Impact of Indolent Schistosomiasis on Morbidity and Mortality from Respiratory Tract Infections in Preschool Age Children from a Schistosomiasis Endemic Area

Introduction Pneumonia is the biggest child killer, after the neonatal period. This is especially so in children from developing countries who are exposed to other infections simultaneously. In this article we investigated the impact of indolent Schistosoma haematobium infection on background of a respiratory infection Method A cross sectional study with 237 preschool age children with a respiratory infection, was performed during winter months in a schistosomiasis endemic area. Participants were clinically examined and investigated appropriately. Upper respiratory tract infection (URTI) and pneumonia were defined and classified as per IMCI and WHO guidelines, respectively. S. haematobium infection diagnosis was by urine filtration on urine collected over three consecutive days. Data was analysed using SPSS. Results S haematobium infection prevalence was 29% (69). Prevalence of repiratory infections were as follows: common cold 79% (188), pneumonia 15% (36) and severe pneumonia 6% (15). Eighty-one percent of participants with the common cold were S. haematobium negative, whilst 80 % of those with severe pneumonia were infected. Schistosomiasis infected children were at greater odds of developing; pneumonia (aOR=3.61 (95% CI 1.73-7.55) and severe pneumonia (aOR=21.13 (95% CI 4.65-95.89). High intensity S. haematobium infection was associated with an increased risk of severe pneumonia RR= 23.78(95% CI 6.86-82.32). Mortality from coinfection emanated from severe pneumonia and severe S. haematobium infection intensity (RR= 26.56 (95% CI 1.49 to 473.89). Number needed to harm (NNH) for S. haematobium infected children who develop respiratory tract infection was 4:1 for pneumonia and 5:1 for severe pneumonia. Conclusion The study demonstrated that coinfection with Schistosomiasis increases morbidity and mortality from respiratory tract infections by up to 20 times in children less than five years old. There is need to cover schistosomiasis screening and treatment in children under 5 years old to avert mortality and morbidity due to coinfection with respiratory infections.