Simple anamnestic questions and recalled water-contact patterns for self-diagnosis of Schistosoma mansoni infection among schoolchildren in western Cote d'Ivoire

A study to determine the diagnostic performance of simple anamnestic questi ons and recalled water-contact patterns for self-diagnosis of Schistosoma m ansoni infection was carried out in western Cote d'Ivoire. A total of 322 s choolchildren were screened over four consecutive days with the Kato-Katz t echnique to assess S. mansoni and concurrent geohelminth infections. Childr en were individually interviewed by teachers using a standardized questionn aire asking about symptoms, reported diseases, and water-contact patterns. The cumulative infection prevalence of S. mansoni was 76.4%. Univariate sta tistics revealed a significant association between the level of S. mansoni infection and three recalled water contact patterns: (1) fishing with nets, (2) swimming/bathing and (3) crossing rivers, but no significant associati on with reported symptoms and/or reported diseases. Multivariate analysis r evealed significant adjusted odds ratios (OR) for crossing the river Tcheor bour (OR = 3.90, P = 0.007), crossing the river Sonbour (OR = 3.90, P = 0.0 08) and swimming/bathing in the latter (OR = 3.28, P = 0.017). The diagnost ic performance of these water-contact patterns was characterized by high sp ecificities but low sensitivities, hence negative predictive values. In the village studied here, recalled water-contact patterns were more useful var iables than anamnestic questions for schoolchildren's self-diagnosis of S. mansoni infection, but no generalization of these findings beyond this popu lation is possible at this time.