Prevalence and Factors for Urinary Schistosomiasis Acquisition Among HIV Positive Women Living in Lower Moshi, Tanzania: A Cross Sectional, Hospital Based Study

Abstract

Background: Schistosomiasis is a neglected tropical disease endemic in sub-Saharan Africa and remains a major public
health concern in rural farming communities. In women of reproductive age, infection is associated with significant
morbidity and may increase susceptibility to HIV infection, making co-infection an important health challenge in endemic
settings such as Tanzania. However, limited data exist on its burden and determinants among HIV positive women. This
study assessed the prevalence and associated factors of schistosomiasis among HIV positive women in Moshi, Tanzania.
Methodology: A hospital based cross sectional study was conducted in Moshi from April to June 2021 among 260
HIV positive women aged 18 years to 49 years attending Care and Treatment Clinics. Systematic sampling was used.
Urine samples were examined for Schistosoma haematobium eggs using the membrane filtration technique. Data were
analysed using chi-square tests and logistic regression, with multivariate analysis used to control for confounding factors.
A P value of less than .05 was considered statistically significant.
Results: A total of 260 HIV positive women were enrolled in the study. Most participants were aged 31years to 40 years
120 (46.2%) and had primary education 206 (79.2%). The overall prevalence of schistosomiasis was 13 (5%). The
infection was slightly less common among women aged less than 30 years 2 (15.4%). In multivariate logistic regression
analysis, previous history of schistosomiasis infection was strongly associated with current infection (AOR=40.0, 95%
CI: 6.5–240.0, P<.001). Use of river water for domestic purposes was also significantly associated with infection
(AOR=5.8, 95% CI: 1.2–26.0, P=.02). In addition, frequent contact with dam/pond water was independently
associated with schistosomiasis infection (AOR=2.5, 95% CI: 1.0–6.5, P=.04).
Conclusion: Schistosomiasis remains present among HIV positive women in Lower Moshi, although at a low prevalence.
Environmental exposure, particularly contact with unsafe and stagnant water sources, together with a history of previous
infection, were the main predictors of infection. The findings highlight the need for integrated control strategies targeting
both schistosomiasis and HIV in high-risk rural populations, alongside improved access to safe water and sustained
health education