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A meta-analysis of changes in schistosomiasis prevalence in Zambia: implications on the 2020 elimination target

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Abstract

Schistosomiasis affects more than 4 million school-aged children in Zambia, mostly in rural communities due to unsafe water and inadequate sanitation facilities. Although several studies were done in Zambia between 1976 and 2019, empirical estimates of the disease burden remain unavailable. Therefore, appraisal of the current schistosomiasis burden is pertinent in the re-evaluation of schistosomiasis-control strategies in Zambia. A random-effect model was used to estimate the prevalence of schistosomiasis infection in Zambia across different age groups for the period between 1976 and 2019. A literature search was done in the following databases: PubMed, ISI Web of Science, Google Scholar, CINAHL, and African Journals Online. Twenty-eight studies with relevant prevalence data were identified and included in the analysis. The pooled prevalence estimate of Schistosoma haematobium and Schistosoma mansoni across studies for the entire period was 35.5% (95% CI: 25.8–45.9) and 34.9% (95% CI: 20.7–50.6), respectively. Prevalence estimates among school-aged children for S. haematobium and S. mansoni were 32.2% (95% CI: 21.1–44.7) and 18.1% (95% CI: 3.0–38.4), respectively. The reported pooled prevalence estimate for S. haematobium among the adults was 54% (95% CI: 23.2–83.7). Only two studies collected information from preschool aged children. Substantial heterogeneity (I2 = 100%, p < 0.0001) was observed among the studies. Although a reduction in disease prevalence was observed from 1990 to 2010, this was not sustained after 2010. In this meta-analysis, S. haematobium was more prevalent compared to S. mansoni, with more cases observed among school-aged children (SAC). Thus, control programs should target age groups that are highly infected or are at high risk of infection.

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Acknowledgments

We also acknowledge the comments from editors and anonymous reviewers, which helped improve the content and quality of the paper. The views, opinions, assumptions, or any other information presented in this paper are solely those of the authors.

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Authors and Affiliations

  1. University of Namibia, Katima Mulilo Campus, Box 1096, Katima Mulilo, Namibia

    Chester Kalinda

  2. Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, Durban, 4001, South Africa

    Chester Kalinda & Moses Chimbari

  3. Institute of Basic and Biomedical Sciences, Levy Mwanawasa Medical University, P.O Box 33991, Lusaka, Zambia

    Mable Mutengo

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CK developed the concept, conducted the literature search, performed statistical analysis, and wrote the initial draft of the manuscript. MMM and MJC contributed to the writing and editing of the paper. All authors approved the final paper for publication.

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Correspondence to Chester Kalinda.

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Supplementary file S1:

Quality Assessment checklist for eligible studies. (DOCX 27 kb)

Supplementary file S2:

Forest plots of the prevalence estimates. (A) Overall prevalence, (B) S. mansoni, (C) S. haematobium, (D) co-infection of S. mansoni and S. haematobium stratified according to age class. (DOCX 1413 kb)

Supplementary file S3:

Assessment of publication bias. (A) Funnel plot of the double arcsine transformed prevalence estimates of schistosomiasis in SAC, PSAC, and adults, (B) Doi plot the double arcsine transformed prevalence of schistosomiasis in SAC, PSAC, and Adults (LFK index: 2.06). (DOCX 100 kb)

Supplementary file S4:

Prevalence data sets for studies included in the meta-analysis (XLSX 14 kb)

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Kalinda, C., Mutengo, M. & Chimbari, M. A meta-analysis of changes in schistosomiasis prevalence in Zambia: implications on the 2020 elimination target. Parasitol Res 119, 1–10 (2020). https://doi.org/10.1007/s00436-019-06534-0

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