facing developing children. The endemicity of the disease in many rural areas is attributed to ignorance, poor living condition, inadequate sanitation, and water contact activity with snail-infected rivers, streams and ponds (WHO, 2003).

Urinary Schistosomiasis is significant due to Schistosomahaematobiumwhich causes significant clinical morbidity and disability in the endemic countries of Africa and the Middle East. A recent report of the World Health Organization (WHO) estimated that about 779 million people in 76 Tropical and subtropical countries are at risk of Schistosomiasis (Steinmannet al.,2006). Over 207 people in these countries are infected; of this, 120 million are symptomatic, with 20 million having severe clinical disease (Houmosouet al., 2012).Atleast 261 million people required preventive treatment for Schistosomiasis, and more than 40 million people were treated for Schistosomiasis in 2013 (WHO, 2015). Schistosomiasis is a parasitic blood – dwelling fluke worm belonging to the genus Schistosoma; the genus Schistosoma contains six species that are of major pathological importance to man, Schistosomahaematobium, S. mansoni, S. japonicum, S. mekongi, S. intercalaturn, and S. guineersir (Webster et al., 2006). The species differ in their final location in the human host, the species of the intermediate (Snail) host they use in their life cycle, the pathology they induce, and the number in size and shape of the eggs they produce.

The severity of vesicular (urinary) Schistosomiasis, caused by Schistosomahaematobium, is found throughout the Middle East and Africa (WHO, 1990). The severity of the disease alerted the Federal Ministry of Health to Establish the National Expert Committee for surveillance of urinary Schistosomiasis in August 1998 to rapidly determine the disease’s prevalence to enable the government to develop feasible control strategies (Adeoye, 1993). Although the occurrence of urinary Schistosomiasis in Nigeria has been documented for several years, its distribution remains inadequately understood (Uwaezuokoet al., 2007). This is because National Programmer for its control has not been sustained due to some factors, including the non – recognition by the great majority of the population of the public health importance of the disease and lack of political will by the policymakers to invest in control (Naleet al., 2003). The intermediate snail host for Schistosomahaemotobium is bulinussp; that of Schistosomamansoni is biophalariasp and that of Schistosomajaponicum is Oncomelaniasp (Ukoli, 1984). The transmission of this disease takes place only where there is contact with infected freshwater, of which a snail intermediate vector host must be present. Various social-epidemiological factors are also responsible for the disease’s transmission and infection level. Among such factors is the distance from transmission, migration and emergence of a new phase of Urbanization, socio-economic status, poor sanitation and contamination of water sources (Bareto, 1982). In Urinary Schistosomiasis, there is a risk of discharge of haematuria, i.e. blood in urine, dysuria which is painful urination, bladder cancer or kidney problem, nutritional deficiencies and in children, growth retardation is well established (Mostafa et al., 1999; WHO, 2010). In intestinal Schistosomiasis, the symptoms are much less obvious and non-specific. They include diarrhea, tiredness, abdominal pain or discomfort and blood in face. Infection can eventually lead to serious complications of the liver and the spleen.

In Nigeria, Schistosomiasis occurs in all 36 states, including Federal Capital Territory, as the country is rated among the 54 countries in Africa where the disease is endemic ( National Schisto News, 1996). The work capacity of the rural inhabitants is severely reduced because of the weakness and lethargy caused by the disease, and school performance and growth patterns of infected children are also retarded (WHO, 1999).

1.2 Justification

Schistosomiasis remains the second cause of morbidity and mortality in Africa after malaria. This is because the disease control programme has not been fully sustained due to the non – recognition by the majority of the population of the public health importance of the disease and the lack of political will by the policymakers to invest in its control. Currently, the complete epidemiological map of Schistosomiasis in Nigeria is yet to be completed. Likewise, the continuous establishment of water resources development projects seems to increase human contact and thus increase the risk of Schistosomiasis. It is hoped that understanding the prevalence of Schistosomiasis in a community will help to inform control managers on the status of the infection in the study area.

1.3 Aim

The study is aimed at evaluating the status of Schistosomiasis in Dabban, Lavun LGA, Niger State.

1.4 Objectives

1. To determine the prevalence of Schistosomiasis in the Dabban community, Niger State.
2. To determine the age and sex with the highest prevalence of Schistosomiasis in the Dabban community, Niger State.
3. To determine the prevalence of hematuria with respect to age and sex in the study area.

1.5 SIGNIFICANCE OF THE STUDY

Several factors, such as cultural, social, environmental and behavioural, directly influence the prevalence and intensity of schistosomiasis. It is important that these factors be identified to aid in designing control programmes. In several areas in Nigeria, there is a complete lack of knowledge on the factors associated with schistosomiasis transmission. Environmental conditions and sewage disposal are deplorable, indiscriminate defaecation and urination are very common, the literacy level is low, and safe/portable water is greatly inadequate with consequent effects on the community health. Dabban, Lavun South Local Government Area is a victim of most of the above if not all. These conditions were supposed to cause an increase in the prevalence of schistosomiasis in the study area, but instead, there was a decrease in the prevalence of the disease, as observed from results in some hospitals and clinics in the Local Government Area from 1985 to 1998. Some of the streams in the Local Government surveyed before the study harboured snail hosts of schistosomes. In view of the above, we decided to go into this study, epidemiological studies of the disease, schistosomiasis, to ascertain the true picture of the disease in the Local. Government Area, presently.

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