Schistosomiasis in Western Lake Turkana, Kenya: An Exploratory Serosurvey and Validation of Dried Blood Spots for Field Studies.

BACKGROUND

Schistosomiasis remains a significant neglected tropical disease in Kenya, but its presence in the western/northern Lake Turkana region is poorly characterised. We conducted an exploratory serosurvey to assess evidence of Schistosoma spp. exposure and a diagnostic accuracy study to evaluate dried blood spots (DBSs) for field serology.

METHODS

We performed a cross-sectional survey in adults (≥18 years) from six communities in the western/northern and shoreline area of Turkana Lake, excluding individuals with >6 months of residence in other Kenyan endemic areas. Capillary blood was collected on DBSs and tested centrally using ELISA for Schistosoma spp. IgG. In parallel, DBS cards performance was compared with paired routine serum ELISA in 23 patients assessed for suspected schistosomiasis at our centre.

RESULTS

We enrolled 155 participants (60% men; median age 30 years), with nearly universal reported freshwater contact (154/155, 99.4%). In the validation study, DBS values were lower than serum values (mean bias 0.27), with moderate correlation (r = 0.54) and modest discrimination (AUC 0.65; sensitivity 80% and specificity 50% at OD index >0.8). The median DBS ELISA OD index for the 155 participants was 0.55 (IQR, 0.34-0.79). Six samples exceeded 0.8, but these values were low, and all had negative IHA (<1/80), yielding no confirmed seropositive cases.

CONCLUSIONS

These findings suggest low or absent sustained transmission in the sampled communities during the study period and indicate that DBS-based serology is operationally feasible but requires careful calibration and confirmatory testing for robust field inference.