A systematic review and meta-analysis on the rate of human schistosomiasis reinfection

Abstract Background While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity information on the global schistosomiasis reinfection rate. Objective This systematic review and meta-analysis aimed at summarizing studies that estimated the human schistosomiasis reinfection rate. Materials and methods The protocol for this review was prepared to guide authors throughout the process. However, registration was not sought. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on human schistosomiasis reinfection rate. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted using statistical R version 3.6.2 and R Studio using “meta” and “metafor” packages. Heterogeneity and publication bias of the studies were determined using Q – test and Egger’s regression test respectively. Random effect model was employed to estimate pooled reinfection rates. Results A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5 – 9 scores) quality. The overal calculated and pooled schistosomiasis reinfection rates were 36.1% (±23.3%) and 33.2% (95% CI, 26.5 – 40.5%) respectively. For intestinal schistosomiasis, the calculated and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8 – 51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3% – 29.2%) respectively. Results of subgroup analysis showed that, the type of Schistosoma species, participants age group, sample size and geographical area had influence on disparity variation in Schistosomiasis reinfection rate (p < 0.05). Conclusion Despite the control measures in place, the re-infection rate was still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing through schistosomiasis elimination and intensive programmatic strategies should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six month, intensive snails control and health education.