title: Prevalence, risk factors, and clinical manifestations of schistosomiasis among school children in the White Nile River basin, Sudan.
abstract: BACKGROUND
  We investigated the prevalence, risk factors, and clinical manifestations of schistosomiasis in White Nile State, Sudan, to determine the local characteristics of schistosomiasis in the White Nile River basin.
  
  
  METHODS
  Urine and stool samples were collected from 338 students (176 boys, 162 girls) at three primary schools and were examined using the urine filtration method and the Kato-Katz technique, respectively. Of the students, 200 were interviewed using a semi-structured questionnaire to assess water-contact patterns and health conditions related with urinary schistosomiasis.
  
  
  RESULTS
  Of the 338 students, egg-positive rates for S. haematobium and S. mansoni were 45.0% and 5.9%, respectively, and 4.4% were mixed. The intensities of S. haematobium and S. mansoni infection were 1.091 ± 0.744 log EP10 (eggs per 10 mL of urine, mean ± SD = 57 ± 172 EP10) and 1.787 ± 0.844 log EPG (eggs per gram of stool, mean ± SD = 156 ± 176 EPG), respectively. The prevalence and intensity of S. haematobium infection differed significantly among the three schools, but not by gender or age. Urinary schistosomiasis was significantly associated with the frequencies of contaminated water contact, taking baths, swimming, and wading the stream; however, frequencies of these events were not significantly correlated with infection intensity. Self-reported hematuria and dysuria also correlated significantly with urinary schistosomiasis.
  
  
  CONCLUSIONS
  The overall prevalence of schistosomiasis, especially urinary schistosomiasis, is high in the White Nile River basin, Sudan, and is closely associated with frequencies of water contact, taking baths, swimming, and wading the stream. We strongly recommend implementation of an integrated schistosomiasis control program in this area.
authors.affiliation: Departments of Infection Biology, Chungnam National University School of Medicine, Daejeon, 301-131, Korea. hassanhassoon@hotmail.com.
authors.forename: Hassan Ahmed Hassan Ahmed
authors.initials: HA
authors.lastname: Ismail
authors.affiliation: Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, Seoul, 110-799, Korea. hst@snu.ac.kr.
authors.forename: Sung-Tae
authors.initials: ST
authors.lastname: Hong
authors.affiliation: Schistosomiasis, Lymphatic Filariasis & Sleeping Sickness Control Program, Federal Ministry of Health, Khartoum, Sudan. zoza_20@hotmail.com.
authors.forename: Azza Tag Eldin Bashir
authors.initials: AT
authors.lastname: Babiker
authors.affiliation: Schistosomiasis Research Laboratory, Department of Zoology, Faculty of Science, University of Khartoum, Khartoum, Sudan. randahssan11@hotmail.com.
authors.forename: Randa Mohamed Abd Elgadir
authors.initials: RM
authors.lastname: Hassan
authors.affiliation: Schistosomiasis Research Laboratory, Department of Zoology, Faculty of Science, University of Khartoum, Khartoum, Sudan. mohamedzakeria63@yahoo.com.
authors.forename: Mohammed Ahmed Zakaria
authors.initials: MA
authors.lastname: Sulaiman
authors.affiliation: Korea Association of Health Promotion (KAHP), Seoul, 157-705, Korea. hoo0667@hanmail.net.
authors.forename: Hoo-Gn
authors.initials: HG
authors.lastname: Jeong
authors.affiliation: Korea Association of Health Promotion (KAHP), Seoul, 157-705, Korea. 0t3777@hanmail.net.
authors.forename: Woo-Hyun
authors.initials: WH
authors.lastname: Kong
authors.affiliation: Korea Association of Health Promotion (KAHP), Seoul, 157-705, Korea. yhalee@gmail.com.
authors.forename: Soon-Hyung
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Korea Association of Health Promotion (KAHP), Seoul, 157-705, Korea. hanik@snu.ac.kr.
authors.forename: Han-Ik
authors.initials: HI
authors.lastname: Cho
authors.affiliation: Department of Preventive Medicine, Chungnam National University School of Medicine, Daejeon, 301-131, Korea. hsnam@cnu.ac.kr.
authors.forename: Hae-Sung
authors.initials: HS
authors.lastname: Nam
authors.affiliation: Korea International Cooperation Agency (KOICA), Soengnam, 461-833, Korea. och7512@hanmail.net.
authors.forename: Chung Hyeon
authors.initials: CH
authors.lastname: Oh
authors.affiliation: Departments of Infection Biology, Chungnam National University School of Medicine, Daejeon, 301-131, Korea. yhalee@cnu.ac.kr.
authors.forename: Young-Ha
authors.initials: YH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D002648:Child; D003625:Data Collection; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010270:Parasite Egg Count; D015995:Prevalence; D012307:Risk Factors; D045483:Rivers; D012552:Schistosomiasis / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology* / Q000652:urine; D013397:Sudan / Q000453:epidemiology; D011795:Surveys and Questionnaires