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 of information on the global reinfection rate of schistosomiasis. This systematic review and meta-analysis aimed at summarizing studies that estimated the reinfection rate of human schistosomiasis. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on reinfection rate of human schistosomiasis. 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. Random effect model was employed to estimate pooled reinfection rates. Heterogeneity was determined using Cochran’s Q (chi-square)–test and Higgins I² statistics. 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 mean and pooled reinfection rates of schistosomiasis were 36.1% (±23.3%) and 33.2% (95% CI, 26.5–40.5%) respectively. For intestinal schistosomiasis, the mean 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. Cochran’s Q (chi-square)–test and Higgins I² statistic indicated significant heterogeneity across studies (p-values < 0.001, I² values > 95%). 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 reinfection rate of schistosomiasis (p < 0.1). Despite the control measures in place, the re-infection rate is still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing intensive programmatic strategies for schistosomiasis elimination should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six months, intensive snails control and health education.

Background: Despite twelve rounds of school-based preventive chemotherapy for schistosomiasis in endemic areas of Tanzania such as Mtama district, Lindi: the burden of Schistosoma haematobium infection has remained highly conceivable due to re-infections. The factors associated with continuity of S.haematobium transmission in Mtama district, Lindi have not been fully established. This study investigated the burden and factors contributing to the ongoing transmission of S.haematobium infection in the endemic district of Mtama, Lindi. Methods: A quantitative cross-sectional survey was carried out among 649 school-age children in the Mtama district to determine the burden and factors associated with continuity of S.haematobium infection transmission. A single urine specimen was obtained from each pupil and tested for macro- and microhaematuria, presence of S.haematobium ova, as well intensity of infection; this was complemented with a survey of Bulinus spp snail intermediate hosts and their infectivity. A structured questionnaire was employed to gather information on individual and environmental risk factors for S.haematobium transmission. Summary statistics were computed for individual variables; while a univariate and multivariate logistic regression analysis was performed to assess the association between risk factors with S.haematobium infection. Results: Prevalence of S.haematobium infection by macro- and microhaematuria was 13.1% and 46.2% respectively. The prevalence of S.haematobium ova was 52.7%; intensity of infection was light in 53.1%, and heavy in 46.9%. Snail intermediate hosts were Bulinus globosus and B.nasutus, whose infectivity was 2.2% and 1.3%, respectively. Among the assessed risk factors, long residency (10–13 years) in the area was a significant risk factor for the continuity of S.haematobium transmission (AOR: 21.79, 95% CI: 1.37–346.4). Conclusions: The observed 52.7% prevalence of S.haematobium infection represents unacceptably high prevalence after 12 rounds of preventive chemotherapy. Therefore, an urgent need for the implementation of integrated multiple control interventions in the Mtama district; is considered to be imperative.

Background: In Tanzania, the uptake of optimal doses (≥ 3) of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria (IPTp-SP) during pregnancy has remained below the recommended target of 80%. Therefore, this study aimed to investigate the predictors for the uptake of optimal IPTp-SP among pregnant women in Tanzania. Methods: This study used data from the 2015–16 Tanzania demographic and health survey and malaria indicator survey (TDHS-MIS). The study had a total of 4111 women aged 15 to 49 who had live births 2 years preceding the survey. The outcome variable was uptake of three or more doses of IPTp-SP, and the independent variables were age, marital status, education level, place of residence, wealth index, occupation, geographic zone, parity, the timing of first antenatal care (ANC), number of ANC visits and type of the health facility for ANC visits. Predictors for the optimal uptake of IPTp-SP were assessed using univariate and multivariable logistic regression. Results: A total of 327 (8%) women had optimal uptake of IPTp-SP doses. Among the assessed predictors, the following were significantly associated with optimal uptake of IPTp-SP doses; education level [primary (AOR: 2.2, 95% CI 1.26–3.67); secondary or higher education (AOR: 2.1, 95% CI 1.08–4.22)], attended ANC at the first trimester (AOR: 2.4, 95% CI 1.20–4.96), attended ≥ 4 ANC visits (AOR: 1.9, 95% CI 1.34–2.83), attended government health facilities (AOR: 1.5, 95% CI 1.07–1.97) and geographic zone [Central (AOR: 5, 95% CI 2.08–11.95); Southern Highlands (AOR: 2.8, 95% CI 1.15–7.02); Southwest Highlands (AOR: 2.7, 95% CI 1.03–7.29); Lake (AOR: 3.5, 95% CI 1.51–8.14); Eastern (AOR: 1.5, 95% CI 1.88–11.07)]. Conclusions: The uptake of optimal IPTp-SP doses is still low in Tanzania. The optimal uptake of IPTp-SP was associated with attending ANC in the first trimester, attending more than four ANC visits, attending government health facility for ANC, having primary, secondary, or higher education level, and geographic zone. Therefore, there is a need for health education and behavior change interventions with an emphasis on the optimal use of IPTp-SP doses.

Water, sanitation, and hygiene (WASH) interventions remain to be important in the prevention of further spread of coronavirus disease-2019 (COVID-19). Basic hygiene interventions such as handwashing with water and soap (HWWS) when applied consistently will deactivate and remove the virus particles from the hands. Realizing the efforts that have been made by countries world over in controlling the COVID-19, this letter seeks to discuss how the available WASH services can be used in the fight against further spread of COVID-19. The letter highlights the challenges being faced by the current WASH services in middle- and low-income countries and suggests measures that can be employed to strengthen the WASH services in this period of the COVID-19 pandemic.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is causing a global pandemic had a zoonotic origin in China. Considering the inter-connectedness between human, environment, and animal health, the One Health approach is the appropriate strategy to control and mitigate the effects of the ongoing coronavirus disease 2019 (COVID-19). This letter explains the benefits of the One Health approach and recommends specific measures that could be taken to accelerate the fight against COVID-19 and prevent the spread of newly emerging infectious diseases.

Introduction: Despite the ongoing intervention for schistosomiasis control among school-age children in the Lindi region of Tanzania, urogenital schistosomiasis continues to be a public health problem, presumably because other at-risk populations are not covered in praziquantel deworming campaigns. Evidence shows that under-fives become infected in their early life hence the need to understand the disease profile and the risk factors for exposure to infection so as to plan effective control strategies in this group. This study examined the prevalence and risk factors of urogenital schistosomiasis among under-fives in the Mtama district, Lindi region of Tanzania. Methodology/Principal findings: A quantitative community-based cross-sectional study was carried out among 770 participants (385 under-fives and their 385 parents/guardians) in the Mtama district to investigate the burden and the risk factors associated with S. haematobium infection. A single urine specimen was collected from the under-fives and tested for macro and microhaematuria, presence of S. haematobium ova, and intensity of infection. A structured questionnaire gathered on risk factors for S. haematobium exposure in under-fives from their parents/guardians. Data analysis was performed using descriptive statistics, chi-square test, and logistic regression. Prevalence of S. haematobium ova was 16.9%, and that of macro and microhaematuria was 6% and 17.9%, respectively. Of the 65 positive under-fives, 49 (75.4%) 95% CI 65.4–86.3 had a light infection intensity, and 16 (24.6%) 95% CI 13.7–35.5 had a heavy infection intensity. Among the assessed risk factors, the parents/guardians habit of visiting water bodies for domestic routines (AOR: 1.44, 95% CI: 1.13–1.74), especially the river (AOR: 6.00, 95% CI: 1.20–35.12), was found to be a significant risk factor for infection of S. haematobium in under-fives. Conclusion/Significance: A moderate prevalence of S. haematobium was found among the under-fives conceivably with adverse health events. The infected under-fives could be a source of continuity for transmission in the community. An intervention that covers this group is necessary and should be complemented with regular screening, health education campaigns, and an adequate supply of safe water.