Work

Repeated biannual cross-sectional surveys in primary schools set baseline seasonal and spatial surveillance for malaria and schistosomiasis in the Shire Valley Transformation Programme (SVTP), Malawi

Year: 2026

Type: article

Abstract: Control of malaria and schistosomiasis among school children poses a key public health challenge in Chikwawa District, Malawi. Furthermore, anticipated environmental changes from the Shire Valley Transformation Programme (SVTP), a large-scale irrigation scheme, are expected to both alter transmission of malaria and schistosomiasis. To later inform future disease surveillance and appropriate control interventions, our study sought to establish comprehensive seasonal and spatial baseline epidemiological data. Four cross-sectional surveys were undertaken in 21 primary schools, covering two wet and two dry seasons. A total of 4,176 children aged 7–13 years were examined using rapid diagnostic tests for malaria, urine reagent strips with egg-filtration microscopy for urogenital schistosomiasis, and urine-Circulating Cathodic Antigen for intestinal schistosomiasis. For malaria, overall prevalence was 10.8% (95% CI:10.3–11.2%), for urogenital schistosomiasis was 36.5% (95% CI:35.8–37.3%) and for intestinal schistosomiasis was 1.3% (95% CI:1.1–1.4%). Con-infection prevalence of malaria and urogenital schistosomiasis was 5.2% (95% CI:4.8–5.5%). While macrohematuria at 5.5% (95% CI: 5.1–5.8%), microhematuria was 26.2% (95% CI:25.5–26.9%). Seasonal fluctuations were noted for malaria whereas schistosomiasis was limited although both diseases exhibited strong spatial heterogeneity. Alarmingly, malaria exceeded 25% and urogenital schistosomiasis surpassed 50% in certain schools and we clearly demonstrate currently unmet public health needs. These are set to further exacerbate by forthcoming SVTP-driven environmental change; hence we provide critical evidence to guide the Malawi Ministry of Health in strengthening surveillance and preparing integrated disease control.

Source: Current Research in Parasitology and Vector-Borne Diseases

DOI: 10.1016/j.crpvbd.2026.100350