Abstract
Background Schistosomiasis is a waterborne disease with high morbidity in Sub-Saharan Africa countries, including Madagascar. Mass drug administration is the main public health control strategy for the disease. Even though recently recommended to all age groups and pregnant women, school-aged children are most targeted due to a lack of prevalence data on other vulnerable populations, including pregnant women. This study has the objective to estimate the prevalence of Schistosome’s infection in pregnant women in the highlands of Madagascar to inform the control strategies in the country.
Methods This cross-sectional study was conducted using baseline data on pregnant women enrolled in a cluster randomized controlled trial freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers). Women were recruited between April 2019 and February 2020 at one of the 42 included Primary Health Care Centers when attending routine antenatal care services during the second or third pregnancy trimester. The urine-based UCP-LF-CAA (Up-Converting Phosphor – Lateral Flow) test was used for the detection of Schistosome infections. The prevalence was estimated for the overall sample and stratified by women characteristics.
Results A total of 4328 urine samples were collected. Of these, 55.9% [CI95%:53.6–58.2] were positive for Schistosome’s infection. The prevalence of Schistosome’s infection was 55.0% [CI95%:52.9%-57.0%] among pregnant women living in rural settings, 62.2% [CI95%:53.3–70.4] among those with no formal education, and 54.4% [CI95%:52.2–56.6] among those working as farmers. The prevalence increased with age, ranging from 51.6% (CI95%:48.7–54.4) among 16–19 years old to 62.3% (CI95%: 59.4–65.1) among 30–49 years old.
Conclusion Our study shows a high prevalence of Schistosome’s infection among pregnant women in the rural highlands of Madagascar. Public health interventions including pregnant women are urgent to progress toward the elimination of schistosomiasis as a public health problem by 2030.
