Prevalence, risk factors and trends of human schistosomiasis in Côte d'Ivoire from 1974-2023: systematic review and meta-analysis.

BACKGROUND

Schistosomiasis is a parasitic worm infection that affects an estimated 250 million people. In Côte d'Ivoire, schistosomiasis remains a public health problem despite control efforts that have been mounted since the new millennium. The aim of this study was to assess the pooled prevalence of human schistosomiasis, to determine trends over the past 50 years and to identify risk factors for schistosomiasis.

METHODS

We systematically searched Google Scholar, PubMed, Scopus and Web of Science Core Collection without language restriction for papers published from January 1, 1974 to December 31, 2023. We adhered to Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. We performed random effect models for meta-analysis and generated forest plots. Pooled schistosomiasis prevalences and corresponding 95% confidence intervals (CIs) were determined. Heterogeneity among studies were evaluated using Cochran's Q test and I2 statistic test. Publication bias was assessed with funnel plot and Egger's test.

RESULTS

Overall, 326 articles involving 279,340 participants were included, comprising 254,954 school-aged children and 520 preschool-aged children. The pooled prevalence of schistosomiasis was 26.1%. The prevalence decreased from 66.5% in 1994-2003 to 15.0% in 2014-2023. The highest pooled prevalence of schistosomiasis was observed in Tonkpi regional health directorate. The main risk factors for schistosomiasis were sex [male: odds ratio (OR) = 1.24, 95% CI: 1.13-1.35], age group (> 15 years: OR = 2.45, 95% CI: 1.82-3.08, compared to children aged 6-10 years), and altitude (< 400 m, OR = 4.76, 95% CI: 4.00-5.88).

CONCLUSION

Our findings revealed that the prevalence of schistosomiasis in Côte d'Ivoire has considerably declined over the past decades. However, the disease remains a public health problem, and hence, surveillance should be tightened up and control efforts targeted to high-risk communities.