ACTORS INFLUENCING BURDEN OF SCHISTOSOMA HAEMATOBIUM INFECTION AMONG PREGNANT MOTHERS IN KWALE COUNTY

Abstract

Schistosomiasis is a disease of global public health importance among populations residing in Schistosoma-infection prone areas. Global interventions have not succeeded yet in control, elimination nor eradication of the burden, with 40 million women of reproductive age still affected. About 250 million people in 78 Countries in Africa are at risk. The Kenyan Coast is endemic to Schistosoma haematobium infections. Preventive measures and mass treatment of infected populations can reduce or possibly eliminate schistosomiasis. In Kenya, pregnancy is a contraindication to PZQ treatment while WHO recommends its use in pregnancy; effects of bilharzia in pregnancy and unborn child are known to be disastrous. Pregnant women in Kwale County remain at high risk together with the unborn child. This study aimed at investigating factors that influence S.haematobium infection among pregnant women in Kwale County. This was a descriptive cross-sectional study; quantitative and qualitative methods were used. Area of study was Kwale County, March through August 2016 within four Sub Counties; Matuga, Kinango, Msambweni and Lunga Lunga. Structured questionnaires were used for quantitative data, in-depth interview guide was used on Key Informants for qualitative data. Clinical investigations were done to detect Schistosoma infection. Quantification of Schistosoma eggs using Kato-Katz technique was done. Pregnancy tests were done to confirm pregnancy. Obstetric history was taken to assess previous deliveries and rule out abnormalities. Overall prevalence of S.haematobium infection was 12.2%. Kinango Sub County reported highest prevalence 14.1%. Mbuguni (site 1) in Matuga Sub County reported highest prevalence 30% among 18 sites. Rice farming was a significant predisposing factor. Among the participants 36.7% utilize river waters and 14% use water pans. Among the participants 29% did not use toilets. Regarding knowledge of bilharziasis; 96.7% knew what bilharzia was and 84.8% were aware of the causal agent as an insect. Prevalence of S.haematobium among pregnant mothers in Kwale County is 12.7%. Intensity of S.haematobium among pregnant mothers in Kwale County is low. Majority of the participants had no formal education which is known to increase the risk. Practices and attitude of the mothers had little significance to the infection. Rice farming was a risk factor, but the areas with highest prevalence are none rice growers. Bathing in rivers and use of untreated water increased the risk of infectivity