Schistosomiasis affects roughly 200 million people worldwide, with at least 600 million being at risk. Although the biology of transmission is reasonably well understood, disease persists. Various social and economic factors are believed to influence environmental exposure, but few studies have carefully examined these variables as they affect infection in highly endemic regions. Those that have are mostly cross-sectional surveys that have limited ability to analyze these factors and relate them to time-space pattems of infection. We propose a prospective, case-control study designed to establish associations between socioeconomic factors and infection, determine whether socioeconomic factors contribute to re-infection risk, assess household-level spatial patterns of schistosomiasis as related to socioeconomic and ecologic risk factors, and calculate economic impacts of infection on households in Mbuani village, Coast Province, Kenya.
Three aims i nvolve a) determining how household-level socioeconomic factors influence host-environment interactions and hence contribute to individual infection and re-infection risk, b) evaluating whether different activity pattems in various land-cover environments are associated with schistosomiasis infection, and c) assessing the micro-economic impact of schistosomiasis infection among village residents. We will test consenting people for infection (treating those who are positive), ask questions about their activities and use of the local environment, and take ground and satellite-based data on the environment that will be analyzed by standard multivariate methods and spatial statistics. Our long-term goal is to produce information that can be used to direct control initiatives that will be effectively tailored to local socioeconomic and environmental dynamics.
