Programmatic Implications for Schistosomiasis Elimination Based on Community-Based Survey in the Blue Nile, North Kordofan, and Sennar States, Sudan

Schistosomiasis prevalence has remained high in some areas due to reinfection despite repeated mass drug administration interventions. We aimed to explore its risk factors in order to help to design adequate interventions in such high-transmission areas. A total of 6225 individuals residing in 60 villages in 8 districts of North Kordofan, Blue Nile, or Sennar States, Sudan participated in the community-based survey in March 2018. First, we investigated Schistosoma haematobium and Schistosoma mansoni prevalences among school-aged children and adults. Second, the associations between risk factors and schistosomiasis were explored. Those without any type of latrine in their households had higher odds of being infected with schistosomiasis than those with a latrine (odds ratio (OR) = 1.53; 95% confidence interval (CI) 1.20-1.94; p = 0.001), and the odds of being positive for schistosomiasis among people living in a household without an improved latrine were higher than for their counterparts with an improved latrine (OR = 1.63; CI 1.05-2.55; p = 0.03). Furthermore, people with households or outside compounds found to contain human faeces had higher odds of being infected with schistosomiasis than their counterparts (OR = 1.36, 95% CI 1.01-1.83, p = 0.04). Installing an improved latrine and eliminating open defecation should be highlighted in schistosomiasis elimination projects in high-transmission areas.