title: Urinary schistosomiasis among schoolchildren in Yemen: prevalence, risk factors, and the effect of a chemotherapeutic intervention.
abstract: BACKGROUND
  Schistosomiasis is one of the most important public health problems in Yemen. The prevalence of urinary schistosomiasis varies considerably across different parts of Yemen and was estimated to be 10% among schoolchildren in Sana'a. Praziquantel (PZQ) is highly effective against all five major human species of schistosomes.
  
  
  OBJECTIVE
  The aim of the present work was to estimate the prevalence of urinary schistosomiasis, describe the risk factors associated with its endemicity, and implement and assess a chemotherapeutic intervention using PZQ in a village in Yemen.
  
  
  METHODS
  The sample included 696 schoolchildren from a village in Abyan Governorate. During the baseline school survey, personal, sociodemographic, and environmental data, and data on practices in relation to water contact were collected from each study participant using a predesigned structured questionnaire. Urine samples from each participant were examined for macrohematuria and the presence of Schistosoma haematobium eggs. The chemotherapeutic intervention was assessed 3 and 6 months after the treatment and certain indicators were calculated.
  
  
  RESULTS
  The prevalence of S. haematobium was 18.1%. The main significant risk factors were male sex; proximity of houses to water ponds; and using pond water for swimming, agricultural activities, and for bathing in houses. PZQ treatment reduced the prevalence of infection and decreased the prevalence of high-intensity infection. Survival analysis showed that the probability of residual infection also dropped after the treatment intervention.
  
  
  CONCLUSIONS
  Male sex and using pond water for various activities were the main significant risk factors associated with urinary schistosomiasis. PZQ is still a cornerstone drug in reducing or eliminating morbidity associated with schistosomiasis infection. Health education programs tailored for the community are required for the control and prevention of urinary schistosomiasis. To address schoolchildren, school curricula should include lessons about urinary schistosomiasis.
authors.affiliation: aDepartment of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Aden University, Aden bDepartment of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen Departments of cEpidemiology dTropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Al-Waleedi
authors.forename: Nessrin A
authors.initials: NA
authors.lastname: El-Nimr
authors.forename: Ali A
authors.initials: AA
authors.lastname: Hasab
authors.forename: Hassan K
authors.initials: HK
authors.lastname: Bassiouny
authors.forename: Latifa A
authors.initials: LA
authors.lastname: Al-Shibani
mesh_terms: D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D012553:Schistosomiasis haematobia / Q000188:drug therapy; D015006:Yemen / Q000453:epidemiology
chemical_list: D000871:Anthelmintics