Where will pediatric praziquantel be needed in Tanzania? Geographical variation in prevalence, and risk factors of in pre-school aged children in southern and north-western Tanzania.

Background: Pediatric schistosomiasis has been recognized as a public health concern in schistosomiasis endemic areas of sub-Saharan Africa, including Tanzania. However, there is limited epidemiological information relating to pediatric schistosomiasis in Tanzania. Therefore, this current focused on assessing the geographical prevalence of infection and its associated risk factors in pre-school children (PreSAC) in southern and north-western Tanzania.

Methods: A total of 1585 PreSAC aged 1-6 years were enrolled in a cross-sectional study. A single urine and stool sample were obtained from each child and processed using point-of-care circulating cathodic (POC-CCA) antigen and Kato Katz (K-K) technique. The overall prevalence of infection based on K-K technique and POC-CCA test were 18.6% (95%CI:16.7-20.6) and 28.3% (95%CI:26.1-30.6), respectively. The overall geometrical mean eggs per gram of faeces was 110.38epg (95% CI:97.3-125.3). The age group 4-6 years had the highest prevalence ( < 0.01) of in both diagnostic tests and infection intensity ( = -2.8398,  < 0.005) using K-K technique. On multivariable analysis, only Ukerewe district was associated with infection based on K-K technique (aOR = 2.8 (95%CI:2.1-3.9),  < 0.001). Based on POC-CCA test, age group (4-6 years), aOR = 1.7, 95%CI:1.3-2.2,  < 0.001), Nyasa (aOR = 6.2, 95%CI:3.0-12.5,  < 0.001), Geita (aOR = 4.2, 95%CI:2.1-8.2,  < 0.001) and Ukerewe (aOR = 28.9, 95%CI:15.0-55.8,  < 0.001) districts remained independently associated with infection.

Conclusion: is a public health concern among PreSAC in the study districts and its prevalence varies from one geographical setting to another. These findings strongly support the need to include pre-school aged in preventive chemotherapy.