Investigation of the Risk of Infection of Urinary Schistosomiasis at Mahem and Galilea Communities in the Greater Accra Region of Ghana

Urinary schistosomiasis is of great public health importance in developing countries. It has adverse economic and health implications on residents living in endemic areas. Various factors including human behaviour are known to play key role in the transmission of the disease. The knowledge of the levels of risk of infection of urinary schistosomiasis and people’s perception will be an important tool in its control. The study determined the prevalence of urinary schistosomiasis and the risk of infection in some communities near the Weija lake in the Ga District. It assessed the knowledge base of the subjects on the disease and its impact on transmission. Data were collected on demographic variables, some behavioural activities in water bodies, knowledge base on the disease and sanitary facilities. Urine samples were analysed using the centrifugation technique. The percentage prevalence for Mahem and Galilea were 58% and 49%, respectively. The difference in prevalence was insignificant; 0.09 (-0.04, 0.21; P < 0.426). Bloody urine was associated with high risk of infection; OR of 4.55 (2.82, 7.36); P < 0.001. Subjects with primary level of education and invariably below 26 years of age had about two times the risk of infection; OR of 2.12 (1.13, 3.97); P < 0.02. The communities had 52% prevalence of urinary schistosomiasis. Frequent contacts and use of the infested lake were associated with infection. Educational intervention alone may not be effective in the control of the disease. The use of an integrated approach should be given favourable consideration. Introduction Urinary schistosomiasis is a disease of great public health importance and remains an important cause of morbidity and mortality globally, particularly in the developing world. After malaria, schistosomiasis is the second most prevalent tropical parasitic disease, and is a leading cause of morbidity in endemic areas of Africa, Asia and South America (WHO, 1995). In some parts of Africa the onset of haematuria due to urinary schistosomiasis is so common in adolescent boys that it is seen as normal (Desowitz, 1981). It is estimated that approximately 200–300 million people are suffering from schistosomiasis in the world (Nash et al., 1982; Savioli, 1990). It is known that Schistosoma haematobium, which causes urinary schistosomiasis, is the predominant human schistosome species in Ghana, and it is widely distributed in the country (McCullough & Ali, 1965; Onori et al., 1963). In Ghana, recent studies indicate that the disease is of great public health importance. A study by Aryeetey et al. (2000) revealed that prevalence of Schistosoma haematobium infection in some communities drained by the Densu river ranged between 54.8% and 60.0%. Various factors, including human behaviour, are known to be important in the transmission of the disease. Human behavioural activities, especially fishing, fetching of water, swimming, washing, and others, play a role in the transmission of the disease (Wagatsuma et al., 2003; Useh & Ejezie, 1999). Identifying the levels of risk of infection of urinary schistosomiasis and knowing the general perception of people about the disease will be an important tool in its control. Materials and methods Study area A cross-sectional study was carried out in two communities (Galilea and Mahem) in the Ga District of the Greater Accra Region of Ghana to investigate the problem of urinary schistosomiasis. These communities are in the western part of the District and close to the Weija lake, believed to be infested with schistosome parasites. The inhabitants of these communities rely on the Weija lake for various activities of which fishing and bathing are no exception. Although there are some other sources of water for the communities, water from the lake is put to a variety of uses. Mahem is more rural compared with Galilea. Fig. 1 gives geographical description of the study area and its immediate environment.