Association of S. haematobium Infection Morbidity and Severity on Co-infections status in Pre-school Age Children Living in a Rural Endemic Area in Zimbabwe

Background: Individuals living in S. haematobium endemic areas are often at risk of having other communicable diseases, simultaneously. This usually creates diagnostic difficulties leading to misdiagnosis and overlooking schistosomiasis infection. In this study we investigated the prevalence and effects of coinfections in pre-school age children.Methodology : About 465 Preschool age children were clinically examined for the following top morbidity conditions: respiratory tract infections, dermatophytosis, malaria and fever of unknown origin. S. haematobium infection was diagnosed by urine filtration and the children were screened for other communicable infections common in rural areas.Results : Prevalence of S. haematobium was 35% (145). A positive relationship between S. haematobium prevalence and under-5 mortality rate in Zimbabwean provinces was demonstrated. The odds of co-infections observed for S. haematobium were: upper respiratory tract infection AOR = 1.98 (95% CI 1.657 to 2.48), dermatophytosis AOR = 5.10 ( 95% CI 2.99 to 8.72), fever of unknown origin AOR = 9.07 ( 95% CI 5.70 to 14.44) and malaria AOR = 0.91 ( 95% CI 0.54 to1.54). The risk ratio of having S. haematobium and co-infections in children who had fever of unknown origin 138%, dermatophytosis 38%, Upper respiratory tract infection 1% increase risk and malaria had a 2% reduced risk. Odds of having severe sequelae following the above conditions were: severe pneumonia AOR = 8.41(95%CI 3.09-22.93), complicated malaria AOR = 7.09 (95% CI 1.51-33.39), severe and persistent dermatophytosis AOR=20.3 (95% CI 4.78-83.2) and seizures AOR=1.62 (95%CI 1.56-4.73).Conclusion : This study is novel as it identifies a possible causal relationship between S. haematobium infection and top morbidity conditions in children under five years. There is need to alert policy makers so as to initiate early treatment of schistosomiasis in pre-school age children.