Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventions

BackgroundSchistosomiasis is a major public health problem in Ghana, significantly impacted by the construction of dams during the 1960s that resulted in the creation of Lake Volta. The Ghana Health Service launched the Neglected Tropical Disease program in 2008, expanding baseline disease mapping f...

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Main Authors: Joseph Opare, Tei Hervie, Ernest Mensah, Charles Brown-Davies, Odame Asiedu, Bright Alomatu, Ebenezer Padi Ako, John Frederick Dadzie, Irene Dzathor, Vance Harris, Julie Ritter, Darin Evans, Anna Elizabeth Phillips
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Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1554069/full
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author Joseph Opare
Tei Hervie
Ernest Mensah
Charles Brown-Davies
Odame Asiedu
Bright Alomatu
Ebenezer Padi Ako
John Frederick Dadzie
Irene Dzathor
Vance Harris
Julie Ritter
Darin Evans
Anna Elizabeth Phillips
author_facet Joseph Opare
Tei Hervie
Ernest Mensah
Charles Brown-Davies
Odame Asiedu
Bright Alomatu
Ebenezer Padi Ako
John Frederick Dadzie
Irene Dzathor
Vance Harris
Julie Ritter
Darin Evans
Anna Elizabeth Phillips
author_sort Joseph Opare
collection DOAJ
description BackgroundSchistosomiasis is a major public health problem in Ghana, significantly impacted by the construction of dams during the 1960s that resulted in the creation of Lake Volta. The Ghana Health Service launched the Neglected Tropical Disease program in 2008, expanding baseline disease mapping first initiated in 2007 to additional geographic areas in 2008 and 2010 and simultaneously rolling out mass drug administration (MDA). Significant reduction of infection across the country was noted in 2015 during the first impact assessment, following five years of MDA. After another five years of treatment, a second nationwide survey has been rolled out since 2021 to re-evaluate the situation of schistosomiasis this time at the sub-district level.MethodsPrevalence at three time points is presented. At baseline (2007–2010), a cross-section of 13,299 school-aged children (SAC) were tested from 251 schools across 154 districts in Ghana. During the first impact assessment (2015), 156 schools were sampled across 114 districts, with a total of 7,803 SAC tested. More recently, a second impact evaluation (2021-2024) has been rolled out across 1,146 schools sampled in 61 districts, with a total, 29,924 SAC tested. In all surveys, urine samples were filtered for the presence of Schistosoma haematobium eggs, with haemastix® testing conducted in recent surveys only, and Kato-Katz performed on each stool sample for the presence of Schistosoma mansoni.ResultsAt baseline, overall schistosomiasis prevalence was 21.1% (95% CI 17.0–26.0), with 20.4% (95% CI 16.4–25.2) S.haematobium and 1.01% (95% CI 0.55–1.84) S.mansoni. Prevalence of schistosomiasis decreased dramatically at first impact assessment, with overall prevalence at 3.5% (95% CI 2.6–4.7) and remained low in recent surveys at 6.8% (95% CI 6.1–7.6), which represents a 67.8% reduction from baseline to current prevalence.ConclusionAfter over a decade of treatment since 2008, Ghana has made significant progress in reducing the burden of schistosomiasis infection. Indeed, the most recent surveys demonstrated that elimination as a public health problem (heavy intensity of infection <1%) has been achieved in 75.4% districts surveyed, which is a considerable achievement. Furthermore, recent assessments have been conducted at the sub-district level, which has therefore enabled the Ghana Health Service to change to a more focal intervention and therefore tackle morbidity in the remaining high transmission zones.
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spelling doaj-art-4bd8ab6323ec4244b1ae0d3e8dfb80112025-08-20T03:26:15ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.15540691554069Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventionsJoseph Opare0Tei Hervie1Ernest Mensah2Charles Brown-Davies3Odame Asiedu4Bright Alomatu5Ebenezer Padi Ako6John Frederick Dadzie7Irene Dzathor8Vance Harris9Julie Ritter10Darin Evans11Anna Elizabeth Phillips12Neglected Tropical Diseases Programme, Ghana Health Service, Accra, GhanaNeglected Tropical Diseases Programme, Ghana Health Service, Accra, GhanaNeglected Tropical Diseases Programme, Ghana Health Service, Accra, GhanaFamily Health International (FHI 360), Accra, GhanaNeglected Tropical Diseases Programme, Ghana Health Service, Accra, GhanaNeglected Tropical Diseases Programme, Ghana Health Service, Accra, GhanaNeglected Tropical Diseases Programme, Ghana Health Service, Accra, GhanaNeglected Tropical Diseases Programme, Ghana Health Service, Accra, GhanaFamily Health International (FHI 360), Accra, GhanaFamily Health International (FHI 360), Washington, DC, United StatesFamily Health International (FHI 360), Washington, DC, United StatesUnited States Agency for International Development (USAID), Washington, DC, United StatesFamily Health International (FHI 360), Washington, DC, United StatesBackgroundSchistosomiasis is a major public health problem in Ghana, significantly impacted by the construction of dams during the 1960s that resulted in the creation of Lake Volta. The Ghana Health Service launched the Neglected Tropical Disease program in 2008, expanding baseline disease mapping first initiated in 2007 to additional geographic areas in 2008 and 2010 and simultaneously rolling out mass drug administration (MDA). Significant reduction of infection across the country was noted in 2015 during the first impact assessment, following five years of MDA. After another five years of treatment, a second nationwide survey has been rolled out since 2021 to re-evaluate the situation of schistosomiasis this time at the sub-district level.MethodsPrevalence at three time points is presented. At baseline (2007–2010), a cross-section of 13,299 school-aged children (SAC) were tested from 251 schools across 154 districts in Ghana. During the first impact assessment (2015), 156 schools were sampled across 114 districts, with a total of 7,803 SAC tested. More recently, a second impact evaluation (2021-2024) has been rolled out across 1,146 schools sampled in 61 districts, with a total, 29,924 SAC tested. In all surveys, urine samples were filtered for the presence of Schistosoma haematobium eggs, with haemastix® testing conducted in recent surveys only, and Kato-Katz performed on each stool sample for the presence of Schistosoma mansoni.ResultsAt baseline, overall schistosomiasis prevalence was 21.1% (95% CI 17.0–26.0), with 20.4% (95% CI 16.4–25.2) S.haematobium and 1.01% (95% CI 0.55–1.84) S.mansoni. Prevalence of schistosomiasis decreased dramatically at first impact assessment, with overall prevalence at 3.5% (95% CI 2.6–4.7) and remained low in recent surveys at 6.8% (95% CI 6.1–7.6), which represents a 67.8% reduction from baseline to current prevalence.ConclusionAfter over a decade of treatment since 2008, Ghana has made significant progress in reducing the burden of schistosomiasis infection. Indeed, the most recent surveys demonstrated that elimination as a public health problem (heavy intensity of infection <1%) has been achieved in 75.4% districts surveyed, which is a considerable achievement. Furthermore, recent assessments have been conducted at the sub-district level, which has therefore enabled the Ghana Health Service to change to a more focal intervention and therefore tackle morbidity in the remaining high transmission zones.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1554069/fullSchistosomia haematobiumSchistosomiaMansoni schistosomiasisneglected tropical diseaseGhanaschool - aged children
spellingShingle Joseph Opare
Tei Hervie
Ernest Mensah
Charles Brown-Davies
Odame Asiedu
Bright Alomatu
Ebenezer Padi Ako
John Frederick Dadzie
Irene Dzathor
Vance Harris
Julie Ritter
Darin Evans
Anna Elizabeth Phillips
Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventions
Frontiers in Public Health
Schistosomia haematobium
Schistosomia
Mansoni schistosomiasis
neglected tropical disease
Ghana
school - aged children
title Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventions
title_full Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventions
title_fullStr Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventions
title_full_unstemmed Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventions
title_short Schistosomiasis in Ghana from baseline to now: the impact of fifteen years of interventions
title_sort schistosomiasis in ghana from baseline to now the impact of fifteen years of interventions
topic Schistosomia haematobium
Schistosomia
Mansoni schistosomiasis
neglected tropical disease
Ghana
school - aged children
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1554069/full
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