Genetic profile, Epidemiology, and Community Knowledge of Schistosoma Haematobium in Endemic Regions of Ethiopia
| dc.contributor.advisor | Endakachew Nibret | |
| dc.contributor.author | Tigist Mohammed | |
| dc.date.accessioned | 2026-06-22T14:46:55Z | |
| dc.date.available | 2026-06-22T14:46:55Z | |
| dc.date.issued | 2025 | |
| dc.description.abstract | Background: Schistosomiasis (SCH) is a highly prevalent yet neglected tropical disease (NTD), particularly in sub-Saharan Africa (SSA), where it continues to impose a significant burden on public health and socio-economic development. Urogenital schistosomiasis (UGS), caused by S. haematobium, is a significant public health challenge in low-altitude regions of Ethiopia, including Gambella, Afar and Benishangul-Gumuz. While extensive research has focused on the epidemiology and treatment of SCH, critical gaps remain in understanding the genetic makeup of Schistosoma populations in Ethiopia and the potential hybridization events that may influence transmission dynamics and treatment outcomes. Additionally, comprehensive epidemiological data on S. haematobium infection is lacking across all age groups, particularly among pre-school age children (PSAC). This gap is compounded by limited data on community knowledge, attitudes, and practices (KAP) regarding UGS, which are essential for evaluating the effectiveness of current control measures and designing target-specific interventions. Objectives: This study aimed to investigate the genetic profile of S. haematobium and to identify hybridization events in Afar and Gambella endemic areas; assess the prevalence, intensity, and risk factors of S. haematobium infection among PSAC; evaluate community KAP in Gambella, Abobo district; and to determine the prevalence and infection intensity of S. haematobium across all age groups in the Kurmuk district of Benishangul-Gumuz. iii Methods: A community-based cross-sectional study was conducted between 2021 and 2024 to address all objectives. Multi-locus genetic analysis, targeting the mitochondrial cytochrome oxidase sub-unit I (cox1) gene and the nuclear internal transcribed spacer 2 (ITS2) regions, was performed on miracidia isolated from human urine samples using rapid diagnostic polymerase chain reaction (RD-PCR). Infection status was determined through a urine filtration microscopy (egg detection and count) and dipstick screened for hematuria. Socio-demographic data, risk factors, and outcome variables (KAP) were collected using a pretested structured questionnaire. Data were analyzed using SPSS version 23, with logistic regression and odds ratios employed to assess the strength of associations between dependent and independent variables. Results: A total of 177 miracidia were analyzed using mitochondrial cox1 and 24 miracidia were analyzed using nuclear ITS2 gene markers, revealing exclusive infection with S. haematobium and no evidence of mixed infection/hybridization with S. bovis or S. mansoni. This suggests mono-specific transmission in the Afar and Gambella regions, likely due to ecological separation, species-specific host preferences, and limited zoonotic transmission pathways. The prevalence of S. haematobium infection among PSAC in Abobo, Gambella, was 16.7%, with 20% being heavy-intensity infections. The prevalence of macro and microhematuria were 7.9% and 26.2%, respectively. The prevalence of infection was significantly higher among PSAC playing or bathing in infested water (AOR = 2.9, CI: 1.0–8.1, p=0.041) and residing in Abaro village (AOR = 4.3, CI: 1.6–11.9, p=0.005). The overall prevalence of S. haematobium infection was 34.2% in Kurmuk, Benishangul-Gumuz, with the highest prevalence among participants with Swimming habits (AOR = 2.43, CI: 1.19-4.94, p=0.023). Infection intensity varied significantly across villages, with mean egg counts (MEC) ranging from 2.39 in Ogendu (CI: 1.05-3.72) to 14.1 eggs/10 mL urine in Dulshatalo (CI: 4.98- 23.12). iv Hematuria prevalence was 39.2%, with a higher odd in Dulshatalo village (AOR = 2.64, 95% CI: 1.43-4.87, P = 0.004). Moreover, microhematuria was significantly associated with S. haematobium egg detections (P < 0.001), and a moderate agreement (Kappa = 0.57) was established with the microscope finding. The community KAP assessment in Abobo, Gambella, revealed that most participants (90.6%) had heard of UGS, and over 94% recognized at least one major symptom. However, more than half of the participants perceive (59.9%) drinking contaminated water as a primary way of transmission and understanding prevention measures (15.9% for keeping hygiene, 26.8% for refraining from using contaminated water) were limited. Over 50% did not associate urinating near water to transmission; nearly all had contact with dam/river water. Education and prior infection history were key predictors of better KAP. Conclusion: This study provided critical insights into the epidemiology and genetic profile of S. haematobium infections in endemic regions of Ethiopia, confirming the absence of mixed infection and suggesting mono-specific transmission in Afar and Gambella. The high prevalence of S. haematobium infection and heavy intensity, particularly among PSAC and older children (5–12 years), shows the public health burden of UGS in these areas. The study also identified key risk factors, such as water contact behaviors, and reveals significant gaps in community knowledge of UGS transmission and prevention despite high awareness of the disease. To address these challenges, targeted interventions are needed, including providing safe water sources, improved sanitation, and community-based health education programs to reduce risky behaviors and enhance prevention practices. Control programs should also be expanded to include PSAC, which is currently underserved but exhibits significant infection rates. Strengthening surveillance systems to monitor infection trends and genetic diversity and conducting further research to explore ecological and behavioral drivers of transmission will be v essential for designing effective, context-specific strategies to achieve sustainable SCH control in these endemic regions. Keywords: Genetic profile; Epidemiology; community based; PSAC; S.haematobium; knowledge, attitude, and practice; Afar, Gambella, Benishangul-Gumuz; Ethiopia | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/8287 | |
| dc.language.iso | en | |
| dc.publisher | Addis Ababa Universtity | |
| dc.subject | Genetic profile Epidemiology community based PSAC S.haematobium knowledge attitude and practice Afar Gambella Benishangul-Gumuz Ethiopia. | |
| dc.title | Genetic profile, Epidemiology, and Community Knowledge of Schistosoma Haematobium in Endemic Regions of Ethiopia | |
| dc.type | Thesis |