CHAPTER ONE

 INTRODUCTION

1.1 Background to the Study

Human Schistosomiasis (Bilhariziasis) is second only to Malaria in sub – Sahara Africa causing severe morbidity. Killing 280, 00 people each year in, the Africa region alone (Shashieet al.,2005). Of the world 207 million estimated cases of Schistosomiasis, 93% occur in Sub Sahara African.With Nigeria having thehighest burden of schistosomiasis in the region (Humpheyet al.,2012).Studies have indicated that Urinary Schistosomiasis is a major health problem in the rural areas of Middle East and most African countries. It remains as one of the major health problems facing developing children. The endemicity of the disease in many rural areas are attributed to ignorance, poor living condition, inadequate sanitation, water contact activity with snail infected rivers, streams and ponds (WHO, 2003).

Urinary Schistosomiasis is significant due to Schistosomahaematobiumwhich causes significant clinical morbidity and disability in the endemic countries of Africa and Middle East. Recent report of the World Health Organization (WHO) estimated that about 779 million people in 76 Tropical and subtropical countries are at risk of Schistosomiasis (Steinmannet al.,2006). Over 207 people in these countries are infected; of this 120 million are symptomatic, with 20 million having severe clinical disease (Houmosouet al., 2012).Atleast 261 million people required preventive treatment for Schistosomiasis and more than 40 million people were treated for Schistosomiasis in 2013 (WHO, 2015).Schistosomiasis is a parasistic blood – dwelling fluke worms belonging to the genus Schistosoma; the genus Schistosoma contains six species that are of major pathological importance to man,Schistosomahaematobium, S. mansoni, S. japonicum, S. mekongi, S. intercalaturn, and S. guineersir (Webster et al., 2006). The species differ in their final location in the human host,the species of the intermediate (Snail) host, they use in their life cycle, the pathology they induce, and the number in size and shape of the eggs they produce.

The severity of vesicular (urinary) Schistosomiasis, caused by Schistosomahaematobium, is found throughout Middle East and Africa (WHO, 1990). Severity of the disease alerted the Federal Ministry of Health to Establish the National Expert Committee for surveillance of urinary Schistosomiasis in August, 1998, in order to determine the prevalence of the disease rapidly to enable the government to develop feasible control strategies (Adeoye, 1993). Although the occurrence of urinary Schistosomiasis in Nigeria has been documented in several years, its distribution remains inadequately understood (Uwaezuokoet al., 2007). This is because National Programmer for its control has not been sustained due to some factors including the non – recognition by the great majority of population of the public health importance of the disease, and lack of political will by the policy makers to invest in control (Naleet al., 2003).The intermediate snail host for Schistosomahaemotobiumis bulinusspand that of Schistosomamansoniis biophalariaspand that of Schistosomajaponicumis Oncomelaniasp (Ukoli, 1984). The transmission of this disease takes place only where there is contact with infected fresh water of which a snail intermediate vector host must be present. There are various social-epidemiological factors which are also responsible for the transmission of the disease and level of infection. Among such factors are the distance from transmission, migration and emergence of new phase of Urbanization, socio economic status, poor sanitation and contamination of water sources (Bareto, 1982). In Urinary Schistosomiasis, there is risk of discharge of haematuriai.e. blood in urine, dysuria which is painful urination, bladder cancer or kidney problem, nutritional deficiencies and in children growth retardation is well established (Mostafaet al., 1999; WHO, 2010). In intestinal Schistosomiasis, the symptoms are much less obvious and non-specific. They include diarrhea, tiredness, abdominal pain or discomfort and blood in faces. Infection can eventually lead to serious complication of liver and the spleen.

In Nigeria, Schistosomiasis occurs in all 36 states including Federal Capital Territory as the country is rated among the 54 countries in Africa where the disease is endemic ( National Schisto News, 1996). The work capacity of the rural inhabitants severely reduced because of the weakness and lethargy caused by the disease and school performance and growth pattern of infected children are also retarded (WHO, 1999).

1.2       Justification

Schistosomiasis remain the second cause of morbidity and mortality in Africa after malaria. This is because the programme for the control of the disease has not being fully sustained due to the non – recognition by majority of the population on the public health importance of the disease and lack of political will by the policy makers to invest in its control. Currently, the complete epidemiological map of Schistosomiasis in Nigeria is yet to be completed. Likewise, the continuous establishment of water resources development project seems to increase human contact and thus increase the risk of Schistosomiasis. It is hope that understanding the prevalence of Schistosomiasis in a community will help to inform control managers on the status of the infection in the study area.

 1.3         Aim

The study is aimed at evaluating the status of Schistosomiasis in Dabban, Lavun LGA, Niger State.

 1.4         Onjectives of the study

1. To determine the prevalence of Schistosomiasis in Dabban community, Niger State
2. To determine the age and sex with the highest prevalence of Schistosomiasis in Dabban community, Niger State
3. To determine the prevalence of hematuria with respect to age and sex in the study area.