# Schistosomiasis and Intestinal Helminthiases in a Remote Area of Central Madagascar

## TL;DR

A study in Madagascar found high rates of parasitic infections and undernutrition among children, stressing the need for better sanitation and health interventions.

## Contribution

The study provides new insights into the prevalence and risk factors of schistosomiasis and helminth infections in a remote Malagasy village.

## Key findings

- Schistosoma mansoni was the most prevalent helminth infection at 76.3%.
- Stunting was more common in children infected with Ascaris lumbricoides.
- Risk factors included age over 9 years, rice field work, and poor hygiene practices.

## Abstract

Schistosomiasis and intestinal helminthiases are significant public health issues that severely impact the development of children and adolescents in impoverished regions, such as the rural village of Soavinarivo in central Madagascar. These issues are often associated with deficient hygienic and sanitary conditions.

A prospective cross-sectional study was conducted in October 2017 on children aged 3–15 years. A total of 114 stool samples were collected and analysed using microscopy and molecular techniques to identify schistosomiasis and intestinal helminthiases. Descriptive statistics assessed prevalence, and binary logistic regression identified risk factors for helminth infections.

Helminth prevalence was 88.6%, with Schistosoma mansoni being the most common (76.3%), followed by Hymenolepis (= Rodentolepis) nana (31.6%). Soil-transmitted helminths, including Trichuris trichiura and Ascaris lumbricoides, each affected 14% of participants. It should be noted that 5.3% of participants tested positive for Taenia solium. Undernutrition affected 66.7% of participants, with 58.8% suffering from stunting and 22.8% from wasting. Stunting was more likely in participants with A. lumbricoides. Risk factors for S. mansoni included being over 9 years old and working in rice fields. Not washing fruits and vegetables before eating and contact with pigs were related to A. lumbricoides infections. Clinical symptoms, such as abdominal distension and pain, were associated with S. mansoni infection.

The prevalence rates of schistosomiasis and soil-transmitted helminthiases, highlighting S. mansoni, and its coexistence with undernutrition in the same population, are alarming. These findings underscore the urgent need to intensify current control strategies, which include deworming, provision of clean water, implementation of sewage systems and education on sanitation and hygiene.