The World Health Organization (WHO) classifies Schistosomiasis as one of the Neglected Tropical Diseases (NTDs). Schistosomiasis, simply put, is an acute and chronic parasitic disease caused by Schistosoma parasite. When larval stages (cercariae) of the parasite penetrate the skin via contact with infested water, people get infected. Intestinal and urogenital schistosomiasis are the two primary manifestations of the disease. In advanced cases of intestinal schistosomiasis, stomach pain, diarrhea, blood in the stool, and liver and spleen enlargement might occur. On the other hand, haematuria is the most distinctive sign of urogenital schistosomiasis (blood in urine). However, urogenital schistosomiasis can progress to bladder cancer and infertility in later stages.
Schistosomiasis is endemic to Nigeria, and current data indicate that Nigeria has the highest prevalence of the disease in the world. While there are inadequate baseline data to provide a true picture of the disease burden in Nigeria, it is believed that 29 million Nigerians are affected, with children accounting for about half of the total.
In July 2021, One Health and Development Initiative (OHDI) with support from the Conservation, Food, and Health Foundation embarked on a research study to determine the current distribution of schistosomiasis in Nigeria’s south-west. The three most important objectives of this project are:
1.To determine the distribution of schistosomiasis across the 6 south-western states in Nigeria, identifying the areas and/or communities where it is most prevalent and determine peculiar environmental health risks and factors that drive the continuous prevalence of schistosomiasis in the identified communities especially with regards to the existence of WASH facilities and practices (if any).
2. To determine the animal-related risk factors that perpetuate the existence and prevalence of schistosomiasis in identified communities especially with regards to the presence of snails (intermediate hosts) and general livestock farm practices that may be a source of schistosomiasis species cross-infection and re-infection.
3. To determine any sociocultural risk factors that may influence of perpetuate the prevalence of schistosomiasis.
During this project, OHDI trained eight community data collectors to conduct Key Informant Interviews (KIIs) to examine community knowledge, attitudes, and perceptions of schistosomiasis in six South West states in Nigerian. Because of the intimate association between schistosomiasis and poor hygiene and sanitation, the disease’s burden is higher in poor, rural areas. People get the disease by coming into contact with Schistosoma parasite-infested water. And considering the disease’s public health implications, OHDI decided to conduct a six-month research study in South West Nigeria using a One Health approach.
The most important accomplishments of this project so far are listed as follows:
- Collection of research ethical approval in the 6 South-Western states – Ogun, Ondo, Osun, Oyo, Lagos and Ekiti – as required to begin implementation of the data collection aspect of the research project
- Recruitment and training of data collectors across the six southwestern states
- Establishment of institutional stakeholder relationships and further engagement with them on the research process and data collection process. In the states where research approval has been granted, the NTD focal persons have been equally recruited and engaged to partake in facilitating the data collection process for their respective LGAs
- Gaining the approval of the Federal Ministry of Health and collaboration with the National Coordinator on NTDs for support and commitment on the research process and contributing to the goal of combating schistosomiasis in Nigeria as this will help to collectively design and implement intervention strategies to combat schistosomiasis in south-west Nigeria
- Completion of literature review across all 6 southwestern states which serves as the determinant of the distribution of schistosomiasis across these states in Nigeria and the identification of areas and/or communities where schistosomiasis is most prevalent. To this effect a report has been written
- Designing of data collection tools and collection of data via Key informant interviews (KIIs) with public and private sector health officials and community Focus Group Discussions (FGDs) across 4 states. Data collection in the remaining 2 states are ongoing
- The commencement of a collaborative process of data analysis and report documentation in collaboration with the state and national-level NTD/Schistosomiasis
- The written draft of the situational report for the project which, upon completion, would be disseminated to stakeholders and necessary bodies for review, publication, and dialogues for next-level initiation of One Health intervention
OHDI seeks to use this knowledge and the findings of the study to influence policies, strategies, and plan for interventions in Nigeria for the diagnosis and control of Schistosomiasis.