- Background to the Study
Schistosomiasis is a very serious environmental health problem in many tropical countries and one of the most prevalent neglected tropical diseases considered a major public health problem. It is a parasitic infection caused by trematode flatworms of the genus Schistosoma. It is estimated that over 240 million people are infected, with about 700 million people worldwide at risk of infection (Hotez, Asojo & Adesina, 2012). According to Vander and Brooker (2013), over 90% of this infection occurs in sub-Saharan Africa with almost 300,000 deaths annually from schistosomiasis in Africa particularly the poor in rural settlements in the developing countries. It is considered by the World Health Organization as the second most socio-economically devastating parasitic disease, next only to malaria, with hundreds of millions infected worldwide both in the tropical and subtropical regions. Schistosomiasis prevalence and morbidity is highest among schoolchildren, adolescents and young adults (King & Dangerfield-Cha, 2016). Thus, the negative impacts on school performance and the debilitation caused by untreated infections demoralize both social and economic development in endemic areas.
Urogenital schistosomiasis, caused by Schistosoma (S) haematobium, is characterized by hematuria, dysuria, bladder wall pathology, hydronephrosis, and it can also lead to squamous cell carcinoma (Vander & Brooke, 2013). In adults, the infection can cause genital ulcers and other lesions resulting in poor reproductive health, with sexual dysfunction and infertility. On the other hand, intestinal schistosomiasis, caused by S. mansoni, presents with bloody diarrhoea and bowel ulceration, chronic infections progressing to hepatomegaly and/or associated with peri-portal liver fibrosis, portal hypertension, and hematemesis. Although S. intercalatum can cause another form of intestinal schistosomiasis, its distribution is limited to West and Central Africa (King & Dangerfield-Cha, 2016). Other health impacts associated with the disease are risk of anemia, bladder cancer, nutritional deficiencies, delay puberty in children, stunted growth in children and impairment of cognitive development in infected individuals as well as decreasing physical activity, school performance, work capacity and productivity (Aminaho, 2017).
Nigeria has the greatest number of cases of schistosomiasis worldwide, with about 29 million infected people, among which 16 million are children, and about 101 million people are at risk of schistosomiasis (Hotez, Asojo & Adesina, 2012). Natural ponds and lakes are typical sources of infection, but over the past few decades man-made reservoirs and irrigation systems have contributed to the spread of schistosomiasis. The disease is largely a rural problem, but urban foci can be found in many endemic areas (Aminaho, 2017). Snail populations, cercarial density, and patterns of human water contact show strong temporal and spatial variations, resulting in a focal distribution of the infection within regions, and villages. Those at high risk of infection are people involved in fishing activities, farming, bathing, paddling of canoes, swimming and possibly handling of infected snail host in the case of collecting edible ones.
Several environmental and socio-economic factors have been identified to be responsible for the continued persistence of intestinal parasitic infection in children. Some of these factors include poor sanitary conditions, unhygienic practices, lack of potable water, poor housing and poverty ((Hotez, Asojo & Adesina, 2012). The conditions lead to continued exposure to the causal parasites and thus high rates of re-infection. This infection is also associated with rural agricultural and other human activities around the freshwater bodies such as swimming, fishing, washing and bathing in ponds, rivers and dams, where the snail intermediate hosts breed. School age children and youths are thought to have frequent water contact that would make them more vulnerable to schistosomiasis, however, reports reveal that Schistosome infections are usually at their peak in late childhood to early adulthood and occurs more in adolescent males (Aminaho, 2017).
In some parts of Nigeria including Abua/Odual Local Government Area of Rivers State, the onset of urinary and related symptoms are common in adolescent, and due to lack of knowledge, it is seen as a normal phenomenon. However, adolescents especially secondary school students continue to present at primary health centers in Abua/Odual Local Government Area with complaints of dysuria, suprapubic pain, bloody urine, fever and general feeling of being unwell. The foregoing motivated this epidemiological study of schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State
1.2 Statement of the Problem
The researcher who happens to reside in Abua/Odual Local Government Area of Rivers State and is privileged to work in one of the primary health centers had observed a seeming increase in the number of male and female secondary school students of different age brackets being diagnosed and being treated for schistosomiasis. Oftentimes, these young people present to primary health centers only when they are experiencing excruciating pains and severe urinary symptom as well as when they can no longer carry out activities of daily living including not being able to go to school. These health related behaviours of the students which bothers the researcher may not be unconnected with the fact that regardless of the known burden schistosomiasis causes, the disease often receives little attention by healthcare providers, national governments and international agencies compared to malaria, HIV/AIDS and tuberculosis, childhood diseases and diarrhea, simply because not every individual infected shows clinical signs.
Considering the negative consequences of schistosomiasis, the researcher is forced to believe that a good number of individuals especially secondary school students may have been affected as many individuals do not experience symptoms. Given the foregoing, this study set out to investigate prevalence and risk factors for schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State.
- Purpose of the Study
The main aim of this study is to examine schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State. The specific objectives of this study included to:
- Determine the prevalence of schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State based on their gender
- Ascertain the prevalence of schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State based on their age
- Determine the risk factors for schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State.
1.4 Research Questions
The following research questions were answered in this study:
- What is the prevalence of schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State based on their gender?
- What is the prevalence of schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State based on their age?
- What are the risk factors for schistosomiasis among secondary school students in Abua/Odual Local Government Area of Rivers State.
1.5 Scope of the Study
This study focused on students of five (5) selected public secondary schools inAbua/Odual Local Government Area of Rivers State. The content scope of the study included the prevalence and risk factors for schistosomiasis among secondary school students.
1.6 Significance of the Study
The findings of this study would beneficial to environmentalists and public healthcare practitioners, government, students, communities and other researchers who may want to carry out a related study. Environmentalists and public healthcare practitioners would by the findings of this study be provided with information that would enable them plan and implement appropriate and adequate health education programmes on schistosomiasis, the negative effects on public health, its prevention and control measures.
Government would by the results of this study be provided with data that would guide relevant policy formulation and implementation regarding schistosomiasis and related public health problems. Student will be provided with information on the factors that could predispose them to schistosomiasis which would motivate them to avoid such as much as possible.
Communities would be provided with information on the risk factors for schistosomiasis which would in turn motivate appropriate health promoting behaviours among the populace. The study would add to the already existing stock of literatures on the prevalence and risk factors for schistosomiasis which would be useful to other researchers who may want to conduct a similar study.
1.7 Limitations of the Study
Some of the challenges encountered by the researcher in the course of conducting this study were her work and study schedule. However, these constraints were overcome by drawing a periodic work, study and research schedule. Also the study focused on Abua/Odual Local Government Area of Rivers State. Increasing the area of study to include more Local Government Area would have yielded more robust results.
1.8 Operational Definition of Terms
The following terms are hereby defined within the context of this study:
Prevalence. The proportion of secondary school students with schistosomiasis in Abua/Odual Local Government Area of Rivers State.
Risk factors. Variables or factors that puts secondary school students in Abua/Odual Local Government Area of Rivers State at risk for schistosomiasis.
Epidemiology. The study of the causes/risk factors, prevalence, pattern and distribution of a particular disease. Within the context of this study, epidemiology is the study of the causes/risk factors, prevalence, pattern and distribution of schistosomiasis in Abua/Odual Local Government Area of Rivers State
Secondary School Students. Students in junior and senior secondary schools (immediate post-primary schools) in Abua/Odual Local Government Area of Rivers State.