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Appears in Collections:Economics Journal Articles
Peer Review Status: Refereed
Title: Impacts of host gender on Schistosoma mansoni risk in rural Uganda-A mixed-methods approach
Author(s): Trienekens, Suzan C M
Faust, Christina L
Meginnis, Keila
Pickering, Lucy
Ericsson, Olivia
Nankasi, Andrina
Moses, Arinaitwe
Tukahebwa, Edridah M
Lamberton, Poppy H L
Issue Date: 13-May-2020
Citation: Trienekens SCM, Faust CL, Meginnis K, Pickering L, Ericsson O, Nankasi A, Moses A, Tukahebwa EM & Lamberton PHL (2020) Impacts of host gender on Schistosoma mansoni risk in rural Uganda-A mixed-methods approach. PLoS Neglected Tropical Diseases, 14 (5), Art. No.: e0008266.
Abstract: Background The World Health Organization identified Uganda as one of the 10 highly endemic countries for schistosomiasis. Annual mass drug administration (MDA) with praziquantel has led to a decline in intensity of Schistosoma mansoni infections in several areas. However, as hotspots with high (re)infection rates remain, additional research on risk factors and implementing interventions to complement MDA are required to further reduce disease burden in these settings. Through a mixed-methods study we aimed to gain deeper understanding of how gender may impact risk and reinfection in order to inform disease control programmes and ascertain if gender-specific interventions may be beneficial. Methodology/Principal findings In Bugoto, Mayuge District, Eastern Uganda we conducted ethnographic observations (n = 16) and examined epidemiology (n = 55) and parasite population genetics (n = 16) in school-aged children (SAC), alongside a community-wide household survey (n = 130). Water contact was frequent at home, school and in the community and was of domestic, personal care, recreational, religious or commercial nature. Qualitative analysis of type of activity, duration, frequency, level of submersion and water contact sites in children showed only few behavioural differences in water contact between genders. However, survey data revealed that adult women carried out the vast majority of household tasks involving water contact. Reinfection rates (96% overall) and genetic diversity were high in boys (pre-He = 0.66; post-He = 0.67) and girls (pre-He = 0.65; post-He = 0.67), but no differences in reinfection rates (p = 0.62) or genetic diversity by gender before (p = 0.54) or after (p = 0.97) treatment were found. Conclusions/Significance This mixed methods approach showed complementary findings. Frequent water exposure with few differences between boys and girls was mirrored by high reinfection rates and genetic diversity in both genders. Disease control programmes should consider the high reinfection rates among SAC in remaining hotspots of schistosomiasis and the various purposes and settings in which children and adults are exposed to water.
DOI Link: 10.1371/journal.pntd.0008266
Rights: © 2020 Trienekens et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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