# Prevalence, risk factors and trends of human schistosomiasis in Côte d’Ivoire from 1974–2023: systematic review and meta-analysis

## TL;DR

This study reviews 50 years of data to show that schistosomiasis in Côte d’Ivoire has decreased but still affects many people, especially in certain regions and among specific groups.

## Contribution

The study provides the first comprehensive meta-analysis of schistosomiasis prevalence and risk factors in Côte d’Ivoire over five decades.

## Key findings

- The pooled prevalence of schistosomiasis in Côte d’Ivoire is 26.1%.
- Prevalence dropped from 66.5% in 1994–2003 to 15.0% in 2014–2023.
- Key risk factors include being male, older age (>15 years), and living at low altitude (<400 m).

## Abstract

Schistosomiasis is a parasitic worm infection that affects an estimated 250 million people. In Côte d’Ivoire, schistosomiasis remains a public health problem despite control efforts that have been mounted since the new millennium. The aim of this study was to assess the pooled prevalence of human schistosomiasis, to determine trends over the past 50 years and to identify risk factors for schistosomiasis.

We systematically searched Google Scholar, PubMed, Scopus and Web of Science Core Collection without language restriction for papers published from January 1, 1974 to December 31, 2023. We adhered to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. We performed random effect models for meta-analysis and generated forest plots. Pooled schistosomiasis prevalences and corresponding 95% confidence intervals (CIs) were determined. Heterogeneity among studies were evaluated using Cochran’s Q test and I2 statistic test. Publication bias was assessed with funnel plot and Egger’s test.

Overall, 326 articles involving 279,340 participants were included, comprising 254,954 school-aged children and 520 preschool-aged children. The pooled prevalence of schistosomiasis was 26.1%. The prevalence decreased from 66.5% in 1994–2003 to 15.0% in 2014–2023. The highest pooled prevalence of schistosomiasis was observed in Tonkpi regional health directorate. The main risk factors for schistosomiasis were sex [male: odds ratio (OR) = 1.24, 95% CI: 1.13–1.35], age group (> 15 years: OR = 2.45, 95% CI: 1.82–3.08, compared to children aged 6–10 years), and altitude (< 400 m, OR = 4.76, 95% CI: 4.00–5.88).

Our findings revealed that the prevalence of schistosomiasis in Côte d’Ivoire has considerably declined over the past decades. However, the disease remains a public health problem, and hence, surveillance should be tightened up and control efforts targeted to high-risk communities.

The online version contains supplementary material available at 10.1186/s40249-025-01410-9.