Clinical morbidity of single or mixed schistosome species infection in two communities of southern Malawi

Kayuni, Sekeleghe A., Kinley, Louis, Mainga, Bright, Kumwenda, Dingase, Cunningham, Lucas, Lally, David, Chammudzi, Priscilla, Kapira, Donales, Namacha, Gladys, Chisale, Alice, Nchembe, Teleza, Chibwana, Ephraim, Nkhalemba, Bazwell, Chapweteka, Gilbert, Chibowa, Henry, Kumfunda, Victor, Juhasz, Alexandra, Jones, Sam, Cowlishaw, Ruth, Archer, John, O'Ferrall, Angus M., Rollason, Sarah, Nguluwe, Andrew, Chiphwanya, John, Luhanga, Michael, Kafanikhale, Holystone, Makaula, Peter, LaCourse, E. James, Stothard, J. Russell and Musaya, Janelisa 2026. Clinical morbidity of single or mixed schistosome species infection in two communities of southern Malawi. Philosophical Transactions B: Biological Sciences 381 (1941) , 20240524. 10.1098/rstb.2024.0524

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Abstract

As part of a larger community-based epidemiological study entitled Hybridisation in Uro-Genital Schistosomiasis (HUGS), a parasite infection and clinical morbidity sub-study, implementing portable ultrasonography annually, was undertaken upon 701 participants from two communities in Mangochi and Nsanje Districts, southern Malawi. Our aim was to document the clinical morbidity a year after praziquantel treatment in those with previously proven human and/or zoonotic schistosomiasis, repeated a calendar year later after biannual praziquantel treatment. The median participant age was 12.0 years, with 293 (41.8%) having urinary Schistosoma haematobium egg-patent infections. Upon molecular analyses, these participants were co-infected with S. mansoni (29, 9.9%), S. mattheei (38, 13.0%), and six were infected with all three schistosome species occurring concurrently. A total of 166 participants (23.7%) had abnormal bladder wall thickness, 72 severely abnormal thickened bladder walls and 7 had bladder wall masses, among other abnormalities by ultrasonography. On the second annual follow-up, 203 participants were available (median age: 22.0 years), and of these, 27 (13.3%) presented with urinary S. haematobium egg-patent infections, with 2 (1.0%) having Schistosoma mansoni, 8 (3.9%) having Schistosoma mattheei and 2 with all species concurrently. Of these, only six participants (3.0%) had severely abnormal thickened bladder walls and other abnormalities. Overall, greater morbidity was observed in those with S. haematobium alone than in those with mixed species infections.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Biosciences
Publisher:	Royal Society, The
ISSN:	0962-8436
Date of First Compliant Deposit:	14 January 2026
Date of Acceptance:	20 October 2025
Last Modified:	14 Jan 2026 10:14
URI:	https://orca.cardiff.ac.uk/id/eprint/183883

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