title: Distribution of schistosomiasis and soil transmitted helminthiasis in Zimbabwe: towards a national plan of action for control and elimination.
abstract: BACKGROUND
  Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009-2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted.
  
  
  METHODS
  A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques.
  
  
  RESULTS
  Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%-18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened.
  
  
  CONCLUSIONS
  This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe.
authors.affiliation: Department of Medical Microbiology, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Midzi
authors.affiliation: Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe; College of Health Sciences, University of KwaZulu Natal, Durban, South Africa.
authors.forename: Takafira
authors.initials: T
authors.lastname: Mduluza
authors.affiliation: College of Health Sciences, University of KwaZulu Natal, Durban, South Africa.
authors.forename: Moses J
authors.initials: MJ
authors.lastname: Chimbari
authors.affiliation: Epidemiology & Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Clement
authors.initials: C
authors.lastname: Tshuma
authors.affiliation: Afro-Regional Zimbabwe Offices, World Health Organization, Harare, Zimbabwe.
authors.forename: Lincoln
authors.initials: L
authors.lastname: Charimari
authors.affiliation: Epidemiology & Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Gibson
authors.initials: G
authors.lastname: Mhlanga
authors.affiliation: Epidemiology & Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Portia
authors.initials: P
authors.lastname: Manangazira
authors.affiliation: Biomedical Research and Training Institute, Harare, Zimbabwe.
authors.forename: Shungu M
authors.initials: SM
authors.lastname: Munyati
authors.affiliation: Epidemiology & Disease Control, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Isaac
authors.initials: I
authors.lastname: Phiri
authors.affiliation: National Institute of Health Research, Harare, Zimbabwe.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Mutambu
authors.affiliation: Afro-Regional Zimbabwe Offices, World Health Organization, Harare, Zimbabwe.
authors.forename: Stanley S
authors.initials: SS
authors.lastname: Midzi
authors.affiliation: Ministry of Education Sport Arts and Culture, Harare, Zimbabwe.
authors.forename: Anastancia
authors.initials: A
authors.lastname: Ncube
authors.affiliation: Ministry of Education Sport Arts and Culture, Harare, Zimbabwe.
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Muranzi
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.affiliation: University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Francisca
authors.initials: F
authors.lastname: Mutapi
mesh_terms: D000293:Adolescent; D002648:Child; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006373:Helminthiasis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D015995:Prevalence; D012552:Schistosomiasis / Q000453:epidemiology; D012987:Soil / Q000469:parasitology*; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D012987:Soil