Rates of Parasitic Worm and Hepatitis B Infections in School Children

Greg Howard
9th April, 2025

Rates of Parasitic Worm and Hepatitis B Infections in School Children

The overall prevalence of Schistosoma mansoni infection was high at 29.6%, with peak infection rates found in the 11–12 year age group and among children who had recently received praziquantel treatment, suggesting rapid reinfection despite mass drug administration programs.

Image adapted from: Temesgen et al. / CC BY (Source)

Key Findings

  • In the Jille Timuga district of Amhara, Ethiopia, nearly 30% of schoolchildren were infected with the parasite Schistosoma mansoni despite recent treatments
  • The study found a very low rate of Hepatitis B (0.3%) among the children, with no cases of both infections occurring together
  • Boys and older children (ages 11–12) were more likely to have schistosomiasis, suggesting targeted efforts are needed for these groups
Schistosomiasis and Hepatitis B Virus (HBV) are significant health concerns in Ethiopia, particularly affecting children in endemic regions. Schistosomiasis, caused by parasitic worms, impacts over 250 million people worldwide, with Ethiopia experiencing a high prevalence, especially in rural areas[2]. HBV, a viral infection affecting the liver, is also highly prevalent in developing countries and poses substantial health challenges. A recent study conducted by researchers at Addis Ababa University[1] aimed to explore the relationship between Schistosoma mansoni infection and HBV carriage among schoolchildren in the Jille Timuga district of the Amhara region. This cross-sectional study, carried out from January to March 2024, involved 300 children aged between 7 and 14 years from two primary schools. The researchers sought to determine the prevalence of S. mansoni and its association with HBV, providing valuable insights into the effectiveness of current public health interventions. The study revealed that 29.6% of the participating children were infected with S. mansoni. This finding is particularly concerning given the ongoing preventive chemotherapy programs using praziquantel, a medication used to treat schistosomiasis. Interestingly, the prevalence of S. mansoni was higher (34%) among children who had recently received praziquantel treatment within the past six months. This suggests that while mass drug administration (MDA) programs are crucial, there might be limitations such as rapid re-infection or inadequate coverage, highlighting the need for complementary strategies like snail control to break the parasite's life cycle. In contrast to the high schistosomiasis prevalence, the study found a remarkably low HBV sero-prevalence of just 0.3%. Moreover, no cases of co-infection with S. mansoni and HBV were observed among the children studied. This lack of association contradicts some previous reports that suggested a potential link between schistosomiasis and increased susceptibility to HBV infection. The absence of co-infection in this study underscores the complexity of interactions between different pathogens and suggests that the relationship between schistosomiasis and HBV may not be as straightforward as previously thought. The findings of this study align with earlier research highlighting the high burden of schistosomiasis in Ethiopia. For instance, a systematic review reported an overall pooled prevalence of schistosomiasis in Ethiopia at 22%, with rural areas experiencing higher rates than urban settings[2]. Another study focusing on schoolchildren in Southwest Ethiopia found an even higher infection rate of 73.8%, raising questions about the effectiveness of existing intervention programs[3]. Additionally, surveys from the Amhara region between 2011 and 2015 indicated a schistosomiasis prevalence of 6.9% among children, guiding preventive chemotherapy distribution[4]. The current study builds on these findings by providing recent data and highlighting ongoing challenges in controlling schistosomiasis despite preventive measures. One notable aspect of the current study is the significant association between gender and S. mansoni infection rates. Male children were found to have more than twice the odds of being infected compared to their female counterparts. This gender disparity may be influenced by behavioral factors, such as increased water contact activities among boys, which exposes them more to the parasite. Understanding these behavioral patterns is essential for designing targeted interventions that address specific risk factors within communities. The high prevalence of heavy S. mansoni infections, particularly among older children aged 11-12 years, emphasizes the need for sustained and comprehensive control efforts. Heavy infections are associated with more severe health consequences, including growth stunting and impaired cognitive development, which can have long-term impacts on children's overall well-being and educational outcomes. The study conducted by Addis Ababa University highlights critical gaps in the current approach to schistosomiasis control. While mass drug administration remains a cornerstone of public health efforts, the persistence of high infection rates suggests that additional measures are necessary. Integrated control programs that combine MDA with environmental management, such as snail control and improved sanitation, could enhance the effectiveness of existing interventions and reduce the risk of re-infection. Furthermore, the low HBV prevalence observed in this study raises important questions about the factors influencing HBV transmission in schistosome-endemic areas. It suggests that factors other than schistosomiasis may play a more significant role in HBV prevalence, or that effective HBV vaccination and prevention programs are mitigating the spread of the virus. However, the study recommends further research with larger sample sizes and controlled designs to better understand the potential interactions between schistosomiasis and HBV. In conclusion, the study underscores the ongoing challenge of controlling schistosomiasis in Ethiopia despite preventive efforts. The high prevalence of S. mansoni among schoolchildren, particularly in those who have recently received treatment, indicates the need for more robust and integrated control strategies. Additionally, the low HBV prevalence and lack of co-infection observed warrant further investigation to elucidate the dynamics between these two infections. Continued research and adaptive public health strategies are essential to move closer to the World Health Organization's goal of eliminating schistosomiasis as a public health problem by 2030.

MedicineHealth

References

Main Study

1) Schistosoma mansoni infection and hepatitis B surface antigen carriage rate among school children in Jille Timuga District, Amhara Region, Northeast Ethiopia

Published 8th April, 2025

https://doi.org/10.1371/journal.pntd.0012976

Related Studies

2) Prevalence of schistosomiasis and its association with anemia in Ethiopia, 2024: a systematic review and meta‑analysis.

https://doi.org/10.1186/s12879-024-09926-5

3) Intestinal schistosomiasis in remote areas of Southwest Ethiopia, a target region for large-scale mass drug administration.

https://doi.org/10.1038/s41598-024-84987-9

4) Prevalence of soil-transmitted helminths and Schistosoma mansoni among a population-based sample of school-age children in Amhara region, Ethiopia.

https://doi.org/10.1186/s13071-018-3008-0


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