Clinical morbidity of single or mixed schistosome species infection in two communities of southern Malawi
Year: 2026
Type: article
Study design: Observational Study
Abstract: As part of a larger community-based epidemiological study entitled Hybridisation in Uro-Genital Schistosomiasis (HUGS), a parasite infection and clinical morbidity sub-study, implementing portable ultrasonography annually, was undertaken upon 701 participants from two communities in Mangochi and Nsanje Districts, southern Malawi. Our aim was to document the clinical morbidity a year after praziquantel treatment in those with previously proven human and/or zoonotic schistosomiasis, repeated a calendar year later after biannual praziquantel treatment. The median participant age was 12.0 years, with 293 (41.8%) having urinary Schistosoma haematobium egg-patent infections. Upon molecular analyses, these participants were co-infected with S. mansoni (29, 9.9%), S. mattheei (38, 13.0%), and six were infected with all three schistosome species occurring concurrently. A total of 166 participants (23.7%) had abnormal bladder wall thickness, 72 severely abnormal thickened bladder walls and 7 had bladder wall masses, among other abnormalities by ultrasonography. On the second annual follow-up, 203 participants were available (median age: 22.0 years), and of these, 27 (13.3%) presented with urinary S. haematobium egg-patent infections, with 2 (1.0%) having Schistosoma mansoni, 8 (3.9%) having Schistosoma mattheei and 2 with all species concurrently. Of these, only six participants (3.0%) had severely abnormal thickened bladder walls and other abnormalities. Overall, greater morbidity was observed in those with S. haematobium alone than in those with mixed species infections. 'This article is part of the Royal Society Science+ meeting issue 'Parasite evolution and impact in action: exploring the importance and control of hybrid schistosomes in Africa and beyond'.
Authors: Sekeleghe A. Kayuni, Louis Kinley, Bright Mainga, Dingase Kumwenda, Lucas Cunningham, David Lally, Priscilla Chammudzi, Donales Kapira, Gladys Namacha, Alice Chisale, Teleza Nchembe, Ephraim Chibwana, Bazwell Nkhalemba, Gilbert Chapweteka, Henry Chibowa, Victor Kumfunda, Alexandra Juhasz, Sam Jones, Ruth Cowlishaw, John Archer, Angus M. O'Ferrall, Sarah Rollason, Andrew Nguluwe, John Chiphwanya, Michael Luhanga, Holystone Kafanikhale, Peter Makaula, E. James LaCourse, J. Russell Stothard, Janelisa Musaya
Institutions: Liverpool School of Tropical Medicine, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Kamuzu Central Hospital, Kamuzu University of Health Sciences, Queen Elizabeth Central Hospital, Semmelweis University, University of Glasgow, Cardiff University, Malawi Government, Ministry of Health
Language: English
Subfield: Parasitology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: hybrid
Funder: Wellcome Trust
OpenAlex ID: W7118906375