A cross-sectional survey on parasitic infections in schoolchildren in a rural Tanzanian community

Infectious diseases remain the leading cause of death in children in low- and middle-income countries. Infection with helminths and intestinal protozoa cause considerable morbidity. The aim of this study was to assess the health status of schoolchildren in nine villages of the Kilombero district. We conducted a cross-sectional survey and subjected 427 children aged 6-12 years to standardized diagnostic tests. We found that 15% of children were infected with Entamoeba histolytica/Entamoeba dispar/Entamoeba moshkovskii, 12% with Schistosoma mansoni, and 5% with Plasmodium falciparum. The most common soil-transmitted helminth species was Trichuris trichiura (7%). Strongyloides stercoralis, Schistosoma haematobium, Giardia intestinalis and lymphatic filariasis were rare. Having a latrine inside the house was associated with a lower odds of parasite infections (odds ratio (OR) 0.51, 95% confidence interval (CI) 0.27-0.96, p=0.04). Children from households with goats were at higher odds of E. histolytica/E. dispar/E. moshkovskii infection (OR 3.03, 95%CI 1.29-7.10, p=0.01).When compared to a cross-sectional survey conducted in the same district in the 1980s, there seems to have been a substantial reduction in the prevalence and intensity of parasitic infections, except for T. trichiura, which showed a similar prevalence. Our data suggest that the general development, coupled with infectious disease control programmes improved children's health markedly. However, continued efforts to control parasitic diseases, including new approaches of drug combinations, stronger intersectoral collaboration, rigorous surveillance and public health responses tailored to the local settings are needed to move from control to elimination.