High burden of Schistosoma mansoni infection in school-aged children in Marolambo District, Madagascar

Background: A school-based survey was undertaken to assess prevalence and infection intensity of schistosomiasis in school-aged children in the Marolambo District of Madagascar. Methods: School aged children from six purposively selected schools were tested for Schistosoma haematobium by urine filtration and Schistosoma mansoni using circulating cathodic antigen (CCA) and Kato-Katz stool analysis. The investigators did not address soil-transmitted helminths (STH) in this study. Results: Of 399 school-aged children screened, 93.7% were infected with S. mansoni based on CCA analysis. Kato-Katz analysis of stool revealed S. mansoni infection in 73.6% (215/292). Heavy infections (> 400 eggs per gram) were common (32.1%; 69/215), with a mean of 482 eggs per gram of stool. Moderate infection intensities were detected in 31.2% (67/215) and light infection intensities in 36.7% (79/215) of infected participants. No infection with S. haematobium was detected by urine filtration. Conclusions: Intestinal schistosomiasis appears a considerable public health issue in this remote area of Madagascar where there is a pressing need for mass drug administration.