Ecological and social determinants for schistosomiasis infection in communities around water reservoirs in Malawi

Schistosomiasis is highly prevalent in Malawi. In spite of this state, the disease receives little medical attention. The present study investigated the ecological and social determinants for schistosomiasis in communities living around water reservoirs in Malawi. Human stool and urine samples were examined for Schistosoma eggs; snails were collected, identified and examined for Schistosoma cercariae. Communities’ knowledge, attitudes and practices (KAP) and risk factors for schistosomiasis were investigated by use of questionnaires. A prevalence of 51.2 % was recorded for Schistosoma haematobium and 9.5 % for Schistosoma mansoni. Prevalence was significantly higher in the dry season (58 %) than in wet season (36.6 %) (P=0.010). Prevalence was similar in all age groups (P=0.291). However prevalence was significantly higher in communities proximal to the reservoirs than those furthest (P=0.036). Two snail intermediate host species, Bulinus globosus and Biomphalaria pfeifferi were found infected by Schistosoma cercariae. Further more, 94 % of the people were aware of schistosomiasis however, only 5.1 % knew the detailed features of schistosomiasis. A total of 28.4 % believed that schistosomiasis is harmless. Irrigation farming, washing and bathing and proximity to the reservoir were the main risk factors. It is concluded that schistosomiasis is endemic in communities around water reservoirs in Malawi. The communities’ KAP on schistosomiasis is poor and consequently, communities are exposed to a number of risk factors that enhance contraction. It is recommended that earnest measures must be instituted to prevent and control schistosomiasis in these communities. Focus should be on MDA program and education campaign to encourage use of latrines to eliminate faecal contamination of aquatic environments.