Survey results released from the Performance Monitoring and Accountability 2020 (PMA2020) project done by the Health Ministry and Makerere School of Public Health found that Schistosomiasis affects 3 in 10 people (29% prevalence) in Uganda, with children ages 2 to 4 at greatest risk where 4 in 10 are infected (42%). Schistosomiasis is a highly endemic and neglected parasitic disease that is transmitted by contact with contaminated fresh water inhabited by snails carrying the parasite, commonly known as Bilharzia. Infected persons with severe cases may die from direct causes of Bilharzia or have organ damage such as liver failure. The disease can have negative economic impacts on households and particularly the poor who do not have adequate resources to seek treatment.
The survey was conducted with the Uganda Bureau of Statistic to develop a nationally representative prevalence rate of Schistosomiasis. Data collection took place between October and December 2017, under the PMA2020 project, which uses mobile technology and local networks of female data collectors to generate survey data on important health indicators. The survey found that Schistosomiasis is widespread. In fact, it is prevalent among all geographies and demographics throughout Uganda.
“These data indicate that Schistosomiasis is an urgent public health problem in Uganda,” explains Dr. Fredrick Makumbi, PMA2020 Uganda Principal Investigator, “We must work together, across the health and water and sanitation sectors to develop comprehensive solutions to combat Schistosomiasis throughout the country.”
Since 2003 the Ministry of Health Vector Control Division has implemented a national program to control Bilharzia with annual mass drug treatment in endemic districts and health education. The mass drug treatment program and findings from the survey indicate, however, that mass treatment alone is unlikely to combat Bilharzia. Hence the integration of provision of clean water, construction of sanitation facilities and behavior change are necessary to prevent transmission and effectively control the disease. The researchers found that open defecation and urination in surface water and the bush remain a key determinant of the high prevalence of Schistosomiasis.
The results were released at a dissemination event hosted by Makerere University School of Public Health and Ministry of Health and was attended by members of parliament, district officers and development partners. This was the second consecutive national Schistosomiasis survey completed by PMA2020.
PMA2020 Schistosomiasis is implemented by Makerere University School of Public Health in Kampala, in partnership with the Uganda Bureau of Statistics (UBOS), the Uganda Ministry of Health’s Vector Control Division and the Schistosomiasis Control Initiative. The survey sample included a total of 4,787 households and 4,624 individuals. Infection with Schistosomiasis was the main outcome of interest and was found to be positive in 1,290 individuals and negative in 3,295 individuals for a total of 4,585 participants tested and a nearly universal acceptance rate (99.2%). Participants were offered treatment for Schistosomiasis with oral doses of praziquantel if they were found to be positive and met the criteria for treatment as advised by the Uganda Ministry of Health. Overall direction and support was provided by the Johns Hopkins University Water Institute and the Bill and Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health through a generous gift from Maxmind, Inc.