Schistosomiasis Outbreak, Kwite village, Mangwe district, Zimbabwe

Background: On 20th of June 2012, 31 pupils from Kwite primary school reported to the local clinic complaining of passing bloody urine. A study was conducted to identify factors, the etiology and risks of contracting schistosomiasis.

Methods: An unmatched 1:2 case control study was conducted in Kwite village. A case was defined as any child aged between seven to fifteen years, resident in Empandeni Ward for not less than two months, who had passed bloody urine with or without dysuria, fever, fatigue or lower abdominal pains from the 01/06/12 to 07/07/12. A control was a classmate of a case, staying in the same ward, who had not passed bloody urine. Controls were chosen by lottery method. A pretested questionnaire was administered to pupils and their caregivers. Environmental assessment was conducted; line lists, case notes, and district outbreak preparedness and response were reviewed using standard checklists.

Results: All the 42 cases, and 84 controls were enrolled into the study. The median age for cases and controls was 10 years (Q1=9, Q3=12) and 10 years (Q1=8, Q3=11), respectively. Swimming in Kwite dam [Adjusted OR=9.02, 95% CI (2.29-35.53)] and bathing in the dam [Adjusted OR=3.22, 95% CI (1.10-9.41)] were independent factors associated with contracting schistosomiasis. Schistosoma hematobium was isolated in 31 out of 100 urine specimens examined. Bulinus globosus snails were identified at Kwite dam.

Conclusion: The outbreak was driven by human contact with Schistosoma hematobium infested Kwite dam water, and poor knowledge on schistosomiasis. As a result of this study, health education, mass drug administration in school children and mollusciding were done. The provincial health team adopted the inclusion of schistosomiasis prevention and control activities in malaria pre-elimination activities.

Key words: Schistosomiasis outbreak, Kwite village, Empandeni ward, bloody urine, Zimbabwe