Background Vector control, identification of at-risk populations, and the encapsulation of community perceptions remains a prerequisite to planning and designing as well as the implementation of control measures. MDA is the gold stand technique in the control of schistosomiasis in Africa. Hence the objectives of this study were to investigate community perceptions of the disease and determine the prevalence and Risk factors of urogenital schistosomiasis in Northern Malawi.

Methods A total of 1841 in-depth interviews (IDIs) were conducted between April 2022 and May 2023. The study also enrolled 251 participants that responded to the in-depth interview and submitted urine for microscopy. The study also conducted a seasonal snail survey in Karonga, Rumphi, Nkhatabay, and Nkhotakota districts for species distribution and infection status.

Results In general, out of the 1841 study participants involved in the IDIs, less than 20% had a fairly good level of knowledge about the disease, its spread, and prevention techniques. Out of 251 children that were enrolled 87 (34.7%) were found to have S. haematobium eggs. Chi-square analysis established that having a parent in rice farming (p=0.029) occupation is a key risk factors for urogenital schistosomiasis. It was also surprising to note that those schoolchildren who received Praziquantel during MDA had significantly higher prevalence (p=0.010). Furthermore, this study revealed that they are no association between a child involved in MDA advocacy campaigns and a level of knowledge on schistosomiasis transmission. Bulinus and Biomphalaria were found to be the abundant species and Bulinus was found to be the key vector.