The epidemiology of human schistosomiasis in Gauteng Province, South Africa, 2017-2022

Abstract

BACKGROUND : Schistosimiasis affects over 250 million people globally. It is considered a moderately endemic condition in South Africa, with 36 people per 100 000 infected annually between 2011 and 2018. Despite its ability to cause long-term complications, it remains under-studied in Gauteng Province, and its epidemiological patterns are poorly understood. AIM : To describe the prevalence and trends of human schistosomiasis from 2017 to 2022. SETTING : Gauteng Province, South Africa. METHODS : A descriptive cross-sectional study was conducted using all clinical and laboratory human schistosomiasis cases in Gauteng Province from 2017 to 2022. Descriptive statistics summarised cases. Annual trends, seasonal patterns, and geographic distribution were assessed. Yearly incidence rates and overall provincial prevalence were estimated per 100 000 population. RESULTS : There were 2526 human schistosomiasis cases recorded. The median age was 28 years (interquartile range [IQR]: 19–42), and men aged 10–19 years were most affected (15%). Cases declined by 37 per year over the study period, with seasonal peaks in February–March and August–September. The highest incidence occurred in 2019 (3.83 cases per 100 000). City of Tshwane Metropolitan and Mogale City had region-specific prevalence of > 25 cases per 100 000; overall provincial prevalence was 15 cases per 100 000. CONCLUSION : Enhanced surveillance, strengthened reporting, targeted awareness and preventative measures in vulnerable communities are recommended to reduce transmission. Ongoing research is crucial to inform evidence-based interventions in Gauteng Province and South Africa. CONTRIBUTION : The study identified key demographic patterns, geographic hotspots, and temporal trends of human schistosomiasis cases in Gauteng Province.