Risk factors for Schistosoma mansoni and hookworm in urban farming communities in western Cote d'Ivoire

Objectives To identify risk factors for Schistosoma mansoni and hookworm infections in urban farming communities, and to investigate small-scale spatial patterns of infection prevalence. Methods A cross-sectional survey was carried out in 113 farming households (586 individuals) and 21 non-farming households (130 individuals) from six agricultural zones in the town of Man, western Cote d'Ivoire. Heads of households were interviewed on common agricultural activities, land and water use, education attainment, socioeconomic status and sanitation facilities. Household members provided stool specimens that were processed by the Kato-Katz technique and a formol-ether concentration method and diagnosed for S. mansoni, hookworms and other soil-transmitted helminths and intestinal protozoa. Bayesian statistics were employed for spatial analyses. Results The prevalences of S. mansoni and hookworm in farming households were 51.4% and 24.7%, respectively. Risk factors for a S. mansoni infection comprised living in close proximity to the Ko River, water contact with irrigation wells and ponds and low education attainment. Living in zones of smallholder irrigated rice plots or large rice perimeters, using water from domestic wells, and low socioeconomic status were risk factors for a hookworm infection. We found significant spatial heterogeneity between agricultural zones, with the highest infection prevalences of S. mansoni and hookworm in the zone where there was a large rice perimeter. Conclusions In this urban setting, both S. mansoni and hookworm infections were related to specific agricultural activities. Health education and active participation of urban farmers for the control of schistosomiasis and soil-transmitted helminthiasis is recommended.