Piloting the Schistosomiasis Practical and Precision Assessment approach in five health districts of the N'zérékoré region, Republic of Guinea

Guinea’s N’Zérékoré region has long been endemic for both Schistosoma mansoni and S. haematobium. After eight years of mass praziquantel treatment under a multi-country project, Guinea was selected to pilot the Schistosomiasis Practical and Precision Assessment (SPPA) approach across five health districts in the forest region, aiming to determine current infection status and treatment strategy per sub-district and test the SPPA’s feasibility.

A cross-sectional study sampled children aged 10–14 from 15 schools per district (32 children each), collecting stool and urine for Kato-Katz, urine filtration and hemastix testing. Of 2,400 targeted children, 2,325 (96.9%) provided samples.

Combined Schistosoma prevalence across districts was 66.4%, driven by S. mansoni at 66.1% (above 50% in four districts), while S. haematobium was low at 4.3%. Soil-transmitted helminth prevalence was 11.7%. Sex, age and recent freshwater contact showed no significant association with infection.

The consistently high prevalence across all five districts supports maintaining annual treatment per sub-district, extending it to whole communities aged two and older, and strengthening cross-sectoral interventions such as behaviour change and environmental management.