# Epidemiology of Schistosoma haematobium infection and microhaematuria among schoolchildren in a setting of sustained mass drug administration in Banfora, Burkina Faso

## TL;DR

This study examines the current prevalence of Schistosoma haematobium infection and blood in urine among schoolchildren in Banfora, Burkina Faso, after years of mass drug administration.

## Contribution

The study provides updated epidemiological data on S. haematobium in a region with sustained mass drug administration.

## Key findings

- The prevalence of S. haematobium infection was 3.67% among schoolchildren in Banfora.
- Boys and those with urinary tract infections were at higher risk for S. haematobium infection.
- Rural residence and S. haematobium infection were significant risk factors for microhaematuria.

## Abstract

Limited evidence exists regarding the current epidemiology of Schistosoma (S.) haematobium infection following decades of mass drug administration implementation in many areas of Burkina Faso, including the Cascades region, which is predominantly a riverine community with a high risk of schistosomiasis. This study aimed to determine the prevalence and correlates of S. haematobium infection and microhaematuria among schoolchildren in the municipality of Banfora, southwestern Burkina Faso.

An analytical cross-sectional study was conducted in November 2024 among schoolchildren aged 5–15 years in the Banfora municipality. Sociodemographic and water contact data were collected using a pre-tested structured questionnaire. Each consenting child provided a freshly voided urine sample, which was examined for the presence of S. haematobium eggs and microhaematuria using the urine filtration technique and urine multistix reagent test strips, respectively. Correlates of S. haematobium infection and microhaematuria were determined using multivariable logistic regression.

The mean age of the children was 8.79 ± 2.22 years. Of the 300 school children tested, 11 (3.67 %) were found to be infected with S. haematobium eggs. The geometric mean intensity of S. haematobium infection was 14.94 eggs/10 mL of urine (95 % CI: 4.96–44.98), and 27.27 % of the infected participants (3/11) had a heavy infection. The prevalence of microhaematuria was 13.33 % (40/300). Being a boy was the main risk factor for S. haematobium infection (adjusted OR: 11.0, 95 % CI: 2.5–48.2), while having a urinary tract infection was significantly associated with S. haematobium infection (adjusted OR: 59.6, 95 % CI: 6.9–515.7). Risk factors for microhaematuria included living in rural areas (adjusted OR: 8.3, 95 % CI: 2.4–28.6) and S. haematobium infection (adjusted OR: 31.3, 95 % CI: 5.9–165.8).

Our findings show that S. haematobium infection is hypoendemic in the Banfora municipality. However, the high prevalence of heavy infections is a particular concern, and targeted treatment strategies and complementary measures, including health education, should prioritize school-aged children living in rural areas.

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